Individuals with schizophrenia often experience hallucinations. Hallucinations are perceptual experiences which occur without any actual source. In other words, there is no actual stimulus in the environment creating the sound, image, etc. The schizophrenic perceives something as very real even though it isn’t real at all.
Hallucinations can involve any one of the senses – sight, sound, taste, smell or touch. The most common hallucinations experienced by schizophrenics, however, are auditory in nature.
Auditory hallucinations
Auditory hallucinations usually involve voices talking to or about the person. Most of the time, the voices either provide a running commentary on whatever the schizophrenic individual is doing or they tell the person what he/she should do. They may also be carrying on conversations, or give warnings, alerting the schizophrenic about potential danger or harm.
The imaginary voices heard by schizophrenic individuals can be very disturbing. Voices which tell them what to do are referred to as “command hallucinations”. These can be especially problematic if they are telling them to harm themselves or someone else. This can potentially make schizophrenic individuals vulnerable to suicide or violence, as they feel compelled to obey the voices.
Voices can also be problematic if they are telling them to not take their medication or warning them that everyone is out to get them (for example, healthcare staff or family who are trying to help). As a result, voices can play a significant role in a schizophrenic person’s adherence to treatment. Auditory hallucinations also disrupt the person’s thinking, making it difficult to focus or concentrate.
Auditory hallucinations may involve other things besides voices, although it is much less common. The person may hear music playing. S/he may also hear other sounds, such as footsteps or sirens, for example.
Visual hallucinations
Schizophrenics can also have visual hallucinations, which are the second most common type with this disorder. Visual hallucinations involve seeing things which aren’t really there. They may involve images which are very clear, as well as vague or distorted. Visual hallucinations can be especially frightening, depending on the image.
Olfactory, tactile, and gustatory hallucinations
Other types of hallucinations are olfactory, tactile and gustatory.
- Olfactory hallucinations involve the sense of smell. They often involve an unpleasant smell, and sometimes the schizophrenic person believes (much to his/her embarrassment) that the odor is coming from his/her own body.
- Tactile hallucinations involve the sense of touch, and may, for example, involve the feeling that snakes or bugs are crawling on or inside the body. Also, the person may believe an invisible hand or fingers are touching him/her.
- Gustatory hallucinations involve the sense of taste. This may be experienced as a strange taste in something they are eating or drinking.
Connection to delusions
Quite often the hallucinations coincide with delusions (false beliefs) which the schizophrenic is also experiencing. For example, if a schizophrenic man has the delusion that aliens have invaded his home, he may hear voices which he believes are aliens talking to him or about him. He may believe he sees them moving about his home, or smell odd odors which he attributes to their presence.
Treatment
Hallucinations are most effectively treated with antipsychotic medications. For some individuals, antipsychotics may completely eradicate the hallucinations. For others, they may only reduce them to some degree.
What Causes Hallucinations?
The exact cause of hallucinations in the brains of schizophrenics is not yet fully understood. Studies which involve brain imaging have shown that activity occurring in the temporal lobe is involved in hallucinations. Also, the Broca’s area of the brain is also believed to be involved 1. A 2007 study involving 23 schizophrenic males and 10 healthy males suggested that the cingular gyri and middle and superior temporal area are involved in auditory hallucinations 2.
written by Dr. Cheryl Lane, PsyD
References
- Auditory Hallucinations: What's It Like Hearing Voices?
- Chronic auditory hallucinations in schizophrenic patients: MR analysis of the coincidence between functional and morphologic abnormalities.
