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Vivid Imagination or Hallucinations?

  • Posted on August 22, 2012 at 8:00 AM

As you might remember, Willy had a video EEG, which involved an overnight hospital stay. Before we were released from the hospital during that stressful morning-after period, we were visited by a lead doctor and a string of interns. This was an event significant in and of itself.

Now, while the doctors’ interactions were interesting—I always find it rather interesting to watch an experienced doctor teaching a student-doctor—that’s not the point of this post.

See, Willy started something that added a nice twist to the conversation. They were focused on his reflexes and his processing time and all the things that might be affected by the three seizures he had while in the hospital, including confusion. All very important things that added to their understanding of what Willy is experiencing and what they need to do to help him.

Then, Willy added that twist. He brought up his imaginary friends, who are all characters from games he plays. Now, I’m not a psychologist, but I know enough to recognize the area of concern. When talking to Willy about these imaginary friends, it’s impossible to tell just how “real” he experiences these friendships. Are they just imaginary friends? Or are they hallucinations?

This isn’t the first time someone has tried to answer that question using typical strategies. It’s not the first time someone has failed, either. You’ll never know, questioning him as you would a typical child, whether he experiences these friends with a semblance of perceived reality or whether he recognizes that they are fictional.

Willy is different from me in many ways. But he’s also similar to me in many ways. I’m 95% certain these friends are just imaginary friends, not hallucinations—though even I wonder sometimes. This isn’t to say there’s not room for concern. I know all too well how vivid these imaginary playmates can be, how vivid their stories can be. I write fantasy fiction! That’s not a fluke, people. My imagination is a powerful, wonderful thing and the inner reality it creates is a very real, and admittedly dangerous, competitor with our shared world.

But it’s not hallucinations and it’s not mental illness. It’s something different. Something wonderful and beautiful, but at the same time terrible and unpredictable.

After Willy brought up his imaginary friends, talking about them as if they were real and in the room with them, expressing his own concerns about his mortality through his friends, the lead doctor took over the questioning. I watched silently while the doctor questioned him. I knew what he was doing. I knew what he was looking for. I knew he wouldn’t find it. I watched Willy, totally at ease discussing his friends, knowing Willy didn’t pick up on how uneasy his vivid imagination made other people.

Then, after the conversation petered out inconclusively and the lead doctor let the senior intern take over the questioning and testing, I said in a soft voice, meant to be heard but not to gain unnecessary attention, “You’re not going to be able to know whether they’re hallucinations or not, not like that.”

The lead doctor looked at me, probably disconcerted by the apparent amusement on my face. “They’ve never hurt him nor have they ever told him to do anything, at least nothing that hurts someone else or himself.”

“Has he been evaluated?”

I shake my head “no,” because he’s never been officially evaluated. I shrug. “He’s like me. I’m a writer. I tell stories. So does he.”

The doctor wasn’t satisfied with that explanation or my lack of concern, but I knew I couldn’t explain it to him. It’s one of those things that seems to differentiate those on the spectrum (or near the spectrum) from those who aren’t. The only people I have ever met who can fully grasp how “real” I experience stories are people who are on the spectrum (or their parents who are near the spectrum). Even non-spectrum writers, those who love stories just as much as I do, don’t experience them the way I do or the way Willy does.

In a way, they are real. In a way, they are so real they compete with the real world—and sometimes the stories win. They’re not hallucinations, but they seem to be something fundamentally different from “normal” experience. It’s more like a living dream or a deep meditative state. It’s powerful. It’s alluring. And, yes, it’s dangerous. But it’s also wonderful, magical, and one of the most essential parts of how I experience the world. Without it… Now, that’s unimaginable!