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Classification and external resources
ICD-10 R44.
ICD-9 780.1
DiseasesDB 19769
MeSH D006212

A hallucination, in the broadest sense, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid, substantial, and located in external objective space. The latter definition distinguishes hallucinations from the related phenomena of dreaming, which does not involve wakefulness; illusion, which involves distorted or misinterpreted real perception; imagery, which does not mimic real perception and is under voluntary control; and pseudohallucination, which does not mimic real perception, but is not under voluntary control.[1] Hallucinations also differ from "delusional perceptions", in which a correctly sensed and interpreted genuine perception is given some additional (and typically bizarre) significance.

Hallucinations can occur in any sensory modality — visual, auditory, olfactory, gustatory, tactile, proprioceptive, equilibrioceptive, nociceptive, thermoceptive and chronoceptive.

A mild form of hallucination is known as a disturbance, and can occur in any of the senses above. These may be things like seeing movement in peripheral vision, or hearing faint noises and/or voices. Auditory hallucinations are very common in schizophrenia of the paranoid type. They may be benevolent (telling the patient good things about himself) or malicious, cursing the patient etc. Auditory hallucinations of the malicious type are frequently heard like people talking about the patient behind his back. Like auditory hallucinations, the source of their visual counterpart can also be behind the patient's back. Their visual counterpart is the feeling of being looked-stared at, usually with malicious intent. Not infrequently, auditory hallucinations and their visual counterpart are experienced by the patient together.

Hypnagogic hallucinations and hypnopompic hallucinations are considered normal phenomena. Hypnagogic hallucinations can occur as one is falling asleep and hypnopompic hallucinations occur when one is waking up.

Hallucinations can also be associated with drug or alcohol use (particularly deliriants), sleep deprivation, psychosis, neurological disorders, and delirium tremens.



One study from as early as 1894[2] reported that approximately 10% of the population experienced hallucinations. A 1996-1999 survey of over 13,000 people[3] reported a much higher figure, with almost 39% of people reporting hallucinatory experiences, 27% of which were daytime hallucinations, mostly outside the context of illness or drug use. From this survey, olfactory (smell) and gustatory (taste) hallucinations seem the most common in the general population.

Hallucination modalities

Hallucinations may be manifested in a variety of forms.[4] Various forms of hallucinations affect different senses, sometimes occurring simultaneously, creating multiple sensory hallucinations for those experiencing them.

Visual hallucinations

The real shadow of the hallucinating person transforms into the corporal image.

The most common modality referred to when people speak of hallucinations. These include the phenomena of seeing things which are not present or visual perception which does not reconcile with the consensus reality. There are many different causes, which have been classed as psychophysiologic (a disturbance of brain structure), psychobiochemical (a disturbance of neurotransmitters), and psychological (e.g. meaningful experiences intruding into consciousness). Numerous disorders can involve visual hallucinations, ranging from psychotic disorders to dementia to migraine, but experiencing visual hallucinations does not in itself mean there is necessarily a disorder.[5]

Auditory hallucinations

Auditory hallucinations (also known as Paracusia),[6] particularly of one or more talking voices, are particularly associated with psychotic disorders such as schizophrenia or mania, and hold special significance in diagnosing these conditions, although many people not suffering from diagnosable mental illness may sometimes hear voices as well. Auditary hallucinations of non-organic origin are most often met with in paranoid schizophrenia. their visual counterpart in that disease is the non-reality-based feeling of being looked or stared at.

Other types of auditory hallucination include exploding head syndrome and musical ear syndrome, and may occur during sleep paralysis. In the latter, people will hear music playing in their mind, usually songs they are familiar with. Recent reports have also mentioned that it is also possible to get musical hallucinations from listening to music for long periods of time.[7] This can be caused by: lesions on the brain stem (often resulting from a stroke); also, tumors, encephalitis, or abscesses.[8] Other reasons include hearing loss and epileptic activity.[9] Auditory hallucinations are also a result of attempting wake-initiation of lucid dreams.

Olfactory hallucinations

Phantosmia is the phenomenon of smelling odors that aren't really present. The most common odors are unpleasant smells such as rotting flesh, vomit, urine, feces, smoke, or other unpleasant smells. Phantosmia often results from damage to the nervous tissue in the olfactory system. The damage can be caused by viral infection, brain tumor, trauma, surgery, and possibly exposure to toxins or drugs.[10] Phantosmia can also be induced by epilepsy affecting the olfactory cortex and is also thought to possibly have psychiatric origins.[citation needed] Phantosmia is different from parosmia, in which a smell is actually present, but perceived differently from its usual smell.

Olfactory hallucinations have also been reported in migraine, although the frequency of such hallucinations is unclear.[11] [12]

Tactile hallucinations

Other types of hallucinations create the sensation of tactile sensory input, simulating various types of pressure to the skin or other organs. This type of hallucination is often associated with substance use, such as someone who feels bugs crawling on them (known as formication) after a prolonged period of cocaine or amphetamine use.[13]

Types of hallucinations

Hallucinations can be caused by a number of factors.

Hypnagogic hallucination

These hallucinations occur just before falling asleep, and affect a surprisingly high proportion of the population. The hallucinations can last from seconds to minutes, all the while the subject usually remains aware of the true nature of the images. These are usually associated with narcolepsy, but can also affect normal minds. Hypnagogic hallucinations are sometimes associated with brainstem abnormalities, but this is rare.[14]

Peduncular hallucinosis

Peduncular means pertaining to the peduncle, which is a neural tract running to and from the pons on the brain stem. These hallucinations usually occur in the evenings, but not during drowsiness, as in the case of hypnagogic hallucination. The subject is usually fully conscious and can interact with the hallucinatory characters for extended periods of time. As in the case of hypnagogic hallucinations, insight into the nature of the images remains intact. The false images can occur in any part of the visual field, and are rarely polymodal.[14]

Delirium tremens

One of the more enigmatic forms of visual hallucination is the highly variable, possibly polymodal delirium tremens. Individuals suffering from delirium tremens may be agitated and confused, especially in the later stages of this disease. Insight is gradually reduced with the progression of this disorder. Sleep is disturbed and occurs for a shorter period of time, with Rapid eye movement sleep.

Parkinson's disease and Lewy body dementia

Parkinson's disease is linked with Lewy body dementia for their similar hallucinatory symptoms. The symptoms strike during the evening in any part of the visual field, and are rarely polymodal. The segue into hallucination may begin with illusions[15] where sensory perception is greatly distorted, but no novel sensory information is present. These typically last for several minutes, during which time the subject may be either conscious and normal or drowsy/inaccessible. Insight into these hallucinations is usually preserved and REM sleep is usually reduced. Parkinson's disease is usually associated with a degraded substantia nigra pars compacta, but recent evidence suggests that PD affects a number of sites in the brain. Some places of noted degradation include the median raphe nuclei, the noradrenergic parts of the locus coeruleus, and the cholinergic neurons in the parabrachial and pedunculopontine nuclei of the tegmentum.[14]

Migraine coma

This type of hallucination is usually experienced during the recovery from a comatose state. The migraine coma can last for up to two days, and a state of depression is sometimes comorbid. The hallucinations occur during states of full consciousness, and insight into the hallucinatory nature of the images is preserved. It has been noted that ataxic lesions accompany the migraine coma.[14]

Charles Bonnet syndrome

Charles Bonnet syndrome is the name given to visual hallucinations experienced by blind patients. The hallucinations can usually be dispersed by opening or closing the eyelids until the visual images disappear. The hallucinations usually occur during the morning or evening, but are not dependent on low light conditions. These prolonged hallucinations usually do not disturb the patients very much, as they are aware that they are hallucinating.[14] A differential diagnosis are opthalmopathic hallucinations [16].

Focal epilepsy

The visual hallucinations from focal epilepsy are characterized by being brief and stereotyped. They are usually localized to one part of the visual field, and last only a few seconds. Other epileptic features may present themselves between visual episodes. Consciousness is usually impaired in some way, but nevertheless, insight into the hallucination is preserved. Usually, this type of focal epilepsy is caused by a lesion in the posterior temporoparietal.[14]

Schizophrenic hallucination

Hallucinations caused by schizophrenia.

Drug-induced hallucination

Hallucinations caused by the consumption of psychoactive substances.

Scientific explanations

Various theories have been put forward to explain the occurrence of hallucinations. When psychodynamic (Freudian) theories were popular in psychiatry, hallucinations were seen as a projection of unconscious wishes, thoughts and wants. As biological theories have become orthodox, hallucinations are more often thought of (by psychologists at least) as being caused by functional deficits in the brain. With reference to mental illness, the function (or dysfunction) of the neurotransmitters glutamate and dopamine are thought to be particularly important.[17] The Freudian interpretation may have an aspect of truth, as the biological hypothesis explains the physical interactions in the brain, while the Freudian deals with the origin of the flavor of the hallucination. Psychological research has argued that hallucinations may result from biases in what are known as metacognitive abilities.[18] These are abilities that allow us to monitor or draw inferences from our own internal psychological states (such as intentions, memories, beliefs and thoughts). The ability to discriminate between internal (self-generated) and external (stimuli) sources of information is considered to be an important metacognitive skill, but one which may break down to cause hallucinatory experiences. Projection of an internal state (or a person's own reaction to another's) may arise in the form of hallucinations, especially auditory hallucinations. A recent hypothesis that is gaining acceptance concerns the role of overactive top-down processing, or strong perceptual expectations, that can generate spontaneous perceptual output (that is, hallucination).[19]

Stages of a hallucination

  1. Emergence of surprising or warded-off memory or fantasy images [20]
  2. Frequent reality checks [20]
  3. Last vestige of insight as hallucinations become "real" [20]
  4. Fantasy and distortion elaborated upon and confused with actual perception [20]
  5. Internal-external boundaries destroyed and possible pantheistic experience [20]


There are few treatments for many types of hallucinations. However, for those hallucinations caused by mental disease, a psychologist or psychiatrist should be alerted, and treatment will be based on the observations of those doctors. Antipsychotic medications may also be utilized to treat the illness.[21] For other causes of hallucinations there is no factual evidence to support any one treatment is scientifically tested and proven. However, abstaining from hallucinogenic drugs, managing stress levels, living healthily, and getting plenty of sleep can help reduce the prevalence of hallucinations. In all cases of hallucinations, medical attention should be sought out and informed of one's specific symptoms.

See also


  1. ^ Leo P. W. Chiu (1989). "Differential diagnosis and management of hallucinations" (PDF). Journal of the Hong Kong Medical Association 41 (3): 292–7. 
  2. ^ Sidgwick H, Johnson A, Myers FWH et al. (1894). "Report on the census of hallucinations". Proceedings of the Society for Psychical Research 34: 25–394. 
  3. ^ Ohayon MM (Dec 2000). "Prevalence of hallucinations and their pathological associations in the general population". Psychiatry Res 97 (2-3): 153–64. doi:10.1016/S0165-1781(00)00227-4. PMID 11166087. 
  4. ^ Chen E. and Berrios G.E. (1996) Recognition of hallucinations: a multidimensional model and methodology. Psychopathology 29: 54-63.
  5. ^ Visual Hallucinations: Differential Diagnosis and Treatment (2009)
  6. ^ "Medical dictionary". 
  7. ^ Young, Ken (July 27, 2005). "IPod hallucinations face acid test". Retrieved 2008-04-10. 
  8. ^ "Rare Hallucinations Make Music In The Mind". August 9, 2000. Retrieved 2006-12-31. 
  9. ^ Engmann, Birk; Reuter, Mike: Spontaneous perception of melodies – hallucination or epilepsy? Nervenheilkunde 2009 Apr 28: 217-221. ISSN 0722-1541
  10. ^ Phantom smells
  11. ^ Wolberg FL, Zeigler DK (1982). "Olfactory Hallucination in Migraine". Archives of Neurology 39 (6): 382. 
  12. ^ Sacks, Oliver (1986). Migraine. Berkeley: University of California Press. p. 75-76. ISBN 9780520058897. 
  13. ^ Berrios G E (1982) Tactile Hallucinations. Journal of Neurology, Neurosurgery and Psychiatry 45: 285-293
  14. ^ a b c d e f Manford M, Andermann F (Oct 1998). "Complex visual hallucinations. Clinical and neurobiological insights". Brain 121 ((Pt 10)): 1819–40. doi:10.1093/brain/121.10.1819. PMID 9798740. 
  15. ^ Mark Derr (2006) Marilyn and Me, "The New York Times" February 14, 2006
  16. ^ Engmann, Birk (2008). "Phosphenes and photopsias - ischaemic origin or sensorial deprivation? - Case history" (in German). Z Neuropsychol. 19 (1): 7–13. doi:10.1024/1016-264X.19.1.7. 
  17. ^ Kapur S (Jan 2003). "Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia". Am J Psychiatry 160 (1): 13–23. doi:10.1176/appi.ajp.160.1.13. PMID 12505794. 
  18. ^ Bentall RP (Jan 1990). "The illusion of reality: a review and integration of psychological research on hallucinations". Psychol Bull 107 (1): 82–95. doi:10.1037/0033-2909.107.1.82. PMID 2404293. 
  19. ^ Grossberg S (Jul 2000). "How hallucinations may arise from brain mechanisms of learning, attention, and volition". J Int Neuropsychol Soc 6 (5): 583–92. doi:10.1017/S135561770065508X. PMID 10932478. 
  20. ^ a b c d e Horowitz MJ (1975). "Hallucinations: An Information Processing Approach". in West LJ, Siegel RK. Hallucinations; behavior, experience, and theory. New York: Wiley. ISBN 0-471-79096-6. 
  21. ^ "Hallucinations: Treatment: Information from" Wiki Q&A combined with free online dictionary, thesaurus, and encyclopedias. (accessed January 20, 2010).

Further reading

External links

1911 encyclopedia

Up to date as of January 14, 2010

From LoveToKnow 1911

Medical warning!
This article is from the 1911 Encyclopaedia Britannica. Medical science has made many leaps forward since it has been written. This is not a site for medical advice, when you need information on a medical condition, consult a professional instead.

HALLUCINATION (from Lat. alucinari or allucinari, to wander in mind, Gr. aXba6Ew or aXuecv, from an, wandering), a psychological term which has been the subject of much controversy, and to which, although there is now fair agreement as to its denotation, it is still impossible to give a precise and entirely satisfactory definition. Hallucinations constitute one of the two great classes of all false sense-perceptions, the other class consisting of the "illusions," and the difficulty of definition is clearly to mark the boundary between the two classes. Illusion may be defined as the misinterpretation of sense-impression, while hallucination, in its typical instances, is the experiencing of a sensory presentation, i.e. a presentation having the sensory vividness that distinguishes perceptions from representative imagery, at a time when no stimulus is acting on the corresponding sense-organ. There is, however, good reason to think that in many cases, possibly in all cases, some stimulation of the sense-organ, coming either from without or from within the body, plays a part in the genesis of the hallucination. This being so, we must be content to leave the boundary between illusions and hallucinations ill-defined, and to regard as illusions those false perceptions in which impressions made on the senseorgan play a leading part in determining the character of the percept, and as hallucinations those in which any such impression is lacking, or plays but a subsidiary part and bears no obvious relation to the character of the false percept. As in the case of illusion, hallucination may or may not involve delusion, or belief in the reality of the object falsely perceived. Among the sane the hallucinatory object is frequently recognized at once as unreal or at least as but quasi-real; and it is only the insane, or persons in abnormal states, such as hypnosis, who, when an hallucination persists or recurs, fail to recognize that it corresponds to no physical impression from, or object in, the outer world. Hallucinations of all the senses occur, but the most commonly reported are the auditory and the visual, while those of the other senses seem to be comparatively rare. This apparent difference of frequency is no doubt largely due to the more striking character of visual and auditory hals lucinations, and to the relative difficulty of ascertaining, in the case of perceptions of the lower senses, e.g. of taste and smell, that no impression adequate to the genesis of the percept has been made upon the sense-organ; but, in so far as it is real, it is probably due in part to the more constant use of the higher senses and the greater strain consequently thrown upon them, in part also to their more intimate connexion with the life of ideas.

The hallucinatory perception may involve two or more senses, e.g., the subject may seem to see a human being, to hear his voice and to feel the touch of his hand. This is rarely the case in spontaneous hallucination, but in hypnotic hallucination the subject is apt to develop the object suggested to him, as present to one of his senses, and to perceive it also through other senses. Among visual hallucinations the human figure, and among auditory hallucinations human voices, are the objects most commonly perceived. The figure seen always appears localized more or less definitely in the outer world. In many cases it appears related to the objects truly seen in just the same way as a real object; e.g. it is no longer seen if the eyes are closed or turned away, it does not move with the movements of the eyes, and it may hide objects lying behind it, or be hidden by objects coming between the place that it appears to occupy and the eye of the percipient. Visual hallucinations are most often experienced when the eyes are open and the surrounding space is well or even brightly illuminated. Less frequently the visual hallucination takes the form of a self-luminous figure in a dark place or appears in a luminous globe or mist which shuts out from view the real objects of the part of the field of view in which it appears.

Auditory hallucinations, especially voices, seem to fall into two distinct classes - (I) those which are heard as coming from without, and are more or less definitely localized in outer space, (2) those which seem to be within the head or, in some cases, within the chest, and to have less definite auditory quality. It seems probable that the latter are hallucinations involving principally kinaesthetic sensations, sensations of movement of the organs of speech.

Hallucinations occur under a great variety of bodily and mental conditions, which may conveniently be classified as follows.

I. Conditions which imply normal waking Consciousness and no distinct Departure from bodily and mental Sanity. a. It would seem that a considerable number of perfectly healthy persons occasionally experience, while in a fully waking state, hallucinations for which no cause can be assigned. The census of hallucinations conducted by the Society for Psychical Research showed that about ro % of all sane persons can remember having experienced at least one hallucination while they believed themselves to be fully awake and in normal health. These sporadic hallucinations of waking healthy persons are far more frequently visual than auditory, and they usually take the form of some familiar person in ordinary attire. The figure in many cases is seen, on turning the gaze in some new direction, fully developed and lifelike, and its hallucinatory character may be revealed only by its noiseless movements, or by its fading away in situ. A special interest attaches to hallucinations of this type, owing to the occasional coincidence of the death of the person with his hallucinatory appearance. The question raised by these coincidences will be discussed in a separate paragraph below.

b. A few persons, otherwise normal in mind and body, seem to experience repeatedly some particular kind of hallucination. The voice (batpJwtov) so frequently heard by Socrates, warning or advising him, is the most celebrated example of this type.

II. Conditions more or less unusual or abnormal but not implying distinct Departure from Health. a. A kind of hallucination to which perhaps every normal person is liable is that known technically as "recurrent sensation." This kind is experienced only when some sense-organ has been continuously or repeatedly subjected to some one kind of impression or stimulation for a considerable period; e.g. the microscopist, after examining for some hours one particular kind of object or structure, may suddenly perceive the object faithfully reproduced in form and colour, and lying, as it were, upon any surface to which his gaze is directed. Perhaps the commonest experience of this type is the recurrence of the sensations of movement at intervals in the period following a sea voyage or long railway journey.

b. A considerable proportion of healthy sane persons can induce hallucinations of vision by gazing fixedly at a polished surface or into some dark translucent mass; or of hearing, by applying a large shell or similar object to the ear. These methods of inducing hallucinations, especially the former, have long been practised in many countries as modes of divination, various objects being used, e.g. a drop of ink in the palm of the hand, or a polished finger-nail. The object now most commonly used is a polished sphere of clear glass or crystal (see Crystal-Gazing). Hence such hallucinations go by the name of crystal visions. The crystal vision often appears as a picture of some distant or unknown scene lying, as it were, in the crystal; and in the picture figures may come and go, and move to and fro, in a perfectly natural manner. In other cases, written or printed words or sentences appear. The percipient, seer or scryer, commonly seems to be in a fully waking state as he observes the objects thus presented. He is usually able to describe and discuss the appearances, successively discriminating details by attentive observation, just as when observing an objective scene; and he usually has no power of controlling them, and no sense of having produced them by his own activity. In some cases these visions have brought back to the mind of the scryer facts or incidents which he could not voluntarily recollect. In other cases they are asserted by credible witnesses to have given to the scryer information, about events distant in time or place, that had not come to his knowledge by normal means. These cases have been claimed as evidence of telepathic communication or even of clairvoyance. But at present the number of wellattested cases of this sort is too small to justify acceptance of this conclusion by those who have only secondhand knowledge of them.

c. Prolonged deprivation of food predisposes to hallucinations, and it would seem that, under this condition, a large proportion of otherwise healthy persons become liable to them, especially to auditory hallucinations.

d. Certain drugs, notably opium, Indian hemp, and mescal predispose to hallucinations, each tending to produce a peculiar type. Thus Indian hemp and mescal, especially the latter, produce in many cases visual hallucinations in the form of a brilliant play of colours, sometimes a mere succession of patches of brilliant colour, sometimes in architectural or other definite spatial arrangement.

e. The states of transition from sleep to waking, and from waking to sleep, seem to be peculiarly favourable to the appearance of hallucinations. The recurrent sensations mentioned above are especially prone to appear at such times, and a considerable proportion of the sporadic hallucinations of persons in good health are reported to have been experienced under these conditions. The name "hypnagogic" hallucinations, first applied by Alfred Maury, is commonly given to those experienced in these transition states.

f. The presentations, predominantly visual, that constitute the principal content of most dreams, are generally described as hallucinatory, but the propriety of so classing them is very questionable. The present writer is confident that his own dream-presentations lack the sensory vividness which is the essential mark of the percept, whether normal or hallucinatory, and which is the principal, though not the only, character in which it differs from the representation or memory-image. It is true that the dream-presentation, like the percept, differs from the representative imagery of waking life in that it is relatively independent of volition; but that seems to be merely because the will is in abeyance or very ineffective during sleep. The wide currency of the doctrine that classes dream-images with hallucinations seems to be due to this independence of volitional control, and to the fact that during sleep the representative imagery appears without that rich setting of undiscriminated or marginal sensation which always accompanies waking imagery, and which by contrast accentuates for introspective reflection the lack of sensory vividness of such imagery.

g. Many of the subjects who pass into the deeper stages of hypnosis (see Hypnotism) show themselves, while in that condition, extremely liable to hallucination, perceiving whatever object is suggested to them as present, and failing to perceive any object of which it is asserted by the operator that it is no longer present. The reality of these positive and negative hallucinations of the hypnotized subject has been recently questioned, it being maintained that the subject merely gives verbal assent to the suggestions of the operator. But that the hypnotized subject does really experience hallucinations seems to be proved by the cases in which it is possible to make the hallucination, positive or negative, persist for some time after the termination of hypnosis, and by the fact that in some of these cases the subject, who in the post-hypnotic state seems in every other respect normal and wide awake, may find it difficult to distinguish between the hallucinatory and real objects. Further proof is afforded by experiments such as those by which Alfred Binet showed that a visual hallucination may behave for its percipient in many respects like a real object, e.g. that it may appear reflected in a mirror, displaced by a prism and coloured when a coloured glass is placed before the patient's eyes. It was by means of experiments of this kind that Binet showed that hypnotic hallucinations may approximate to the type of the illusion, i.e. that some real object affecting the sense-organ (in the case of a visual hallucination some detail of the surface upon which it is projected) may provide a nucleus of peripherally excited sensation around which the false percept is built up. An object playing a part of this sort in the genesis of an hallucination is known as a "point de repere." It has been maintained that all hallucinations involve some such point de repere or objective nucleus; but there are good reasons for rejecting this view.

h. In states of ecstasy, or intense emotional concentration of attention upon some one ideal object, the object contemplated seems at times to take on sensory vividness, and so to acquire the character of an hallucination. In these cases the state of mind of the subject is probably similar in many respects to that of the deeply hypnotized subject, and these two classes of hallucination may be regarded as very closely allied.

III. Hallucinations which occur as symptoms of both bodily and mental diseases. a. Dr H. Head has the credit of having shown for the first time, in the year Igor, that many patients, suffering from more or less painful visceral diseases, disorders of heart, lungs, abdominal viscera, &c., are liable to experience hallucinations of a peculiar kind. These "visceral" hallucinations, which are constantly accompanied by headache of the reflected visceral type, are most commonly visual, more rarely auditory. In all Dr Head's cases the visual hallucination took the form of a shrouded human figure, colourless and vague, often incomplete, generally seen by the patient standing by his bed when he wakes in a dimly lit room. The auditory "visceral" hallucination was in no instance vocal, but took such forms as sounds of tapping, scratching or rumbling, and were heard only in the absence of objective noises. In a few cases the "visceral" hallucination was bisensory, i.e. both auditory and visual.

In all these respects the "visceral" hallucination differs markedly from the commoner types of the sporadic hallucination of healthy persons.

b. Hallucinations are constant symptoms of certain general disorders in which the nervous system is involved, notably of the delirium tremens, which results from chronic alcohol poisoning, and of the delirium of the acute specific fevers. The hallucinations of these states are generally of a distressing or even terrifying character. Especially is this the rule with those of delirium tremens, and in the hallucinations of this disease certain kinds of objects, e.g. rats and snakes, occur with curious frequency.

c. Hallucinations occasionally occur as symptoms of certain nervous diseases that are not usually classed with the insanities, notably in cases of epilepsy and severe forms of hysteria. In the former disorder, the sensory aura that so often precedes the epileptic convulsion may take the form of an hallucinatory object, which in some cases is very constant in character. Unilateral hallucinations, an especially interesting class, occur in severe cases of hysteria, and are usually accompanied by hemi-anaesthesia of the body on the side on which the hallucinatory object is perceived.

d. Hallucinations occur in a large, but not accurately definable, proportion of all cases of mental disease proper. Two classes are recognized: (1) those that are intimately connected with the dominant emotional state or with some dominant delusion; (2) those that occur sporadically and have no such obvious relation to the other symptoms of disease. Hallucinations of the former class tend to accentuate, and in turn to be confirmed by, the congruent emotional or delusional state; but whether these are to be regarded as primary symptoms and as the cause. of the hallucinations, or vice versa, it is generally impossible to say. Patients who suffer delusions of persecution are very apt to develop later in the course of their disease hallucinations of the voices of their persecutors; while in other cases hallucinatory voices, which are at first recognized as such, come to be regarded as real and in these cases seem to be factors of primary importance in the genesis of further delusions. Hallucinations occur in almost every variety of mental disease, but are commonest in the forms characterized by a cloudy dream-like condition of consciousness, and in extreme cases of this sort the patient (as. in the delirium of chronic alcohol-poisoning) seems to move waking through a world consisting largely of the images of his own creation, set upon a background of real objects.

In some cases hallucinations are frequently experienced for long periods in the absence of any other symptom of mental disorder, but these no doubt usually imply some morbid condition. of the brain.

Physiology of Hallucination

There has been much discussion. as to the nature of the neural process in hallucination. It is generally and rightly assumed that the hallucinatory perception of any object has for its immediate neural correlate a state of excitement which, as regards its characters and its distribution in the elements of the brain, is entirely similar to the neural correlate of the normal perception of the same object. The hallucination is a perception, though a false perception. In the perception of an object and in the representation of it, introspective analysis discovers a number of presentative elements. In the case of the representation these elements are memory images only (except perhaps in so far as actual kinaesthetic sensations enter into its composition); whereas, in the case of the percept, some of these elements are sensations, sensations which differ from images in having the attribute of sensory vividness; and the sensory vividness of these elements lends to the whole complex the sensory vividness or reality, the possession of which character by the percept constitutes its principal difference from the representation. Normally, sensory vividness attaches only to those presentative elements which. are excited through stimulations of the sense-organs. The normal percept, then, owes its character of sensory reality to the fact that a certain number of its presentative elements are sensations peripherally excited by impressions made upon a sense-organ. The problem is, then, to account for the fact that the hallucination contains presentative elements that have sensory vividness, that are sensations, although they are not excited by impressions from the external world falling upon a sense-organ. Most of the discussions of this subject suffer from the neglect of this preliminary definition of the problem. Many authors, notably W. Wundt and his disciples, have been content. to assume that the sensation differs from the memory-image only in having a higher degree of intensity; from which they infer that its neural correlate in the brain cortex also differs. from that of the image only in having a higher degree of intensity. For them an hallucination is therefore merely a representation whose neural correlate involves an intensity of excitement of certain brain-elements such as is normally produced only by peripheral stimulation of sensory nerves in the sense-organs. But this view, so attractively simple, ignores an insuperable objection. Sensory vividness is not to be identified with superior intensity; for while the least intense sensation has it, the memory image of the most intense sensation lacks it completely.

And, since intensity of sensation is a function of the intensity of the underlying neural excitement, we may not assume that sensory vividness is also the expression in consciousness of that intensity of excitement. If Wundt's view were true a progressive diminution of the intensity of a sensory stimulus should bring the sensation to a point in the scale of diminishing intensity at which it ceases to be sensation, ceases to have sensory vividness and becomes an image merely. But this is not the case; with diminishing intensity of stimulation, the sensation declines to a minimal intensity and then disappears from consciousness. This objection applies not only to Wundt's view of hallucinations, but also to H. Taine's explanation of them by the aid of his doctrine of "reductives," for this too identifies sensory vividness with intensity. (H. Taine, De l'intelligence, tome i. p. 108.) Another widely current explanation is based on the view that the representation and the percept have their anatomical bases in different element-groups or "centres" of the brain, the "centre" of the representation being assigned to a higher level of the brain than that of the percept (the latter being sometimes assigned to the basal ganglia of the brain, the former to the cortex). It is then assumed that while the lower perceptual centre is normally excited only through the sense-organ, it may occasionally be excited by impulses playing down upon it from the corresponding centre of representation, when hallucination results.

This view also is far from satisfactory, because the great additions recently made to our knowledge of the brain tend very strongly to show that both sensations and memoryimages have their anatomical bases in the same sensory areas of the cerebral cortex; and many considerations converge to show that their anatomical bases must be, in part at least, identical.

The views based on the assumptions of complete identity, and of complete separateness, of the anatomical bases of the percept and of the representation are then alike untenable; and the alternative - that their anatomical bases are in part identical, in part different, which is indicated by this conclusion - renders possible a far more satisfactory doctrine. We have good reason to believe that the neural correlate of sensation is the transmission of the nervous impulse through a sensori-motor arc of the cortex, made up of a chain of neurones; and the view suggests itself that the neural correlate of the corresponding memoryimage is the transmission of the impulse through a part only of this chain of cortical elements, either the efferent motor part of this chain or the afferent sensory part of it. Professor W. James's theory of hallucinations is based on the latter assumption. He suggests that the sensory vividness of sensation and of the percept is due to the discharge of the excitement of the chain of elements in the forward or motor direction; and that, in the case of the image and of the representation, the discharge takes place, not in this direction through the efferent channel of the centre, but laterally into other centres of the cortex. Hallucination may then be conceived as caused by obstruction, or abnormally increased resistance, of the paths connecting such a cortical centre with others, so that, when it becomes excited in any way, the tension or potential of its charge rises, until discharge takes place in the motor direction through the efferent limbs of the sensori-motor arcs which constitute the centre.

It is a serious objection to this view that, as James himself, in common with most modern authors, maintains, every idea has its motor tendency which commonly, perhaps always, finds expression in some change of tension of muscles, and in many cases issues in actual movements. Now if we accept James's theory of hallucination, we should expect to find that whenever a representation issues in bodily action it should assume the sensory vividness of an hallucination; and this, of course, is not the case.

The alternative form of the view that assumes partial identity of the anatomical bases of the percept and the representation of an object, would regard the neural correlate of the sensation as the transmission of the nervous impulse throughout the length of the sensori-motor arc of the cortex, from sensory inlet to, motor outlet; and that of the image as its transmission through the efferent part of this arc only; that is to say, in the case of the image, it would regard the excitement of the arc as being initiated at some point between its afferent inlet and its motor outlet, and as spreading, in accordance with the law of forward conduction, towards the motor outlet only, so that only the part of the arc distal or efferent to this point becomes excited.

This view of the neural basis of sensory vividness, which correlates the difference between the sensation and the image with the only known difference between their physiological conditions, namely the peripheral initiation of the one and the central initiation of the other, enables us to formulate a satisfactory theory of the physiology of hallucinations.

The anatomical basis of the perception and of the representation of any object is a functional system of nervous elements, comprising a number of sensori-motor arcs, whose excitement by impulses ascending to them by the sensory paths from the sense organs determines sensations, and whose excitement in their efferent parts only determines the corresponding images. In the case of perception, some of these arcs are excited by impulses ascending from the sense-organs, others only by the spread of the excitement through the system from these peripherally excited arcs; while, in the case of the representation, all alike are excited by impulses that reach the system from other parts of the cortex and spread throughout its efferent parts only to its motor outlets.

If then impulses enter this system by any of the afferent limbs of its sensori-motor arcs, the presentation that accompanies its excitement will have sensory vividness and will be a true perception, an illusion, or an hallucination, according as these impulses have followed the normal course from the sense-organ, or have been diverted, to a lesser or greater degree, from their normal paths. If any such neural system becomes abnormally excitable, or becomes excited in any way with abnormal intensity,, it is thereby rendered a path of exceptionally low-resistance capable of diverting to itself, from their normal path, any streams of impulses ascending from the sense-organ; which ascending impulses, entering the system by its afferent inlets, excite sensations that impart to the presentation the character of sensory vividness; the presentation thus acquires the character of a percept in spite of the absence of the appropriate impression on the sense-organ, and we call it an hallucination.

This view renders intelligible the modus operandi of many of the predisposing causes of hallucination; e.g. the pre-occupation with certain representations of the ecstatic, or of the sufferer from delusions of persecution; the intense expectation of a particular sense impression, the generally increased excitability of the cortex in states of delirium; in all these conditions the abnormally intense excitement of the cortical systems may be supposed to give them an undue directive and attractive influence upon the streams of impulses ascending from the sense-organs, so that sensory impulses may be diverted from their normal paths. Again, it renders intelligible the part played by chronic irritation of a sense-organ, as when chronic irritation of the internal ear leads on to hallucinations of hearing; perhaps also the chronic irritation of sensory nerves that must accompany the states of visceral disease, shown by Head to be so frequently accompanied by a liability to hallucinations; for any such chronic irritation supplies a stream of disorderly impulses rising constantly from the sense-organ, for the reception of which the brain has no appropriate system, and which, therefore, readily enters any organized cortical system that at any moment constitutes a path of low-resistance. A similar explanation applies to the influence of fixed gazing upon a crystal, or the placing of a shell over the ear, in inducing visual and auditory hallucinations. The "recurrent sensations" experienced after prolonged occupation with some one kind of sensory object may be regarded as due to an abnormal excitability of the cortical system concerned, resulting from its unduly prolonged exercise. The hypothesis renders intelligible also the liability to hallucination of persons in the hysterical and hypnotic states, in whose brains.

the cortical neural systems are in a state of partial dissociation, which renders possible an unduly intense and prolonged excitement of some one system at the expense of all other systems (cf. Hypnotism).

Coincidental Hallucinations

It would seem that, in wellnigh all countries and in all ages, apparitions of persons known to be in distant places have been occasionally observed. Such appearances have usually been regarded as due to the presence, before the bodily eye of the seer, of the ghost, wraith, double or soul of the person who thus appears; and, since the soul has been very commonly supposed to leave the body, permanently at death and temporarily during sleep, trance or any period of unconsciousness, however induced, it was natural to regard such an appearance as evidence that the person whose wraith was thus seen was in some such condition. Such apparitions have probably played a part, second only to that of dreams, in generating the almost universal belief in the separability of soul and body.

In many parts of the world traditional belief has connected such apparitions more especially with the death of the person so appearing, the apparition being regarded as an indication that the person so appearing has recently died, is dying or is about to die. Since death is so much less common an event than sleep, trance, or other form of temporary unconsciousness, the wide extension of this belief suggests that such apparitions may coincide in time with death, with disproportionate frequency. The belief in the significance of such apparitions still survives in civilized communities, and stories of apparitions coinciding with the death of the person appearing are occasionally reported in the newspapers, or related as having recently occurred. The Society for Psychical Research has sought to find grounds for an answer to the question "Is there any sufficient justification for the belief in a causal relation between the apparition of a person at a place distant from his body and his death or other exceptional and momentous event in his experience?" The problem was attacked in a thoroughly scientific spirit, an extensive inquiry was made, and the results were presented and fully discussed in two large volumes, Phantasms of the Living, published in the year 1886, bearing on the title-page the names of Edmund Gurney, F. W. H. Myers and F. Podmore. Of the three collaborators Gurney took the largest share in the planning of the work, in the collection of evidence, and in the elaboration and discussion of it.

Gurney set out with the presumption that apparitions, whether coincidental or not, are hallucinations in the sense defined above; that they are false perceptions and are not excited by any object or process of the external world acting upon the sense-organs of the percipient in normal fashion; that they do not imply the presence, in the place apparently occupied by them, of any wraith or any form of existence emanating from, or specially connected with, the person whose phantasm appears. This initial assumption was abundantly justified by an examination of a large number of cases for it, which showed that, in all important respects, most of these apparitions of persons at a distance, whether coincidental or not, were similar to other forms of hallucination.

The acceptance of this conclusion does not, however, imply a negative answer to the question formulated above. The Society for Psychical Research had accumulated an impressive and, to almost all those who had first-hand acquaintance with it, a convincing mass of experimental evidence of the reality of telepathy, the influence of mind on mind otherwise than through the recognized channels of sense. The successful experiments had for the most part been made between persons in close proximity, in the same room or in adjoining rooms; but they seemed to show that the state of consciousness of one person may induce directly (i.e. without the mediation of the organs of expression and sense-perception) a similar state of consciousness in another person, especially if the former, usually called the "agent," strongly desired or "willed" that this effect should be produced on the other person, the "percipient." The question formulated above thus resolved itself for Gurney into the more definite form, "Can we find any good reason for believing that coincidental hallucinations are sometimes veridical, that the state of mind of a person at some great crisis of his experience may telepathically induce in the mind of some distant relative or friend an hallucinatory perception of himself ?" It was at once obvious that, if coincidental apparitions can be proved to occur, this question can only be answered by a statistical inquiry; for each such coincidental hallucination, considered alone, may always be regarded as most educated persons of the present time have regarded them, namely, as merely accidental coincidences. That the coincidences are not merely accidental can only be proved by showing that they occur more frequently than the doctrine of chances would justify us in expecting. Now, the death of any person is a unique event, and the probability of its occurrence upon any particular day may be very simply calculated from the mortality statistics, if we assume that nothing is known of the individual's vitality. On the other hand, hallucinatory perceptions of persons, occurring to sane and healthy individuals in the fully waking state, are comparatively rare occurrences, whose frequency we may hope to determine by a statistical inquiry. If, then, we can obtain figures expressing the frequency of such hallucinations, we can deduce, by the help of the laws of chance, the proportion of such hallucinations that may be expected to coincide with (or, for the purposes of the inquiry, to fall within twelve hours of) the death of the person whose apparition appears, if no causal relation obtains between the coinciding events. If, then, it appears that the proportion of such coincidental hallucinations is greater than the laws of probability will account for, a certain presumption of a causal relation between the coinciding events is thereby established; and the greater the excess of such coincidences, the stronger does this presumption become. Gurney attempted a census of hallucinations in order to obtain data for this statistical treatment, and the results of it, embodied in Phantasms of the Living, were considered by the authors of that work to justify the belief that some coincidental hallucinations are veridical. In the year 1889 the Society for Psychical Research appointed a committee, under the chairmanship of the late Henry Sidgwick, to make a second census of hallucinations on a more extensive and systematic plan than the first, in order that the important conclusion reached by the authors of Phantasms of the Living might be put to the severer test rendered possible by a larger and more carefully collected mass of data. Seventeen thousand adults returned answers to the question, "Have you ever, when believing yourself to be completely awake, had a vivid impression of seeing or being touched by a living being or inanimate object, or of hearing a voice; which impression, so far as you could discover, was not due to any external physical cause ?" Rather more than two thousand persons answered affirmatively, and to each of these were addressed careful inquiries concerning their hallucinatory experiences. In this way it was found that of the total number, 381 apparitions of persons living at the moment (or not more than twelve hours dead) had been recognized by the percipients, and that, of these, 80 were alleged to have been experienced within twelve hours of the death of. the person whose apparition had appeared. A careful review of all the facts, conditions and probabilities, led the committee to estimate that the former number should be enlarged to 1300 in order to make ample allowance for forgetfulness and for all other causes that might have tended to prevent the registration of apparitions of this class. On the other hand, a severe criticism of the alleged death-coincidences led them to reduce the number, admitted by them for the purposes of their calculation, to 30. The making of these adjustments gives us about i in 43 as the proportion of coincidental death-apparitions to the total number of recognized apparitions among the 17,000 persons reached by the census. Now the death-rate being just over 19 per thousand, the probability that any person taken at random will die on a given day is about 1 in 1 9 ,000; or, more strictly speaking, the average probability that any person will die within any given period of twenty-four hours duration is about 1 in 19,000. Hence the probability that any other particular event, having no causal relation to his death, but occurring during his lifetime (or not later than twelve hours after his death) will fall within the same twenty-four hours as his death is 1 in 19,000; i.e. if an apparition of any individual is seen and recognized by any other person, the probability of its being experienced within twelve hours of that individual's death is 1 in 19,000, if no causal relation obtains between the two events. Therefore, of all recognized apparitions of living persons, 1 only in 19,000 may be expected to be a death-coincidence of this sort. But the census shows that of 1300 recognized apparitions of living persons 30 are death-coincidences and that is equivalent to 440 in 19,000. Hence, of recognized hallucinations, those coinciding with death are 440 times more numerous than we should expect, if no causal relation obtained; therefore, if neither the data nor the reasoning can be destructively criticized, we are compelled to believe that some causal relation obtains; and, since good evidence of telepathic communication has been experimentally obtained, the least improbable explanation of these death-apparitions is that the dying person exerts upon his distant friend some telepathic influence which generates an hallucinatory perception of himself.

These death-coincidences constitute the main feature of the argument in favour of telepathic communication between distant persons, but the census of hallucinations afforded other data from which a variety of arguments, tending to support this conclusion, were drawn by the committee; of these the most important are the cases in which the hallucinatory percept embodied details that were connected with the person perceived and which could not have become known to the percipient by any normal means. The committee could not find in the results of the census any evidence sufficient to justify a belief that hallucinations may be due to telepathic influence exerted by personalities surviving the death of the body.

The critical handling of the cases by the committee seems to be above reproach. Those who do not accept their conclusion based on the death-coincidences must direct their criticism to the question of the reliability of the reports of these cases. It is to be noted that, although only those cases are reckoned in which the percipient had no cause to expect the death of the person whose apparition he experienced, and although, in nearly all the accepted cases, some record or communication of the hallucination was made before hearing of the death, yet in very few cases was any contemporary written record of the event forthcoming for the inspection of the committee. (W. McD.)

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Simple English

File:The Temptation of Saint Anthony (Grünewald)
The Temptation of Saint Anthony, Detail, Mathias Grünewald, 1515. This painting might have been influenced by the description of hallucinations.

A hallucination is a perception without a stimulus. Usually people have to be awake and conscious to have hallucinations. That way, a person who sees or hears something that is not really there has a hallucination. Hallucinations are different from dreams. When people dream they are not awake. Hallucinations are also different from illusions. Illusions are based on real perceptions, which are distorted or interpreted in a wrong way.

Certain drugs can cause hallucinations. Some illegal drugs are taken because they cause hallucinations. Certain mental illnesses can also cause hallucinations. In some cases, withdrawal of a drug can also cause hallucinations. This has especially been reported by people trying to stop taking sleeping pills, or by alcoholics.

People who have hallucinations are not necessarily ill, lack of sleep can also cause hallucinations. Hallucinations just before going to sleep or just after waking up are considered normal.


What are the different types of hallucinations?

Hallucinations can affect all of a person's senses. People with the mental illness of schizophrenia may hear sounds or voices that are not really there. People with certain mental illnesses may also have hallucinations in which they see a person or thing which is not really there. People are less likely to have hallucinations in which they smell or touch something that is not really there. Certain forms of epilepsy can cause hallucinations. Finally, hallucinations can be the result of certain substances taken or of certain physical constellations. Most of the time, these substances are taken to get the hallucinations. Sometimes, (severe) lack of sleep, or high fever can lead to hallucinations brought on by such viruses as the common cold.

How many people are affected by hallucinations?

Many studies have shown hallucinatory experiences take place across the world. Several studies, one of them done as early as 1894,[1] have reported that approximately 10% of the population experience hallucinations. A recent survey of over 13,000 people[2] reported a much higher figure. According to the study, almost 39% of the people reported hallucinatory experiences. 27% of the people reported daytime hallucinations, mostly outside the context of illness or drug use. From this survey, hallucinations affecting smell or taste seem the most common in the general population.

What are the causes of hallucinations?


Diseases or illnesses

Some diseases such as brain disorders or infections may cause a person to have hallucinations. As well, an alcoholic (person who is addicted to alcohol) who stops drinking alcohol suddenly may experience a type of hallucinations called delirium tremens (or "DT's"). Some people have hallucinations if they do not sleep for a number of days, or if they do not eat for a number of days.

Chemicals or drugs

Some people have hallucinations because they purposefully or accidentally put chemicals or drugs into their bodies.

Illegal drugs

Some people use illegal drugs that cause vivid (strong) hallucinations, such as LSD ("acid") and PCP ("angel dust"). Many kinds of drugs - even legal ones - will cause hallucinations, if very large doses are taken, and it is seen as a side effect.

Legal drugs

Some legal drugs that dentists, doctors, or surgeons use cause hallucinations. The dentists, doctors, and surgeons use drugs called anaesthetics to make people not feel pain, or to make people become unconscious. The main effects (result) of these drugs are that they make the patient not feel pain, or become unconscious. But the drugs also have some other additional effects, which are called side effects, such as nausea (feeling sick) and hallucinations.

Many dentists use an anaesthetic called nitrous oxide ("laughing gas"). Inhaling large quantities of nitrous oxide can cause people to have hallucinations. Doctors and surgeons use many types of anaesthetic gases so that patients who are being operated become unconscious. When a person inhales anaesthetic gases, they may have hallucinations for several minutes, until they become unconscious.

Accidental poisoning

Some adults accidentally swallow a poisonous chemical because it is in a bottle that has the wrong label. In some cases, children swallow a poisonous chemical because they think that it is a food product or a drink. Some dangerous, poisonous chemicals which can make people very sick or even kill them also cause hallucinations.

Lack of sleep

Some people have hallucinations when they have not slept for a long time; other people have something resembling a hallucination before falling asleep. This is usually called Hypnagogia. Most of the time, the people experiencing this kind of hallucinations are aware of the fact that they are not real.


  1. Sidgwick, H., Johnson, A, Myers, FWH et al (1894) Report on the census of hallucinations. Proceedings of the Society for Psychical Research, 34, 25-394.
  2. Ohayon MM. (2000). "Prevalence of hallucinations and their pathological associations in the general population". Psychiatry Research (97(2-3)): 153-64.. 

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