A Psychotic Patient and a Guru Walk Into a Bar…

The eerie intersection of religion and psychiatry

Photo by Jannes Jacobs on Unsplash

There is a popular joke making the rounds amongst mental health professionals.

Do you know the difference between a guru and a psychotic person? The guru has an audience.

Yes, yes, it’s a harsh joke and maybe outside the bounds of political correctness. It’s also at once very generalized and overly reductionistic, I know. But there is a reason that it resonates with mental health practitioners. You only have to spend time with — or listening to — a psychotic patient and a guru. It would be interesting to see if you can always tell the difference.

In fact, I didn’t know this joke till last week. A colleague told me this joke after we saw a patient. He was tall, dressed smartly, and clean-shaven. He was also very coherent and articulate; a somewhat accomplished sportsman with a university education. He had travelled and could speak 3 languages. He was one of those patients that if you met on the street, nothing would give off any hint that he needed psychiatric care.

When he opened his mouth in speech, I was amazed. We — my colleague and I — just sat and listened.