Hallucinations

by Oliver Sacks

“consensual validation”;

inner life

Just like the use of "inner life"

portend

one does not hope to discover anything surprising or novel in one’s own imagery, whereas hallucinations may be full of surprises. They are often much more detailed than imagery, and ask to be inspected and studied.

Reminds me of the closed-eye visuals after MDMA. Also reminds me of lucid dreaming. Lucid dreams seem to take place in the "world" (I'm in a believable environment), whereas the closed-eye visuals are usually more abstract, such as a string of words scrolling across my visual field. The closed-eye visuals also feel much more like I'm "watching a movie" (I have no control over them)

were more “like a movie” than a dream;

Charles Bonnet syndrome.

Sometimes people with CBS may hallucinate letters, lines of print, musical notes, numerals, mathematical symbols, or other types of notation.

“text hallucinations”

not only subjectively but physiologically, hallucinations are unlike imagination and much more like perceptions.

Dreams are neurological as well as psychological phenomena, but very unlike CBS hallucinations. Dreamers are wholly enveloped in their dreams, and usually active participants in them, whereas people with CBS retain their normal, critical waking consciousness.

coda

(The study was concerned not only with hallucinations but with the power of blindfolding to improve and heighten tactile skills and the ability to conceive of space and the world around one in nonvisual terms.)

Similar to the blindfold experiment at Harvard

This made it clear that, at a physiological level, visual imagery differs radically from visual hallucination.

Unlike the top-down process of voluntary visual imagery, hallucination is the result of a direct, bottom-up activation of regions in the ventral visual pathway, regions rendered hyperexcitable by a lack of normal sensory input.

Sleep deprivation beyond a few days leads to hallucination, and so may dream deprivation, even with otherwise normal sleep.

hypostasized

Julian Jaynes, in his influential 1976 book, The Origin of Consciousness in the Breakdown of the Bicameral Mind, speculated that, not so long ago, all humans heard voices—generated internally, from the right hemisphere of the brain, but perceived (by the left hemisphere) as if external, and taken as direct communications from the gods. Sometime around 1000 B.C., Jaynes proposed, with the rise of modern consciousness, the voices became internalized and recognized as our own.5

This musical network can be stimulated directly, on occasion, as by a focal epilepsy, a fever, or delirium, but what seems to occur in most cases of musical hallucinations is a release of activity in the musical network when normally operative inhibitions or constraints are weakened.

Think this was referred to in school as "disinhibition" (specifically in reference to synesthesia)

although the musical hallucinations of deafness and the visual hallucinations of CBS may be akin physiologically, they have great differences phenomenologically,

music is performed by the mind/brain whenever it is recollected; and this is also so when it erupts spontaneously, whether as an earworm or as a hallucination.

equanimity

And we need freedom (or at least the illusion of freedom) to get beyond ourselves, whether with telescopes and microscopes and our ever-burgeoning technology or in states of mind which allow us to travel to other worlds, to transcend our immediate surroundings. We need detachment of this sort as much as we need engagement in our lives.

We may search, too, for a relaxing of inhibitions that makes it easier to bond with one another, or for transports that make our consciousness of time and mortality easier to bear. We seek a holiday from our inner and outer restrictions, a more intense sense of the here and now, the beauty and value of the world we live in.

All of these cravings, high or low, are nicely met by the plant kingdom, which has various psychoactive agents that seem almost tailored to the neurotransmitter systems and receptor sites in our brains. (They are not, of course; they have evolved to deter predators or sometimes to attract other animals to eat a plant’s fruit and disseminate its seeds. Nevertheless, one cannot repress a feeling of wonder that there should be so many plants capable of inducing hallucinations or altered brain states of many kinds.)1

I did not try them myself until I was thirty and a neurology resident. This long virginity was not due to lack of interest.

the taste of the categorical imperative (which is something like veal).”

lol

and in my urine stream was a video or movie of the past played back in reverse.

Everything that had just happened in the room was coming out of me like watching a movie in my urine stream, playing in reverse. This totally blew my mind.

Then my eyes became a microscope, and I looked at my wrist and was able to see each individual cell breathing or respirating, like little factories with little puffs of gas shooting o...

My eyes were able to see inside each skin cell, and I saw that I was choking myself from the inside by smoking five packs of cigarettes a day and the debris was clog...

One may cease to perceive motion as continuous and see instead a series of static “snapshots,” as with a film run too slowly.

stroboscopic

As a boy, I had known extreme delight in the study of chemistry and the setting up of my own chemistry lab. This delight seemed to desert me at the age of fifteen or so; in my years at school, university, medical school, and then internship and residency, I kept my head above water, but the subjects I studied never excited me in the same intense way as chemistry had when I was a boy. It was not until I arrived in New York and began seeing patients in a migraine clinic in the summer of 1966 that I began to feel a little stirring of the intellectual excitement and emotional engagement I had known in my earlier years.

Do the arabesques and hexagons in our own minds, built into our brain organization, provide us with our first intimations of formal beauty?

In this sense, the geometrical hallucinations of migraine allow us to experience in ourselves not only a universal of neural functioning but a universal of nature itself.

jamais vu,

Jackson was also an extraordinary theorist, who proposed that higher and higher levels had evolved in the human nervous system—and that these were hierarchically organized, with higher centers constraining lower ones.

(polyopia)

(palinopsia)

paroxysmal—they present themselves suddenly, go through their course, and then disappear.

It is unusual for people with migraine to have complex hallucinations, whereas epilepsy commonly affects higher parts of the brain;

jamais vu

I would sometimes not recognize my home, but I knew I was in my home.

He has also developed a tendency to sudden rage: on one occasion, when a car cut him off, he attacked the offender physically, hurling a can at his car, then punching him. (He wonders, in retrospect, whether some seizure activity played a part in this.) Despite all his problems, Stephen L. is able to continue working in medical research, and he remains an engaging, sensitive, and creative person.

a patient would feel equally that he was in the operating room in Montreal and that he was, say, riding horseback in a forest.

Penfield’s notion of actual memories or experiences being reactivated has been disputed. We now know that memories are not fixed or frozen, like Proust’s jars of preserves in a larder, but are transformed, disassembled, reassembled, and recategorized with every act of recollection.7

which always seemed to Dostoevsky revelations of ultimate truth, direct and valid knowledge of God—

Alajouanine suggested that “epilepsy had created in the person of Dostoevsky a ‘double man’ … a rationalist and a mystic; each having the better of the other according to the moment … [and] more and more the mystical one seems to have prevailed.”

“Geschwind syndrome”). Patients with it often develop an intense preoccupation with religion (Geschwind referred to this as “hyper-religiosity”). They may also develop, like Stephen L., compulsive writing or unusually intense artistic or musical passions.

there is no doubt that those who have ecstatic seizures may be profoundly moved by them, and even actively seek to have more such seizures. In 2003, Hansen Asheim and Eylert Brodtkorb, in Norway, published a study of eleven patients with ecstatic seizures; eight of them wished to experience their seizures again, and of these, five found ways to induce them. More than any other sort of seizure, ecstatic seizures may be felt as epiphanies or revelations of a deeper reality.