UQx PSYC1030.3x 2.3.4 Hallucinations

Summary

This script delves into the symptom of hallucinations in schizophrenia, which are false sensory experiences that feel real but are not. Auditory hallucinations, often hearing derogatory voices, are the most prevalent. It distinguishes between internal thoughts and external auditory hallucinations. The script also covers less common sensory hallucinations like visual, olfactory, gustatory, and tactile, emphasizing the importance of ruling out organic causes before attributing them to schizophrenia.

Takeaways

• 👂 Hallucinations in schizophrenia are false sensory experiences that can occur through any of the five senses.
• 🗣️ Auditory hallucinations, particularly hearing voices, are the most common type experienced by individuals with schizophrenia.
• 💬 The voices heard during auditory hallucinations are often derogatory and negative, causing distress to the individual.
• 🤔 It's crucial to differentiate between auditory hallucinations and internal thoughts or self-talk.
• 👁️ Visual hallucinations, which involve seeing things that aren't there, can also occur but should prompt consideration of organic brain disease.
• 👃 Olfactory hallucinations involve the sense of smell, where a person perceives odors that do not exist.
• 👅 Gustatory hallucinations pertain to the sense of taste, creating the false experience of tasting something that isn't present.
• 👋 Tactile hallucinations involve the sense of touch, such as feeling something crawling on or under the skin when it isn't there.
• 🏥 For any type of hallucination, it's important to rule out organic causes before attributing them to a psychotic illness like schizophrenia.
• 🧠 The possibility of an organic cause should be considered and investigated with appropriate medical examinations, such as an MRI.

Q & A

What are hallucinations in the context of schizophrenia?

Hallucinations in schizophrenia are disturbances of perception where a person experiences false sensory experiences, believing they are experiencing something through one of the five senses when they are not.

How do hallucinations typically affect individuals with schizophrenia?

Hallucinations are typically very distressing for individuals with schizophrenia because they feel as real as actual experiences, regardless of whether they involve hearing, seeing, or feeling something that is not really there.

Which sense is most commonly affected by hallucinations in schizophrenia?

The auditory sense is the most common sensory modality affected by hallucinations in schizophrenia, with the most common type being the experience of hearing voices.

What is the typical nature of the voices heard in auditory hallucinations?

The voices heard in auditory hallucinations are typically derogatory and negative towards the person experiencing them, often saying mean things like 'he's worthless' or 'he's useless.'

How can one differentiate between thoughts and auditory hallucinations?

The key difference between thoughts and auditory hallucinations is whether the individual feels the words are coming from inside or outside their own mind. Thoughts are internal, while auditory hallucinations feel external.

Can hallucinations occur in senses other than hearing?

Yes, hallucinations can occur in any of the other senses, including visual, olfactory, gustatory, and tactile hallucinations.

What is the significance of considering organic causes for hallucinations?

It is important to consider organic causes for hallucinations because they can be a product of organic brain disease. An organic cause should be ruled out early on, even if other aspects of the person's presentation are consistent with a psychotic illness.

What is an example of an olfactory hallucination mentioned in the script?

An example of an olfactory hallucination is a 27-year-old woman experiencing the smell of burning human flesh, which was not actually present.

How are gustatory hallucinations experienced?

Gustatory hallucinations involve the sense of taste, where a person experiences tasting something that they are not actually tasting, such as food tasting rotten to them while others eating the same food find it fine.

What is a common example of a tactile hallucination?

A common tactile hallucination is the sensation of something crawling on or under the skin, like maggots or cockroaches, when no such physical contact is occurring.

Why is it crucial to exclude organic causes before attributing hallucinations to schizophrenia?

It is crucial to exclude organic causes before attributing hallucinations to schizophrenia to ensure accurate diagnosis and appropriate treatment. Organic causes may require different interventions compared to those for schizophrenia.

Outlines

00:00

👂 Hallucinations in Schizophrenia

This paragraph discusses hallucinations as a symptom of schizophrenia, which are false sensory experiences that can be very distressing. The most common type of hallucination for individuals with schizophrenia is auditory, where they hear voices that are typically derogatory and negative. The paragraph also distinguishes between these hallucinations and a person's internal monologue, clarifying that the key difference lies in whether the voices seem to originate from inside or outside the individual's mind. Other forms of hallucinations, such as visual, olfactory, gustatory, and tactile, are also mentioned, with the caveat that an organic cause must be ruled out before attributing them to schizophrenia.

Keywords

💡Hallucinations

Hallucinations are false sensory experiences that can occur in any of the five senses, making the person believe they are experiencing something that is not actually present. In the context of the video, hallucinations are a significant symptom of schizophrenia, often causing distress due to their realistic nature. The script mentions that auditory hallucinations, particularly hearing voices, are the most common type experienced by individuals with schizophrenia.

💡Sensory Experience

Sensory experience refers to the perception of stimuli through the senses. The video script discusses disturbances in sensory experiences, such as hallucinations, which can lead to the perception of non-existent stimuli. This is central to understanding how hallucinations can be so convincing for those experiencing them, as they feel as real as actual sensory input.

💡Auditory Hallucinations

Auditory hallucinations involve hearing sounds or voices that are not present. The script explains that these are the most common type of hallucination in schizophrenia, often involving derogatory voices that can be very distressing. The example given is of voices saying things like 'he's worthless' or 'he's useless', which illustrates the negative impact these hallucinations can have.

💡Delusions

Delusions are fixed false beliefs that are not based in reality. Although not explicitly defined in the script, delusions are mentioned in parallel with hallucinations as a symptom of schizophrenia. They are important to the video's theme as they can also cause significant distress and are often a part of the experience of individuals with the condition.

💡Organic Cause

An organic cause refers to a physical or biological factor that can lead to symptoms or illnesses. The script emphasizes the importance of ruling out organic causes for hallucinations, such as brain disease, before attributing them to a psychiatric condition like schizophrenia. This highlights the need for thorough medical evaluation to ensure accurate diagnosis.

💡Olfactory Hallucinations

Olfactory hallucinations involve the false perception of smells. The script provides a vivid example of a 27-year-old woman experiencing the smell of burning human flesh, which is not actually present. This illustrates the distressing and sometimes bizarre nature of hallucinations that can occur in any sensory modality.

💡Gustatory Hallucinations

Gustatory hallucinations pertain to the false experience of taste. The video script mentions an example where food tastes rotten to the person experiencing the hallucination, even though others eating the same food do not detect any off taste. This highlights how hallucinations can distort the normal sensory experiences.

💡Tactile Hallucinations

Tactile hallucinations involve the false sensation of touch. The script describes a common tactile hallucination as feeling something crawling on or under the skin, such as maggots or cockroaches, when no such thing is present. This type of hallucination can be particularly distressing due to the vivid and invasive nature of the sensations.

💡Internal Monologue

An internal monologue refers to one's own thoughts or self-talk. The script differentiates between an internal monologue and auditory hallucinations by whether the person feels the words are coming from inside or outside their mind. This distinction is crucial for understanding the nature of the voices heard by individuals with schizophrenia.

💡Psychotic Illness

A psychotic illness is a mental health condition characterized by a loss of contact with reality, often involving hallucinations and delusions. The video script discusses how hallucinations are a symptom of such illnesses, particularly schizophrenia, and the importance of considering organic causes before diagnosing a psychotic illness.

Highlights

Hallucinations in schizophrenia are disturbances of perception, causing false sensory experiences.

Hallucinations can occur through any of the five senses and are typically distressing.

Auditory hallucinations are the most common, often involving derogatory voices.

Negative voices in auditory hallucinations are usually critical, saying things like 'he's worthless'.

Positive auditory hallucinations are rare, with only one benign case mentioned in the transcript.

The distinction between thoughts and auditory hallucinations lies in whether the voice seems internal or external.

Visual hallucinations should prompt consideration of organic brain disease as a potential cause.

Organic causes must be ruled out for any type of hallucination before attributing it to schizophrenia.

Olfactory hallucinations involve the false perception of smells, such as the distressing smell of burning flesh.

Gustatory hallucinations are the false experience of taste, like food tasting rotten to the person.

Tactile hallucinations create a false sense of touch, such as feeling insects crawling on the skin.

It's crucial to differentiate between internal thoughts and external auditory hallucinations for diagnosis.

The need for medical investigations like MRI to exclude organic causes before diagnosing hallucinations as schizophrenia.

Hallucinations can significantly impact the individual's well-being, making it essential to address them in treatment.

The importance of understanding the nature of hallucinations for accurate diagnosis and appropriate treatment.

The rarity of positive auditory hallucinations and the significance of this finding in the clinical context.

The variety of sensory experiences that can be affected by hallucinations, highlighting the complexity of the condition.

Transcripts

The next symptom set of schizophrenia is hallucinations, which are disturbances of perception.

When a person experiences hallucinations, they are having a false sensory experience.

They believe that they are experiencing something through one of the five senses when in fact

they are not.

Hallucinations, like delusions, are typically very distressing for the people who experience

them, because the experience––whether it involves hearing, seeing or feeling something

that is not really there––feels every bit as real as if it was actually happening.

For people with schizophrenia, by far the most common sensory modality in which hallucinations

are experienced is the auditory sense.

Auditory referring to what we hear.

The most common type of auditory hallucination that people with schizophrenia experience

is hearing voices.

Typically, when a person is experiencing auditory hallucinations and hearing voices, the voices

are very derogatory and negative about the person in question.

A person may hear one or more voices, but generally, they’re saying awful, mean things

to the person – for example, “he’s worthless”, "he's useless".

It’s very unusual for the voices to say anything positive about the person experiencing

them.

In many years of working as a clinical psychologist, I’ve only ever met one person who experienced

voices that were benign––that said nice things to her.

Sometimes, when a person says they are hearing voices, they are actually talking about their

own thoughts, or internal monologue.

The key difference between thoughts and an auditory hallucination in the form of ‘a

voice’ is whether the individual feels that the words being spoken are coming from inside

or outside of their own mind.

Generally speaking, people are able to be quite clear on this issue.

If the words or voices are coming from inside your mind, we’re usually talking about a

thought or self-talk.

Whereas, if the words or voices are coming externally, as though someone else is talking

to you, we’re usually talking about an auditory hallucination.

Although auditory hallucinations are the most common form of hallucinations, these false

sensory experiences can occur in any of the other senses.

Visual hallucinations refer to the experience of seeing something that is not actually there.

Importantly, if a client tells you that they are experiencing visual hallucinations, you

need to keep in mind that visual hallucinations can be a product of organic brain disease.

Actually, this possibility – an organic cause – needs to be kept in mind for any

type of hallucination.

So, the possibility of an organic cause needs to be ruled out very early on.

Even if other aspects of the person’s presentation are consistent with a psychotic illness, we

need to exclude organic causes, by referring the client for an MRI or whatever other investigation

is appropriate.

It is possible for somebody with schizophrenia to experience visual hallucinations, but you

need to exclude organic causes first before attributing it to schizophrenia.

Olfactory hallucinations involve the sense of smell – so this is where someone has

the experience of smelling something that in fact is not there.

One example that stands out for me over the years is a 27-year-old woman who had a very

distressing olfactory hallucination, whereby she would quite frequently experience the

smell of burning human flesh.

Gustatory hallucinations involve the sense of taste.

So, when a person experiences a gustatory hallucination, they have the experience of

tasting something that they are not actually tasting.

A common example is the experience that the food you are eating tastes rotten when it

tastes fine to others who are eating the same food.

Finally, a tactile hallucination refers to a false sensory experience in relation to

the sense of touch.

When a person has a tactile hallucination, there is the sense of physical contact with

a stimulus that is not real.

One of the most common tactile hallucinations is the experience of something crawling on

or under your skin.

For example, maggots or cockroaches.