Does the Hollywood "imaginary friend" trope exist in real life mental illness?

A pretty common Hollywood plot line twist is to have a major character turn out to be nothing but figment of another, mentally ill, character’s imagination. Examples include:

Beatuiful Mind, Fight Club and several episodes of the Sopranos

The character can be seen, heard, and touched by the mentally ill person, and has their own personality that can be interacted with, but does not exist in the real world.

Does this actually happen in real life mental illnesses? Not just hearing voices but seeing, hearing and touching entirely non-existent persons.

Having read the book I know that John Nash’s real life mental illness did not involve a imaginary friend as related in the film A Beatuiful Mind.

No. As you rightly surmise, hallucinated voices, which may indeed have their own distinct personalities, are common in schizophrenia, but visual, let alone tactile, hallucinations are relatively rare in the disease, and nothing like so consistent (and when they do occur, they are not necessarily, or even commonly, i think, visions of people at all). The mentally ill person may think there is another person (or more than one) who is always or often “in their head” talking to them, but they will not believe that they can see and touch them when this happens. Furthermore, generally speaking when people suffer visual and other hallucinations caused by psychosis (especially ones that they mistake for realities), it is not just a matter of seeing or feeling things that are not there, their perception of the stuff that really is there is likely to be highly disordered and confused.

There are non-psychotic conditions, such as Charles Bonnet Syndrome, where people experience visual hallucinations without being mentally confused or having their general perceptual experience become disordered, but in such cases they almost never, more than momentarily, mistake the hallucination for a reality. (Charles Bonnet Syndrome occurs in people with certain forms of partial blindness, and sufferers are not generally mentally ill at all.)

I cannot say for sure that something like the condition that movies like to depict has never happened ever, but, frankly, I very much doubt if it has, and it is certainly not common or typical of any sort of psychosis. It is a Hollywood invention. It is necessary, I suppose, because actual psychotic hallucinatory experience would not only be impossible to accurately reproduce on film, but, even a moderately realistic rendering of the sensory confusion involved would, if it continued for more than a very short time, be very confusing and very unpleasant for the audience (as, indeed, the real thing is for those who actually suffer it).

In which episode did the Sopranos have an imaginary character who someone believed was real? :confused:

The imaginary house-sitter from Italy who Tony meets at his neighbour’s house, not sure which season or episode this is. Edit: This is actually what got me thinking about this as he discusses it with his psychiatrist (I had always assumed those scenes are pretty well researched with the help of a real life psychiatrist)

Jimmy Stewarts most famous film role was Harvey. A imaginary rabbit that he saw and talked too.

Like the OP I had wondered if cases like this were real.

In Daniel Tammet’s autobiography “Born on a Blue Day” I recall at one point he discusses a very real-seeming imaginary friend he had at one point in his childhood - an older woman named Anne who had, to some degree, quite an appearance of a separate existence. In has case his ability to create this character seemed to be related to his autism and synesthesia - he’s not mentally ill, and knew perfectly well she wasn’t real.

I just saw this one a few weeks ago. The episode is the next-to-last episode of Season 1 and is called “Isabella.” As I recall, he skipped several doses of lithium and then took too many in an effort to make up for it. I’m not sure if that was what was supposed to have caused the hallucination or not.

To experience a real imaginary friend sounds like it’s having a split personality, and I read that there is no such thing as split personality (ex: the psychologist that wrote “Sybil” made it all up).

Too bad if it isn’t for reals. It could improve some people’s lives.
Imaginary lovers
Never disagree.
They always care.
They’re always there
When you you need
Satisfaction guaranteed.

But that’s different. Harvey was a pooka.

This shows a project where they tried to let people experience something like a psychosis. It’s quite disconcerting and also interesting. Of course we can’t really know if that really is what it’s like.

Sorry, the third video here shows what it’s like in the mask, you can skip ahead a little or watch the explanation by the creator as well.