After 20 years of research and writing, my book, In Their Right Minds: The Lives and Shared Practices of Poetic Geniuses (2015) Exeter, UK: Imprint Academic, is available from the publisher in a very well-made paperback edition. Initially a #1 Hot New Release in Neuropsychology and Poetry/Literary Criticism on, it can be acquired on Amazon in most countries, either in print, a Kindle edition, or both. If you are interested in consciousness, creativity, poetry, psychology, and/or the paranormal, I think you will find it an illuminating read.

Oliver Sacks's Hallucinations: What a trip!

Sacks says that, despite the bizarre forms they may take,  hallucinations are a rather common experience. They can present themselves using any or all forms of sensory experience--aural, visual, olfactory or tactile--or you can seem to leave your body all together. Sacks sees schizophrenic hallucinations as a category apart and does not consider them in this book. If you are interested in  psychotic hallucinations, see my earlier post.

  As others before him have done,  Sacks suggests that folklore, religion and aboriginal art may all have derived their myths and imagery from hallucinations, often with a sense of divine provenance. Julian Jaynes, whom Sacks mentions, considered poetry and prophecy as originating in the right or non-dominant hemisphere and said that all people before 1000 B.C. had divided minds.  Jaynes believed that a singular consciousness arose after the introduction of written language and migrations that dealt a blow to consensual acceptance of the existence of the gods. Sacks recognizes that altered states produce anomalous sense impressions; but uses first-hand contemporary accounts, including his own, along with his up-to-date knowledge of brain anatomy and neuroscience to present his own case. 

    The major source of hallucinations, for Sacks, is in the area of the brain responsible for interpreting the sense experience during normal conscious experience. So, the right inferotemporal cortex, responsible for face recognition, will hallucinate faces; the visual word form area in the left fusiform gyrus will produce hallucinations of letters, musical notes, mathematical symbols and numbers. Usually, the letters are unreadable or nonsensical, such as in the case of a woman with Charles Bonnet Syndrome who saw “black Hebrew letters dressed in ballet dresses of white . . . danc[ing] to beautiful music” that appeared from right to left. Right to left is significant, because the left hemisphere is projecting the vision.

Additionally, different brain areas may be simultaneously activated, producing an “involuntary, incongruous collision or conflation.” Dancing Hebrew letters may be one effect; or, you might get surreal imagery, with a flower jutting out from the side of a face. Human figures may be seen floating through the street; or someone may produce a double, another self, who walks beside or in front of them. Think Moses, Jung or Flournoy's account of Hélène Smith's dissociative priest. Visions can expand, filling up the whole horizon, or shrink to minuscule beings. Handwriting can be written on the wall. The divine is often felt. How else to explain these strange occurrences? 

   As in Charles Bonnet Syndrome brought on by blindness, it is when a sense is deprived of input that the hallucinatory goes into overdrive. Dark caves, vast deserts, frigid, lonely mountain-trekking, long-distance sails or car trips, may produce hallucinations. Whether seeking sensory deprivation in specialized tanks or being thrown as a prisoner into a dark dungeon, the effect is the same: hallucinations. It is the lack of external input that produces compensatory hyperactivity in the regions responsible for the neglected sense. The dreaming mind falls prey to the same overcompensation.

While visual hallucinations may be produced where there is an organic problem, with entertaining or terrifying results, one-line auditory hallucinations can present themselves under external circumstances that require immediate action. They command or give a particular message. Anyone who is sufficiently stressed in a dangerous situation can produce a commanding voice. It happened to Sacks when he was injured on a mountain and needed to keep going despite the pain. Freud even had two sense modalities present themselves at once when he was in extreme danger: “I heard the words as if somebody was shouting them into my ear, and at the same time I saw them as if they were printed on a piece of paper floating in the ear.” A sense of another’s presence, not seen or heard, but felt, is also a common experience, often described as on the right. 

    The most bizarre hallucinations are usually the product of drugs. Cocaine and amphetamines stimulate the reward systems via the neurotransmitter dopamine. Hallucinogens—mescaline, psilocybin, LSD, and probably DMT—act by boosting serotonin in the brain. Stimulants affect left-hemispheric approach action; hallucinogens boost internal right-hemispheric events.  Sacks describes his own experience taking 20 Artane pills, normally used in much smaller quantities for Parkinson’s disease. He hallucinates an entire conversation with friends, sight unseen, from one room to the next as he made breakfast for them, only to discover they were never there at all and he had cooked way too many eggs. He also hears the deafening sound of a helicopter overhead and rushes outside thinking his parents have dropped by to visit from England. No, they have not! Back in the kitchen, he carries on a long, philosophical conversation with a spider on the wall.

   Sacks’s most fascinating account involves staring at a spot on his sleeve, motionless, for 12 hours, as the armies of the English and the French prepared to fight the battle of Agincourt in 1415, the direct result of having read a historical text along with Shakespeare’s Henry V. The two texts now conflate in miniature and in Technicolor. On another occasion, stoked on amphetamines, he reads straight through a 19th-century, 500-page textbook on migraines, not sure whether he is reading or writing the book, wondering who in his time could be like this admirable author from the past. A very loud external voice says, “You silly bugger! You’re the man!” This is not the first case I’ve read of an avocation unveiled by a hallucinatory voice.
Yes, hallucinations or delirium can solve problems and provide important breakthroughs. Sacks cites Vladimir Nabokov who did advanced mathematical calculating when delirious. With malarial fever, Alfred Russell Wallace conceived of the idea of natural selection. Poet Richard Howard saw a pageant of literature acted out by the staff in period dress on different floors in the hospital where he had just had back surgery. Although not mentioned in the book, Francis Crick got his vision of DNA on LSD. Other folks converse with their deceased spouse without the aid of drugs or delirium. Mrs. Blake, for one, as I know from my own research. 

Sacks’s bottom line is this: “Something has to happen in the mind/brain for imagination to overleap its boundaries and be replaced by hallucination. Some dissociation or disconnection must occur, some breakdown of the mechanisms that normally allow us to recognize and take responsibility for our own thoughts and imaginings, to see them as ours and not as external in origin . . . . but dissociation cannot explain everything, for quite different sorts of memory may be involved.” Connecting with my earlier post on OBEs/NDEs, Sacks attributes these events to the right hemisphere because of its role in body image and vestibular sensations.

It's a trip reading Hallucinations: sometimes terrifying, sometimes hysterical, always illuminating, but never boring!!


Elaine said...

I did some exploring and found your article on Oliver Sacks. I see it's a year old, but it was timely after reading Sack's piece in the New York Times today. The only hallucinations I've experienced were psychedelic drug induced many years ago. Some of them were life-changing.

Right Mind Matters said...

Yes, Elaine, I haven't done any new posts since the Sacks piece because I was working on my book all last year, which will be coming out later this year.

Sacks certainly had interesting experiences and who would of thought he had such a penchant for mind-altering drugs? Nonetheless, they can be transformative, as you suggest.

Today, low doses of psilocybin and LSD have been touted as somehow reframing a person's perspective on a damaging behavior that leads to healing, for instance, in alcoholism.