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Hallucinations

Cover of Hallucinations

Hallucinations

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Have you ever seen something that wasn't really there? Heard someone call your name in an empty house? Sensed someone following you and turned around to find nothing?

Hallucinations don't belong wholly to the insane. Much more commonly, they are linked to sensory deprivation, intoxication, illness, or injury. People with migraines may see shimmering arcs of light or tiny, Lilliputian figures of animals and people. People with failing eyesight, paradoxically, may become immersed in a hallucinatory visual world. Hallucinations can be brought on by a simple fever or even the act of waking or falling asleep, when people have visions ranging from luminous blobs of color to beautifully detailed faces or terrifying ogres. Those who are bereaved may receive comforting "visits" from the departed. In some conditions, hallucinations can lead to religious epiphanies or even the feeling of leaving one's own body.

Humans have always sought such life-changing visions, and for thousands of years have used hallucinogenic compounds to achieve them. As a young doctor in California in the 1960s, Oliver Sacks had both a personal and a professional interest in psychedelics. These, along with his early migraine experiences, launched a lifelong investigation into the varieties of hallucinatory experience.

Here, with his usual elegance, curiosity, and compassion, Dr. Sacks weaves together stories of his patients and of his own mind-altering experiences to illuminate what hallucinations tell us about the organization and structure of our brains, how they have influenced every culture's folklore and art, and why the potential for hallucination is present in us all, a vital part of the human condition.



From the Hardcover edition.

Have you ever seen something that wasn't really there? Heard someone call your name in an empty house? Sensed someone following you and turned around to find nothing?

Hallucinations don't belong wholly to the insane. Much more commonly, they are linked to sensory deprivation, intoxication, illness, or injury. People with migraines may see shimmering arcs of light or tiny, Lilliputian figures of animals and people. People with failing eyesight, paradoxically, may become immersed in a hallucinatory visual world. Hallucinations can be brought on by a simple fever or even the act of waking or falling asleep, when people have visions ranging from luminous blobs of color to beautifully detailed faces or terrifying ogres. Those who are bereaved may receive comforting "visits" from the departed. In some conditions, hallucinations can lead to religious epiphanies or even the feeling of leaving one's own body.

Humans have always sought such life-changing visions, and for thousands of years have used hallucinogenic compounds to achieve them. As a young doctor in California in the 1960s, Oliver Sacks had both a personal and a professional interest in psychedelics. These, along with his early migraine experiences, launched a lifelong investigation into the varieties of hallucinatory experience.

Here, with his usual elegance, curiosity, and compassion, Dr. Sacks weaves together stories of his patients and of his own mind-altering experiences to illuminate what hallucinations tell us about the organization and structure of our brains, how they have influenced every culture's folklore and art, and why the potential for hallucination is present in us all, a vital part of the human condition.



From the Hardcover edition.
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    Hearing ThingsIn 1973 the journal Science published an article that caused an immediate furor. It was entitled "On Being Sane in Insane Places," and it described how, as an experiment, eight "pseudopatients" with no history of mental illness presented themselves at a variety of hospitals across the United States. Their single complaint was that they "heard voices." They told hospital staff that they could not really make out what the voices said but that they heard the words "empty," "hollow," and "thud." Apart from this fabrication, they behaved normally and recounted their own (normal) past experiences and medical histories. Nonetheless, all of them were diagnosed as schizophrenic (except one, who was diagnosed with "manic-depressive psychosis"), hospitalized for up to two months, and prescribed antipsychotic medications (which they did not swallow). Once admitted to the mental wards, they continued to speak and behave normally; they reported to the medical staff that their hallucinated voices had disappeared and that they felt fine. They even kept notes on their experiment, quite openly (this was registered in the nursing notes for one pseudopatient as "writing behavior"), but none of the pseudopatients were identified as such by the staff. This experiment, designed by David Rosenhan, a Stanford psychologist (and himself a pseudopatient), emphasized, among other things, that the single symptom of "hearing voices" could suffice for an immediate, categorical diagnosis of schizophrenia even in the absence of any other symptoms or abnormalities of behavior. Psychiatry, and society in general, had been subverted by the almost axiomatic belief that "hearing voices" spelled madness and never occurred except in the context of severe mental disturbance.

    This belief is a fairly recent one, as the careful and humane reservations of early researchers on schizophrenia made clear. But by the 1970s, antipsychotic drugs and tranquilizers had begun to replace other treatments, and careful history taking, looking at the whole life of the patient, had largely been replaced by the use of DSM criteria to make snap diagnoses.

    Eugen Bleuler, who directed the huge Burghölzli asylum near Zurich from 1898 to 1927, paid close and sympathetic attention to the many hundreds of schizophrenic people under his care. He recognized that the "voices" his patients heard, however outlandish they might seem, were closely associated with their mental states and delusions. The voices, he wrote, embodied "all their strivings and fears ... their entire transformed relationship to the external world ... above all ... [to] the pathological or hostile powers" that beset them. He described these in vivid detail in his great 1911 monograph, Dementia Praecox; or, The Group of Schizophrenias:

    The voices not only speak to the patient, but they pass electricity through the body, beat him, paralyse him, take his thoughts away. They are often hypostasized as people, or in other very bizarre ways. For example, a patient claims that a "voice" is perched above each of his ears. One voice is a little larger than the other but both are about the size of a walnut, and they consist of nothing but a large ugly mouth.

    Threats or curses form the main and most common content of the "voices." Day and night they come from everywhere, from the walls, from above and below, from the cellar and the roof, from heaven and from hell, from near and far ... When the patient is eating, he hears a voice saying, "Each mouthful is stolen." If he drops something, he hears, "If only your foot had been chopped off."

    The voices are often very contradictory. At one time they may be against...

About the Author-
  • OLIVER SACKS is a professor of neurology and psychiatry at Columbia University Medical Center and the author of many books, including Musicophilia, The Man Who Mistook His Wife for a Hat, and Awakenings (which inspired the Oscar-nominated film).

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