I don't actually see anything wrong with joking about anything no matter how harsh, insensitive, serious, ridiculous or painful it is. Humor is there to cheer us up and not everyone has the same sense of humor, which means that every joke has the potential to insult, annoy or make laugh. Trying to put limits on what can be turned into a joke doesn't help anyone.

However, I don't think LKH is joking at all, which is really sad for her. I believe she's just so tragically ignorant about the world that she doesn't understand that voices in one's head are a serious issue that cannot be ignored except when you need to write a shitty book or paint an ugly picture. I honestly believe that she has the emotional and social maturity of a fourteen year old and that she thinks saying things like this makes her look deep to everyone and that those who complain are just jealous. She has enough moronic followers and clearly surrounds herself with enough yes men that this idea is getting reinforced, which is very sad.

I don't thinks he has any concept of ever accidentally insulting anyone, which is really just another example of her emotional immaturity.