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Hallucinations





Hallucinations Differentiated from Illusions and
Delusions.--Hallucinations are vivid impressions on the consciousness
which appeal to their subject as strongly as if they were really the
result of sensory impressions, though those who experience them know,
either at the moment, or on investigation afterwards, that they had no
objective reality, that is, were not due to any external physical
cause. Illusions are deceptions of the senses, due to the imperfection
of the senses or the conditions in which the perception occurs.
Delusions are mental states in which ideas are accepted, or
conclusions drawn, or information assumed to be gained, though the
whole process is mental and has no relation to reality. (For
illustrations of illusions see chapter with that title in the
Appendix.)

Hallucinations lie in between illusions and delusions as a mode of
deception. They are mental occurrences, but they seem to come from the
senses and probably the best explanation for them is that a previous
sensory impression is vaguely aroused and then finds its way into the
consciousness as if it were coming through the senses. It has been
suggested that they might be due to a reversal of the nervous process
by which a sensation reaches the brain. The external object produces
the sensation, this travels along a nerve causing a perception, this
perception is stored in the memory, and then, when very vividly
reawakened, causes impulses to travel backward along the nerve to the
periphery with the production of a feeling very like sensation.


Frequency.--While hallucinations are often supposed to be only
incidents in the life of the insane, or at least of those who are in
the danger zone near mental disequilibration, carefully collected
recent observations show that many perfectly sane people have
experienced them, and some of them have been much disturbed by them
for fear they portended loss of mental control or some developing
pathological condition. A certain number of men and women have seen
things that either had no existence or existed only for them and for
the moment, and that evidently were due to some state of mind rather
than to their senses. They have heard things that were not said or
that were not audible to others, or that were only reproductions of
their memory of previous sounds and quite naturally such mysterious
manifestations disquiet them. It was the rule in the past to dismiss
such phenomena without serious consideration, or at most to consider
that they were only subjective manifestations not worth discussing, or
to go to the opposite extreme and say that they were due to mental
disturbances.

Of course, as a rule, hallucinations are an index of mental
disturbance. No matter how apparently sane the patient, this must be
the first thought and must be carefully excluded before proceeding
with the case. The subject of hallucinations is larger than that,
however, and it is a mistake to brush it aside in every case as if it
were either very serious or of no importance and that in either case
nothing can be done to relieve solicitude about it. Physicians can
often do much, first to prevent hallucinations by getting at the
physical causes of them; second, to prevent them from disturbing
patients seriously by showing them how common are such experiences and
by indicating their possible physical significance; third, by securing
such mental discipline and control as will render their recurrence
much less frequent; and, fourth, they can make the almost inevitable
unfavorable effect upon the mind of the patient and then reflexly upon
his body, much less than it would otherwise be, by sympathetically
discussing and entering into the details of them enough, at least, to
explain their significance or throw some light on their origin in
physical conditions.

Hallucinations of vision, the seeing of things and persons that have
no real existence at the time and place they are seen, are usually
considered to be rather uncommon and to occur only in those whose
mentality is seriously disturbed. Careful studies of the subject,
however, show that at least one in ten of educated people
consulted have had some hallucinations of vision. Either they have
wakened up, or they have dreamt that they waked in the early morning,
and have seen some one whom they knew, but knew to be at the moment at
a distance, standing near them. Such visions have gradually faded away
or suddenly disappeared. Occasionally these persons have in full light
had some appearance, wraithlike or otherwise, some manifestation that
appeals to vision, yet that they knew at the time or learned
afterwards was non-existent.

Many people are backward about confessing that they have had such
experiences, for they fear that it will make them ridiculous or even
cause them to be suspected of disturbed mentality. Just as soon as it
is made clear to them that their admissions will be taken as evidence
for a phenomenon to be discussed seriously, many more than would
otherwise be thought confess to such hallucinations. Most of these, it
may be said at once, are quite sensible people, a great many of them
belong to the educated classes; all of them are trustworthy witnesses
as far as good will goes, and the circumstances of their
hallucinations are such in many cases that there cannot be a mere
mistake, or error of judgment.

The frequency with which hallucinations occur may be appreciated from
the investigation made some years ago at the instance of the Congress
of Experimental Psychology. The following question was put to 17,000
persons, mostly residents of Great Britain, and answers received:
"Have you ever, when believing yourself to be completely awake, had a
vivid impression of seeing or being touched by living beings or
inanimate objects, or of hearing a voice, which impression, so far as
you could discover, was not due to any external physical cause?" The
answers showed that 655 out of 8,372 men and 1,029 out of 8,628 women
had experienced a sensory hallucination at some time in their lives.
Some of them had had a number of them. That is, one out of ten in the
educated classes has had some hallucination, and nearly one out of
every eight women. An analysis of the statistics, however, brings out
some interesting suggestions. There were nearly twice as many
hallucinations related as having occurred during the year before the
question was asked as in the preceding years. There was a definite
reduction in the number that had occurred in all the preceding years,
except the fifth and tenth, and these were evidently due to
uncertainties of memory, so that five- and ten-year periods seemed
about the length of time that had passed since the event.

It is evident then that in spite of the fact that an hallucination
would seem to be very important and surely startling enough to be well
remembered, it is yet easily forgotten, since even a year's interval
made so much difference in the number that were remembered. The
committee, after considering this easy forgetfulness in the matter,
considered that to arrive at the actual total of visual hallucinations
experienced by this group of 17,000 persons during the ten-year period
in question, the numbers in the table should be multiplied by four.
That means that probably very nearly one in three people have had an
hallucination of some kind within ten years. The great majority of the
visual hallucinations consist of apparitions of human figures. Other
forms that are seen are so few, as Mr. Podmore has insisted in his
"Telepathic Hallucinations, The New View of Ghosts," [Footnote 45]
that they are almost negligible. A frank discussion of these
details with a person who is much disturbed by having experienced an
hallucination is the best possible remedy for the physical and mental
disturbance that may result.

[Footnote 45: The Twentieth Century Science Series, New York, 1910.]

Sir Francis Galton, well known for his investigation of many subjects
and who may well be called the father of biometrics or statistical
biology, in his "Memories of My Life" [Footnote 46] tells of his own
investigations of the visions of sane persons. The fact that he
delivered a lecture on this subject at the Royal Institution of London
shows how seriously his studies were made and how much value
scientists placed on them. Galton's well-recognized training in the
careful weighing of evidence and his ability to strip phenomena of
everything that might divert their significance from what they really
were, add to the worth of his conclusions. Those who care to study the
subject further will find his discussion in the Proceedings of the
Royal Institution (London, 1882).

[Footnote 46: New York, 1909.]

There are few people beyond middle age who have not had one or more
curious experiences in the matter of visions or appearances. Mostly
these have been vague and have not proved a disturbing element in the
minds of the subjects. Many more than are thought, however, have seen
visions vividly and with a detail that makes it almost impossible for
them to believe that what they saw was merely an externation of ideas
already in their mind. In this matter it must not be forgotten that
the dreams of many people, especially nervous people, often present
themselves with marvelous vividness of detail. They see people or
places in their dreams and reason about them quite rationally.
Occasionally a dream will bring back details that have been forgotten.
The dreaming state seems in some people to have wonderful power over
the subconscious. Things that are not remembered at all in the waking
state sometimes come back in dreams, and only then are recalled by the
individual as representing past events in his life. He is apt to
wonder where the details could possibly come from, since he had before
no conscious memory of them. This same thing holds for the day-dreams
or sudden visual appearances that come when the attention has been
wrapped in something else.

A typical example of such visual hallucinations is the following
incident told by a prominent London physician of himself:

One afternoon at tea time, before a meeting of the Royal Society,
Sir Risdon Bennett (1809-1891, a well-known physician. President of
the College of Physicians in 1876, and a fellow of the Royal
Society), drew me apart and told me of a strange experience he had
had very recently. He was writing in his study separated by a thin
wall from the passage, when he heard the well-known postman's knock,
followed by the entrance into his study of a man dressed in a
fantastic medieval costume, perfectly distinct in every particular,
buttons and all, who, after a brief time, faded and disappeared. Sir
Risdon says that he felt in perfect health; his pulse and breathing
were normal and so forth, and he was naturally alarmed at the
prospect of some impending brain disorder. Nothing, however, of the
sort had followed. The same appearance recurred; he thought the
postman's knock somehow originated the hallucination. ... I heard
the story at length, very shortly after the event, told me with
painstaking and scientific exactness and in tones that clearly
indicated the narrator's earnest desire to be minutely correct.

Those who are especially interested in this subject will find any
number of similar stories, some apparently rich with meaning, most of
them quite meaningless, in the volumes of transactions of the
English Psychic Research Society, in F. W. H. Myers' "Human
Personality," in Podmore's "Naturalizing the Supernatural," in
Flammarion's "The Unknown," or many other books published in recent
years. It is quite easy to get sufficient material to bring
reassurance to any patient that visual hallucinations, at least, mean
nothing serious for the mind or body of the individual having the
experience.


Hallucinations in the Past.--It must not be thought, however, that
this subject of hallucinations is new. Literature is full of it and
from the earliest times we find traces of it. Egyptian, Babylonian and
Chaldean writers mention them. Nor indeed is the scientific
consideration of the subject new. Aristotle speaks of them and it is
evident that many of the old writers thought of them as psychic
incidents on some physical basis, or at least due to some
predisposition in the individual or in some special state of his
senses. Two generations ago Johann Mueller, the great German
physiologist, discussed the whole subject at length in a monograph,
and considered it of so much importance for physicians that he
introduced a resume of it into his great text-book of physiology. His
explanation of the occurrence of visual hallucinations is not only a
striking illustration of the thoroughly scientific character of his
treatment of the subject, but it serves to show how well men
considered these subjects long before the present fad for the study of
abnormal psychology or mental influence came in. His discussion of the
subject is sufficient of itself to make any patient understand his
hallucinations and keep them from bothering him better than anything
else I know:

The subjective images of which we are speaking have sometimes,
however, both color and light; different particles of the retina, of
the optic nerve, and of its prolongations to the brain, being
conceived as existing in special states of action. This happens
rarely in the state of health, but frequently in disease. These are
the true phantasms which may occur to the sense of hearing and other
senses as well as to that of vision. The process by which
"phantasms" are produced, is the reverse of that to which the vision
of actual external objects is due. In the latter case particles of
the retina thrown into an active state by external impressions, are
conceived in that condition by the sensorium; in the former case,
the idea of the sensorium excites the active state of corresponding
particles of the retina or optic nerve. The action of the material
organ of vision, which has extension in space, upon the mind, so as
to produce the idea of an object having extension, form and relation
of parts, and the action of such an idea upon the organ of vision so
as to produce a corresponding sensation, are both equally wonderful;
and hence the spectral phenomena or visions are not more
extraordinary than the ordinary function of sight. (Vol. II, p.
1393, Eng. transl., 1842.)


Apparitions and their Explanation.--In spite of suggested explanations
on physical grounds, some of these apparitions that appear to people
seriously disturb them. They cannot get them out of their minds. They
are sure that they portend evil. Hence worries, and the more nervous
the people are and the more worried already, the more likely is such a
thing to recur and then to be made much of. Only through their minds
can these people be treated, and it must be made clear to them not
only how common are hallucinations, but that there is an easy psychic
explanation of most of them. Sir Arthur Mitchell, K. C. B., in his
book "About Dreaming, Laughing and Blushing," [Footnote 47] tells a
story and then gives his explanation of it in such a way as to
illuminate many of these occurrences:

[Footnote 47: Longmans, London, 1900, page 21.]



Perhaps I should illustrate how I think that apparitions may be
nothing more than dream hallucinations. A. B., a gentleman of
culture and strong character, called one hot day, after a hearty
lunch, on an ecclesiastic in a high position, who happened to be
engaged in his library at the time of the call. A. B. was shown into
a room opening off the library, and requested to wait. He sat down
beside a table, and with his elbow resting on it, he leant his head
on his hand. While in this position he saw a man in clerical costume
come through the door communicating with the library, without any
opening of the door. A. B. was absolutely certain that he had seen
an apparition, and was surprised and hurt when I expressed a doubt.
He called on me to explain, and I said that it was at least possible
that he had been asleep for some moments, that if he had slept at
all, however short the dream of the sleep, he must have had a dream,
if I am right in thinking that there is no dreamless sleep, and that
thus what he regarded as an apparition might be nothing more than a
dream hallucination. He assured me persistently that he was
continuously wide-awake, but I assured him that these moments of
sleep often occurred without any consciousness that they had
occurred. He refused to be deprived of his ghost, and I refused to
believe in the supernormal when the normal was sufficient.

Such wraith-like appearances are supposed to occur especially in
connection with the deaths of persons at a distance. Startling stories
are told, particularly of those who are very near relatives, husbands
and wives, mothers and sons, and, above all, twins, who have been very
closely associated with one another during life. There are a large
number of stories of this kind, however, that have been collected by
the Psychic Research Society and other agents with strong evidence in
their favor, in which the appearances have had no ulterior
significance at all and have evidently been mere figments of the
imagination, the externation of images from memory so vividly that
they seem to be the reseen. Reassurances in this matter are the best
possible source of relief from the sense of impending ill for many
patients. The physician who wishes to relieve such symptoms must
familiarize himself with some of the many stories that have been
investigated and that serve to prove that these and like appearances
must not be taken as significant of anything more than a definite
tendency, that exists in human nature at moments of day dreaming or
when one's attention is suddenly turned from a book in which one has
been absorbed, to see externally what is really passing through the
imaginative memory.


A Disappearance.--A very interesting commentary on some of these
appearances is to be found in Mark Twain's story of a disappearance,
which could probably be duplicated many times if experiences in this
line were collected and collated. Mr. Clemens, sitting on the porch of
his residence one day, saw a stranger of rather peculiar appearance
come up the walk toward the front door and he expected to hear him
ring the bell and have the servant come to the door and usher him in,
and then perhaps be called to see him. About the middle of the walk,
however, the stranger disappeared and Mr. Clemens was quite surprised
to come to himself, rub his eyes and conclude that he had had one of
these curious visions or hallucinations, in which the Psychic Research
Society would surely be interested. He had plainly seen the stranger
enter the gate, come up the walk, and then disappear. He was so
impressed by the disappearance that he roused himself to go into the
house to get his notebook, so as to make notes of what had happened
before the details escaped him. To his surprise he found the stranger
in conversation with the servant in the house. There had simply
been a lapse in Mr. Clemen's vision of him. He had had a disappearance
phenomenon instead of an appearance. The story will be found to amuse
patients who complain of appearances disturbing them, though Mr.
Clemens always told his disappearance story very seriously, and it is
as interesting a psychic phenomenon as any told of the wraith-like
appearances.


Treatment.--Considering how frequent are such phenomena, the physician
must be prepared to treat those who are disquieted by them. A
wraith-like appearance, for instance, will disturb many people very
seriously and often for days, sometimes for weeks, make them nervous,
excitable, and impair their appetite, disturb their digestion and
sleep and often such unfortunate occurrences are prone to come just
when they are run down in weight and when they need the help of every
factor that makes for improvement of health. Simply to dismiss such an
appearance as if it were quite imaginary, that is, non-existent in
some form of reality, or quite baseless and trivial, serves no good
purpose, for, as a rule, the persons concerned are deeply impressed
with what they have seen. The only way to remove the unfavorable
impression produced by it is to discuss it straightforwardly on the
basis of what we have come to know as the result of recent
investigations and the collation of the literature which has been
published by the various psychical research societies and authorities
on the subject. We know now that while occasionally such wraith-like
appearances seemed to have a definite significance, because of
something that happened simultaneously or shortly afterwards, this is
mere coincidence and there are literally thousands of such cases in
which a well authenticated wraith-like appearance was followed by no
serious consequence, was never shown to mean anything beyond a curious
psychic phenomenon, and was evidently merely due to some personal
subjective influence, some externation of an image in the memory,
unusual, but not at all unique, or even very rare, and evidently due
to a curious peculiar externalizing power with which certain
intellects are gifted.


Auditory Hallucinations.--Hallucinations of hearing are more common
than those of vision. Many people have had the experience of waking up
thinking that someone was calling them. A great many people are sure
that they have, at some time or other, heard a voice when no one was
near enough to them to have said anything. They have even recognized
the voice. Some people, when thinking deeply about a person, have the
voice of that person occur to them so clearly that they cannot quite
make out whether they have actually heard it or whether it has only
been very vividly reproduced in their memory. Such experiences are so
common as to be well known, though many people hesitate to tell the
stories of them, for hearing voices is rightly looked upon as a
frequent preliminary symptom of insanity.

Hallucinations of hearing are the most common early symptom of
insanity. The hearing of voices must always arouse suspicion at once.
It must not be forgotten, however, that a great many recognizedly sane
people who have remained so for life, have thought that they heard
voices. Of course, we have no definition for insanity, and it is
difficult to draw the line. We have no definition for health either,
yet we have a practical working standard for the recognition of it, as
also for insanity. These hallucinations then, both of vision and
hearing, deserve to be discussed seriously, and in nearly every
case, even though there is some mental disturbance, the physician can
in this way benefit his patients and keep them from being overmuch
distressed by their hallucinations.

There is an expression in such common use that it is evidently the
result of an almost universal experience, according to which men
sometimes explain, after having acted in a particular way, that
"something told them to." What they mean, of course, is that a
conclusion formed in their minds the reasons for which they could not
understand, but which yet had force enough to cause them to follow it
to a practical application. When we hear of Socrates being advised in
life by a demon, a so-called familiar spirit, we are apt to wonder
whether by this term is meant anything more than just this curious
feeling of aloofness from ourselves that we sometimes have when we are
trying to make up our minds, or, indeed, not infrequently when we are
deeply engaged in any intellectual occupation. As discussed in the
chapter on Unconscious Cerebration, our minds seem in a certain way to
act independently of us. Occasionally they draw us to conclusions
quite different from those which we previously expected to reach.
There seems to be a something within us that works quite of itself and
beyond our will. Whether under these circumstances there may not
occasionally come so vivid a feeling of this power within us
impressing itself upon us, that it seems to come from without, must
always be taken into account in the effort to get at the real
significance of these curious hallucinations. Only thus are we able to
come to the relief of patients who are bothered by them.


Explanation by Sound Reproduction.--Auditory hallucinations are
probably not more than reproductions of sounds heard before recalled
vividly and apparently heard again at moments when attention is not
attracted to actual auditory sensations and we are in receptive mood.
Some of them are very startling because they are apparently warnings
of future events, as is proved by their fulfillment. These, however,
do not seem to be more than coincidences noted with regard to similar
events connected with Premonitions, Dreads and Dreams (see chapters on
these subjects). There is, for instance, a well authenticated story
published by the English Psychic Research Society of a woman who was
about to take a dose of what she thought was some ordinary home
remedy, when she distinctly heard a voice telling her to taste it. The
dose to be taken was a tablespoonful, and when she tasted it she found
that by mistake she had placed her hands on a bottle containing a
rather strong poison and a tablespoonful of it would almost inevitably
have killed her. Unfortunately, such occurrences are so rare and the
reason for them is so hard to find that their consideration as
anything more than coincidences seems out of the question. Every
medical journal almost brings the story of someone who has taken a
dose of medicine that proves fatal, and there is no warning. If such
warnings came with definite frequency, it would be easier to
appreciate their significance.

There are similar stories with regard to other warnings. There is the
story of the young man who in a storm drove under a shed for
protection. Just as he did so he heard his mother's voice--she had
been long dead--distinctly say "Drive out!" Ho drove out at once in
the teeth of the storm, so deeply impressed was he, and was scarcely
beyond the entrance when the shed fell, crushing everything within it.
Similar warnings of impending accidents are rather frequent in
certain people's minds, yet it is hard to think of them as anything
else than premonitions. These somehow take on the character of
auditory hallucinations in certain sensitive minds. Compared to the
whole number of accidents, however, such incidents are extremely rare
and follow no law, and while there are those who like to think that
perhaps such phenomena are due to the solicitude of some being in the
other world, this is extremely doubtful. In that case, as St.
Augustine suggested, they would be much more frequent and have a
clearer significance than is at present the rule. St. Augustine,
discussing the possibility, was sure that he would have had
communications from his mother. Most men would re-echo his feeling.


Coincidences.--Most of these stories as they have been analyzed by
careful investigators are indeed such trivial unmeaning things that it
would be too bad to let people be bothered by them. They have
occurred, however, from time immemorial. Veridical warnings are a
commonplace in the literature of all countries. Undoubtedly some may
suggest the action of a Higher Power, but the more one knows of the
conditions in which they happened, the people to whom they came and
their ultimate effects, the less will they seem providential. It is
evident that under certain conditions they may be produced even at
moments when men are not particularly excited and when they think that
they are perfectly calm and self-possessed. Each story must be
discussed in its own merits. The only thing to do, then, is not to
make too light of them and, above all, not to treat them as merely
imaginary or as utterly illusory; for they are often natural
phenomena, the reasons for which and the conditions of their
production we do not as yet fully understand. If patients can be
brought to this viewpoint, they may even become interested in
searching out just what it was that caused each particular
hallucination. Over and over again it has been found that a moonbeam
or a peculiar unexpected reflection of the sun, or the light shining
through an unnoted aperture, or any or several of these in connection
with a mirror has been the main cause of the wraith-like appearance.
When they happen during the day it is sometimes at the moment of
passing from very bright light to a darker hall that the occurrence
takes place and evidently there is some physical occasion for the
appearances in the eye itself. Unusual noises of various kinds are
responsible for the auditory hallucinations.


Dangers of Serious Considerations.--There is one serious aspect of
these hallucinations and supposed warnings--they tend to paralyze
action. If a person allows himself to become firmly persuaded that
doubts and premonitory possibilities must be weighed and solved before
he may dare to act with assurance, then action becomes almost
impossible. Premonitions may serve to bring people into danger, or at
least keep people from having such presence of mind as will enable
them to get out of it, as they otherwise would. Doubts lead to
inaction and make a state of mind that is eminently miserable. The
patient's one hope is to put aside resolutely such hallucinations if
they rise to the level of a disturbing doubt or a paralyzing
premonition and to discipline himself against being influenced by
them. In many persons this is a difficult matter, but it represents
the only efficient path to the regaining of mental health and
strength.





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Previous: Mental Incapacity Psychasthenia



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