Auditory hallucination - a form of hallucination when the perception of sounds occurs without auditory stimulation. There is a common form of auditory hallucination in which a person hears one or more voices.
Types of auditory hallucinations
Simple auditory hallucinations
Acoasma
Main article: Acoasm
Non-speech hallucinations are characteristic. With this type of hallucination, a person hears individual sounds of noise, hissing, roaring, and buzzing. Often there are the most specific sounds associated with certain objects and phenomena: steps, knocks, creaking floorboards, and so on.
Phonemes
The simplest speech deceptions are typical in the form of shouts, individual syllables or fragments of words.
Complex auditory hallucinations
Hallucinations of musical content
With this type of hallucination, one can hear the playing of musical instruments, singing, a choir, known melodies or excerpts thereof, and even unfamiliar music.
Potential causes of musical hallucinations:
- metal-alcohol psychoses: often these are vulgar ditties, obscene songs, songs of drunken groups.
- epileptic psychosis: in epileptic psychosis, hallucinations of musical origin often look like the sound of an organ, sacred music, the ringing of church bells, the sounds of magical, “heavenly” music.
- schizophrenia.
Verbal (verbal) hallucinations
With verbal hallucinations, individual words, conversations, or phrases are heard. The content of statements may be absurd, devoid of any meaning, but most often verbal hallucinations express ideas and thoughts that are not indifferent to patients. S.S. Korsakov considered hallucinations of this kind as thoughts dressed in a bright sensory shell. V. A. Gilyarovsky pointed out that hallucinatory disorders are directly related to inner world person, his state of mind. They express violations mental activity, personal qualities, disease dynamics. In particular, in their structure one can detect disorders of other mental processes: thinking (for example, its fragmentation), will (echolalia), and so on.
There are a large number of types of verbal hallucinations, depending on their plot. Among them are:
- Commentary (evaluative) hallucinations. The opinion of voices about the patient's behavior is reflected. An opinion can have a different connotation: for example, benevolent or judgmental. “Voices” can characterize and evaluate current, past actions or intentions for the future.
- Threatening. Hallucinations can acquire a threatening character, consonant with delusional ideas of persecution. Imaginary threats of murder, torture, and discredit are perceived. Sometimes they have a clearly expressed sadistic overtones.
- Imperative hallucinations. A type of verbal hallucination that is socially dangerous. Contains orders to do something or prohibitions on actions, to commit actions that directly contradict conscious intentions: including attempting suicide or self-harm, refusing to take food, medicine or talking with a doctor, and so on. Patients often take these orders personally.
Potential Causes
One of the main causes of auditory hallucinations, in the case of psychotic patients, is schizophrenia. In such cases, patients exhibit a consistent increase in the activity of the thalamic and subcortical nuclei of the striatum, hypothalamus and paraliminal regions; confirmed by positron emission and magnetic resonance imaging. Another comparative study of patients found increases in temporal white matter and temporal gray matter volumes (regions critical to internal and external speech). The implication is that both functional and structural abnormalities in the brain can cause auditory hallucinations, but both may have a genetic component. It is known that mood disorder can also cause auditory hallucinations, but they are more mild than those caused by psychosis. Auditory hallucinations are a relatively common complication of serious neurocognitive disorders (dementia) such as Alzheimer's disease.
Research has shown that auditory hallucinations, particularly voices commenting and voices telling people to harm themselves or others, are much more common in psychotic patients who experienced physical or sexual abuse as children than in psychotic patients who were not abused as children. violence. Moreover, the stronger the form of violence (incest or a combination of both physical and sexual abuse of children), the stronger the degree of hallucinations. If there were multiple episodes of violence, this also influenced the risk of developing hallucinations. It has been noted that the content of hallucinations in people who have been victims of childhood sexual abuse includes both elements of flashbacks (flashbacks of memories of a traumatic experience) and more symbolic embodiments of the traumatic experience. For example, a woman who had been sexually abused by her father since age 5 heard "men's voices outside her head and children's voices screaming inside her head." In another case, when a patient experienced hallucinations telling her to kill herself, she identified the voice as that of the perpetrator.
Diagnosis and treatment methods
Pharmaceuticals
The main medications used in the treatment of auditory hallucinations are antipsychotic drugs, which affect dopamine metabolism. If the main diagnosis is an affective disorder, then antidepressants or mood stabilizers are often additionally used. These drugs allow a person to function normally, but are not essentially a treatment, since they do not eliminate the root cause of the thinking disorder.
Psychological treatments
Cognitive therapy was found to help reduce the frequency and distress of auditory hallucinations, especially in the presence of other psychotic symptoms. Intensive supportive therapy was found to reduce the frequency of auditory hallucinations and increase the patient's resistance to hallucinations, leading to a significant reduction in them negative impact. Other cognitive and behavioral treatments have been used with mixed success.
Experimental and alternative treatments
IN last years studied repetitive transcranial magnetic stimulation (TMS) as a biological treatment for auditory hallucinations. TMS affects the neural activity of the cortical areas responsible for speech. Research has shown that when TMS is used as an adjunct to antipsychotic treatment in difficult cases, the frequency and intensity of auditory hallucinations may decrease. Another source for unconventional methods is the discovery of the international voice-hearing movement.
Current Research
Non-psychotic symptoms
Research continues into auditory hallucinations that are not a symptom of a particular psychotic illness. More often auditory hallucinations occur without psychotic symptoms in prepubertal children. These studies found that a remarkably high percentage of children (up to 14% of respondents) heard sounds or voices without any external cause; although it should also be noted that "sounds" as psychiatrists believe are not examples of auditory hallucinations. It is important to distinguish auditory hallucinations from “sounds” or normal internal dialogue, since these phenomena are not characteristic of mental illness.
Causes
The causes of auditory hallucinations with nonpsychotic symptoms are unclear. Durham University doctor Charles Fernyhough, exploring the role of the inner voice in auditory hallucinations, offers two alternative hypotheses for the origin of auditory hallucinations in people without psychosis. Both versions are based on research into the process of internalization of the inner voice.
Internalization of the inner voice
- First level (external dialogue) makes it possible to maintain an external dialogue with another person, for example when a baby talks to his parents.
- Second level (private speech) includes the ability to conduct external dialogue; It has been observed that children comment on the process of play when playing with dolls or other toys.
- Third level (extended inner speech) is the first internal level of speech. Allows you to conduct internal monologues when reading to yourself or viewing lists.
- Fourth level (condensation of inner speech) is the final level of the internalization process. Allows you to simply think without the need to express thoughts in words to grasp the meaning of the thought.
Internalization disorder
MixingA disruption may occur during the normal process of inner voice acquisition when a person is unable to identify his or her own inner voice. Thus, the first and fourth levels of internalization are mixed.
Extension
The disorder may manifest itself in the internalization of the inner voice when a second one appears. which seems alien to a person; The problem occurs when the fourth and first levels are shifted.
Treatment
Psychopharmacological treatment uses antipsychotic drugs. Research in psychology has shown that the first step in treating a patient is to recognize that the voices he hears are figments of his imagination. Understanding this allows patients to regain control over their lives. Additional psychological interventions may influence the control of auditory hallucinations, but more research is required to prove this.
Hallucinations- perception disorders, when a person, due to mental disorders, sees, hears, feels something that does not exist in reality. This is, as they say, perception without an object.
Mirages - phenomena based on the laws of physics - cannot be classified as hallucinations. Like illusions, hallucinations are classified according to the senses. Usually isolated auditory, visual, olfactory, taste, tactile and the so-called hallucinations of the general sense, which most often include visceral and muscular hallucinations. There may also be combined hallucinations (for example, the patient sees a snake, hears its hissing and feels its cold touch).
All hallucinations, regardless of whether they are related to visual, auditory or other deceptions of the senses, are divided into true And pseudohallucinations.
True hallucinations are always projected outward, associated with a real, concretely existing situation (the “voice” sounds from behind a real wall; the “devil”, waving its tail, sits on a real chair, entwining its legs with its tail, etc.), most often do not evoke patients have no doubt about their actual existence, as vivid and natural for the hallucinating as real things. True hallucinations are sometimes perceived by patients even more vividly and clearly than actually existing objects and phenomena.
Pseudohallucinations more often than true, they are characterized by the following distinctive features:
a) most often projected inside the patient’s body, mainly in his head (the “voice” sounds inside the head, inside the patient’s head he sees a business card with obscene words written on it, etc.);
Pseudohallucinations, first described by V. Kandinsky, resemble ideas, but differ from them, as V. Kandinsky himself emphasized, in the following features:
1) independence from human will;
2) obsession, violence;
3) completeness, formality of pseudohallucinatory images.
b) even if pseudohallucinatory disorders are projected outside one’s own body (which happens much less frequently), then they lack the character of objective reality characteristic of true hallucinations and are completely unrelated to the real situation. Moreover, at the moment of hallucination, this environment seems to disappear somewhere, the patient at this time perceives only his hallucinatory image;
c) the appearance of pseudohallucinations, without causing the patient any doubts about their reality, is always accompanied by a feeling of being done, rigged, induced by these voices or visions. Pseudo-hallucinations are, in particular, an integral part of the Kandinsky-Clerambault syndrome, which also includes delusions of influence, which is why patients are convinced that the “vision” was “made to them using special devices,” “voices are directed directly into the head with transistors.”
Auditory hallucinations most often expressed in the patient’s pathological perception of certain words, speeches, conversations (phonemes), as well as individual sounds or noises (acoasms). Verbal hallucinations can be very diverse in content: from so-called calls (the patient “hears” a voice calling his name or surname) to entire phrases or even long speeches pronounced by one or more voices.
Most dangerous for the condition of patients imperative hallucinations, the content of which is imperative, for example, the patient hears an order to remain silent, to hit or kill someone, to injure himself. Due to the fact that such “orders” are a consequence of the pathology of the mental activity of a hallucinating person, patients with this kind of painful experience can be very dangerous both for themselves and for others, and therefore require special supervision and care.
Hallucinations are threatening are also very unpleasant for the patient, since he hears threats addressed to himself, less often - to people close to him: they “want to stab him to death,” “hang him,” “throw him from the balcony,” etc.
TO auditory hallucinations also include commentators when the patient “hears speeches” about everything he thinks or does.
A 46-year-old patient, a furrier by profession, who had been abusing alcohol for many years, began to complain about “voices” that “wouldn’t let him pass”: “now he’s sewing skins, but it’s bad, his hands are shaking,” “I decided to rest,” “I went for vodka.” ", "what a good skin he stole", etc.
Antagonistic (contrasting) hallucinations are expressed in the fact that the patient hears two groups of “voices” or two “voices” (sometimes one on the right and the other on the left) with contradictory meaning (“Let’s deal with them now.” - “No, let’s wait, he’s not that bad.” ; “There’s no need to wait, give me the ax.” - “Don’t touch it, it belongs on the board”).
Visual hallucinations can be either elementary (in the form of zigzags, sparks, smoke, flames - so-called photopsia), or objective, when the patient very often sees animals or people (including those he knows or knew) that do not exist in reality , insects, birds (zoopsia), objects or sometimes parts of the human body, etc. Sometimes these can be entire scenes, panoramas, for example a battlefield, hell with many running, grimacing, fighting devils (panoramic, movie-like). “Visions” can be of normal size, in the form of very small people, animals, objects, etc. (Lilliputian hallucinations) or in the form of very large, even gigantic ones (macroscopic, Gulliverian hallucinations). In some cases, the patient can see himself, his own image (double hallucinations, or autoscopic).
Sometimes the patient “sees” something behind him, out of sight (extracampal hallucinations).
Olfactory hallucinations most often represent an imaginary perception of unpleasant odors (the patient smells rotting meat, burning, decay, poison, food), less often - a completely unfamiliar smell, and even less often - the smell of something pleasant. Often, patients with olfactory hallucinations refuse to eat, because they are sure that “they are being spiked with poisonous substances” or “being fed rotten human meat.”
Tactile hallucinations are expressed in a sensation of touching the body, burning or cold (thermal hallucinations), a feeling of grasping (haptic hallucinations), the appearance of some liquid on the body (hygric hallucinations), and insects crawling over the body. The patient may feel as if he is being bitten, tickled, or scratched.
Visceral hallucinations- feeling of presence in own body some objects, animals, worms (“a frog sits in the stomach”, “in bladder the tadpoles have multiplied", "a wedge has been driven into the heart").
Hypnagogic hallucinations- visual illusions of perception, usually appearing in the evening before falling asleep, with the eyes closed (their name comes from the Greek hypnos - sleep), which makes them more related to pseudohallucinations than to true hallucinations (there is no connection with the real situation). These hallucinations can be single, multiple, scene-like, sometimes kaleidoscopic (“I have some kind of kaleidoscope in my eyes,” “I now have my own TV”). The patient sees some faces, grimacing, sticking out their tongues, winking, monsters, bizarre plants. Much less often, such hallucinations can occur during another transitional state - upon awakening. Such hallucinations, also occurring when the eyes are closed, are called hypnopompic.
Both of these types of hallucinations are often one of the first harbingers of delirium tremens or some other intoxicating psychosis.
Functional hallucinations- those that arise against the background of a real stimulus acting on the senses, and only during its action. A classic example described by V. A. Gilyarovsky: the patient, as soon as water began to flow from the tap, heard the words: “Go home, Nadenka.” When the tap was turned on, the auditory hallucinations also disappeared. Visual, tactile and other hallucinations may also occur. Functional hallucinations differ from true hallucinations by the presence of a real stimulus, although they have a completely different content, and from illusions by the fact that they are perceived in parallel with the real stimulus (it is not transformed into some kind of “voices,” “visions,” etc.).
Suggested and induced hallucinations. Hallucinatory deceptions of the senses can be instilled during a hypnosis session, when a person will smell, for example, the smell of a rose, and throw off the rope that is “twisting” around him. With a certain readiness to hallucinate, hallucinations may appear even when these deceptions of the senses no longer appear spontaneously (for example, if a person has just suffered from delirium, especially alcoholic delirium). Lipman's symptom - inducing visual hallucinations by lightly pressing eyeballs patient, sometimes an appropriate suggestion should be added to the pressure. The blank sheet symptom (Reichardt's symptom) is that the patient is asked to very carefully look at a blank sheet of white paper and tell what he sees there. With Aschaffenburg's symptom, the patient is asked to talk on a switched off phone; In this way, readiness for the occurrence of auditory hallucinations is checked. When checking the last two symptoms, you can also resort to suggestion, saying, for example: “Look, what do you think about this drawing?”, “How do you like this dog?”, “What is this female voice telling you on the phone?”
Occasionally, suggested hallucinations (usually visual) can also have an induced character: a healthy but suggestible person with hysterical character traits can, following the patient, “see” the devil, angels, some flying objects, etc. Even more rarely, induced hallucinations may occur in a few people, but usually for a very short time a short time and without that clarity, imagery, brightness, as happens in patients.
Hallucinations - a symptom of a painful disorder(albeit sometimes short-term, for example, under the influence of psychotomimetic drugs). But sometimes, as already noted, quite rarely, they can occur in healthy people (suggested in hypnosis, induced) or with pathologies of the organs of vision (cataracts, retinal detachment, etc.) and hearing.
Hallucinations are often elementary (flashes of light, zigzags, multi-colored spots, noise of leaves, falling water, etc.), but can also be in the form of bright, figurative auditory or visual illusions of perception.
A 72-year-old patient with loss of vision up to the level of light perception (bilateral cataracts), in whom no mental disorders, in addition to a slight decrease in memory, after an unsuccessful operation, she began to say that she saw some people on the wall, mostly women. Then these people “came off the wall and became like real people. Then a small dog appeared in the arms of one of the girls. There was no one for a while, then a white goat appeared.” Later, the patient sometimes “saw” this goat and asked those around her why there was suddenly a goat in the house. The patient did not have any other mental pathology. A month later, after a successful operation on the other eye, the hallucinations completely disappeared and during the follow-up (5 years), no mental pathology, except for memory loss, was detected in the patient.
These are the so-called hallucinations of the type of Charles Bonnet, a 17th-century naturalist who observed hallucinations in the form of animals and birds in his 89-year-old grandfather, who suffered from cataracts.
Patient M., 35 years old, long time alcohol abuser, after past pneumonia I began to experience fears and sleep poorly and restlessly. In the evening, he anxiously called his wife and asked, pointing to the shadow of the floor lamp, “to remove this ugly face from the wall.” Later I saw a rat with a thick, very long tail, which suddenly stopped and asked in a “disgusting, squeaky voice”: “Have you finished drinking?” Closer to night, I saw the rats again, suddenly jumped up on the table, and tried to throw the telephone set onto the floor, “to scare these creatures.” When hospitalized in emergency room, feeling his face and hands, he said irritably: “Such a clinic, but the spiders were bred, cobwebs stuck all over my face.”
Hallucinatory syndrome(hallucinosis) - an influx of abundant hallucinations (verbal, visual, tactile) against the background of clear consciousness, lasting from 1-2 weeks (acute hallucinosis) to several years (chronic hallucinosis). Hallucinosis may be accompanied by affective disorders (anxiety, fear), as well as crazy ideas. Hallucinosis is observed in alcoholism, schizophrenia, epilepsy, organic brain lesions, including syphilitic etiology.
Hallucinations are an image that appears in the mind of an individual without the presence of an external stimulus. They can arise as a result of severe fatigue, when using a number of medicines psychotropic effects and for certain neurological diseases and some mental illness. In other words, hallucinations are unreal perceptions, an image without an object, sensations that arise without stimuli. Images that are not supported by truly existing stimuli can be represented as an error in the processes of perception of the sensory organs, when the patient feels, sees or hears something that does not really exist.
There are hallucinations that have a sensually bright coloring and persuasiveness. They can be projected externally, do not differ from true perceptions and are called true. In addition, there are hallucinations perceived by the internal auditory or visual analyzer, localized in the internal sphere of consciousness and felt as a result of the influence of some external force, provoking visions, such as voices. They are called pseudohallucinations.
Causes of hallucinations
Imaginary images, not supported by actually present stimuli and associated with the visual system, are characterized by patients seeing a variety of objects or events that do not actually exist in which they can take part.
These hallucinations in humans arise as a consequence of poisoning with alcohol-containing substances (that is, it is one of the manifestations of alcohol), when using narcotic drugs, as well as psychostimulants, such as LSD, cocaine, etc., medications with M-anticholinergic effects (for example, antidepressants), some organic tin structures. In addition, visual imaginary images, as well as auditory hallucinations characteristic of some ailments (peduncular hallucinosis).
Visual hallucinations, therefore, are a so-called visual illusion, a disturbed perception of reality. With this disease, the patient cannot separate real existing objects from imaginary images.
Orders given by a “voice from above”, words of praise from invisible friends, shouts - refer to hallucinations from the outside auditory system. They are often observed when schizophrenic disorders, simple partial seizures, occur with alcoholic hallucinosis, are a consequence of various poisonings.
The feeling of imaginary odors is characteristic of olfactory erroneous perceptions, which are also found in patients who often feel extremely unpleasant “odors” of rot, rottenness, etc. In addition, olfactory hallucinations can be caused by brain defects, namely lesions of the temporal lobe. Partial seizures and encephalitis caused by the herpes virus, along with olfactory imaginary perceptions, also cause taste hallucinations, characterized by patients feeling a pleasant or disgusting taste in the mouth.
Verbal hallucinations of a threatening nature are expressed in the patient’s persistent perception of verbal threats against themselves, for example, it seems to them that they are going to be hacked to death, castrated, or forced to drink poison.
Contrasting imaginary perceptions have the character of a collective dialogue - one set of voices furiously condemns the patient, demands that he be subjected to sophisticated torture or put to death, while the other group hesitantly defends him, timidly asks for a postponement of torture, assures that the patient will improve, stop drinking alcoholic beverages, and become kinder . Characteristic of this type of disorder is that a group of voices does not address the patient directly, but communicates with each other. Often they give the patient exactly the opposite orders (to fall asleep and dance at the same time).
Speech motor hallucinations are characterized by the patient’s belief that someone has taken over his own speech apparatus by influencing the muscles of the tongue and mouth. Sometimes the articulatory apparatus pronounces voices that are not heard by others. Many researchers attribute the described imaginary perceptions to variations of pseudohallucinatory disorders.
Visual hallucinations in individuals, in terms of their prevalence, occupy the second position in psychopathology after auditory ones. They can also be elementary (for example, a person sees smoke, fog, flashes of light), that is, with incomplete objectivity and the presence of objective content, namely zoopsy (visions of animals), polyopic (multiple images of illusory objects), demonomaniacal (visions of mythological characters , devils, aliens), diplopic (visions of double illusory images), panoramic (visions of colorful landscapes), endoscopic (visions of objects inside one’s body), scene-like (visions of plot-related imaginary scenes), autovisceroscopic (vision of one’s internal organs).
Autoscopic imaginary perceptions involve the patient observing one or more of his own doubles, completely copying his behavioral movements and manners. There are negative autoscopic misperceptions when the patient is unable to see his own reflection in a mirror surface.
Autoscopies are observed in case of organic disorders in the temporal lobe and parietal part of the brain, in alcoholism, in cases of postoperative hypoxia, due to the presence of severe psychotraumatic events.
Microscopic hallucinations are expressed in deceptions of perception, representing an illusory reduction in the size of people. Such hallucinations are most often found in psychoses of infectious origin, alcoholism, chloroform poisoning, and ether intoxication.
Macroscopic illusions of perception - the patient sees enlarged living beings. Polyopic imaginary perceptions involve the patient seeing many identical imaginary images, as if created as a carbon copy.
Adelomorphic hallucinations are visual distortions that lack clarity of shapes, brightness of colors and three-dimensional configuration. Many scientists attribute this type disorders to a special type of pseudohallucinations, which is characteristic of schizophrenia.
Extracampal hallucinations consist of the patient seeing with angular vision (that is, outside the normal field of vision) some phenomena or people. When the patient turns his head towards a non-existent object, such visions instantly disappear. Hemianopsic hallucinations are characterized by loss of one half of vision and are observed with organic disorders occurring in the human central nervous system.
Hallucinations of Charles Bonnet are true distortions of perception, observed when one of the analyzers is damaged. So, for example, with retinal detachment or glaucoma, visual hallucinations, and with otitis – auditory illusions.
Olfactory hallucinations are a false perception of very unpleasant, sometimes disgusting and even suffocating odors (for example, the patient smells a decomposing corpse, which in reality does not exist). Often, olfactory hallucinations cannot be differentiated from olfactory illusions. It happens that one patient may have both disorders, as a result of which such a patient refuses to eat. Deceptive perceptions of the olfactory type can arise as a result of various mental illnesses, but they are predominantly characteristic of organic defects of the brain and are localized in the temporal region.
Gustatory hallucinations are often observed in combination with olfactory deceptive perceptions, manifested in the sensation of a taste of rot, pus, etc.
Tactile hallucinations consist of the patient feeling the appearance of some liquid on the body (hygric), touching something of high or low temperature (thermal hallucinations), grasping from the back of the body (haptic), an illusory sensation of the presence of insects or under the skin (internal zoopathy), crawling of insects or other small creatures on the skin (external zoopathy).
Some scientists classify as tactile hallucinations the symptom of feeling a foreign object in the mouth, for example, thread, hair, thin wire, observed in tetraethyl lead delirium. This symptom, in fact, is an expression of the so-called oropharyngeal imaginary perceptions. Tactile illusory ideas are characteristic of cocaine psychoses, delirious clouding of consciousness of various etiologies, and schizophrenia. Often tactile hallucinations in schizophrenia are localized in the genitourinary area.
Functional hallucinations arise against the background of a really existing stimulus and live until the end of the stimulus. For example, against the background of a piano melody, the patient can simultaneously hear the sound of a piano and a voice. When the melody ends, the illusory voice also disappears. Simply put, the patient simultaneously perceives a real stimulus (piano) and a commanding voice.
Functional hallucinations are also divided depending on the analyzer. Reflex hallucinations are akin to functional ones; they are expressed in the appearance of imaginary perceptions of one analyzer when exposed to another and exist exclusively during stimulation of the first analyzer. For example, the patient may feel the touch of something wet on the skin (reflexive hygric hallucinations) when viewing a certain picture. As soon as the patient stops looking at the picture, the unpleasant sensations will disappear.
Kinesthetic (psychomotor) erroneous perceptions are manifested in patients’ perception of movements of individual parts of the body that occur against their will, but in reality there are no movements.
Ecstatic hallucinations in a person are found when he is in a state of ecstasy. They are distinguished by their colorfulness, imagery, and influence on the emotional sphere. Often characterized by religious, mystical content. There are visual and auditory, as well as complex. Many drugs provoke hallucinations, but they are not always accompanied by positive emotions.
Hallucinosis is psychopathological syndrome, characterized by the presence of pronounced multiple hallucinations against the background of clear awareness.
Delusions and hallucinations form Plaut's hallucinosis, which is verbal (less often olfactory and visual) imaginary perceptions combined with delusions of persecution in clear consciousness. This form of hallucinosis occurs with a disease such as syphilis of the brain.
Hallucinosis of an atherosclerotic nature is observed more often in the female population. At the same time, at first, deceptive perceptions are fenced off; as atherosclerosis develops, an exacerbation is noted characteristic features such as memory loss, decreased intellectual activity, . The content of distorted perceptions is often neutral in nature and relates to simple everyday matters. With the deepening of atherosclerosis, deceptive perceptions can take on an increasingly fantastic character.
Hallucinations in children are often confused with illusions, which are children’s inadequate perception of real-life objects. In addition, for little babies, seeing illusions is considered a physiological norm, since with their help the development of fantasy occurs.
Hallucinations are spontaneously appearing types of various objects, characterized by colorfulness, the perception of objects and actions that do not exist in reality.
Hallucinations in children are a constant subject of study by scientists. Recent studies indicate that auditory hallucinations appear in approximately 10% of students in primary school. The occurrence of imaginary perceptions in children does not depend on their gender.
Treatment of hallucinations
For effective treatment disturbances of perception, it is necessary to find out the reason that provoked the appearance of this condition.
Hallucinations, what to do? Today, many methods have been developed to treat different types hallucinations. But for a number of ailments, therapy is aimed at curing the disease that caused hallucinations and eliminating or mitigating symptoms. Since hallucinations in isolated form are quite rare. They are often an integral part of a series psychopathic syndromes, often combined with different variations of delirium. Often the appearance of imaginary perceptions, especially at the beginning of the disease, usually affects the patient and is accompanied by excitement, feelings, and anxiety.
Until now, the issue regarding the effective treatment of hallucinations is controversial, but almost all healers agree on one thing: treatment should be individually targeted.
First of all, it is necessary to exclude various diseases and intoxication, which are often factors that provoke the appearance of this condition. Then you should pay attention to medicines used by the patient. Since in clinical practice there have been many cases when, to treat errors in the perception of various analyzers, it was enough to stop taking certain medications.
People suffering from the appearance of hallucinations may be characterized by a critical attitude towards imaginary ideas that arise in the mind, and not critical. The individual may realize that the voices he hears or the scenes he observes do not exist in reality, or he may think that they are true. Often, patients can see quite real scenes that correspond to reality, for example, observing events with the participation of relatives.
Some patients suffering from this condition are able to distinguish imaginary perceptions from reality, while others are unable to; some may feel changes in the body that are harbingers of imminent hallucinations. Close circles can notice the appearance of this disorder in an individual by his behavior, namely, by observing his gestures, facial expressions, actions, listening to the words he utters, which do not correspond to the surrounding reality. This is very important, since quite often patients, fearing placement in a “psychiatric hospital” or due to their delusional considerations, try to hide symptoms and dissimulate hallucinatory experiences.
A patient suffering from hallucinations is characterized by concentration and alertness. He can gaze intently at the surrounding space, listen intently to something, or silently move his lips in response to his unreal interlocutors. It happens that this state occurs periodically in individuals. In such cases, it is characterized by a short-term course, so it is important not to miss an episode of hallucination. The facial expressions of patients often correspond to the content of imaginary perceptions, as a result of which they reflect surprise, fear, anger, and less often joy and delight.
With hallucinations characterized by the vividness of perception, they can respond out loud to the voices they hear, cover their ears, hold their nose with their hands, close their eyes, and fight off non-existent monsters.
Hallucinations, what to do? At the pre-medical stage, the main thing is the safety of the sick individual and his environment. Therefore, it is necessary to prevent possible dangerous and traumatic actions.
Responsibility for treating individuals suffering from an erroneous perception of reality, first of all, falls on their closest circle - their relatives.
At the medical stage, an anamnesis is first collected, the nature of what is visible, audible, and felt is clarified, and a laboratory examination is carried out in order to accurately diagnose and prescribe therapy, methods of care and monitoring of the patient.
Treatment is focused on stopping attacks of agitation and is aimed at eliminating symptoms such as delusions and hallucinations. For this purpose they can be used intramuscular injections Tizercin or Aminazine in combination with Haloperidol or Trisedyl. The patient is hospitalized in a psychiatric clinic in the presence of a serious mental illness that provokes the appearance of hallucinations.
Failure to provide assistance to patients is dangerous because this disorder can progress and can become chronic (hallucinosis), especially in the presence of aggravating factors, such as alcoholism. The patient is unable to distinguish all his hallucinations from reality, and as time passes he begins to think that this is the norm. 
In psychology Special attention focuses on hallucinations that happen various types and symptoms. The reasons for their occurrence often lie in the brain, where corresponding images, sounds, and sensations that do not exist arise. Psychologists talk about the need to treat the person who has hallucinations, since they do not indicate health.
Hallucinations mean the perception by the senses of something that is not in reality. You can see portals to other worlds, demons that surround you, hear voices, etc. In ancient times, these manifestations were considered normal and even desirable. People thought that in this way they were connecting with the divine worlds, which could endow them with knowledge or power.
The most primitive method of achieving hallucinations is the use of special mushrooms or alcohol in large quantities. Don't forget about drugs, under the influence of which people also experience certain sensations.
Hallucinations are an illusion, a deception, a mirage that does not exist in reality. Some scientists explain this by saying that signals in the brain appear in different places, which is why the pictures get mixed up and begin to distort reality.
However, there is more pathological causes occurrence of hallucinations. These are diseases when brain activity is disrupted. There are many mental illnesses that include hallucinations as one of their symptoms.
Treatment of all types of hallucinations is carried out exclusively with medication. Only doctors can help restore health or improve it.
What are hallucinations?
People often use the word hallucinations. What it is? This is the perception of the surrounding world, the appearance of a picture without a real external stimulus. In simple words, a person can see a chair, although in fact it is only surrounded by trees.
This may be a consequence of severe overwork, when people often use various medicinal and psychotropic substances for self-soothing, as well as serious neurological diseases. In the external world there is no stimulus that is seen or felt by a person. He sees images that are not there, sounds that do not sound, sensations that are not produced by the world around him. Hallucinations are an error of perception by the senses when a person hears, sees or feels something that is not really there.
Conventionally, hallucinations are divided into:
- true - images that are projected externally and do not differ from real objects, have persuasiveness and a sensually bright color;
- pseudohallucinations are sensations projected in the internal sphere of consciousness as a result of the influence of an external force.
Pseudohallucinations are of a violent and intrusive nature, in which the patient seems to be really influenced by third parties. He begins to distrust people, believe in aliens, otherworldly forces, because this is the only way he can explain the occurrence of his sensations.
Hallucinations should be distinguished from:
- Mirages are images that obey the laws of physics.
- Illusions are a distorted perception of really existing objects.
Hallucinations appear without the presence of real objects, people and phenomena to which the person refers.
Types of hallucinations
There are different types of hallucinations, which depend on the sense organ through which they are perceived:
- Visual.
- Auditory.
- Olfactory.
- Flavoring.
- General: muscular and visceral.
Auditory hallucinations are divided into the following types:
- Elementary: voices, noises, sounds.
- Verbal, which are imperative, speech motor, commentary, threatening, contrasting illusory perception.
Imperative hallucinations are of a commanding nature and often force the patient to commit a bad act. He is unable to resist, so he becomes dangerous both to himself and to others. The patient can cut off his own finger, kill or hit someone, steal, etc.
Threatening hallucinations are expressed in hearing voices that threaten the patient with something: to kill, offend, hit, etc.
The contrasting hallucinations are a dialogue between two voices directed at each other. One voice can condemn the patient and talk about the need for punishment. Another voice will timidly defend him, pointing out the possibility of deferring the punishment. The voices speak to each other, giving the patient only orders that contradict each other.
Speech motor hallucinations are expressed in the fact that the patient feels as if some force has taken over his voice, tongue and mouth and is now transmitting some messages through him. Often a person thinks that he is speaking in a different language, although in fact he is speaking in his own.
Visual hallucinations are the second most common and are divided into the following types:
- Elementary: smoke, flash of light, fog.
- Subject:
- Zoopsia is the vision of animals.
- Polyopic – vision of many identical, carbon-copy illusory objects.
- Demonomaniacal - visions of characters from mythology, aliens.
- Diplopic - vision of double images.
- Panoramic – vision of bright pictures.
- Scene-like - a vision of some storylines.
- Endoscopic - seeing other objects inside your body.
- Autovisceroscopic – vision of one’s internal organs.
- Autoscopic – seeing one’s doubles who copy the patient’s behavior. Sometimes it's the inability to see yourself in the mirror.
- Microscopic – seeing people in reduced sizes.
- Macroscopic – seeing objects magnified.
- Adelomorphic - seeing objects as fuzzy, without configuration or shape.
- Extracampal - visions with angular vision. When you turn your head in their direction, the visions stop.
- Hemianopsia – loss of one half of vision.
Hallucinations of Charles Bonnet characterize their appearance with a true violation of perception by the senses. With otitis media, auditory hallucinations may occur, and with retinal detachment, visual hallucinations may occur.
Olfactory hallucinations often overlap with olfactory illusions, when a person thinks that he hears odors of a disgusting nature. For example, he may smell the smell of a decomposing body. This often leads to refusal of food.
Gustatory hallucinations may be accompanied by olfactory hallucinations, when a rotten taste may be felt in the mouth, etc.
Tactile hallucinations are expressed in sensations on the body, which are divided into the following types:
- Hygric – sensation of fluid on the body.
- Thermal - touching an object with low or high temperature.
- Haptic – girth from the back.
- Internal or external zoopathy is the sensation of insects on or under the skin.
Depending on the analyzer, hallucinations are divided into:
- Reflex – irritation of one analyzer after exposure to another.
- Psychomotor (kinesthetic) - a feeling of movement in individual parts of the body in the absence of any movements in the real world.
- Ecstatic – vivid, emotional images under the influence of ecstasy.
Hallucinations in children are often confused with illusions that help little people understand the world around them.
Causes of hallucinations
Visual hallucinations are visions that are not supported by anything from real life. The patient can take part in them. The causes of their occurrence can be the abuse of alcohol (delirium delirium), drugs, psychostimulants (LSD, cocaine, etc.), medications (for example, antidepressants).
Another cause of both visual and auditory hallucinations is a mental illness, for example, peduncular, schizophrenia, partial seizure. The influence of poisoning should also be noted.
Olfactory hallucinations are a consequence of various mental illnesses (schizophrenia), brain defects (damage to the temporal lobe). Encephalitis caused by herpes partial seizures provoke not only olfactory, but also taste hallucinations.
Tactile hallucinations can be a consequence. It also causes visual and auditory hallucinations. Unpleasant sensations inside the body may be caused by encephalitis or schizophrenia.
Hallucinations are distinguished by their emotionality and vividness. The brighter and more emotional the vision, the more people gets involved in them. Otherwise, he simply remains indifferent.
Scientists cannot clearly identify the factors that influence the occurrence of hallucinations. The reasons remain unclear and unexplored. However, another factor stands out - mass suggestion, when a large number of people can see what they have been inspired to see. This will be called “mass psychosis”, when healthy people simply submit to external influences.
Other causes of hallucinations include:
- Aging. Inevitable changes for the worse occur in the body. Dementia, paranoia and other illnesses can provoke various visions.
- Depressed mood, fear of death, pessimism, and increased anxiety also provoke various visions.
- Taking hallucinogenic mushrooms.
Here is a list of diseases on the website psychiatric care site that provoke hallucinations:
- Alcohol psychosis.
- Schizophrenia.
- A brain tumor.
- Herpetic encephalitis.
- Syphilis.
- Infectious diseases.
- Cerebral atherosclerosis.
- Hypothermia.
- Decompensation of cardiovascular diseases.
- Rheumatic diseases of blood vessels and heart.
- Amentia.
- Psychosis.
Symptoms of hallucinations
Hallucinations differ in their symptoms only in how they manifest themselves. Visual hallucinations will be different from olfactory hallucinations. However, they all have one symptom - seeing something that does not exist.
Symptoms may include:
- Vision of movement under the skin, changes in internal organs.
- Smelling smells that no one else can smell.
- Hearing voices that no one else can hear.
- Hearing doors slamming, knocking, footsteps, music in their real absence.
- Seeing patterns, creatures, lights that no one else sees.
The main symptom is that a person sees or hears something that is not available to others. Nothing is happening in the world, but the patient talks about the presence of some creatures, sounds, smells, etc.
Hallucinations can occur both in the external world and affect the human body. If they are abundant and accompanied by delusions, then we are talking about hallucinosis. This disorder often becomes a chronic condition in which the patient can maintain orderly behavior, a critical attitude towards visions or voices, and efficiency.
People with dementia often experience visual hallucinations. Individuals with paranoia experience gustatory, olfactory, or tactile hallucinations.
Treatment of hallucinations
Before starting treatment for hallucinations, doctors examine the patient to identify the causes of their occurrence. The main therapy is aimed at eliminating the disease that provoked the disease, otherwise it is aimed at eliminating or mitigating symptoms.
There is no clear course of treatment, since there are many causes of hallucinations. Used in medicine individual approach, where medications are selected based on what doctors are trying to cure.
If hallucinations are provoked by taking medications or psychotropic substances, then they are excluded from use. The patient’s body is also cleansed if poisoning has been detected.
The patient is isolated: either locked in the house or hospitalized in a psychiatric hospital. Drugs are used to relieve tension, as well as eliminate hallucinations and delusions. Tizercin, Aminazine, Haloperidol, Trisedil are administered intramuscularly.
Individual psychotherapy is also used, which is aimed at restoring mental health person. The set of measures is individual, depending on the causes and symptoms of hallucinations.
Forecast
Refusing treatment is not advisable. Hallucinations are a progressive disease that will only worsen the patient's condition. Forecast in in this case will be disappointing, since a person is not able to distinguish the real from the imaginary.
The result of the lack of treatment can only be the development of the disease, when a person becomes more and more distant from reality, plunging into his own world. Depending on the impact of hallucinations, life expectancy may be shortened or remain unchanged.
If hallucinations are caused by illness or the use of psychotropic substances, then the patient will not be able to help himself. His body will collapse, his consciousness will begin to change, which will put the patient’s life into question: how long will he live?
Hallucinations do not indicate a healthy state of a person. If they occur, then you should consult a doctor who will begin individual treatment aimed at restoring brain function.
Illusions
Illusions are a distorted perception of a real existing object (E. Esquirol, 1817).
With an illusion, recognition of the object is lost. One of the additional questions: how does illusion differ from psychosensory disorders? Both of them are a distorted perception of reality. With metamorphopsia, the recognition of objects is preserved, but with illusion, it is lost.
Illusions are not an absolute sign of psychosis. Illusions are quite common in our everyday life. We are walking through the forest, picking mushrooms, and it seems like it’s a hat. They bent down - and this is a leaf. We saw a leaf, but then decided it was a mushroom. An irritant is definitely needed.
If you want to experience various illusions, you need to walk through the cemetery at night. There are many optical illusions. For example, a spoon standing in a glass of water looks curved.
Illusions associated with mental reality:
- affective (affectogenic) illusions (affect is emotional tension, a person enters a room in fear, opens the door, the room is poorly lit - instead of a curtain he sees a lurking person; or instead of a tie he sees a snake)
- verbal (two people are talking about the weather, and a person who has verbal illusions begins to hear not what they are saying about the weather, but that they are going to kill him. That is, there must be an irritant - the speech of other people). There is also delirium of interpretation - the patient stands next to people talking about the weather. He hears this speech, but interprets it in his own way (They talk about rain, which means they will kill me and the shot will not be heard).
- pareidolic (from the Greek para - solo and eidos - image). Described by K. Kahlbaum in 1866. They are no longer found in healthy people, they are the beginning acute psychosis. And most often they are a harbinger of the appearance of true visual hallucinations. Happens with delirium tremens. This is a violent appearance visual image. As a rule, some kind of object is needed. Occurs if a person looks at the wallpaper. The pattern is frosty on the glass, the branches are intertwined.
A person looks at a pattern (drawing), and suddenly instead of it he sees a grinning dog’s muzzle. Or the face of a witch.
Pareidolic illusions are the beginning of acute psychoses.
A hallucination is a perception that occurs without a real object. Esquirol, 1917
We look at the lattice building, it is reduced - this is metamorphopsia (in the form of micropsia). For an illusion to occur, a stimulus is required, and it is distorted. When a hallucination occurs, this stimulus is not needed.
A hallucination is a sensory experience of a previous perception without the presence of a corresponding external stimulus. The hallucinations of patients are true perceptions, and not something imaginary. For a person experiencing hallucinations, his subjective sensory sensations become as valid as those coming from outside world(W. Griesinger).
Hallucinations are already an unconditional sign of psychosis. Hallucinations in mental health healthy person do not arise.
In a state of hypnosis, you can suggest to a person that he is fishing, and he will sit and fish. But he has an altered state of mind, induced by a hypnologist.
With neuroses, there can be no hallucinations. They can only occur in psychosis. Hallucinations occur only in major psychiatry. This psychotic level disorders, level of psychosis.
Psychosis– gross disintegration of mental activity, leading to gross maladjustment.
Hallucinations are classified by sense organs: visual, auditory (verbal), tactile, olfactory, gustatory, visceral (hallucinations of the general sense), etc. The most common are auditory and visual hallucinations.
Hallucinations in psychiatry are considered a nonspecific disorder that can occur in many diseases, but some features of their occurrence can be emphasized. For example, auditory hallucinations most often occur in endogenous (internal, chronic) diseases. Visual - for exogenous diseases (trauma, intoxication...). And, for example, the appearance of olfactory hallucinations indicates that the painful process is beginning to acquire a progressive character. They don't happen that often. Schizophrenia often debuts with olfactory hallucinations, and then the patient’s prognosis is unfavorable. Endogenous diseases auditory pseudohallucinations are characteristic (for example, in patients with schizophrenia). In patients exogenous diseases there will be true visual hallucinations. Almost every second patient with schizophrenia experiences Kandinsky-Clerambault syndrome, one of the symptoms of which is auditory pseudohallucinations. The dynamics of schizophrenia are long-term. It can last 10-15 years. Hallucinations may not pass, but be replaced by others. It may begin with imperative hallucinations and then be replaced by others. There was one voice - there were many voices...
Hallucinosis – psychological syndrome, always arising against the background of a clear state of consciousness and characterized by an influx of hallucinatory images within one analyzer.
Hallucinosis is only the presence of hallucinations (there are no other symptoms). More often - auditory analyzer. This condition will be called alcoholic verbal hallucinosis. Against the background of a clear consciousness, the patient begins to hear voices of blasphemous content (they blaspheme him). Psychosis occurs at least in the second stage of acute alcoholism. The voices say: “The creature, you got drunk, the children are hungry, and you drink... You won’t live, we decided to kill you.” Next they tell how exactly they will kill him.
- Imperative
That's an order. When patients experience these hallucinations, they are subject to forced hospitalization under Article 29a. The patient poses a danger to himself and others. The patient may be ordered: “The first person around the corner appears - you must kill him.” The sick cannot resist. Or another example: voices say: take a razor, cut your vein. Then they say: there is not enough blood, cut your neck. At that moment, the mother came in, and the patient was miraculously saved. Another example. The patient was walking down the street, voices said, “Go straight.” He walked and approached the river. Then the voices say: “Stop, wait, now we’ll find the boat.” He stood, waited, got nothing and went back. Voices can also prohibit the patient from doing something, for example, prohibiting them from talking to a doctor or eating.
- Persuaders (if imperative is a direct order (“Kill yourself”), then persuaders say: “A terrible death awaits you. Therefore, we will put you into a hypnotic state, numb your hands, you will cut your wreaths and die quietly, calmly.” The patient was cutting veins, she was miraculously saved).
- Threatening (we will kill, stab, execute).
