Many cultures regard hallucination, like dreams, as a special, privileged state of consciousness—one that is actively sought through spiritual practices, meditation, drugs, or solitude. But in modern Western culture, hallucinations are more often considered to portend madness or something dire happening to the brain—even though the vast majority of hallucinations have no such dark implications. There is great stigma here, and patients are often reluctant to admit to hallucinating, afraid that their friends and even their doctors will think they are losing their minds. I have been very fortunate that, in my own practice and in correspondence with readers (which I think of, in some ways, as an extension of my practice), I have encountered so many people willing to share their experiences. Many of them have expressed the hope that telling their stories will help defuse the often cruel misunderstandings which surround the whole subject.
I think of this book, then, as a sort of natural history or anthology of hallucinations, describing the experiences and impact of hallucinations on those who have them, for the power of hallucinations is only to be understood from first-person accounts.
Some of the chapters that follow are organized by medical categories (blindness, sensory deprivation, narcolepsy, etc.), and others are organized by sensory modality (hearing things, smelling things, etc.). But there is a great deal of overlap and interconnection between these categories, and similar hallucinations may occur in a wide variety of conditions. Here, then, is a sampling which I hope will give a sense of the great range, the varieties, of hallucinatory experience, an essential part of the human condition.
1
Silent Multitudes: Charles Bonnet Syndrome
One day late in November 2006, I got an emergency phone call from a nursing home where I work. One of the residents, Rosalie, a lady in her nineties, had suddenly started seeing things, having odd hallucinations which seemed overwhelmingly real. The nurses had called the psychiatrist in to see her, but they also wondered whether the problem might be something neurological—Alzheimer’s, perhaps, or a stroke.
When I arrived and greeted her, I was surprised to realize that Rosalie was completely blind—the nurses had said nothing about this. Though she had not seen anything at all for several years, she was now “seeing” things, right in front of her.
“What sort of things?” I asked.
“People in Eastern dress!” she exclaimed. “In drapes, walking up and down stairs . . . a man who turns towards me and smiles, but he has huge teeth on one side of his mouth. Animals, too. I see this scene with a white building, and it is snowing—a soft snow, it is swirling. I see this horse (not a pretty horse, a drudgery horse) with a harness, dragging snow away . . . but it keeps switching. . . . I see a lot of children; they’re walking up and down stairs. They wear bright colors—rose, blue—like Eastern dress.” She had been seeing such scenes for several days.
I observed with Rosalie (as with many other patients) that while she was hallucinating, her eyes were open, and even though she could see nothing, her eyes moved here and there, as if looking at
an actual scene. It was that which had first caught the nurses’ attention. Such looking or scanning does not occur with imagined scenes; most people, when visualizing or concentrating on
their internal imagery, tend to close their eyes or else to have an abstracted gaze, looking at nothing in particular. As Colin McGinn brings out in his book
Her hallucinations, Rosalie said, were more “like a movie” than a dream; and like a movie, they sometimes fascinated her, sometimes bored her (“all that walking up and down, all that Eastern dress”). They came and went, and seemed to have nothing to do with her. The images were silent, and the people she saw seemed to take no notice of her. Apart from their uncanny silence, these figures seemed quite solid and real, though sometimes two-dimensional. But she had never before experienced anything like this, so she could not help wondering: was she losing her mind?
