What does it mean to “hear things” and “see things”?
This question has been one that has puzzled me for as long as I have understood schizophrenia. When I was a child and I met my aunt, completely taken over by the schizophrenic illness with her unkempt hair and lack of teeth, my father explained to me that she “heard” and “saw” things no one else did. For the rest of my adolescent life, I attempted to understand what that meant. How could someone perceive something as real as the reality that I saw before me yet others did not?
When people reference “seeing things” they usually do so in context to a preposition. She saw spiders on the floor. He saw a creature in the corner. In these cases it is conveyed that the hallucinations are interacting with the shared reality of most people.
When people reference “hearing things” they say so in the manner of equating the extra sensory experience on equal footing as the shared reality with the rest of the world. Esme Weijun Wang describes her voices as “real as a person talking to me.” Similarly as Elyn Saks writes of her hallucinations being “real”. Limited recollections make it difficult for others to know what it means to hear and see things otherwise.
The thought is terribly frightening. The idea of someone having the ability to see “extra” things as real as the rest of the world that others are not privy to made me fearful of my aunt, just as perhaps the idea makes many people afraid of individuals with schizophrenia. What if they reacted a different way and justified their behavior on a thing that I could not access, resulting in some form of attack or pain onto me? What about my safety? I felt helpless as a person existing around the space of this relative, for I was completely incapable of affecting the types of things that my aunt would “see” and “hear”, thus making it less likely that I would be able to affect and predict her behavior.
This type of fear, I suspect, is a fear shared widely by society towards those with schizophrenia symptoms. This is a response to schizophrenia’s positive symptoms, which are symptoms that are experiences added on to the individual’s experience, rather than a detraction of an existing trait, like affect.
I am a person with schizoaffective disorder. It means that I share the positive symptoms of schizophrenia. I hallucinate. I “hear” and “see” things. But I also have rampant mood swings, to where I am extremely ecstatic for an hour, perhaps several days. Then I may be depressed and suicidal for the next hour or several days. Hearing these descriptions used by voice hearers themselves as well as their doctors and medical literature that described them, it never occurred to me to associate the word “hallucination” to my own experiences. When I was reading Surviving Schizophrenia by E. Fuller Torrey, I had an inkling that I may have been psychotic but was unsure how the symptom language fit my parameter of experience. It was always unclear to me if I was experiencing the same thing. I am still not certain as to whether I experience the same phenomena as others who use “hallucination” in their vocabulary, which leads me to wonder if there are different degrees and types of hallucinations that can occur.
Oliver Sacks in Hallucinations describes different types of hallucinations, but they differ by subject and not how the subject's awareness, consciousness, and autonomy is interacting with it. Sacks reports a telling detail of a person that is hallucinating: eye movement. He mentions that as people are hallucinating, their eyes dart back and forth, indicating that there is an actual sight the viewer is following in her field of vision. In other literature, medicalists report their patients becoming enveloped by conversations with their own voices.
I was 25 giving my presentation to a group of ninth graders with the National Alliance on Mental Illness when I heard my lead presenter speak of her daughter’s schizoaffective symptoms in a similar manner to which I experienced them. She said, “When my daughter gets angry, she sees black creatures crawling on the floor.”
This was the first time that I heard someone convey that the hallucination was prompted or cued by a trigger. I had never understood hallucinations to be triggered. It is often the case that my hallucinations and psychosis occurs as a result of a stressful build up, as explained in one trip to New York City, the ever-pressing, most sensory-inundated experience one can get.
In one moment I just arrived in New York City. The city is disorienting. The minute I land in LaGuardia the scene is swarming in blurs like video effects. I start comparing my reality to video. This is a sign my internal focus is changing.
In the next morning, I am stressed and disoriented. I feel like I am two feet above, apart from my body. Just the thought of going outside is frightening. This New York apartment has unknown objects surrounding me near to my skin. This makes me float out of my body maybe one or two inches. As the week goes on and I drift in and out of the city, outside and then in, I float even more out of my body.
When I go outside, immediately I realize there is no place to run or hide. I am thrown into the action right as I step out of the front door. I find it thrilling and exciting, but unfortunately at the same time uncomfortable and psychologically triggering. Everywhere there is a body, a concrete structure, a storefront ready to interact with me in my face. I am not prepared for these interactions.
The women’s march is today. I discover it as I am browsing the end of Central Park. The women are chanting and shouting. At this time, faced with all of this stimuli, I cannot really pinpoint where myself and where reality begins. The cultural and historical significances of this event are too much for me to understand, though I kind of think about them and how I find myself situated in the middle of the scene. I am a part of history. My identity between myself and the world seems to blur, and suddenly the greatness of the moment feels too monumental to handle on my own. I have to find a place to rest so I go to a nearby cafe and watch while I eat. Even inside it is crowded, and I am sweating trying to find opportunities to slip through into a secluded area.
I walk away from the march and eventually get to the New York Public Library, where it is also crowded. I step into the study hall where rows of desks are facing the central position in the room. There is a spot open for me. I need time to digest and process. I take out my journal, in which I begin to draw the very intense visuals that I see fluttering across my eyes. I refer to them as hallucinations to my psychiatrist, but even that word doesn’t feel quite right, unless I don’t understand what a hallucination is. These images are a bright, colorful, an engulfing overlay layer that takes me over. At times I become lost in these, and the only thing I can do is to stand and watch them where I am while they occur.
During this moment, right after the women’s march, I see spiders crawling everywhere in my field of vision. I see people chanting and I am paranoid that there is a crowd mob wanting to overthrow the government. I draw these things. I am not a very good drawer, but I try my best with markers. I send the drawings to Mike and he says they are cute. Cute! But they are so scary to me!
Later that week I have another instance of intense visuals. This time it occurs after a fight with Mike. On his couch, I start seeing the very intense visuals again. I see the bourgeuousie dressed like Marie Antoinette only they are all putting their backs to me. I immediately see that there is a party going on, and I become sad that they are not inviting me to this party. My emotions are turned up by these intense visuals, and I become engulfed in the world of them.
Later, when it is time to go to bed, I am still stressed, and I fall to the ground from the bed. This frightens Mike, even though it seems so perfectly normal to me to lay on the floor. The floor is cool. He says it is dirty. He finally gets down on the floor with me and lays with me while I tell him what I see across my eyes. I tell him I see Greek Gods and Goddesses. I see a God throwing lightning bolts at him. They are all arguing, and I can hear them. Their voices are very distracting. Sometimes I even just scream so that I can hear my own voice while they are talking.
The lack of comparative answer to the question of What does it mean to hallucinate? prevented me from reporting my symptoms as hallucinations, having never come across a detailed description of the pure phenomenology or reality of having the experience.
In my cases, I experience a tunneling, narrowing of my focus and attention. If my attention, focus, consciousness all had antennas, they suddenly would be not focused in the reality and more tuned in to the hallucination. I experience it more like a camera digital lenses (digital camera lense) focusing on its subject, to where the background becomes blurrier depending on how lost I am in it. My degree or ability to tune in works very much like the F stop: my window of light of the external world is turned into a certain value, and when that value is combined with a certain shutter speed, it can produce a variety of pictures. One picture may be very bright with the subject with equal degree of focus with the background. Or it may be very dim with all but the subject completely blurred. The latter is how I experience visual hallucination, although it is more accurate to say that this is how I experience the memory of hallucination. Being meditatively present during hallucination requires a lot of cognitive capacity to be able to analyze, think about which descriptions to use, and a further degree of consciousness in order to accurately gauge experience. It is difficult for me to do so in the moment because I am usually highly stressed when I hallucinate.
My tunnel visuals convey a sense of distance, however. Whereas a recount of a memory or a what if scenario were playing “in my head”, I would feel the desire to drift my eyes upward above people’s heads, out of the range of faces and into a free space such as the ceiling or otherwise inanimate place. When a hallucination scene is unfolding before my eyes, the scene does not interact with anything of the environment, rather, they behave within the reality, as if I am accessing two dimensions at once. My hallucinations never pick up objects, or pay regards to any law of physics. They do not walk with gravity. My gaze is usually level headed.
It is by studying the first person experience of my eyes and watching others' that I began to measure and correlate my inner experiences to the muscles of the eyes with specific mental processes. Learning the rules of my eyes and correlating them with my internal states led me to begin to seek other people’s eyes and what that may indicate for their internal state. For example, if a person squints a lot, they are contemplating and narrowing their vision, both can be said of the physical as well as the internal. If I am in a conversation with someone and they squint a lot either at me or up in the air I take it they are analyzing or processing a concept. Such is the case too, when responding to internal stimuli such as a hallucination.
Concerning auditory hallucinations, my first word choices would not be “hearing” things. It is true, that the stimulation that I receive are most closely associated with auditory abilities. I perceive them as external characters communicating with me, but the voice is not perceived the same as an individual in the shared reality’s voice. The auditory hallucinations do not have a vibrational cadence. I am very aware that they do not come from my ears externally. In fact, I most closely identify them as very loud thoughts. Although thoughts would not be wholly accurate either. What demarcates these experience different from my own internal thoughts is that these experiences happen that I perceive to be stimuli and characters that are not me. They have the effect of affecting my emotions and my reactions to them. For example, if I have an abusive voice, I react as though it is my mother abusing me. I merely react the same way, but I do not perceive them the same way as if my mother were talking to me. These experiences are uncontrollable, and only subside with medication. Therefore, the realness of them is dependent on my level of reacting to them as if they are real, not that I perceive to be as real as the person next to me is.
These descriptions and languages surrounding these symptoms made it incredibly difficult for me to identify as a person with schizophrenia symptoms for a long time. The accuracy of the language may affect how society perceives these experiences as a whole. Indeed, it is incredibly frightening to have a voice as real as your friend happen to you, but this has only happened on occasion to me, and if so it only happens for a brief split second before I am able to study my internal effects of how it is affecting me.
Looking back on writing these experiences to explain to people is a strange and unique experience. In some ways I have some social awareness of the uniqueness of my experiences, but in other ways I really do not. These experiences occur at any time, are with me at my limits and at my states of rest. They are with me and a part of me, and I view them as things so natural as my left arm. Hopefully, by taking the time to meditate on what it really means to be symptomatic, we may gain a more thorough understanding of hallucinations.
ABOUT THE AUTHOR
Sarah is a nonfiction writer who focuses on mental illness, skepticism, science, and human rights. She has been published at the Huffington Post, Free Inquiry, the National Alliance on Mental Illness (NAMI) blog, Eclectica Magazine, and more. Psychology, neuroscience, and mental health are the epitome of her career focus, as she studied psychology in college. She is pursuing a graduate degree in neuroscience starting in the fall semester of 2020. She has spoken with NAMI since 2018 with two of their speaker programs, Ending the Silence and In Our Own Voice. Both programs seek to educate and raise public awareness of mental illness through personal stories of recovery. Currently, she is working on a book about mental illness titled, These Thoughts Happen to Me.