1. My colleague Steven Frucht described to me a hallucination experienced by a patient of his, an intellectually intact woman who has been treated with medications for Parkinson’s disease for more than fifteen years. Her hallucinations, however, started only a year ago. She also sees a cat — a grey cat with “beautiful” eyes which wears a serene, “beautiful expression” on its face and seems to be of a most friendly disposition. To her own surprise (for she has never liked cats), she enjoys visits from the grey cat and worries that “something may happen to him.” Though she knows the cat is a hallucination, he seems very real to her: she can hear him coming, feel the warmth of his body, and touch him if she wishes. The first time the cat appeared, wanting to rub against her legs, she said, “Don’t touch me, don’t get too close.” And since then the cat has kept a decorous distance. Occasionally, in the afternoon, the cat is joined by a large black dog. When Dr. Frucht asked her what happens when the cat sees the dog, she replied that the cat “looks away and is peaceful.” She later remarked, “He is fulfilling his purpose in coming to visit me.”
2. Impairment of the sense of smell may appear early in Parkinson’s disease and may perhaps predispose to smell hallucinations as well. But even in the absence of a noticeable impairment of smell, as Landis and Burkhard suggested in a 2008 paper, patients with incipient Parkinson’s disease may have olfactory hallucinations before they develop motor symptoms.
Humans share much with other animals — the basic needs of food and drink or sleep, for example — but there are additional mental and emotional needs and desires which are perhaps unique to us. To live on a day-to-day basis is insufficient for human beings; we need to transcend, transport, escape; we need meaning, understanding, and explanation; we need to see overall patterns in our lives. We need hope, the sense of a future. And we need freedom (or at least the illusion of freedom) to get beyond ourselves, whether with telescopes and microscopes and our ever-burgeoning technology or in states of mind which allow us to travel to other worlds, to transcend our immediate surroundings. We need detachment of this sort as much as we need engagement in our lives.
We may search, too, for a relaxing of inhibitions that makes it easier to bond with one another, or for transports that make our consciousness of time and mortality easier to bear. We seek a holiday from our inner and outer restrictions, a more intense sense of the here and now, the beauty and value of the world we live in.
William James was deeply interested, throughout his life, in the mystagogic powers of alcohol and other intoxicants, and he wrote about this in his 1902 book
Our normal waking consciousness, rational consciousness, as we call it, is but one special type of consciousness, whilst all about it, parted from it by the filmiest of screens, there lie potential forms of consciousness entirely different.… Looking back on my own experiences, they all converge towards a kind of insight to which I cannot help ascribing some mystical significance. The keynote of it is invariably a reconciliation. It is as if the opposites of the world, whose contradictoriness and conflict make all our difficulties and troubles, were melted into unity.… To me [this sense] only comes in the artificial mystic state of mind.
Many of us find the reconciliation that James speaks of and even Wordsworthian “intimations of immortality” in nature, art, creative thinking, or religion; some people can reach transcendent states through meditation or similar trance-inducing techniques or through prayer and spiritual exercises. But drugs offer a shortcut; they promise transcendence on demand. These shortcuts are possible because certain chemicals can directly stimulate many complex brain functions.
Every culture has found chemical means of transcendence, and at some point the use of such intoxicants becomes institutionalized at a magical or sacramental level; the sacramental use of psychoactive plant substances has a long history and continues to the present day in various shamanic and religious rites around the world.
At a humbler level, drugs are used not so much to illuminate or expand or concentrate the mind, to “cleanse the doors of perception,” but for the sense of pleasure and euphoria they can provide.
