Yeah...

I come from a superstitious Hispanic family lol and so I do believe in the paranormal, but I'd like to think that most of us we can distinguish what we consider demons and self-made demons. I also believe this poor guy does have a severe mental disorder in which he's personified his conscience as his dead ex-girlfriend. It's pretty damn tragic. Honestly, getting the crossdresser to ease him out of his trama by lying to him first may be his best bet for a cure. I can't think of anything else in the world that could distract him from his self hatred.