Tactile hallucinations. Auditory, tactile, visual and olfactory hallucinations

HALLUCINATIONS The scientific understanding and definition of hallucinations has developed in the process of historical development of the study of this problem in psychiatry. The original, everyday meaning of the word “allucinacio” translated from Latin corresponds to such concepts as “meaningless

Tactile Problems I often misbehaved in church because my petticoat would itch and scratch. Sunday clothes feel different than weekday clothes. Most people get used to the feel of different types of clothing within a few minutes. Even now I avoid wearing new ones

Tactile receptors A burning sensation when touching the refrigerator, causeless hiccups, allergic itching. Source plant material: valerian, nettle, galangal, maclura, maralia, Manchurian aralia, ginseng, Leuzea safflower, lemongrass, strawberry (fruits),

3. A few nanograms of wine: olfactory hallucinations A person very rarely has the ability to imagine smells - in most cases, people cannot do this, even if they can vividly imagine visual or auditory images. Ability to imagine smells

4. Auditory hallucinations In 1973, Science magazine published an article that created a real sensation. The title of the article was: “How does a healthy person feel in a psychiatric hospital.” It described how healthy people in all respects who had no

Delusions and hallucinations The strongest impression on the environment is usually made by the patient's delusions and hallucinations. The fact that the patient “sees” and that he “spells” is most often cited as evidence of mental illness. Delusional-hallucinatory world

July 6 Tactile sensations If we talk about positive and negative tactile sensations, then the difference is clearly expressed. Suppose we imagine toothache as a positive sensation, then negative toothache seems inverted in the form of this

Hallucinations- perception disorders, when a person, due to mental disorders, sees, hears, feels something that does not exist in reality. This is, as they say, perception without an object.

Mirages - phenomena based on the laws of physics - cannot be classified as hallucinations. Like illusions, hallucinations are classified according to the senses. Usually isolated auditory, visual, olfactory, taste, tactile and the so-called hallucinations of the general sense, which most often include visceral and muscular hallucinations. There may also be combined hallucinations (for example, the patient sees a snake, hears its hissing and feels its cold touch).

All hallucinations, regardless of whether they are related to visual, auditory or other deceptions of the senses, are divided into true And pseudohallucinations.

True hallucinations are always projected outward, associated with a real, concretely existing situation (the “voice” sounds from behind a real wall; the “devil”, waving its tail, sits on a real chair, entwining its legs with its tail, etc.), most often do not evoke patients have no doubt about their actual existence, as vivid and natural for the hallucinating as real things. True hallucinations are sometimes perceived by patients even more vividly and clearly than actually existing objects and phenomena.

Pseudohallucinations more often than true, they are characterized by the following distinctive features:

a) most often projected inside the patient’s body, mainly in his head (the “voice” sounds inside the head, inside the patient’s head he sees a business card with obscene words written on it, etc.);

Pseudohallucinations, first described by V. Kandinsky, resemble ideas, but differ from them, as V. Kandinsky himself emphasized, in the following features:

1) independence from human will;
2) obsession, violence;
3) completeness, formality of pseudohallucinatory images.

b) even if pseudohallucinatory disorders are projected outside one’s own body (which happens much less frequently), then they lack the character of objective reality characteristic of true hallucinations and are completely unrelated to the real situation. Moreover, at the moment of hallucination, this environment seems to disappear somewhere, the patient at this time perceives only his hallucinatory image;

c) the appearance of pseudohallucinations, without causing the patient any doubts about their reality, is always accompanied by a feeling of being done, rigged, induced by these voices or visions. Pseudo-hallucinations are, in particular, an integral part of the Kandinsky-Clerambault syndrome, which also includes delusions of influence, which is why patients are convinced that the “vision” was “made to them using special devices,” “voices are directed directly into the head with transistors.”

Auditory hallucinations most often expressed in the patient’s pathological perception of certain words, speeches, conversations (phonemes), as well as individual sounds or noises (acoasms). Verbal hallucinations can be very diverse in content: from so-called calls (the patient “hears” a voice calling his name or surname) to entire phrases or even long speeches pronounced by one or more voices.

Most dangerous for the condition of patients imperative hallucinations, the content of which is imperative, for example, the patient hears an order to remain silent, to hit or kill someone, to injure himself. Due to the fact that such “orders” are a consequence of the pathology of the mental activity of a hallucinating person, patients with this kind of painful experience can be very dangerous both for themselves and for others, and therefore require special supervision and care.

Hallucinations are threatening are also very unpleasant for the patient, since he hears threats addressed to himself, less often - to people close to him: they “want to stab him to death,” “hang him,” “throw him from the balcony,” etc.

TO auditory hallucinations also include commentators when the patient “hears speeches” about everything he thinks or does.

A 46-year-old patient, a furrier by profession, who had been abusing alcohol for many years, began to complain about “voices” that “wouldn’t let him pass”: “now he’s sewing skins, but it’s bad, his hands are shaking,” “I decided to rest,” “I went for vodka.” ", "what a good skin he stole", etc.

Antagonistic (contrasting) hallucinations are expressed in the fact that the patient hears two groups of “voices” or two “voices” (sometimes one on the right and the other on the left) with contradictory meaning (“Let’s deal with them now.” - “No, let’s wait, he’s not that bad.” ; “There’s no need to wait, give me the ax.” - “Don’t touch it, it belongs on the board”).

Visual hallucinations can be either elementary (in the form of zigzags, sparks, smoke, flames - so-called photopsia), or objective, when the patient very often sees animals or people (including those he knows or knew) that do not exist in reality , insects, birds (zoopsia), objects or sometimes parts of the human body, etc. Sometimes these can be entire scenes, panoramas, for example a battlefield, hell with many running, grimacing, fighting devils (panoramic, movie-like). “Visions” can be of normal size, in the form of very small people, animals, objects, etc. (Lilliputian hallucinations) or in the form of very large, even gigantic ones (macroscopic, Gulliverian hallucinations). In some cases, the patient can see himself, his own image (double hallucinations, or autoscopic).

Sometimes the patient “sees” something behind him, out of sight (extracampal hallucinations).

Olfactory hallucinations most often represent an imaginary perception of unpleasant odors (the patient smells rotting meat, burning, decay, poison, food), less often - a completely unfamiliar smell, and even less often - the smell of something pleasant. Often, patients with olfactory hallucinations refuse to eat, because they are sure that “they are being spiked with poisonous substances” or “being fed rotten human meat.”

Tactile hallucinations are expressed in a sensation of touching the body, burning or cold (thermal hallucinations), a feeling of grasping (haptic hallucinations), the appearance of some liquid on the body (hygric hallucinations), and insects crawling over the body. The patient may feel as if he is being bitten, tickled, or scratched.

Visceral hallucinations- a feeling of the presence of some objects, animals, worms in one’s own body (“a frog is sitting in the stomach,” “tadpoles have multiplied in the bladder,” “a wedge has been driven into the heart”).

Hypnagogic hallucinations- visual illusions of perception, usually appearing in the evening before falling asleep, with the eyes closed (their name comes from the Greek hypnos - sleep), which makes them more related to pseudohallucinations than to true hallucinations (there is no connection with the real situation). These hallucinations can be single, multiple, scene-like, sometimes kaleidoscopic (“I have some kind of kaleidoscope in my eyes,” “I now have my own TV”). The patient sees some faces, grimacing, sticking out their tongues, winking, monsters, bizarre plants. Much less often, such hallucinations can occur during another transitional state - upon awakening. Such hallucinations, also occurring when the eyes are closed, are called hypnopompic.

Both of these types of hallucinations are often one of the first harbingers of delirium tremens or some other intoxicating psychosis.

Functional hallucinations- those that arise against the background of a real stimulus acting on the sense organs, and only during its action. A classic example described by V. A. Gilyarovsky: the patient, as soon as water began to flow from the tap, heard the words: “Go home, Nadenka.” When the tap was turned on, the auditory hallucinations also disappeared. Visual, tactile and other hallucinations may also occur. Functional hallucinations differ from true hallucinations by the presence of a real stimulus, although they have a completely different content, and from illusions by the fact that they are perceived in parallel with the real stimulus (it is not transformed into some kind of “voices,” “visions,” etc.).

Suggested and induced hallucinations. Hallucinatory deceptions of the senses can be instilled during a hypnosis session, when a person will smell, for example, the smell of a rose, and throw off the rope that is “twisting” around him. With a certain readiness to hallucinate, hallucinations may appear even when these deceptions of the senses no longer appear spontaneously (for example, if a person has just suffered from delirium, especially alcoholic delirium). Lipman's symptom is the induction of visual hallucinations by lightly pressing on the patient's eyeballs, sometimes an appropriate suggestion should be added to the pressure. The blank sheet symptom (Reichardt's symptom) is that the patient is asked to very carefully look at a blank sheet of white paper and tell what he sees there. With Aschaffenburg's symptom, the patient is asked to talk on a switched off phone; In this way, readiness for the occurrence of auditory hallucinations is checked. When checking the last two symptoms, you can also resort to suggestion, saying, for example: “Look, what do you think about this drawing?”, “How do you like this dog?”, “What is this female voice telling you on the phone?”

Occasionally, suggested hallucinations (usually visual) can also have an induced character: a healthy but suggestible person with hysterical character traits can, following the patient, “see” the devil, angels, some flying objects, etc. Even more rarely, induced hallucinations may occur in several people, but usually for a very short time and without the clarity, imagery, and brightness that occurs in patients.

Hallucinations - a symptom of a painful disorder(albeit sometimes short-term, for example, under the influence of psychotomimetic drugs). But sometimes, as already noted, quite rarely, they can occur in healthy people (suggested in hypnosis, induced) or with pathologies of the organs of vision (cataracts, retinal detachment, etc.) and hearing.

Hallucinations are often elementary (flashes of light, zigzags, multi-colored spots, noise of leaves, falling water, etc.), but can also be in the form of bright, figurative auditory or visual illusions of perception.

A 72-year-old patient with loss of vision down to the level of light perception (bilateral cataracts), who had no mental disorders identified except for a slight decrease in memory, after an unsuccessful operation began to say that she saw some people, mostly women, on the wall. Then these people “came off the wall and became like real people. Then a small dog appeared in the arms of one of the girls. There was no one for a while, then a white goat appeared.” Later, the patient sometimes “saw” this goat and asked those around her why there was suddenly a goat in the house. The patient did not have any other mental pathology. A month later, after a successful operation on the other eye, the hallucinations completely disappeared and during the follow-up (5 years), no mental pathology, except for memory loss, was detected in the patient.

These are the so-called hallucinations of the type of Charles Bonnet, a 17th-century naturalist who observed hallucinations in the form of animals and birds in his 89-year-old grandfather, who suffered from cataracts.

Patient M., 35 years old, who had been abusing alcohol for a long time, after suffering from pneumonia, began to experience fears, sleep poorly and restlessly. In the evening, he anxiously called his wife and asked, pointing to the shadow of the floor lamp, “to remove this ugly face from the wall.” Later I saw a rat with a thick, very long tail, which suddenly stopped and asked in a “disgusting, squeaky voice”: “Have you finished drinking?” Closer to night, I saw the rats again, suddenly jumped up on the table, and tried to throw the telephone set onto the floor, “to scare these creatures.” When I was admitted to the emergency room, feeling my face and hands, I said irritably: “This is a clinic, but the spiders were bred, cobwebs stuck all over my face.”

Hallucinatory syndrome(hallucinosis) - an influx of abundant hallucinations (verbal, visual, tactile) against the background of clear consciousness, lasting from 1-2 weeks (acute hallucinosis) to several years (chronic hallucinosis). Hallucinosis may be accompanied by affective disorders (anxiety, fear), as well as delusional ideas. Hallucinosis is observed in alcoholism, schizophrenia, epilepsy, organic brain lesions, including syphilitic etiology.

Hallucinatory syndromes are symptom complexes of mental disorders, in the clinical picture of which the leading place is occupied by hallucinations - perceptions that arise without the presence of a real object (sounds, voices, smells, etc.). Hallucinations are distinguished: visual, auditory, olfactory, gustatory, and general senses (tactile, visceral).

With visual hallucinations, the patient can see flames, smoke, light, various objects, people, animals, insects, fantastic creatures (devils, monsters, etc.), entire scenes (wedding, funeral, battle, natural disasters, etc.). Visions can be stationary and moving, monotonous, and changeable in content. Visual hallucinations are more often observed in the evening and at night with altered consciousness (delirious state).

A patient with auditory hallucinations hears various sounds or words, conversations (verbal hallucinations); they can be quiet or loud. The content of the “votes” may vary. Often the patient hears threats. “Voices” can address the patient himself or talk to each other about his actions, actions in the present and past (commenting on auditory hallucinations). Sometimes “voices” order the patient to perform one or another action (imperative hallucinations). The danger of these conditions is that patients are often unable to resist the “order” and can commit actions dangerous to themselves or others (jump out of a window, kill someone, etc.). Auditory hallucinations occur with unchanged consciousness, often in silence; when the patient is alone. Olfactory hallucinations are expressed by various imaginary odors, most often unpleasant. Taste hallucinations are sensations of an unusual taste that is not characteristic of a given food or the appearance of unpleasant taste sensations in the mouth without eating. With tactile hallucinations, the patient experiences unpleasant sensations of crawling on the body, insect bites, and worms. Sometimes these sensations are localized in the skin or under the skin. With visceral hallucinations, patients feel the presence in the body of living beings, similar to real or fantastic.

Often various hallucinations are combined - visual and auditory; olfactory and tactile; auditory, visceral and visual, etc. Very often, hallucinations are accompanied by delusions, the content of which depends on “voices” or visions (hallucinatory delusions). When hallucinations appear, the behavior of patients changes - they listen to something, respond to “voices” or try to cover their ears, peer intently, their facial expression quickly changes, etc. In contrast to the described true hallucinations, in which the patient does not distinguish them from real stimuli, there may be pseudohallucinations that patients consider special, unnatural, “made.” Thus, patients say that they are specially shown pictures, evoke images (visual pseudohallucinations), their thoughts are heard, they are given “made” thoughts (auditory pseudohallucinations), etc. Pseudohallucinations, as a rule, are combined with delusions of influence. Close to pseudohallucinations are the feeling of being uncontrollable by one’s own thinking - influxes, acceleration of thoughts (mentism), as well as visual hallucinations that occur when falling asleep (hypnagogic hallucinations).

Just like delusional disorders, hallucinations can be not only fragmentary and isolated, but also pronounced, persistent, combined with other disorders of mental activity. In accordance with this, the following hallucinatory syndromes are distinguished.

The syndrome of acute hallucinosis (visual, auditory, tactile) occurs acutely, is characterized by an influx of visual or auditory, often scene-like hallucinations or multiple unpleasant painful sensations, often accompanied by delusions (hallucinatory): fear, confusion. Acute hallucinosis usually occurs due to infectious or (!). Chronic hallucinosis syndrome develops more often after acute hallucinosis. As a rule, auditory and less often tactile hallucinations predominate. With it, the behavior of patients is more correct, perhaps even a critical attitude towards these symptoms. Chronic hallucinosis develops against the background of chronic (alcoholism!), organic, vascular diseases of the brain.

Kandinsky-Clerambault syndrome is characterized by a predominance of pseudohallucinations, accompanied by delusions of physical influence and persecution. Occurs most often in chronic, less often in acute.

Hallucinations

Hallucinations (Latin hallucinatio delusions, visions; synonyms: deceptions of the senses, imaginary perceptions) are one of the types of disturbances of sensory cognition, characterized by the fact that ideas, images arise without a real stimulus, a real object in the perceived space and, acquiring unusual intensity, sensuality [corporality, according to Jaspers (K. Jaspers), they become for the patient’s self-awareness indistinguishable from real objects, from images of objects of reality. With Hallucination, as with any symptom of mental illness, the entire activity of the brain changes: not only perception or ideation changes, but also the patient’s attitude towards the environment, his affects and his thinking.

The first definition of Hallucinations as imaginary perceptions and distinguishing them from illusions (see) - erroneous perceptions - was given in 1817 by J. Esquirol in his report “On hallucinations in the mentally ill” presented to the Paris Academy of Sciences.

The term “hallucinations” denotes not one specific phenomenon, but a group of deceptions of the senses, similar in basic structure, but different in content, imagery, brightness, physicality, acuity of experiences, features of the projection and localization of images in time, and the conditions of their occurrence.

Sometimes the term “hallucinations” refers to phenomena that have nothing to do with them. So, for example, they talk about Memory Hallucination, although in this case we are usually talking about an erroneous memory, and not about an imaginary perception. The classification of so-called phantasms as hallucinations is controversial. With this term, Ziehen (Th. Ziehen, 1906) designated daydreams, in which fantastic images reach varying brightness and clarity. Hallucinations cannot be attributed to eidetism (Greek eidos image) - the ability of some individuals to mentally imagine an image of an object (mainly visual or tactile) with such sensory brightness and clarity that they really seem to see, touch what they had been persistently looking at or touched. This ability was first described by Urbantschitsch (V. Urbantschitsch, 1888). Although eidetism is “perception without an object,” an eidetic image, unlike a Hallucination, is usually the result of the action of a previous external stimulus and differs from an ordinary image by a high degree of sensory sensitivity. Eidetism is normally more common in children and adolescents. It usually disappears with age. In this regard, some authors consider eidetism as a stage of age-related development, others as a more or less permanent constitutional feature. It has been shown (E. A. Popov) that manifestations of eidetism can also be a temporary painful feature of persons suffering from true Hallucinations (see below).

Variants of hallucinations and their systematization

The systematization of Hallucinations is based on various features: the occurrence of Hallucinations in the area of ​​one of the analyzers, the nature of the projection of the hallucination image, the conditions under which Hallucinations develop, the degree of similarity of Hallucinations to real images of perception, the structure of Hallucinations, and others.

Hallucinations, as a rule, are not an isolated disorder, but a hallucinatory state: for example, visual Hallucinations occur against the background of states of confusion, auditory Hallucinations develop more often in the structure of delusional syndrome. These conditions, based on their structure, severity, multiplicity, persistence, combination with other mental disorders, as well as the degree of identification of hallucinatory images with real impressions in the clinic, are usually divided into true Hallucinations, pseudohallucinations, hallucinoids, functional and reflex Hallucinations, hallucinosis and hallucinatory syndromes.

Based on the area of ​​occurrence in one or more analyzers, the following Hallucinations are distinguished: 1) visual, or optical; 2) auditory, or acoustic; 3) olfactory; 4) taste; 5) tactile (tactile); 6) Hallucinations of the general sense - enteroceptive, vestibular, motor.

Hallucinations are often combined: visual and auditory, visual and tactile, auditory and olfactory, visceral and visual, and so on. One of the variants of this combination is synesthetic hallucinations of Mayer-Gross (W. Mayer-Gross, 1928) - patients see moving figures of people and at the same time hear their speech; see flowers and smell them.

Visual hallucinations are quite diverse in their characteristics. They can be formless, elementary - so-called photopsies (light flashes, spots, stripes, sparks, flames, smoke) and complex. In the latter case, the patient can see various objects, people, animals, insects, fantastic creatures (devils, monsters and others), entire scenes (wedding, funeral, ball, battle, natural disasters, and so on), the fruits of human creativity. Visions can be stationary and moving, monotonous and changeable in content. Hallucinatory images can be colorless, like black and white photographs, colored, or monochromatic (for example, in epilepsy, everything can be colored red or blue). The patient can see several or one figure in its entirety (for example, a human figure) or only part of it (face, one ear, nose, one eye); in the latter case, the patient perceives these fragments as a part belonging to a really existing object.

Depending on the patient’s subjective assessment of the size of objects, visual hallucinatory images are distinguished as normopsic hallucinations - images of objects correspond to established general ideas about their sizes; micropsitic (“Liliputian”) and macropsimic (giant).

Visual hallucinations identified with specific objects, faces, animals are called relief hallucinations. Hallucinations, the images of which unfold in moving, sequentially changing pictures, experienced scenes of developing events with the nature of an attack, violence, and so on, are designated by the term “scene-like hallucinations” (“cinematic” Hallucinations). If the hallucinated images are dominated by detailed landscapes, visions of the landscape, often motionless, then such Hallucinations are called panoramic.

The projection of hallucinatory images into the habitually perceived external space is not preserved in all cases. There are visual hallucinations: extracampal (E. Bleuler) - images appear outside the field of vision, often “behind oneself”; autoscopic (contemplative) - Hallucinations accompanied by a vision of one’s own image (in particular, a vision of a double); hemianoptic - images Hallucinations occur in hemianoptic visual fields; visual verbal hallucinations [Segla (J. Seglas), 1914] - vision of words “written” on a wall, in space, on clouds, which the patient can read, while experiencing a feeling of the exclusive purpose of these “words”.

Visual hallucinations more often occur in the evening, at night, often in a state of darkened consciousness (delirious state), while changes in self-awareness and the relationship of the subject to the object take place.

Visual hallucinations in old and senile age are known - the so-called Bonnet hallucinations (Gh. Bonnet), which the author associates with damage to the eyeball (for example, cataracts, retinal detachment and other cases of vision loss). With Bonnet hallucinations, either single or multiple scene-like, in some cases brightly colored (this is especially typical for cases when patients “see” some kind of landscape) hallucinatory images may appear. They can be motionless, moving in space, crowding the patient. If the patient sees people or animals, then these Hallucinations are not accompanied by auditory deceptions. With low intensity of such Hallucinations, criticism remains towards them, but they, as a rule, cause surprise; with intense hallucinatory images, anxiety and fear may appear and at the same time the patient’s behavior may change.

Auditory hallucinations are also varied. There are acoasms, phonemes and verbal hallucinations. Acoasmas - elementary, non-speech hallucinations - the patient hears individual sounds, noises, crackling, roaring, hissing. With phonemes and complex verbal hallucinations, the patient hears individual parts of words, words, speech, conversation that can be addressed to him. The patient often refers to speech and fragments of conversational situations and scenes as “voices.” These “voices” can have different intensities: whispering, loud or deafening conversation. Verbal Hallucinations can be assessed by the patient as belonging to familiar or unfamiliar persons, adults or children, men or women.

The content of auditory hallucinations can be different, and the nature is often associated with the characteristics of the patient’s affective state or with the content of delusions. “Voices” can be threatening, scolding, condemning, mocking and teasing, including in the form of questions; imperative (imperative) - when “voices” order, “force” the patient to commit this or that act, sometimes reprehensible; commenting - voices discuss his actions, actions, experiences in the present or past; soothing, protecting; narrative - outlining events. Threatening, accusing auditory hallucinations occur more often during states of depression and anxiety, and benevolent ones - when the patient is in an elevated mood.

Mandatory auditory hallucinations are especially dangerous, since patients may not be able to resist the “threat”, “order”, “command” and commit actions dangerous to themselves or others, including suicide, attempted deliberate murder.

With true auditory verbal hallucinations, the images are clear, vivid, and accompanied by a sense of objective reality; they are perceived by both ears, the source of the voice is localized outside (outside the window, behind the wall, above the ceiling, etc.); less often, voices are heard in one ear - the so-called unilateral hallucinations. Auditory Hallucinations usually occur with unchanged consciousness, often in silence, at night, when the patient is alone.

Olfactory hallucinations are expressed by various, not always clearly demarcated, imaginary odors, often unpleasant, causing a feeling of disgust (rotten, burnt, smelling of smoke).

Taste hallucinations are characterized by the appearance of unpleasant taste sensations in the mouth without eating food, liquid, or the sensation of an unusual taste that is unusual for a given food (bitter, salty, burning, etc.); More often than not, such hallucinations are accompanied by a feeling of disgust.

It is not always possible to distinguish olfactory and gustatory hallucinations from illusions and pseudohallucinations (see below). Sometimes it is difficult to exclude the presence of a faint odor that is detected by the patient and not detected by the doctor. It is not always possible to reject the influence of food residues, substances released in saliva, and the like on taste endings.

Tactile (tactile) hallucinations

The patient usually experiences unpleasant sensations of crawling across the body, tickling, pressure in the skin and muscles; Sometimes these sensations are localized in the skin or under the skin.

Tactile hallucinations must be distinguished from senestopathies (see). Senestopathies are understood as painful, unbearable, painful sensations in various parts of the body, often so unusual that patients are forced to call them with their own definitions. Patients feel excruciating pain in the stomach, intestines, spinning, turning over, burning, a special piercing current, and so on; similar sensations may occur in the heart and other organs. Patients feel gurgling in the head, “turning over” of the brain, and so on. However, unlike tactile hallucinations, with senestopathies there is no objectivity - a clear description of the physical. signs of what is causing the sensation.

The so-called haptic hallucinations should be distinguished from tactile hallucinations and senestopathies - a feeling of a sharp touch, grasping, biting (some evaluate the terms “tactile” and “haptic” as synonyms). They can appear in isolation, but more often as part of complex scene-like hallucinations.

Hallucinations of general feeling

These include enteroceptive, motor and vestibular hallucinations.

With enteroceptive (visceral) hallucinations, the patient feels the presence of foreign objects, living beings and even “little men” that move inside the blood vessels, heart, and gastrointestinal tract, causing certain changes in the internal organs.

The sensation of a living being inside the body (worms, snakes, etc.) is usually combined with delusions of possession. Many cases of the type described do not relate to Hallucination, but to a delusional interpretation of pathological sensations. The term “endoscopic hallucinations” refers to the vision of the internal organs of one’s own body, the term “transformation hallucinations” refers to a feeling of specific changeability of internal organs, body, personality in the absence of corresponding objective signs. Two terms have strengthened and become widespread: senesthetic hallucinations [Sivadon] - unusual sensations in the body or internal organs, which the patient assesses as a consequence of external influences (burns, tingling, etc.), and genital hallucinations (V. Magnan, 1895, 1896) - the patient experiences a feeling of obscene, shameless, cynical actions performed on his genitals.

Among motor hallucinations there are: kinesthetic - sensations of muscle contraction with their objective immobility; kinesthetic verbal (full verbal motor) - the sensation of the movement of the tongue and kinesthetic graphic (full graphic motor) - the feeling of the movement of writing, and both of these sensations in some cases have the nature of violence (the patient is “forced” to move the tongue, write).

Vestibular hallucinations (Hallucinations of the sense of balance) are a fictitious perception of imbalance, arising primarily in the visual and kinesthetic spheres. At the same time, patients feel a feeling of being suspended, losing balance, falling, and flying. In other cases, they experience a feeling of loss of stability of the environment, see an increasing tilt, the walls of the room moving closer together, and the ceiling falling. The mechanism of such hallucinations is complexly represented in the so-called Pick illusion (A. Pick, 1909) - the patient sees people around him passing through the wall, moving behind it; this results from a mismatch between visual and vestibular stimuli. Diplopia and nystagmus are associated.

Variants of hallucinations depending on the conditions in which they develop

Depending on the period and degree of wakefulness, Hallucinations are distinguished: hypnagogic - occurring in half-sleep, during the period of falling asleep or with eyes closed; hypnopompic - predominantly visual, less often auditory and other hallucinations that occur upon awakening; bordering - imaginary space is replaced by perceived space. The patient's perceptions are localized in imaginary space, as in dreams.

Pantophobic Hallucinations [Lewi-Valensi] are described in oneiroid (see Oneiroid syndrome) - frightening scenes of events move before the patient’s eyes, as well as visual hallucinations of J. Jackson (1876) - an aura, or epileptic equivalent, in the form of a twilight state with an abundance of visual true hallucinations.

Psychogenic Hallucinations reflect the content of emotionally charged experiences. Most often visual or auditory. Typical: temporary connection with mental shock, psychological clarity of the content, proximity to the individual’s current experiences, emotional richness of images, their projection outward. Auditory psychogenic hallucinations in the form of “knocking” and “ringing” were described by Ahlenstiel (N. Ahlenstiel, 1960), who considers them as a form of a kind of “acoustic memory” in mentally healthy individuals. They usually occur in situations of intense anticipation and anxiety.

Hallucinations of the imagination of Dupre (E. Dupre) - Hallucinations, the plot of which directly follows from the closest ideas that have been nurtured for a long time in the imagination. They appear especially easily in people with a painfully heightened imagination or in children. The so-called collective induced Hallucinations (usually visual), developing under the influence of suggestion and massive emotional involvement (mainly in a crowd) in subjects who are easily suggestible and even more prone to hysterical reactions, can reach great severity.

Negative Hallucinations: 1) the result of hypnotic suggestion, suppressing the vision of persons or objects [Dessuet]; 2) a feeling of absence of internal organs (see Cotard syndrome).

Associated (associated) Hallucinations [Segla (J. Seglas)] - images appear in a logical sequence: a “voice” announces a fact that is immediately seen and felt. They develop into a wedge, a picture of reactive psychoses and conditions resulting from massive mental shock. Such Hallucinations are united by the unity of the plot of hallucinatory experiences with the content of the traumatic circumstance.

Functional and reflex Hallucinations are phenomena of disturbance of sensory cognition, similar in manifestations to Hallucinations, however, in terms of the mechanism of occurrence and the state of self-awareness of patients, they occupy an intermediate place between Hallucinations proper and illusions. They are often the initial symptom of mental illness and in some cases precede, accompany or replace hallucinatory states (see below).

Various forms of hallucinatory states and their clinical course

Hallucinations are an important symptom of many mental illnesses, having clinical and, in some cases, prognostic significance. Isolated, episodic (single) hallucinations can develop in practically healthy individuals one or several times throughout life; they usually arise in a state of emotional stress and, thus, can be classified as psychogenic. Hallucinations (in the broad sense) are regarded as a temporary, episodic disturbance of sensory cognition without mental illness.

True hallucinations (complete, detailed, genuine, perceptual) are characterized by clarity, volume, physicality, sensual liveliness, clear exteroprojection of the image, the patient’s complete conviction of his objective reality, and lack of criticism.

True Hallucinations can be single or multiple, relate to the sphere of one of the senses (visual, auditory, tactile, olfactory, gustatory imaginary perceptions) or several. They are characterized by: a subjective assessment of the scale of hallucinatory images, cinematic or panoramic nature, dependence on the period and degree of wakefulness. True Hallucinations differ from ideas not only by greater brightness and clarity (greater sensory liveliness), but also by other characteristics. Among them, the most typical are the localization of the hallucinatory image to the outside (exteroprojection) and the feeling of the objectivity of this image.

Pseudo-hallucinations differ from true hallucinations in the absence of a sense of the objective reality of images, sensory liveliness, an indefinite projection or, more often, internal projection of images - they are localized by the patient not in “objective”, but in “subjective” space - they are seen with “spiritual eyes”, “mentally, with the mind, with the inner eye” , with the eye of your mind"; heard by the “inner ear” and the like; the images are characterized by unexpressed sensory, small delineation and contouring.

The lack of objective reality in pseudohallucinations is their main difference from true hallucinations. With pseudohallucinations, patients talk about special visions, about special “voices,” that is, they do not identify them with real phenomena, as happens with true hallucinations, but distinguish them from reality. In addition, pseudohallucinations, in contrast to true hallucinations, as a rule, arise with the nature of the impact: the patient does not hear “voices”, but “voices are conveyed to him”, “voices are made”, “cause” the sound of thoughts, “cause” visions in sleep, inside the head; patients are “stuffed” with microbes, insects, and so on.

Pseudohallucinations, just like true hallucinations, can be visual, olfactory, gustatory, visceral and (most often) auditory with all their inherent features. For example, pseudohallucinatory visual images can be colorless, monochromatic, natural colors, total and partial; with auditory pseudohallucinations, “voices” can be silent, loud, spoken by familiar and unfamiliar persons in the form of a monologue, story, with reproachful, scolding, even imperative content character. In most cases, kinesthetic hallucinations are also considered pseudohallucinations rather than true hallucinations.

Among the pseudohallucinations there are: catathymic auditory [Weitbrecht (N. Weitbrecht), 1967] - voices of a threatening or anticipatory nature, occurring more often in anxious and excited elderly people; verbal-motor (hyperendophasia, or autoendophasia, according to Segla) - enhanced production of inner speech; pseudohallucinatory pseudomemories (V.Kh. Kandinsky) - ideas of the past that arise in the patient’s mind instantly become a pseudohallucination and are mistakenly assessed by him as a memory of an actual fact (one of the mechanisms of “insight”, “insight” in illness).

Similar in structure to pseudo-memories are the so-called Memory Hallucinations and Memory Hallucinations. Hallucinations of memory are the patient’s hallucinatory attribution of a fact to the past, whereas at the moment it dates there were no hallucinations (they also arise in the field of vision). Hallucinations of memory (mnestic ecmnesia, according to Dessuet) - ekforation, restoration in consciousness of visual images in a “perverted, inappropriate form” (S. Freud).

As a mental illness develops, especially with its progressive course, it is possible to trace how the patient gradually develops true

Hallucinations are replaced by pseudohallucinations with the nature of being made. Very often, for example, this transition can be observed with the development of chronic alcoholic hallucinosis, chronic delusional schizophrenia, and the transition is usually accompanied by the simultaneous development of delusions of physical effects (see Delirium) and indicates a worsening prognosis of the disease.

Hallucinoids are the initial rudimentary manifestations of visual hallucinations, which are characterized by fragmentation, sensory, and a tendency to exteroprojection of an image with a neutral, contemplative attitude towards it (G.K. Ushakov, 1969). This is a series of intermediate phenomena between a simple idea or image of a memory and a true Hallucination.

According to E. A. Popov, hallucinoids are an intermediate stage in the development or disappearance of true hallucinations. In cases where true Hallucinations appear or disappear relatively quickly, hallucinoids are difficult to detect. But if this process proceeds gradually, then it is possible to trace how hallucinoids first appear, then they turn into true Hallucinations, which, upon recovery, in turn give way to hallucinoids, and, finally, the deceptions of the senses disappear altogether. Hallucinoids may persist throughout the illness.

Functional and reflex hallucinations in some manifestations resemble true hallucinations, but in the mechanism of occurrence they differ from both them and illusions. These Hallucinations sometimes precede or replace true Hallucinations or coexist with true ones. Functional (K. Kahlbaum), or differentiated, Hallucinations include auditory, less often visual, Hallucinations that occur in the presence of a real sound stimulus (whistles, traffic noise, ticking clocks, the rhythmic sound of a pendulum swinging, the sound of pouring water, the creaking of a writing pen, etc.) and exist as long as this real stimulus persists. Unlike illusions, in which the real object itself is falsely, erroneously perceived and interpreted, with functional hallucinations a dual perception occurs - the real and the imaginary coexist. For example, water flows from a tap, and the patient simultaneously and separately hears the noise of flowing water and hallucinatory “voices” (for example, swearing, threats towards oneself). In these cases, the stimulus acts on the same analyzer in the area of ​​which hallucinations arise, and with the disappearance, for example, of objective noise, the hallucinatory “voice” also disappears.

A variety are the so-called reflex hallucinations, which occur in the sphere of one analyzer (visual, auditory, tactile) when a real stimulus acts on another analyzer: auditory hallucinations when the eyes are irritated; visual hallucinations arising from the sound of a tuning fork; Hallucinations when meeting a specific person or performing a certain action. For example, when a patient turns a key in a keyhole, he feels within himself the same movement of the key, “turning in his heart.”

Reflex pseudohallucinations have also been described (V.I. Rudnev, 1911) - the patient, having heard a word, simultaneously pseudohallucinarily hears another word or even a phrase.

Hallucinatory disorders are not pathognomonic for any one mental illness. We can only talk about the types of these disorders that are characteristic or typical for one or another nosological form. In borderline neuropsychiatric disorders and reactive psychoses, only variants of psychogenic, paranoid hallucinations are observed (G.K. Ushakov, 1971) as hallucinations of the imagination. In psychosis, complex hallucinations are most typical. With exogenous psychoses, true visual, less often auditory (verbal) or tactile hallucinations occur more often. For endogenous psychoses (schizophrenia), auditory and other hallucinations included in the Kandinsky-Clerambault syndrome (see Kandinsky-Clerambault syndrome) are more typical.

True hallucinations and pseudohallucinations are often combined with delusional ideas and, along with them, belong to disorders that are especially often observed in a number of mental illnesses.

Functional Hallucinations are one of the initial symptoms of acute mental disorder both in intoxication psychoses and (often) in acute onset schizophrenia. In schizophrenia, this disorder is often visible.

Hallucinosis and hallucinatory syndromes

Depending on the severity of hallucinatory disorders, their persistence, multiplicity, and combination with other mental symptoms, two groups of hallucinatory syndromes are distinguished - hallucinosis and the so-called hallucinatory syndromes (symptom complexes). Hallucinosis may become more complicated and give way to hallucinatory syndromes; the latter, in turn, can become simplified and give way to hallucinosis, that is, there is no clear boundary between these two groups of syndromes.

Hallucinosis (K. Wernicke), or a state of continuous hallucination (V. X. Kandinsky), is a psychopathological condition with a predominance of some abundant hallucinations (much less often their combination), while other psychopathological disorders recede into the background and are not dominate the clinical picture.

The term "hallucinosis" is used in different senses. French psychiatrists [Hey (N. Eu) and others] use this term primarily to designate acute conditions with an influx of multiple persistent hallucinations, to which the patient maintains a critical attitude. German researchers also call hallucinosis a hallucinatory-delusional state with the obligatory presence of clear consciousness and apply this concept primarily to verbal hallucinosis. V. X. Kandinsky described hallucinosis as “continuous hallucination.”

Most hallucinoses (with the exception of visual ones) occur with clear consciousness, are not accompanied by disturbances in auto- and allopsychic orientation, and are often accompanied by the patient’s awareness of the painful nature of the experiences.

The affective reactions of patients with hallucinosis are, as a rule, negative, only sometimes deceptions of feelings can cause positive emotions in them; in the chronic course of hallucinosis, an indifferent, neutral attitude towards them can be developed.

Mentally ill people most often develop auditory (verbal) hallucinosis, less often visual, tactile and olfactory. Acute hallucinosis syndrome (auditory, tactile) occurs acutely, is characterized by an influx of auditory, often scene-like, hallucinations or multiple unpleasant painful sensations, often accompanied by delirium, fear, and confusion. It usually occurs during infectious or intoxication psychoses.

Chronic hallucinosis syndrome develops more often after acute hallucinosis. As a rule, auditory hallucinations predominate, less often tactile hallucinations. With it, the behavior of patients is more correct; perhaps even a critical attitude towards the condition. This syndrome develops with chronic intoxication (alcoholism!) and various organic diseases of the brain.

Visual hallucinosis. The following hallucinoses are distinguished: visual hallucinosis of Van Bogart, peduncular hallucinosis of Lhermitte and visual hallucinosis in intoxication with lysergic acid diethylamide (LLA), hallucinosis of the Bonnet type.

Van Bogaert visual hallucinosis has been described in encephalitis. After a 1-2 week period of increased sleepiness, narcoleptic attacks appear (see Narcolepsy), in the interval between which there are continuous visual hallucinations in the form of many butterflies, fish, and animals painted in different colors; Over time, anxiety increases, the affective coloring of images becomes more vivid, delirium develops, followed by amnesia and complex acoustic disorders.

Lhermitte's visual hallucinosis is an acute psychopathological condition with incomplete clarity of consciousness associated with damage to the cerebral peduncles. It usually develops in the evening hours, before bedtime. Hallucinations are always visual, affectively neutral or surprising; their images (birds, animals) are mobile, but silent, painted in natural colors, and the patient understands the painful origin of the images. As the hallucinosis deepens, fear joins in and criticism is disrupted.

Visual hallucinosis due to DLK intoxication [Rosenthal (S. N. Rosenthal), 1964] occurs with frequent use of DLK. Typical for him are multiple brightly colored visual hallucinations, which are often accompanied by anxiety and panic. Hallucinosis easily becomes protracted.

Verbal (auditory) hallucinoses, unlike visual ones, develop, as a rule, with clear consciousness. They can be either an acute short episode or last for many years (chronic auditory hallucinosis).

Clinically, the picture is limited to verbal true hallucinations. In some cases, they can proceed in the form of a monologue addressed directly to the patient. In other cases, verbal hallucinosis is of a scene-like nature: the patient hears a dialogue, a conversation between two or more people, not addressed to him; in such cases, the patient takes the position of an eavesdropper, the position of a witness to the ongoing conversation. The imaginary dialogue that the patient hears is very often contrasting in content: one of the speakers scolds the patient, the other defends him. With the development of psychosis, verbal hallucinosis sometimes occurs in the form of a dialogue, then it increasingly becomes a monologue addressed directly to the patient.

With verbal hallucinosis, affective disorders (especially at the beginning) - fear, anxiety, and so on - are unusually intense. Over time, the nature of Hallucinations changes: in some cases, true Hallucinations are replaced by pseudohallucinations, that is, a progression of hallucinosis is noted; in other cases, true hallucinations are replaced by verbal illusions or functional hallucinations, that is, hallucinosis is regredient.

The acute development of verbal hallucinosis is accompanied by anxiety, fear, and confusion. A violent influx of abundant hallucinations can lead to the so-called hallucinatory confusion. With further intensification of Hallucination, a state of immobility may develop - hallucinatory stupor.

Verbal hallucinosis, similar to the described wedge picture, occurs in the most common acute alcoholic psychosis (Kraepelin's alcoholic delirium), after drug intoxication, traumatic brain injury, infectious diseases of the brain, endogenous intoxication (diabetic, uremic hallucinosis and others).

Illusory and fantastic hallucinosis, periodic hallucinosis [Schroder (P. Schroder), 1926, 1933] occur with endogenous and exogenous psychoses. Illusory hallucinosis develops against the background of severe anxious depression, accompanied by ideas of relation. The content - primarily accusations and threats - always corresponds to the affect and plot of delusional ideas. Unlike true verbal hallucinations, what is heard is conveyed to patients only in general terms; there are no characteristics characteristic of “voices” - volume, tone, specific affiliation. With fantastic hallucinosis, the content of pathological sensations from the body is in the nature of implausible sensations.

Tactile hallucinosis is a condition in which the picture is dominated by tactile hallucinations, which acquire a particularly persistent course.

Algohallucinosis (algohallucinosis van Bogaert) is continuously ongoing phantom pain radiating to the amputated part of the limb.

Olfactory hallucinosis. Isolated olfactory hallucinosis of Habeck (D. Habeck, 1965) with delusions of relation - the perception of bad odors emanating from one’s own body, which is accompanied by pathological sensations, individual tactile Hallucinations and ideas of relation, closely related to imaginary odors.

Hallucinatory-delusional syndrome is a complex symptom complex of mental disorders, the structure of which is dominated primarily by auditory verbal hallucinations and delusions, characterized by the unity of the plot. Depending on the characteristics (intensity, duration, degree of systematization, correspondence of the content of Hallucinations and delusions), different wedges and variants of the syndrome are distinguished.

Hallucinatory-delusional syndromes are typical for the clinic of the corresponding forms of schizophrenia, intoxication (alcohol), infectious (syphilis of the brain), involutionary, reactive psychoses.

Features of hallucinatory states in the blind and deaf. In patients with lost vision or hearing function, the development of hallucinations has some features.

In people who are blind from birth or blind in early childhood, hallucinations based on visual images are not formed. They usually experience auditory hallucinations, and auditory hallucinosis easily develops (see below). Peculiar disturbances of the sense of touch (tactile sense) are described: the patient feels the “presence” of strangers near him, the approach of allegedly dangerous persons threatening him; usually a delusional interpretation of such “presence”, “approximation” is quickly formed. People who have lost their vision in adulthood may also experience visual hallucinations.

Deaf people (deaf and mute) from birth or from early childhood experience visual, tactile hallucinations and hallucinations of general feeling. Their auditory hallucinations are formed not on the basis of auditory sensations, but mainly muscle (speech motor) and partly visual. Hearing hallucinations occur during illness only in those individuals who can speak, or in deaf and mute people who have learned to speak using a special method. Auditory Hallucinations in the latter are characterized by scarcity, rudimentary, dullness, sporadic verbal images, with a possible abundance and brightness of hallucinatory images in Hallucinations of tactile and general senses.

Pathogenesis

There is no single theory yet that explains the mechanism by which Hallucination occurs. Existing theories can be combined into several main groups.

The so-called peripheral theory of the occurrence of Hallucinations, according to which their formation is associated with an unusual, painful irritation of the peripheral part of the corresponding sensory organ (eye, ear, skin receptors, etc.), has now lost its meaning. It has been clinically established that visual hallucinations can occur even after bilateral enucleation of the eyes, and acoustic hallucinations can occur after bilateral transection of the auditory nerves. The connection with the patient’s thoughts indicates the dependence of Hallucinations on processes occurring in the cerebral cortex.

The “central” theories of the occurrence of Hallucinations may include the so-called psychological, clinical-morphological and physiological.

Psychological theories of the occurrence of Hallucinations are especially widely represented in the concept of “strengthening images of representation”, which asserts the possibility of transition of images of representation (memories) by strengthening them in Hallucinations. Supporters of these theories saw one of their confirmations in the features of eidetism (see above).

Proponents of clinical and morphological theories interpreted the occurrence of Hallucinations as a result of antagonism in the activity of the cerebral cortex and subcortical centers (due to the predominance of excitation or depletion of the cortex). T. Meinert substantiated this mechanism morphologically-localizationist, V.Kh. Kandinsky - clinically and physiologically, as well as K. Kahlbaum.

Physiological theories of the occurrence of Hallucinations are mostly based on the teachings of I. P. Pavlov. The basis of Hallucination, according to I.P. Pavlov, is the formation of pathological inertia (of varying severity) in various instances of the cerebral cortex - in the central projections of the visual, auditory, olfactory, kinesthetic and other analyzers, in systems that provide analysis of the first or second signals of reality. E. A. Popov considered the basis of Hallucinations to be the features of the inhibitory process in the cerebral cortex, in particular the appearance of hypnoid, phase (transitions from wakefulness to sleep) states, primarily the paradoxical phase. At the same time, weak stimuli - traces of previously experienced impressions, being extremely intensified, give rise to images of ideas that are subjectively assessed as images of direct impressions (perceptions). A. G. Ivanov-Smolensky explained the exteroprojection of images of true hallucinations by the spread of inert excitation to the cortical projection of visual or auditory accommodation. Pseudohallucinations differ from true hallucinations by the locality of the phenomena of pathological inertia of the irritable process, which extends mainly to the visual or auditory area.

Modern researchers of the electrophysiological nature of sleep associate the mechanism of Hallucination with a shortening of the REM sleep phase, a reduction of its delta forms, with a peculiar penetration of the REM sleep phase into wakefulness [Snyder (F. Snyder), 1963].

Disturbances in the functions of sleep and wakefulness are undoubtedly related to the problem of Hallucination, but this does not mean that disorders of these functions underlie the mechanism of Hallucination. The relationship between sleep and wakefulness is only participation in the activity of a functional organ that carries out the process of perception, in which many systems of the brain participate.

Diagnostic value of hallucinations

Nosological diagnosis, naturally, cannot be based only on the characteristics of hallucinatory disorders. At the same time, the quality of hallucinations, and especially the syndromes of hallucinatory disorders, is one of the most important criteria for qualifying those diseases for which the clinical picture of these disorders is typical. The differential diagnostic value of hallucinations of various types (see above) is due to the predominance of certain hallucinations and hallucinatory disorders in the wedge, the picture of the disease. For example, delirious syndrome, which presents visual, true, micro or macroscopic hallucinations of zoopsy content (animals, insects), is typical only for intoxication psychoses (alcohol).

Forecast

The addition of Hallucinations to a pre-existing picture of mental illness indicates a complication of its clinical picture. The prognosis becomes more unfavorable when true visual hallucinations are replaced by visual pseudohallucinations; visual Hallucinations - auditory verbal; auditory verbal true hallucinations - verbal pseudohallucinations; hallucinoids - functional hallucinations, true hallucinations, pseudohallucinations; episodic Hallucinations - states of continuous hallucination (hallucinosis); Hallucinations of the imagination, psychogenic, paranoid Hallucinations - verbal true and even more so pseudohallucinations. When a reverse change in hallucinatory disorders is detected, the prognosis improves.

Treatment and prevention

Patients with hallucinatory states are subject to mandatory hospitalization; In case of hallucinosis, the patient must be transported accompanied by a paramedic. It is necessary to treat the underlying disease in which Hallucinations developed.

Prevention of Hallucinations also depends on timely treatment of the underlying disease and possible compliance with the rules of mental hygiene.

See also Alcoholic psychoses, Amentive syndrome, Brain (mental disorders with abscess, tumors, syphilis), Delirious syndrome, Intoxication psychoses, Infectious psychoses, Oneiric syndrome, Traumatic brain injury (mental disorders), Schizophrenia, Epilepsy (epileptic psychoses).

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Have you ever noticed a ringing in your ears for no reason? It’s hard to concentrate on your own thoughts and concentrate on important things. People are accustomed to this phenomenon; they do not look for the source of this noise, knowing that it is just an illusion.

But sometimes reality is so distorted that a person gets lost in his feelings. Gradually, he does not realize the line between his visions and real life. Different images come, foreign odors are felt or arise. The reason for these illusions is sometimes complex and serious illnesses. What do hallucinations indicate?

What are hallucinations?

Sensory hallucinations are distorted perceptions without an object, when images, sounds, and sensations appear in a person’s mind that do not actually exist, but at the same time seem real. Impaired brain function causes imaginary images. These images occur not only in mentally ill people, but also in completely healthy ones. They appear as mild illusions that disappear when their cause is eliminated, and treatment does not take much time.

Sensory hallucinations are a huge area of ​​illness. Every adult should know the types of illusions in order to prevent a complex disease and its negative consequences in time.

Nowadays, hallucinations are not something unknown; they are most often a symptom of a more serious illness. Treatment can be very different, depending on the type and severity of the disease. What types of illusions are there? How to distinguish between types of hallucinations based on symptoms?

Types of hallucinations

Auditory hallucinations

Auditory hallucinations are vocal illusions during which brain activity is disrupted and sounds are perceived without an external auditory stimulus. A person hears extraneous noises, speeches, melodies. It can be either voices in your head or extraneous knocks or creaks behind the wall. Auditory hallucinations can be a symptom of schizophrenia, alcohol or drug addiction, partial seizures, brain cancer, and disorders of the nervous system. Treatment often takes a long time, because it is very difficult to stabilize the body’s condition with such diseases.

Sometimes hallucinations occur in healthy people, for example, during postoperative syndrome. This is a temporary clouding of consciousness after a person recovers from anesthesia. Under the influence of some components of anesthesia, brain function is disrupted in people. During an attack of hallucinosis, auditory hallucinations accompany haptic illusions or strange visions.

Deception of feelings can also occur during lack of sleep or insomnia. 48 hours without sleep is enough for a person to begin to notice strange sounds, causeless rustling and knocking, and experience musical hallucinations.

Visual hallucinations

Visual or visual hallucinations are the appearance of unreal images. The patient himself may participate in visible events that do not actually exist. A person in this state sees fantastic or recursive objects, patterns, spots. Often it is not a new object that appears, but the shapes and colors of an existing one that change. For example, the tree outside the window changes color, begins to shine, expand, and move.

Visual hallucinations can occur with impaired brain function, tumors, schizophrenia, delirium delirium, drug addiction, Alzheimer's disease, and after severe head injuries. Sometimes hypnosis treatment can cause visions.

In healthy people, visual hallucinations occur during sleep deprivation, high blood pressure or temperature. Children often see unreal objects when falling asleep.

Olfactory hallucinations

Olfactory hallucinations are illusions in which a person perceives the presence of an unreal odor, most often it is putrid and unpleasant. Many patients in this case refuse to eat, believing that poison or poison was added there, which caused the strange smell.

Olfactory hallucinations have this peculiarity - it is impossible to get rid of the disgusting smell. No matter what sweet and floral aromas the patient tries to smell, they will not cope with the illusion.

This deception of feelings can have a variety of reasons. Sometimes it is just a violation of the nasal mucosa. But it happens that olfactory illusions occur against the background of epilepsy, schizophrenia, encephalitis, brain damage, and severe viral infections. They can also be caused by recovery from anesthesia, severe depression, or abuse of potent substances. At high pressure or temperature, the sensation of an unpleasant odor is accompanied by a change in the taste of food. The treatment of such deception of the senses consists in eliminating the underlying disease, which has become a false irritant.

Tactile hallucinations

Tactile or tactile hallucinations are the patient’s sensation of non-existent objects that he can touch, touch, feel. Such illusions arise against the background of infectious diseases, alcoholic hallucinosis, brain injuries, tumors, and mental disorders. Sometimes haptic illusions occur in healthy people during sleep. A person tries to grab a non-existent object and feels touches to the body. At temperature and high pressure, consciousness can become clouded, which provokes false signals to the nervous system, which creates haptic errors. They are often accompanied by visual, auditory, and musical hallucinations.

Taste hallucinations

Taste hallucinations are the sensation of the presence of a non-existent stimulus in food. Foods can have both a pleasant and disgusting taste. Such illusions can have negative consequences. For example, the patient begins to be overcome by obsessive thoughts about poisoning.

The causes of illusions lie in infectious diseases (for example, syphilis), schizophrenia, encephalitis, and brain tumors. Sometimes they occur upon recovery from anesthesia and disappear as soon as the active drug is removed from the body.

All types of illusions include various types and subtypes. For example, color hallucinations are a subtype of visual hallucinations. They occur in schizophrenia, infectious diseases of the brain, delirium tremens, cataracts and glaucoma. During such hallucinosis, objects change color, colors become brighter and more saturated. Color hallucinations can be induced through special hypnotic practices or through the use of potent substances.

Auditory hallucinations have several subtypes. The first are verbal hallucinations. At this time, the patient clearly hears phrases and speeches of one or more voices. The second are imperative hallucinations. They manifest themselves in the form of voices that order to commit illegal acts, incite them to commit suicide or murder. Imperative hallucinations are a dangerous type of illusion, because they have the most negative consequences.

The third type is musical hallucinations. The same sound or a whole melody plays on repeat in your head. It is noted that musical hallucinations most often overcome older people. Their treatment is not fully understood, as are the mechanisms of their appearance. However, it is known that strokes, aneurysms of cerebral arteries, and infectious diseases can cause musical hallucinations.

Visceral hallucinations are a subtype of tactile hallucinations. Tactile illusions in this case manifest themselves in the form of an invisible object in the body or under the skin, which interferes with life, causes inconvenience and carries with it negative consequences. They are often accompanied by haptic and visual disturbances. Most often, this type of illusion occurs during delirium delirium, drug overdose, or brain damage.

Some illusions seem fun or not particularly bothersome, such as musical hallucinations. But it is worth remembering that any deception of the senses is a signal from the body that there is a problem. Timely recognition of the disease and its treatment will help the patient return to the real world with loved ones.