Friday, May 6, 2005

Is it auditory hallucination that you are experience? :-O

Friday, May 06, 2005

Someone once asked me about the experience of having auditory hallucination. The reason he asked was partially due to his disbelief that someone functional and cognitive like me would experience the positive symptoms.

Essentially, a hallucination is a sensory perception in the absence of actual external stimuli. In contrast, an illusion is a perceptual distortion for a real stimulus. The commonly experienced hallucination could be experiences in all different modalities – visual, auditory, olfactory, etc.

I still recall the time when I was in my undergrad, taking my abnormal psychology class. For reasons unknown, I just found it extremely difficult to distinguish between these two phenomena.

When I had my internship in a mental health hospital, I had my encounters with numerous patients who showed the symptoms of hallucinations. One of the girls told me that she saw things that did not exist, or, you might want to call it “visual hallucinations”. Ya, the thing the guy in “The Beautiful Mind” experience to date.

I did not understand her experiences then and I still do not understand the experience of visual hallucination today. This is because my extensive empirical experiences do not include visual hallucinations (lol). And, if I have a choice, I would choose to be ignorant about such experiences till the end of my life.

After years of volunteering in the mental health hospitals and after my studies in psychology, I thought I knew what it meant to be psychotic and I thought that I could fully empathize with patients with mental health problems. However, I was proven wrong when I encountered psychotic symptoms for the first time.

You see, even with depression, it took some time for me to finally develop the ability to laugh at it. However, it was a shocking experience for me when confronted by the fact that “I have crossed the boundary between neurosis and psychosis.”

I was already deep in my delusional state when I eventually convinced myself that I need even more help than I was already receiving. In short, at that point, I thought I had the special talent of telepathy. Like any other ordinary delusional stories, I knew I was being watched and people were spying on each every step I took or I was about to take in my everyday life. They had even set up some extremely high tech devices to remotely detect and decode my brain waves and broadcast each every thought of mine.

My psychiatrist told me that I had delusions but I did not buy it. Eventually, I started to realize that all those real-time gossips that I heard were interfering with my normal functioning. I think that was one Saturday when I decided to go to the computer lab in school to do some work. No one else was in the room except for me.

I heard someone playing radio in the office next by and people were broadcasting each every of my moves and thoughts. At some point, I decided to go to the office door… I rested my ear on the door, trying to hear exactly what was going on in there. However, there was no sound. Silence was what I heard.

I thought to myself that maybe it was someone else in the other room. There were two consultants on duty and none of them was making a sound. I thought maybe there was someone in the hallway. I walked into the hallway and found not a single soul.

This was the time when I realized… I was experiencing psychotic symptoms or I was really telepathic.

I tried to put my mind together and get some more work done. However, the voices were distracting that, sitting in front of the computer for hours, I still could not write a complete sentence. At some point, I looked at myself and admitted to myself that I was gradually loosing my concentration. I picked up my stuffs, got back home to put things down, and, went to the emergency room.

I committed myself into the hospital. While they were still waiting for a bed to clear, they put me in bed in the emergency unit of the psychiatric ward. Behind the locked door were the nurses on duty and me. Except for their occasional conversations, the whole place was all quite. However, there was never a second that I was left in silence. I started to get more and more scared. When the psychiatrist came in to check on me, I begged her, “Please help me! I will do whatever it takes to keep my cognition!”

I finally got out of the hospital and eventually got off my medication. I thought that, after my experiences, I should be smart enough to avoid myself in going back to the coo-coo’s nest. However, that belief was proven to be wrong. When the second psychotic episode took place, it was a brand new set of experiences and they took me totally off guard. I was hospitalized again, except for, that time, I was involuntarily committed.

It was over 2 years ago when I was last hospitalized. However, my hallucinations did not seize to exist. In fact, hallucinations have turned to be part of my normal life.

I know there is a norm in life. In a perfect situation, I should be able to gradually regress back to the norm. However, sometimes we need to make a sacrifice, live with the bias, and, adapt to our own norm.

Getting back to the original question, “How do you know that you are experiencing auditory hallucinations?” Personally, the feeling of being in the center of the gossip often come along with auditory hallucinations. Why? It is because the internal voices are talking about you yourself. Duh! lol

So how do you tell between real gossip and auditory hallucinations?

Well, it is easy. Place yourself in an environment where there is no one else or where no one is talking. If you hear people talking, congratulations, you have been selected as the special someone to embrace what the ordinary people could imagine. lol

Of course, sometimes it is not so easy to find a complete silent environment. For instance, I haven’t been able to find a minute of silence since I got back home. My dear mother has been discovering things in my room, including those whose existence I have no idea of. lol

In this case, put yourself in an environment that is a distance away from the crowd. Listen to the surrounding. When you hear someone talking about you, try to hear exactly what they are talking about. If you could not decipher their conversation after you conscious effort, you might not have heard their conversation.

Of course, there is no closed-form solution to identify auditory hallucinations. These are but two methods I use for the purpose of self-monitoring. If I could fight it off this time in one piece, it means that it sort of work for me. However, there is no guarantee that it would work for the whole life time. At the same time, it might work or might not work for the others since the symptoms often catch us off guard and there are no fool-proof methods of prevention.

In one study that was published in 2000, it was found that, out of 13,000 “non-institutionalized” subjects recruited from the United Kingdom, Germany and Italy, almost 39% of them reported to have experienced some form of hallucination. If the results of this study hold true for the greater population at the current time, wouldn’t there be nothing to worry about for people with hallucinations such as those in the auditory modality?

To be honest, auditory hallucinations, in and out of themselves, are not so scary (at least, based on part of my personal experiences). Sometimes, they could be quite entertaining. It is more or less like listening to a radio show that is dedicated to oneself in one’s own mind. When you have more than one voice and they engage in conversations, the experience is more or less like listening to the conversation of the narrators in the Iron Chef TV program.

So what make the hallucinatory experiences, such as auditory hallucinations, so bad a thing?

First, I believe their “uncontrolled” development is linked to, if not the cause of, patients’ gradual loss of ability to concentrate and, subsequently, to perform other executive functions.

Second, I believe hallucinations are necessary (but not sufficient) for the development of a delusional system.

Ya. I do have my psychotic theory of psychosis (lol).

I would have loved to continue elaborating on these two points all night except it’s time for my beauty sleep. Hopefully, I will be able to find some time tomorrow to describe the essential role of auditory hallucinations on the development of delusions based on the cognitive theories that I tested in my dissertation.

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