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I will say very little in this book about the vast and fascinating realm of dreams (which, one can argue, are hallucinations of a sort), other than to touch on the dreamlike quality of some hallucinations and on the “dreamy states” which occur in some seizures. Some have proposed a continuum of dream states and hallucinations (and this may be especially so with hypnagogic and hypnopompic hallucinations), but, in general, hallucinations are quite unlike dreams. Hallucinations often seem to have the creativity of imagination, dreams, or fantasy— or the vivid detail and externality of perception. But hallucination is none of these, though it may share some neurophysiological mechanisms with each. Hallucination is a unique and special category of consciousness and mental life. The hallucinations often experienced by people with schizophrenia also demand a separate consideration, a book of their own, for they cannot be divorced from the often profoundly altered inner life and life circumstances of those with schizophrenia. So I will refer relatively little to schizophrenic hallucinations here, focusing instead on the hallucinations that can occur in “organic” psychoses—the transient psychoses sometimes associated with delirium, epilepsy, drug use, and certain medical conditions. M any cultures regard hallucination, like dreams, as a special, privileged state of consciousness—one that is actively sought through spiritual practices, meditation, drugs, or solitude. But in modern Western culture, hallucinations are more often considered to portend madness or something dire happening to the brain—even though the vast majority of hallucinations have no such dark implications. There is great stigma here, and patients are often reluctant to admit to hallucinating, afraid that their friends and even their doctors will think they are losing their minds. I have been very fortunate that, in my own practice and in correspondence with readers (which I think of, in some ways, as an extension of my practice), I have encountered so many people willing to share their experiences. Many of them have expressed the hope that telling their stories will help defuse the often cruel misunderstandings which surround the whole subject. I think of this book, then, as a sort of natural history or anthology of hallucinations, describing the experiences and impact of hallucinations on those who have them, for the power of hallucinations is only to be understood from firstperson accounts. Some of the chapters that follow are organized by medical categories (blindness, sensory deprivation, narcolepsy, etc.), and others are organized by sensory modality (hearing things, smelling things, etc.). But there is a great deal of overlap and interconnection between these categories, and similar hallucinations may occur in a wide variety of conditions. Here, then, is a sampling which I hope will give a sense of the great range, the varieties, of hallucinatory experience, an essential part of the human condition. 1. My own favorite denition is that given by William James in his 1890 Principles of Psychology: “An hallucination is a strictly sensational form of consciousness, as good and true a sensation as if there were a real object there. The object
happens to be not there, that is all.” Many other researchers have proposed their own denitions, and Jan Dirk Blom, in his encyclopedic Dictionary of Hallucinations, includes dozens of these. 2. We cannot be certain whether other animals have hallucinations, although “hallucinatory behaviors” have been observed in laboratory animals as well as in natural settings, as Ronald K. Siegel and Murray E. Jarvik described in their review of the subject. 3. La Barre provided an extended review of anthropological perspectives on hallucination in a chapter published in 1975.
Page 3 and 4: THIS IS A BORZOI BOOK PUBLISHED BY
Page 5 and 6: Contents Cover Title Page Copyright
Page 7: such things as misperceptions or il
Page 11 and 12: ut nothing else amiss. Neurological
Page 13 and 14: week—a long, hot journey to see a
Page 15 and 16: Marjorie J. wrote to me in 1995 abo
Page 17 and 18: a foot above her head and have to c
Page 19 and 20: eyes. There are strong tendencies t
Page 21 and 22: window into both the powers and the
Page 23 and 24: Many people with mild cognitive imp
Page 25 and 26: hallucinations typically do not int
Page 27 and 28: 2 The Prisoner’s Cinema: Sensory
Page 29 and 30: of the body’s position and even i
Page 31 and 32: article. The immobility produced by
Page 33 and 34: 3 A Few Nanograms of Wine: Hallucin
Page 35 and 36: tasting metallic and a bit rotten,
Page 37 and 38: was … wet cardboard).” Prior to
Page 39 and 40: The voices not only speak to the pa
Page 41 and 42: of the table to another or to use a
Page 43 and 44: they were printed on a piece of pap
Page 45 and 46: pauses, inections and increases and
Page 47 and 48: come to enjoy their internal music
Page 49 and 50: to me, “is straining to monitor f
Page 51 and 52: I n contrast to these postencephali
Page 53 and 54: furry black animal leap onto the di
Page 55 and 56: pattern of damage in parts of the b
Page 57 and 58: of persecution, and occasionally th
Page 59 and 60:
6 Altered States H umans share much
Page 61 and 62:
By the 1890s, Westerners were also
Page 63 and 64:
sky spangled with eyes of ame, diss
Page 65 and 66:
of stereo vision—or even stereo h
Page 67 and 68:
So one Sunday morning, I counted ou
Page 69 and 70:
was utterly transported. I had take
Page 71 and 72:
But it was not. It was getting ligh
Page 73 and 74:
excitements even further that I tur
Page 75 and 76:
named Anhalonium lewinii in his hon
Page 77 and 78:
scintillating scotoma itself, which
Page 79 and 80:
years this was the unvarying aura,
Page 81 and 82:
for services, I was more interested
Page 83 and 84:
But Hughlings Jackson (sometimes ca
Page 85 and 86:
Then she lost consciousness. She ca
Page 87 and 88:
after the actual attack. Laura has
Page 89 and 90:
The patient was an intelligent man,
Page 91 and 92:
might then go on to experience “a
Page 93 and 94:
uriously, though Peneld described s
Page 95 and 96:
hallucinations of psychosis, even t
Page 97 and 98:
3. David Ferrier, a contemporary of
Page 99 and 100:
9 Bisected: Hallucinations in the H
Page 101 and 102:
they come? Surely it was not normal
Page 103 and 104:
W hile Marlene experienced protract
Page 105 and 106:
colour was wrong.” He always real
Page 107 and 108:
two people with temporal lobe epile
Page 109 and 110:
left could not cope with a normal d
Page 111 and 112:
fever. His letter to Darwin proposi
Page 113 and 114:
The innkeeper had some delusions, t
Page 115 and 116:
emarkable sight, a “pageant of li
Page 117 and 118:
I replied that I would not dream of
Page 119 and 120:
these hallucinations that some of h
Page 121 and 122:
In Speak, Memory, Nabokov provided
Page 123 and 124:
suggested. Neuroscientists now tend
Page 125 and 126:
hypnopompic images: The most typica
Page 127 and 128:
colleagues (Gurney et al.) publishe
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12 Narcolepsy and Night Hags S omet
Page 131 and 132:
hallucinated or perhaps dreamt it,
Page 133 and 134:
were woken during REM sleep, they w
Page 135 and 136:
13 The Haunted Mind I n Charles Bon
Page 137 and 138:
grandfather walked in and I was so
Page 139 and 140:
delusional states that can go with
Page 141 and 142:
away in a separate, subterranean ch
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hallucinatory, almost delusional wo
Page 145 and 146:
Sarah had many such experiences; so
Page 147 and 148:
sometimes the first and last halluc
Page 149 and 150:
14 Doppelgängers: Hallucinating On
Page 151 and 152:
into gloves with sensors that would
Page 153 and 154:
a man leaning casually against the
Page 155 and 156:
over and beating him. His only inte
Page 157 and 158:
position and movement of one’s li
Page 159 and 160:
15 Phantoms, Shadows, and Sensory G
Page 161 and 162:
hantom limbs are hallucinations ins
Page 163 and 164:
“amputated” from the neck down
Page 165 and 166:
on the surface of a virtual table).
Page 167 and 168:
surroundings, hyperalert. It is wel
Page 169 and 170:
eligious sphere … [and] my friend
Page 171 and 172:
Acknowledgments I am most grateful,
Page 173 and 174:
2006. Induction of an illusory shad
Page 175 and 176:
Devinsky, Orrin, and George Lai. 20
Page 177 and 178:
childhood sexual abuse. Australian
Page 179 and 180:
McKellar, Peter, and Lorna Simpson.
Page 181 and 182:
and Motor Skills 70: 1227-32. Schne
Page 183 and 184:
Permissions Acknowledgments Gratefu
Page 185 and 186:
A Note About the Author Oliver Sack
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