Oliver Sacks, "Hallucinations"

  – e-book

 

Read from January 4^th to 13^th 2021

My rating:

 

 In the Introduction of his Hallucinations, Oliver Sacks says that he conceived this book as “a sort of natural history or anthology of hallucinations”, and this is exactly what it is, a collection of first-hand testimonies from people whose common ground are hallucinations, either because of some medical condition (macular degeneration, migraine, epilepsy, narcolepsy, Parkinsonism etc.), or because of nightmares, shocks, use of some substances, or a combination of the two categories.

The author also hopes that the stories in this book “will help defuse the often cruel misunderstandings which surround the whole subject”, for although in many cultures hallucinations are a part of spiritual practices tried to be induced by meditation, drugs, or solitude, in modern Western culture, they are often stigmatized, considered either a sign of madness or of a grave illness of the brain.

This is the second book by Oliver Sacks I read after The Man Who Mistook His Wife for a Hat (here are my thoughts about it) and once again I was fascinated both by the narrative and the medical lingo.

Thus, I learnt that:

·         the actual meaning of the word “hallucination” was established in the 19^th century by the French psychiatrist Jean-Étienne Esquirol, before that it simply meant “a wandering mind”, and this phenomenon was called “apparition”. Although its definition is not even today always clear, because of the confusion with misperception and illusion, “generally, hallucinations are defined as percepts arising in the absence of any external reality—seeing things or hearing things that are not there”;

·         narcolepsy occurs to people who do not have the “wakefulness” hormones (orexins), secreted by the hypothalamus (this is why if the hypothalamus is damaged by a head injury or a tumor or a disease, it can cause narcolepsy later in life);

·         nightmares were thought to be provoked by a “mare” (“Old Hag” in Newfoundland), that is a demonic woman who lay on the chest of a sleeping person suffocating him or her. Sometimes the word is written with a hyphen in the medical field (“night-mare”) to differentiate between bad or anxiety dreams and dreams when someone feels he is suffocating and cannot move.

·         blind or almost blind persons can suffer from Charles Bonnet Syndrome, a brain reaction to the eyesight loss. The CBS hallucinations can be comforting or frightening, can occur once or for years, on and off;

·         The Prisoner’s Cinema is a condition with the same effect that visual deprivation, a consequence of the visual monotony suffered by sailors looking at calm and infinite sea), travelers crossing the desert, pilots flying in an empty sky, truckers driving on an endless road;

·         along with visual hallucinations, called phantopsia, there are hallucinations of smell, called phantosmia (and of vile smells – cacosmia), or of sound – phantacusis;

·         hypnagogic hallucinations are involuntary images or quasi-hallucinations many people can experience before sleep. Hypnopompic hallucinations (upon waking, with open eyes, in bright illumination), are very different from hypnagogic ones, seen with closed eyes or in darkness, one’s room. “They sometimes give amusement or pleasure, but they often cause distress or even terror, for they may seem charged with intentionality and ready to attack the just-wakened hallucinator. There is no such intentionality with hypnagogic hallucinations, which are experienced as spectacles unrelated to the hallucinator.”;

·         a painful past experience or a conversion disorder (formerly called hysteria), generated by severe stress accompanied by inner conflicts, can lead to a splitting of consciousness: “Hallucinations of ghosts—revenant spirits of the dead—are especially associated with violent death and guilt.”

Overall, the book shows that hallucinations are much more than “a neurological quirk”, for they have always been a part of our mental lives and culture, and a source of many folkloric, artistic and religious characters, myths and beliefs. Therefore it is quite possible that the geometric patterns seen during a migraine inspired some motifs of the Aboriginal art; that the Lilliputian hallucinations (pretty common) are partly responsible for the elves, imps, leprechauns, and fairies in fairytales and folklore; that the suffocating night-mare was the model for demons, witches or malignant aliens; that the “ecstatic” seizures (as Dostoevsky had), played a role in reinforcing our sense of the divine; that that lack of substance of such images generated the belief in ghosts and spirits.

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.