Verbal hallucinations. Auditory hallucinations (occur most often) What could be the consequences?

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 no longer occur in healthy people; they are the beginning of acute psychosis. And most often they are a harbinger of the appearance of true visual hallucinations. Happens with delirium tremens. This is the forced appearance of a 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 the outside world (W. Griesinger).

Hallucinations are already an unconditional sign of psychosis. Hallucinations do not occur in a mentally healthy person.

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 is a psychotic level of disorder, a 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 are characterized by auditory pseudohallucinations (for example, in patients with schizophrenia). Patients with exogenous diseases will have 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– a psychological syndrome that always occurs against the background of a clear state of consciousness and is characterized by an influx of hallucinatory images within one analyzer.

Hallucinosis is only the presence of hallucinations (there are no other symptoms). Most often - an 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. 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).

Hallucinations are the imaginary perception of phenomena that do not exist in reality. Hallucinatory images displace real ones and are perceived by the patient as objectively existing.

Hallucinosis, or hallucinatory syndrome, is a state of influx of hallucinations without clouding of consciousness. An important characteristic of hallucinosis is clarity of consciousness. If hallucinations occur against the background of confusion, they cannot be called hallucinatory syndrome. This is possible with delirium and various twilight states.

Hallucinosis is often accompanied by the development of delusional ideas. However, it is worth understanding that hallucinatory-delusional syndromes are independent symptoms; the addition of delusions cannot be explained by the presence of hallucinations and attempts to justify them to the patient. Many cases of hallucinosis occur without the addition of delirium.

Hallucinatory syndrome, like any psychopathological condition, can be acute or chronic. Acute hallucinosis has a brighter, more intense picture, with many visual images, and the patient is highly involved in what is happening. Chronic hallucinosis is more monotonous; the patient practically does not pay attention to them.

Types of hallucinosis

Depending on which sense organs are predominantly involved in the hallucinatory syndrome, different types of hallucinations are distinguished. It is customary to describe visual, verbal and other varieties of them. Assessing the type of hallucinations is important for correct diagnosis and selection of further treatment tactics.

Visual hallucinosis is relatively rare and in most cases is not accompanied by delusions or other psychopathological symptoms:

Bonnet hallucinosis occurs in individuals with complete or almost complete loss of vision. Criticism of emerging images has been preserved. Hallucinatory images are represented by bright, moving images of animals and people of normal or reduced size. Often relatives become the object of hallucinations.
Lhermitte's hallucinosis (peduncular visual hallucinosis) is typical for patients with damage to the cerebral peduncles. Grows in darkness or unlit areas. Hallucinatory images are vague, indistinct, in the form of groups of people or animals, scenes with their participation, often moving hallucinations. The appearance of images causes surprise in patients; criticality remains.
Van Bogart's hallucinosis. Characteristic of subacute viral encephalitis. The images are bright, numerous, in the form of flowers, birds, butterflies. Sometimes it is considered as the first manifestation of delirium.

Verbal hallucinosis refers to auditory hallucinations. There are many varieties of them - single voices, dialogues or imaginary conversations of a large number of people. They can be commentary, judgmental, threatening, commanding or neutral. This type of hallucinosis more often than others develops into hallucinatory-delusional syndrome. Delusions are identical in content to hallucinations.

The onset of verbal hallucinations is preceded by a feeling of anxiety, fear, and anxiety. Hallucinations begin with individual words and phrases, developing into detailed dialogues and orders. The moments of maximum manifestation of hallucinosis are accompanied by pronounced motor excitement and fear. Under the influence of voices at such moments, crimes can be committed, escapes from home or a medical institution, attacks on relatives and medical staff.

Subsidence of symptoms and improvement in general condition do not necessarily indicate recovery. Often this is only a temporary lull, after which an equally significant deterioration of the condition occurs.

The chronicity of verbal hallucinosis is accompanied by a decrease in the variety of voices, a change in their intonations from a sharply commanding tone to a persuasive tone, and the monotony of hallucinations. At the same time, the patient’s condition improves, the influence of hallucinations on behavior decreases, and criticality towards them increases.

Hallucinatory syndrome of general feeling. Such syndromes include visceral and tactile hallucinations. In both cases, the patient complains of the presence of moving or non-moving living beings or inanimate objects that cause unpleasant sensations. In the case of tactile hallucinations, imaginary objects are located on the surface of the body; in visceral hallucinations, they are located inside, often in a specific organ. Most often, the objects of hallucinosis are various worms, insects and their clusters. Cases of complaints about the presence of larger living creatures, such as frogs, have also been described. Hallucinations of general feeling are characterized by great persistence. Patients often visit therapists for years with a variety of complaints and receive treatment for several illnesses before seeing a psychiatrist. In the case of complaints about a frog in the stomach, all the patient’s symptoms disappeared after she was induced to vomit at a psychiatrist’s appointment and a live frog was introduced into the vomit.

Complaints similar to hallucinations of general feeling are characteristic of senestopathies. The main difference is the absence of a specific substrate for unpleasant sensations during senestopathies. Patients complain of pain, pulling, cutting sensations, heaviness in various internal organs, but do not indicate its connection with specific objects - insects, stones, animals, as in hallucinations of a general feeling.

Taste and olfactory hallucinatory syndromes practically do not occur; in the vast majority of cases, they are part of the symptoms of some mental illness.

Causes of hallucinosis

It is possible both the isolated development of a hallucinatory syndrome (for example, Bonnet visual hallucinosis in old people with poor vision) and its inclusion in the structure of various mental and organic diseases. The most common causes of hallucinosis:

Epilepsy. Hallucinations most often appear in the structure of the aura before a seizure. Characterized by large-scale, scenic visual hallucinations, with the participation of a large number of people, detailed scenes of mass events, disasters. A distinctive feature is the predominance of blue and scarlet tones in the picture. Less commonly, olfactory or verbal hallucinosis appears.
Organic diseases of the brain. The type of hallucinosis depends on the location of the lesion (tumor, cyst, injured area), so hallucinations of almost any type are possible.
Schizophrenia. Various, numerous hallucinations are characteristic. In most cases, the disease begins with verbal hallucinosis, which can later be joined by visual hallucinosis. A developed system of delusional ideas arises. Negative symptoms are required.
Symptomatic psychoses are caused by long-term severe somatic and infectious diseases. The most characteristic of them is verbal hallucinosis with delusions and psychomotor agitation.
Encephalitis. Various types of hallucinatory syndromes are possible. Visual hallucinations can range from elementary (lights, flashes) to extensive stage hallucinations, typically scenes from family life or professional ones. Verbal hallucinosis is rare; elementary variants of auditory hallucinations are possible - music, noise.

Treatment

Consists of treating the underlying disease. To quickly relieve the hallucinatory syndrome, tranquilizers and antipsychotics are prescribed.

Ecology of health: Science currently does not have a clear answer to the question of what happens in the brain when a person hears voices...

A hallucination is a perception in the absence of an external stimulus that has the quality of a real perception.

Hallucinations can occur in all senses:

auditory,
visual,
tactile,
olfactory.

Probably, most common type hallucinations manifests itself in the fact that a person “hears voices”. They are called classroom verbal hallucinations. They are often symptoms of psychiatric illnesses such as schizophrenia. Visual hallucinations may also be associated with pathologies. Although they are less common in schizophrenia, visual hallucinations sometimes occur in neurological disorders and dementia.

Definition of the concept

Although auditory hallucinations are commonly associated with psychiatric illnesses such as bipolar disorder, they are not always signs of illness. In some cases, hallucinations may be caused by lack of sleep. Marijuana and stimulant drugs can also cause perceptual disturbances in some people. It has been experimentally proven that hallucinations can also be caused by prolonged absence of sensory stimuli.

In the 1960s, experiments were conducted (which would be impossible now for ethical reasons) in which people were kept in dark rooms without sound or any sensory stimuli. Eventually people began to see and hear things that were not there. So hallucinations can occur in both sick and mentally healthy people.

Research into hallucinations has been going on for quite some time. Psychiatrists and psychologists have been trying to understand the causes and phenomenology of auditory hallucinations for about a hundred years (maybe longer). In the last three decades, we have been able to use encephalograms to try to understand what is happening in the brain when people experience auditory hallucinations. We can now look at the areas of the brain involved in hallucinations using functional magnetic resonance imaging or positron tomography. This has helped psychologists and psychiatrists develop models of auditory hallucinations in the brain, mainly related to language and speech function.

Proposed theories of the mechanisms of auditory hallucinations

When patients experience auditory hallucinations—that is, hearing voices—an area of their brain called Broca's area is said to become more active. This area is located in the small frontal lobe of the brain and is responsible for speech production - when you speak, Broca's area works!

One of the first to study this phenomenon were professors Philip McGuire and Sukhi Shergill from King's College London. They showed that their patients' Broca's area was more active during auditory hallucinations than when the voices were silent. This suggests that auditory hallucinations are produced by the speech and language centers of our brain. This led to the creation of “inner speech” models of auditory hallucinations.

When we think about something, we generate “inner speech,” that is, an inner voice that “voices” our thinking. For example, when we think “what will I have for lunch?” or “What will the weather be like tomorrow?”, we generate internal speech and, we believe, activate Broca’s area.

But how does this internal speech begin to be perceived as external, not coming from oneself? Inner speech models of auditory verbal hallucinations suggest that the voices are internally generated thoughts, or inner speech, somehow misidentified as external, foreign voices. This leads to more complex models of how we monitor our own inner speech.

Chris Frith and others have proposed that when we engage in the process of thinking and inner speech, our Broca's area sends a signal to an area of our auditory cortex called Wernicke's area. This signal contains information that the speech we perceive is generated by us. This is because the signal is supposed to dampen the neural activity in the sensory cortex, so it is less activated than by external stimuli, such as someone talking to you.

This model is known as the self-monitoring model, and it suggests that people with auditory hallucinations have a deficit in this monitoring process, causing them to be unable to differentiate between internal and external speech.

Although the evidence for this theory is somewhat weak at this time, it has certainly been one of the most influential models of auditory hallucinations of the last twenty or thirty years.

Consequences of hallucinations

About 70% of people with schizophrenia hear voices to some degree. Sometimes voices “respond” to medications, sometimes they don’t. Usually, although not always, voices have a negative impact on people's lives and health.

For example, people who hear voices and do not respond to treatment have a higher risk of suicide. Sometimes voices tell them to harm themselves. One can imagine how difficult it is for them even in everyday situations, when they constantly hear humiliating and insulting words addressed to them.

However, it would be a gross oversimplification to say that only people with mental disorders experience auditory hallucinations. Moreover, these voices are not always evil. There is a very active Voice Hearing Society led by Marius Romm and Sandra Asher. This movement talks about the positive aspects of voices and fights the stigma around them.

Many people who hear voices live active and happy lives, so we can't assume that voices are always a bad thing. They are often associated with aggressive, paranoid and anxious behavior of mentally ill people, but this behavior may be a consequence of their emotional disturbance rather than the voices themselves. It is perhaps not so surprising that anxiety and paranoia, often at the core of mental illness, manifest themselves in what voices say.

It is worth noting that There is many people without a psychiatric diagnosis report hearing voices. For these people, voices can also be a positive experience, as they calm them down or even guide them in their lives. Professor Iris Sommer from the Netherlands has carefully studied this phenomenon. She discovered a group of healthy, well-functioning people hearing voices. They described their “voices” as positive, helpful, and confidence-boosting.

Treatment of hallucinations

People diagnosed with schizophrenia are usually treated with "antipsychotic" medications. These medications block postsynaptic dopamine receptors in an area of the brain called the striatum. Antipsychotics are effective for many patients, and their psychotic symptoms, especially auditory hallucinations and mania, improve to some extent as a result of treatment.

However, many patients' symptoms do not seem to respond well to antipsychotics. Approximately 25-30% of patients who hear voices have little effect on medications. Antipsychotics also have serious side effects, so these medications are not suitable for all patients.

As for other treatments, There are many non-pharmacological intervention options. Their effectiveness also varies. Example - cognitive behavioral therapy (CBT). The use of CBT for the treatment of psychosis is somewhat controversial, as quite a few researchers believe that it has little effect on symptoms and overall outcome. There are types of CBT designed specifically for patients who hear voices. These therapies usually aim to change the patient's relationship with the voice so that it is perceived as less negative and unpleasant. The effectiveness of this treatment is questionable.

I'm currently leading a study at King's College London to see if we can teach patients to self-regulate neural activity in the auditory cortex.

This is achieved using “real-time fMRI neural feedback.” An MRI scanner is used to measure the signal coming from the auditory cortex. This signal is then sent back to the patient via a visual interface, which the patient must learn to control (i.e., move a lever up and down). Ultimately, it is expected that we will be able to teach voice-hearing patients to control the activity of their auditory cortex, which may allow them to more effectively control their voices. Researchers are not yet sure whether this method will be clinically effective, but some preliminary data will be available in the next few months.

Population Prevalence

About 24 million people worldwide live with a diagnosis of schizophrenia, and about 60% or 70% of them have heard voices at some point. There is evidence that throughout the population, 5% to 10% of people without a psychiatric diagnosis have also heard voices at some point in their lives. Most of us have ever thought that someone was calling our name, and then it turned out that no one was nearby. So there is evidence that hallucinations may not be accompanied by schizophrenia and other mental illnesses. Auditory hallucinations are more common than we think, although exact epidemiological statistics are difficult to come by.

The most famous of the people who heard voices was probably Joan of Arc. From modern history, you can remember Syd Barrett, the founder of Pink Floyd, who suffered from schizophrenia and heard voices. However, again, many people without a psychiatric diagnosis hear voices, but perceive them extremely positively. They can draw inspiration for art from voices. Some, for example, experience musical hallucinations. This can be something like vivid auditory images, or maybe just a variation of them - these people hear music very clearly in their heads. Scientists are not very sure whether this can be equated to hallucinations.

Unanswered questions

Science currently does not have a clear answer to the question of what happens in the brain when a person hears voices. Another problem is that researchers don't yet know why people perceive them as foreign from an external source. It is important to try to understand the phenomenological aspect of what people experience when they hear voices.

For example, when people are tired or take stimulants, they may experience hallucinations, but do not necessarily perceive them as coming from external sources.

The question is why people lose the sense of their own agency when they hear voices. Even if we believe that the cause of auditory hallucinations is excessive activity of the auditory cortex, why do people still believe that the voice of God, or a secret agent, or aliens is speaking to them? It is also important to understand the belief systems that people build around their voices.

The content of auditory hallucinations and its original source is another problem: Do these voices come from inner speech, or are they stored memories? What is certain is that this sensory experience involves activation of the auditory cortex in the speech and language areas. This tells us nothing about the emotional content of these voices, which can often be negative. This, in turn, suggests that the brain may have a problem processing emotional information.

Also interesting:

Scientists about the brain: the best TED lectures with Russian voice acting

Additionally, two people may experience hallucinations very differently, meaning that the brain mechanisms involved may be quite different. published

Translation: Kirill Kozlovsky

In psychology, special attention is paid to hallucinations, which come in 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 are also more pathological causes 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 reality there are only trees surrounding him.

This may be a consequence of severe fatigue, when people often use various medications 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, to 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 provoked 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 can be caused by encephalitis or schizophrenia.

Hallucinations are distinguished by their emotionality and vividness. The brighter and more emotional the visions, the more a person 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 psychiatric help website 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. Medicine uses an 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 a person’s mental health. 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. The forecast 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.

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 a person’s inner world, his state of mind. They express disturbances in mental activity, personal qualities, and the dynamics of the disease. 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 their negative impact. Other cognitive and behavioral treatments have been used with mixed success.

Experimental and alternative treatments

In recent years, repetitive transcranial magnetic stimulation (TMS) has been studied 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 complex cases, the frequency and intensity of auditory hallucinations can be reduced. 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. Most 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

Mixing

A 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 management of auditory hallucinations, but further research is required to prove this.