Hallucinations полностью

Such voices may occur with anyone in situations of extreme threat or danger. Freud heard voices on two such occasions, as he mentioned in his book On Aphasia:

I remember having twice been in danger of my life, and each time the awareness of the danger occurred to me quite suddenly. On both occasions I felt “this was the end,” and while otherwise my inner language proceeded with only indistinct sound images and slight lip movements, in these situations of danger I heard the words as if somebody was shouting them into my ear, and at the same time I saw them as if they were printed on a piece of paper floating in the air.

The threat to life may also come from within, and although we cannot know how many attempts at suicide have been prevented by a voice, I suspect this is not uncommon. My friend Liz, following the collapse of a love affair, found herself heartbroken and despondent. About to swallow a handful of sleeping tablets and wash them down with a tumbler of whiskey, she was startled to hear a voice say, “No. You don’t want to do that,” and then “Remember that what you are feeling now you will not be feeling later.” The voice seemed to come from the outside; it was a man’s voice, though whose she did not know. She said, faintly, “Who said that?” There was no answer, but a “granular” figure (as she put it) materialized in the chair opposite her—a young man in eighteenth-century dress who glimmered for a few seconds and then disappeared. A feeling of immense relief and joy came over her. Although Liz knew that the voice must have come from the deepest part of herself, she speaks of it, playfully, as her “guardian angel.”

Various explanations have been offered for why people hear voices, and different ones may apply in different circumstances. It seems likely, for example, that the predominantly hostile or persecuting voices of psychosis have a very different basis from the hearing of one’s own name called in an empty house; and that this again is different in origin from the voices which come in emergencies or desperate situations.

Auditory hallucinations may be associated with abnormal activation of the primary auditory cortex; this is a subject which needs much more investigation not only in those with psychosis but in the population at large—the vast majority of studies so far have examined only auditory hallucinations in psychiatric patients.

Some researchers have proposed that auditory hallucinations result from a failure to recognize internally generated speech as one’s own (or perhaps it stems from a cross-activation with the auditory areas so that what most of us experience as our own thoughts becomes “voiced”).

Perhaps there is some sort of physiological barrier or inhibition that normally prevents most of us from “hearing” such inner voices as external. Perhaps that barrier is somehow breached or undeveloped in those who do hear constant voices. Perhaps, however, one should invert the question—and ask why most of us do not hear voices. Julian Jaynes, in his influential 1976 book, The Origin of Consciousness in the Breakdown of the Bicameral Mind, speculated that, not so long ago, all humans heard voices—generated internally, from the right hemisphere of the brain, but perceived (by the left hemisphere) as if external, and taken as direct communications from the gods. Sometime around 1000 B.C., Jaynes proposed, with the rise of modern consciousness, the voices became internalized and recognized as our own.²¹

Others have proposed that auditory hallucinations may come from an abnormal attention to the subvocal stream which accompanies verbal thinking. It is clear that “hearing voices” and “auditory hallucinations” are terms that cover a variety of different phenomena.

While voices carry meaning—whether this is trivial or portentous—some auditory hallucinations consist of little more than odd noises. Probably the most common of these are classified as tinnitus, an almost nonstop hissing or ringing sound that often goes with hearing loss, and may be intolerably loud at times.

Hearing noises—hummings, mutterings, twitterings, rappings, rustlings, ringings, muffled voices—is commonly associated with hearing problems, and this may be aggravated by many factors, including delirium, dementia, toxins, or stress. When medical residents, for example, are on call for long periods, sleep deprivation may produce a variety of hallucinations involving any sensory modality. One young neurologist wrote to me that after being on call for more than thirty hours, he would hear the hospital’s telemetry and ventilator alarms, and sometimes after arriving home he kept hallucinating the phone ringing.²²