A situation in which for a person the surrounding reality differs from the real one is traditionally classified as a visual disorder.

Additionally, such patients may show impairments in hearing, smell and other sense organs, but with a much lower frequency. There is a fairly broad classification of deviations in the perception of reality. The most common among these are illusions and hallucinations.

After reading the information below, you will find out what is the difference between illusions and hallucinations from other diseases. For a better understanding of the material, an example of each significant and common disorder will be given.

Optical illusion in general terms

The difference between the deviations of perception is, first of all, in the affected sense organs and the affected aspects of activity. Their manifestation often differs depending on the environment in which the person lives.

An example is as follows: the patient lives in his apartment or house and is looked after by guardians. In this case, a sharp change in the usual situation can lead to the occurrence of deviations. A similar example can be given for any disorder. At the same time, the changes do not have to be too significant and significant.

Example: a person sat at home, went to the store, communicated with strangers to a minimum. During one of the grocery outings, he accidentally met with a longtime acquaintance. It would seem that the situation is not the worst. However, in a person with mental disorders, this can cause significant shock, provoking the emergence of illusions and hallucinations.

Classification of erroneous visual perception

Most often, patients and people around them regard optical illusion as hallucinations, sometimes as illusions. But in reality, there can be many more problems. Let's consider a description and an example for each case.

1. Illusions. The category of illusions includes erroneous perception and incorrect identification of surrounding objects. The problem can be caused by the similarity of one object to another, surface characteristics (for example, an iridescent or reflective surface), as well as environmental conditions (for example, lighting features). In short, illusions arise when a person does not see an object correctly due to the fact that it looks like something else.
2. Misperception. This problem appears in conditions of a deficit of visual information. Example - a person sees only some part of an object, which is why he incorrectly identifies it. Another example is a patient with poor eyesight, due to which the environment is perceived erroneously. Another example can be cited - a person expected to see one thing in a particular situation, relying on previous experience, and therefore did not attach special importance to new changes.
3. Agnosia. It differs from other disorders in that it is characterized as a neurological disorder, the essence of which is reduced to the incorrect recognition of objects and people. A lesion of the cerebral cortex leads to the appearance of a problem. At the same time, the visual apparatus usually maintains normal performance.
4. Aphasia. It is characterized by incorrect identification of objects. Rarely, but there are situations in which a person cannot find the right words to describe his impressions and feelings, cannot determine the appropriate name for objects. Damage to the areas of the brain responsible for speech leads to the appearance of the problem. They are noted with a variety of dementias.
5. Hallucinations. They differ from illusions, first of all, in that in such a state a person can see something that does not really exist. There are no external factors capable of provoking the occurrence of such disorders - the problem is determined purely by the peculiarities of the internal work of the brain. At the same time, problems can completely disappear only if a person is provided with appropriate qualified assistance, or if he realizes that the visions created by his brain are not real.

Otherwise, the duration of violations can be significantly extended and accompanied by repeated cycles, inevitably affecting the behavior and the psyche of the patient as a whole.

A variety of painful conditions provoked by injuries or infections, certain medications, mental illness, alcoholism can lead to the appearance of visions.

If you suspect that someone from your environment is hallucinating, observe the person, try to calmly explain to him that imaginary objects do not exist, see if he understands and remembers what you said.

If the person does not understand the meaning of your words, wait until he calms down and rests, and then talk again. If it doesn’t help, be patient and don’t be nervous - there will be no sense from it. Try to be near the patient, especially if he is afraid. Try to shift his attention to other events, provide support.

It is very difficult to determine what kind of disturbances in the perception of reality a particular person suffers without qualified medical diagnostics and subsequent assistance. Therefore, when the first deviations appear, you should consult a doctor. As a rule, examinations begin with a visit to a general practitioner (therapist). After completing the initial examination, the specialist will determine with which doctor it is most appropriate for the patient to work further.

In order for the doctor to be able to determine the diagnosis as accurately as possible, the patient or members of his environment should, if possible, collect the following information and answers to questions:

• the nature of the distortion of the perception of reality. You can tell what the patient sees, how he describes the environment, how different it is from reality, etc.;
• the period of the day during which the visions appear and become most pronounced;
• events preceding the occurrence of illusions, hallucinations, or other disorders considered. For example, some patients experience difficulties after waking up, others - soon after physical exertion, in others they appear due to recent stress, etc.;
• places in which the patient most often hallucinates or experiences other disturbances in the perception of reality;
• the duration of violations and the frequency of their occurrence;
• external symptoms indicating a pathological emotional and / or physical condition of the patient;
• previous and current diseases, if any;
• a list of drugs taken earlier and / or at the present time, the specifics of their use (frequency, dose, etc.);
• features of the patient's psychoemotional state, his susceptibility to stress, unpleasant situations;
• information about the peculiarities of the use of alcohol, drugs;
• up-to-date data on the state of vision and other organs of perception with a description of the existing problems.

In order to eliminate the occurrence of problems in the future, or at least minimize the likelihood of their occurrence, we must try to create the most comfortable environment for the patient. It has been established that as long as a person is doing well at home, at work and in his personal life, mental abnormalities will make themselves felt at a much lower frequency and the degree of their severity will be significantly lower.

Along with this, the situation is aggravated by the presence of various kinds of cognitive disorders. If these occur, it becomes more difficult for the patient to cope with problems and his psyche can give a serious breakdown.

It has been established that a corny improperly organized interior can lead to the appearance of optical illusion. Care must be taken to ensure that such lighting is organized in the house in which the surrounding objects do not give a shadow and take their natural appearance.

The walls in the apartment / house where the patient lives should be light and monochromatic. With regard to the colors of interior items, furniture and doors, the recommendation is the opposite: it is better that they are bright and contrast with the walls.

For example, in clinical studies it has been found that Alzheimer's patients are more interested in food when they use bright kitchen utensils, and installing a bright door in the toilet helps to solve their problem with incontinence - the patient simply finds a place to cope with natural needs faster.

If the patient, due to age or other circumstances, is forced to use the handrails, they should be as visible as possible so that their search does not take much time and nerves.
You should refrain from using floor coverings, wallpaper and other decorative elements decorated with overloaded ornaments. It is better that the floor and ceiling, as well as the walls, are light. At the same time, materials should not be glossy. With such an interior design, the overall illumination of the room will significantly increase, but the patient will not be blind with additional light.

If possible, the room should be devoid of contrasting joints on the floor surface - the patient may regard them as an obstacle, which will cause difficulties when moving, because the patient may be afraid to fall.

Thus, there is one big difference between illusions and hallucinations: with the former, a person simply incorrectly evaluates the appearance of an existing object, with the latter, he sees something that does not exist in reality.

Also, the difficulties of perceiving reality may be of a different nature and nature - you have already familiarized yourself with the information regarding these moments.
Respond in a timely manner to adverse changes in your condition, follow the recommendations of the treating specialists and be healthy!

Perceptual impairment(disorder) - violation of the process of integral reflection of the object. Represented by four types of violations:

1. Psychosensory disorders

Psychosensory Disorders- Perceptual disorder, in which a real-life perceived object is recognized correctly, but in a changed, distorted form. There are two groups:

• Derealization(the real world does not seem to be the same) is expressed in the form of a violation (distortion) of the shape, size, weight and color of the perceived object.
  • Micropsia- reducing the size of perceived objects;
  • Macropsia- an increase in the size of perceived objects;
  • Impaired color perception(for example, everything appears to be red);
  • Violation of time and space- with manic depressive syndrome (with it, time "goes very quickly") or with some depressive syndromes (on the contrary, time "drags on for a very long time").
• Depersonalization(a state accompanied by a change or loss of the sense of one's own "I")
  • Somatopsychic(violation of the body scheme);
  • Autopsychic- is expressed in the feeling of change of one's "I".

2. Agnosia

Agnosia- violation of perception, expressed in the inability to recognize and explain the meaning of sensory sensations (visual, auditory, tactile). I distinguish:

• True
  • Total agnosia- does not know anything;
  • Agnosia colors;
  • Spatial agnosia- cannot orientate in space;
  • Geographic agnosia- not recognizing the area;
  • Facial agnosia- does not recognize the faces of friends or himself;
  • Astriognosia- tactile agnosia;
  • Somatognosia- not recognizing your body;
  • Auditory agnosia;
    • Amusia- lack of recognition of musical sounds;
• Pseudo-diagnoses- have an additional element that is not present in agnosia: diffuse, undifferentiated perception of signs (at).
  • Simultaneous agnosia- does not recognize an object in an inverted position.

3. Illusions

Illusions- violation of perception, in which a real-life object is perceived as completely or partially different. Distinguish:

1. Physical(due to the characteristics of the environment in which the perceived object is located).
2. Physiological(arise in connection with the conditions of the functioning of receptors).
3. Mental(inadequate reflection of the perceived object).
4. Affective illusions arise against the background of fear or anxiously suppressed mood.
5. Spotting illusion - sees words, letters.
   • Pareidolia- false images appear when a real object is perceived as an illusion (the heart sees in the clouds).
6. Auditory illusions - distortion of the power of sound, etc.
   • Verbal illusions (type of auditory) - a person hears words. He hears the wrong words that are being spoken to him.
7. Tactile illusions - parasthesias - as if snakes, beetles crawl over the body, although they are not. Alien hand syndrome- some part of the body is felt like someone else's.
8. Olfactory illusions,
9. Flavoring illusion.

4. Hallucinations

Hallucinations- an imaginary perception, a false image without sensory stimulation. Distinguish:

• Simple and complex.
• By modality(analyzer type) - visual, auditory, motor, vestibular, visceral, gustatory, olfactory, hallucinations of the skin feeling.
• True and pseudo-hallucinations.
• By the condition of occurrence- functional, psychogenic, etc.

Simple hallucinations(one analyzer):

• Photopsy- elementary visual hallucinations in the form of circles, flies, mesh, flashes, sparks from the eyes;
• Acoasma- simple auditory hallucinations in the form of noise, knocking, squeak, squeak, rumble;
• Phonemes(speech deceptions) - the patient hears individual words, calls.

Complex hallucinations(more than one analyzer):

• Verbal character- the patient hears voices.
• Spotting- vision of complex objects, people, etc. Depending on the nature of the visions, they are distinguished: fragmentary (body fragments), panoramic, scene-like, anthropomorphic (I see the dead), zoops (I see animals), demonomaniac (I see evil spirits), visceroscopic, autovisceroscopic hallucinations, etc.
• Olfactory.

General feeling hallucinations:

• Visceral hallucinations(endoscopic) - the perception of foreign objects inside the body.
• Motor hallucinations.

True hallucinations perceived as an objective reality. They are bright, not
differ from objects of reality. Pseudohallucinations perceived as something special, different from reality. They are not projected into the external world, but “arise” inside the head, body, or “come” from a parallel world (hears voices inside the head that give orders).

Types of hallucinations, depending on the conditions of their occurrence:

• Psychogenic- "suggested", arise after stress, for example, the death of a loved one.
• Induced- deceptions of perception among persons who are, for example, in a crowd engulfed in religious ecstasy.
• Functional- arise under the influence of a real stimulus and exist in the same modality of sensations.

Sources and Literature

• Preparation materials for the exam in psychopathology.

The word "illusion", which came from the Latin language, is translated as deception or delusion. This remains the most accurate description of this term. The bright colorful world of illusion is not always fiction, but it is always a deceptive sensation that pulls out of reality and interferes with living an ordinary life. There are many reasons for the appearance of illusions, as well as its types.

What is an illusion?

Such a phenomenon can be created by a skillful magician or by mother nature herself, but it happens that a person deceives himself. Illusion is when a real object or a phenomenon is perceived in a distorted form and is understood ambiguously. It is believed that an illusion is a companion of any kind, but this is not entirely true, a healthy person is also able to feel the illusion on himself. How can you see an illusion?

1. Due to optical illusion.
2. Being in an unfamiliar state for a person (drug intoxication, with pathology or a standing affect).

In everyday terms, illusion means hopes and dreams. The unreal world, which the illusion creates, is the world of self-deception, and serves as a means that makes life easier for a person, or even is a flight of his fantasy. Human consciousness always strives to protect itself from shocks and strive for illusion, encourages dreams of a miracle, creates images of a "beautiful life" or ideal people.

How are illusions different from hallucinations?

Life situations can create conditions in which people will experience perceptual disorders. Illusions and hallucinations can cause such disorders; even a healthy person is not protected from them. How to tell one from the other:

1. As a result of an illusion, one can see real things from a completely different side or with a great distortion of reality. The usual mistakes with which a person can see something, for example, in the twilight to mistake some things and objects for others, to mistake a bright leaf from a tree for a mushroom cap, can be in quite healthy people. It is necessary to distinguish such errors from painful perception of reality.
2. Hallucinations appear where there is nothing. Haunting images can arise in the context of psychosis. Healthy people arise if they are in a state where their consciousness is changed.

Illusions of perception

Human perception is imperfect, and sometimes you can see the image, hear the sound, feel the taste is not what it really is. It is normal that, against the background of a distorted perception, the brain will build images that do not correspond to reality. A person is able to create the appearance of something that is not in reality or, on the contrary, not notice the obvious. The illusion of perception in psychology is the observation of phenomena, even if a person realizes that it is on the verge of the possible. This way you can see a mirage, distortion of an object in water, and much more.

What kind of illusions are there?

There is at least one illusion for every sense organ, there are a lot of them. The types of illusions that a person can experience have their own division:

• optical - this is an erroneous visual perception;
• sound - hearing failure;
• physiological - peripheral or central links of the sense organs did not work correctly;
• awareness - a sense of presence, also referred to as forms of hallucination;
• physical - associated with natural phenomena;
• affective - may appear with a sharp change in mood;
• organic - erroneous perception of colors, sizes and shapes;
• pareidological - the creation of pictures with the help of thought.

Pareidolic illusions

Illusory perception of real objects is called a paraidological illusion. Such illusions can arise when a person examines a wallpaper pattern, fabric, stains or cracks, clouds. You can see not only faces or objects, but also fantastic images. This happens as a result of the effect of a dual image, when the illusion of the appearance of depth or recognition images is created specifically for provocation. This kind can be observed in several people at once when considering a well-known subject, for example, a cultural property.

Affective illusions

Being in a certain emotional state of the soul, and at the same time, being in an unfamiliar place, a person is able to see the almost incredible. A striking example is a night visit to a cemetery. Being under the influence of fear and in anticipation of something unkind, anyone is able to see an affective illusion. Or in case of fear of spiders, and the presence of a new, unfamiliar place, a person will be afraid of their appearance from everywhere. Many people are able to see different kinds of illusion. Even a healthy person can develop an affective illusion.

Physical illusions

Some pilots in their stories emphasize that if you fly over the sea, when the stars are reflected in it, you get the feeling of an inverted flight. The main feature of physical illusions is their dependence on the mental state. Physiological or physical illusions are short-term phenomena, they are episodic. If a person is able to critically assess the situation, to understand that this is an illusion, then this testifies to him.

How are physiological illusions created? A striking example is a violation of the eye gauge, when "by eye" it is very difficult to determine the distance from a person to an object. Real indicators and false perception of distance give rise to this type of illusion. Almost all people are faced with this type of illusion and knowing that it is an illusion, they can easily correct it. This type of illusion is a feature of the structure of the eye and lighting effects.

Cognitive illusions

Such phenomena arise due to the fact that a person begins to make assumptions about the world, which leads to analysis, sometimes unconscious. Cognitive illusions are erroneous thinking, it is formed as a result of mental behavior. Such an illusion of a person is an example of fast thinking, if a person had initially analyzed his thoughts, then it would not have arisen. Cognitive distortions are actively studied by psychotherapy because they carry consequences of a personal and social nature.

Illusions - psychology

All people are prone to worries, making difficult decisions, looking for answers to questions. People have illusions in order to remove uncertainty in some issues. What is an illusion in psychology? This is the formation of your own image of vision and its replacement, instead of the present and real. Illusions can help a person relieve anxiety and tension. Even if the image is negatively colored in illusions, the person will be warned of what he should be afraid of.

Such thinking is initially erroneous and may have nothing to do with reality. Psychologists do not attribute such illusions to human diseases, but they recommend stopping living in an illusory world. To live with illusions constantly is, to say the least, stupid. If a person lives and constantly harbors illusions about other people, then he needs to consult a psychologist.

Reasons for illusions

When a person observes how a spoon bent when immersed in a glass of water, then this is not a mental disorder. This is an illusion that any healthy person can have. Illusions more often arise in a person with a stormy, they visit creative people. Stress or fatigue may cause people to see and hear something wrong. But if the illusion is already a faithful friend and visits at an enviable frequency, then this is more likely a mental illness.

It also matters what kind of illusion comes to a person. The sound of water dripping from a closed tap is not a reason to run to the doctor, much more serious if voices are heard periodically. The reasons for many illusions are not known to this day, they have no scientific explanation. To live in a world of illusions is to carry out the construction of your life as if a person's existence takes place in another world. It doesn't matter if the illusory world is better or worse, the main thing is that it is different.

How to stop living in illusions?

Human behavior in certain situations and his decisions always lead to certain consequences. A person who has chosen for himself the path of living with illusions begins to use the rules of the fictional world in the real one. He chooses for himself the model of behavior that could be effective in his illusory world, but not in reality. Nourishing illusions in a mild form is even sometimes useful, but living in them is dangerous, so you need to know how to get rid of illusions.

1. It is worth making an attempt to bend the world of illusion to fit itself. With him, you need to start a war in your subconscious and burn out all those ideas that are far from reality. People who continue to live in a made-up world are the future demonstrators. They are ready to pour out their anger on everyone who is at hand. They complain about the life of random people, fellow travelers, c.
2. A person should understand that reality is what it is, it will not be different. All failures are caused not by the fact that a person is bad, but by the fact that he acts incorrectly, looking back at his illusions. A person should grow up. To become an adult is not to give up your goals and stop wanting to see your life better, it means accepting the truth, knowing the world, learning to understand it correctly.

In childhood, illusory deceptions are much more common than in adults. Their development is facilitated by the emotional lability characteristic of children - states of excitement, anxiety, fear, increased activity of the imagination, suggestibility inherent in children, as well as states of overwork.

Unlike physiological, pathological illusions are characterized by repetition, uniformity, the presence of a pronounced affective component and, in some cases, a secondary interpretation.

Visual illusions are encountered already in early childhood. Auditory deceptions, as well as the interpretive component of illusions, appear at school age (for example, the sound of rain is heard as the sound of approaching footsteps, the sound of water in pipes is perceived as a conversation). Tactile and olfactory illusions are less common in children (the fold of the blanket is perceived as a snake, the smell of food from the kitchen is felt as the smell of medicine).

Most often, illusions in children arise with delirious clouding of consciousness in the acute period of intoxication and infectious psychoses. Visual illusions and pareidolia predominate. In schizophrenia, illusions are characterized by fantastic images (lampshade - "a bird without a head"), often with a delusional interpretation. Separate illusory deceptions are also possible within the framework of neuroses - against the background of fear, anxious fears.

Hallucinations (from Lat. Hallucinatio - delirium) is a complex psychopathological phenomenon. The term "hallucinations" was first used by Boissier de Sauvage. There are a number of definitions of hallucinations in the literature. One of the most common is the following: hallucinations - the perception of images that arise without the presence of real objects that affect the senses.

In addition, hallucinations were considered as:

Deceptions of the senses that do not have a source of irritation, in which the patient is unable to detach himself from the inner conviction that he has sensory sensations at a given moment; while in fact no object capable of arousing such sensations acts on his external feelings (J. Eskirol).

Presentation of unusual sensual liveliness (E. Kraepelin).

Such states of consciousness, which are either completely equivalent to normal perceptions, or, in the absence of the latter, are able to replace them with themselves (V.Kh. Kandinsky).

Deceptions of perception, which are not distortions of true perceptions, but arise by themselves as something completely new and exist simultaneously with true perceptions (K. Jaspers).

The image of a representation visualized in the psyche (A. Hey).

Real perception in the sense that the hallucinating person really sees, hears, etc., and not only it seems to him that he sees, hears, etc. (V. Chizh).

Projecting outwardly objectified, "received flesh and blood" representations, not perceptions (V.A. Gilyarovsky).

Representations, characterized by involuntary, intense sensuality, projected into the real world and thereby acquiring the properties of objectivity (A.V. Snezhnevsky).

Common signs of hallucinations are the absence of an objective stimulus and the patient's conviction in the reality of the experience.

Along with the general ones, there are particular criteria for hallucinations:

The sense of reality is the sense of the real existence of the hallucinatory image. It is most pronounced with hallucinations arising against the background of a dim consciousness, as well as with true hallucinations with extraprojection.

The sensory character of a hallucinatory image is the degree of its belonging to sensory images (as opposed to the category of representations). True hallucinations are the most sensory:

“People with dogs - they walked like an army to my house. There was an eerie barking. They walked from all directions. They began to stand in front of my windows. If they saw that I was going to the window, then they instantly disappear. I saw them under every tree. "

Hallucinoids (incomplete pseudo-hallucinations) and pseudo-hallucinations have a lesser degree.

"There is a knock or shock from the wall, an invisible and inaudible sound, as if the wall were vibrating."

Violence of images, a feeling of alienation, made-up. Hallucinations are always involuntary and usually uncontrollable:

“The vision of the pages from the grammar textbook arises, they are seen by the head, and not by the basins. the text is clear, you can read it. "

The feeling of violence without the experience of being made is observed mainly in hallucinations with extraprojection.

“I saw the devil: I was lying on my bed, and he was walking behind, black, bent over me. I had a round vase, the most frightening moment was when this terrible head was on the vase. "

The feeling of being made differs from the experience of violence by the presence of a delusional addiction - the images are specially “made” by someone, “directed”, arose by someone’s evil will under the influence of “hypnosis”, “equipment”. It is typical for pseudo-hallucinations:

The patient sees "portraits of acquaintances and strangers that appear before the eyes" and notes that "visions are shown using a system of lenses and rays."

A state of attention. Focusing on true and pseudo-hallucinations increases their intensity, while distraction weakens them. Hallucinoids disappear when attention is paid to them.

The patient, who was called aside at the moment of hallucination, immediately laughs at himself in a conversation, calls himself “crazy”, understands that voices are a “disease”. But, left alone, he again hears how he is scolded, called "a drunkard", scolded.

Bayarget's mental hallucinations

In the first group, hallucinations are considered, depending on their degree of complexity.

1. Elementary hallucinations are visions of flashes of light, fog, colored spots, etc. (photopsies, phosphrenes); perception of noise, ringing, bell strikes, creaking, etc. (acoasms) or shouts, groans, crying, laughter (phonemes). These hallucinations are characterized by the incompleteness of the objective image.

Simple hallucinations have a clear, complete image and are the most common type of hallucinatory deception.

Complex hallucinations-images appear simultaneously in several analyzers.

Complex hallucinations also capture several senses and, in addition, are united by a common content.

In the second group, the division of hallucinations by sense organs is presented.

2. Visual hallucinations appear in images:

Various items.

People, both familiar and unfamiliar, living or already dead - anthropomorphic hallucinations.

Mystical, mythological characters (angels, devils, witches, mermaids, etc.) - demonomaniac hallucinations.

Animals (rats on the floor, dogs, cats running around the room, insects on a blanket, flies sitting on the skin and biting a patient, etc.) - zooplastic hallucinations.

Landscapes, colorful landscapes, pictures of disasters and other paintings; usually static - panoramic hallucinations.

Habitual household or professional environment - palingnostic hallucinations.

Own double - autoscopic or deuteroscopic hallucinations. Typical for relatively severe forms of organic brain lesions, most often the temporal, parietal lobes, somatogenic psychoses, for example, postoperative psychosis against the background of hypoxia.

Own internal organs - autovisceroscopic hallucinations:

The patient, with his eyes closed, clearly saw a beating heart, pink in color, the size of a fist, which was grasped by a black paw. I saw my lungs, brown in color, covered in yellow smoke. The paw reached for them, but did not reach them.

Objects or living beings inside your body - endoscopic hallucinations.

The same patient saw how a yellow-green crocodile, 1/4 cm in size, appeared under the skin, in the groin area. It crawled down under the skin of the legs and disappeared. Then a black snake appeared from the groin area, began to move up the intestines, made its way into the stomach, passed the esophagus and stuck its head out through the mouth. I saw in the stomach two herring heads lying side by side, and then a gray ball of wool, which also moved through the intestines.

Visual hallucinatory images can have their usual sizes (normoptical hallucinations), be enlarged or reduced (macro- and microptic hallucinations):

For example, with infectious diseases, intoxications, patients see "little gnomes in bright dresses", "small figures of people with sabers bald on small horses."

Images can be static or moving. For example, visual hallucinations in alcoholic delirium are characterized by microzoopsia - visions of many moving small insects, animals (cockroaches, mice, rats). Scene-like hallucinations often appear - visions of plot-related events, scenes (adventures, funerals, battles, afterlife, etc.).

Bifurcation of images or vision of multiple identical objects are possible (diplopic and polyopic hallucinations). In addition, flat, lack of volumetric vision may occur, which is perceived as projected onto the surface of the wall (cinematic hallucinations).

Sometimes the patient sees objects that are out of his field of vision (extracampal hallucinations). Such deceptions are characteristic mainly of schizophrenia.

There are also negative or negative hallucinations in which the patient does not see certain objects in his field of vision. Negative hallucinations can sometimes be induced artificially through hypnotic suggestion.

Among the auditory hallucinations, the most clinically important are the verbal ones described for the first time by G. Seglas. They represent words, phrases, conversations, "voices" that are heard by the patient.

There are a number of types of verbal hallucinations, depending on their content:

Imperative - orders to do something or prohibitions on any action that the patient most often cannot resist. Imperative hallucinations are dangerous. In particular, "voices" can order a sick person to kill someone or throw themselves out of a window.

With schizophrenia, patients feel "the loss of their will", "the inability to resist" orders, call themselves "robots", "puppets", unquestioningly carry out any orders of the "voices":

“I am a toy in the wrong hands. do this, do this ”;

“It makes you redo, for example, pull the string, first one, then another, and then - badly, you have to redo everything. They talk in their heads, and sometimes they move their hands. "

This brings imperative hallucinations closer to psychic automatisms and catatonic phenomena.

Teleological (according to E. Bleuler) - "voices" advise the patient what to do, what is the best way for him to act, teach him.

Persuasive - persuasion to do something, exhortations, the message to the patient of certain information, often false.

Threatening - the patient hears threats against him, promises to punish him, deal with him, kill him, etc .:

"I will destroy you!. Your heart will stop !. Now you are going to die! ".

Insulting - abuse, insults, ridicule addressed to the patient:

"You bastard, I was better in my youth than now."

Accusers - condemnations, accusations of any misconduct, sins, both imaginary and existing.

Commentators - comments and assessment of the patient's actions in "voices":

"Got up. went. opened the refrigerator. wants to get dressed. "

Contrasting - advice or orders to do the opposite of what the patient is doing at the moment, or several "voices" with the opposite content.

There are verbal hallucinations in the form of a monologue - a continuous story about something, for example, about the patient's life, his biography, long-forgotten facts from his past (memoir hallucinations).

In addition to verbal hallucinations, there are musical hallucinations - music, singing, choir are heard. So, patients with an alcoholic genesis of hallucinations hear ditties, drinking songs on an alcoholic theme, etc. Patients with epilepsy hear church, sacred music, bell ringing, magic "heavenly" music. Sometimes unfamiliar melodies sound, which patients try unsuccessfully to remember or write down.

Olfactory hallucinations are represented by the perception of various smells, familiar and unfamiliar, pleasant, indifferent or, more often, unpleasant, disgusting.

Patients feel the smells of rot, blood, feces, burning, "radioactive snow", or flowers, perfume, etc.

Smells can come from various external objects (from the ventilation duct, from food), as well as from the patient himself or from his internal organs. In the first case, olfactory hallucinations are often accompanied by delusions of poisoning, in the second - delusions of bad smells, hypochondriacal and nihilistic delusions.

Episodes of intensely perceived odors may appear within the epileptic aura.

Taste hallucinations can occur both during meals and outside of it. Patients experience various taste sensations, usually of an unpleasant nature. The object of sensation can be familiar, or unknown, unusual ("metallic taste", "cyanide" taste, bitterness, etc.).

Often, gustatory hallucinations are combined with olfactory deception, delirium of poisoning, and can cause the patient to refuse food. In addition, unpleasant gustatory sensations are encountered in hypochondriacal and nihilistic delusions and are interpreted by the patient as signs of a serious "illness", "decomposition" of the body.

Tactile hallucinations are the sensations of the presence of various objects or living beings on the skin, in the skin, or under the skin.

For example, when poisoning with tetraethyl lead, leaded gasoline, a sensation of the presence of hair, crumbs, threads in the mouth is characteristic (a symptom of a foreign body in the mouth).

With cocaine psychosis, Magnan's symptom is observed - a feeling of insects crawling under the skin, moving small objects, crystals.

A schizophrenic patient feels itching in the area of ​​the anus, genitals, where insects "nest" - "microscopic fleas, ants", which "scatter as quickly as lightning bolts" throughout the body.

Unlike senestopathies, with tactile hallucinations, a complete image of an object is perceived, and not just a sensation. Patients feel the touch of the hand, crawling of living beings, scratching with a needle, etc. and can at the same time clearly describe the object-source of the tactile sensation. There are tactile hallucinations:

Temperature character - "apply a hot wire."

Gigric hallucinations are the sensation of the presence of fluids on or under the skin.

Stereognostic - the feeling of the presence in the hand of an object - a glass, a coin.

Erotic - sensations of touch, obscene manipulation of the genitals.

Haptic - sudden sensations of sharp shocks from the outside, blows, grabbing.

Visceral hallucinations (interoceptive, bodily, hallucinations of the general feeling) - a feeling of the presence of living beings, foreign bodies, additional internal organs, etc. inside the body. Like tactile hallucinations, visceral hallucinations are characterized by objective completeness. Patients can describe imaginary objects accurately and in detail.

A patient with psychosis, which arose against the background of atherosclerotic lesions of the brain, complained about the presence in her body of "little men - poltergeists", claimed that they penetrated through the anus and spread throughout all internal organs:

“There were a lot of them, mostly talking. Show me my insides. They wanted to attach a tail. They began to run around the body like little gnats, little men. They ran and made a whole house. Blowing bubbles at the feet. We did what they wanted - there was a small window above the left eye, there was always someone sitting there, like a dispatcher. ” I felt “telephone wires” in my stomach, which the “little men” had stretched out to talk to each other, “the phone was installed by the first one - I hear that someone comes under the pillow and talks to those in me”. I felt small steps when "poltergeists" ran inside her. In my head I felt a "little woman" who directed all the actions of the "little men". She noted that "poltergeists" were capable of both causing disturbances in internal organs and "correcting" them.

Motor hallucinations (kinesthetic) - imaginary sensations of movements (bending the fingers, turning the head, running). In particular, with alcoholic delirium, patients feel that they are performing professional actions, going somewhere, etc., while in reality they are lying in bed.

According to E. Bleuler, motor hallucinations most often belong to the category of pseudo-hallucinations.

Vestibular hallucinations are sensations of falling, lowering or lifting in an elevator, rotation of your own body.

3. The third group includes the following hallucinations. Functional and reflex hallucinations. Unlike other hallucinations, they arise only at the moment when a real stimulus acts on the sensory organs. However, in contrast to illusions, both the real object and the hallucinatory image are perceived (while the illusion replaces the real object).

A functional hallucination develops in the same analyzer, which is acted upon by a real stimulus:

Simultaneously with the sound of the wheels, the phrase is heard: “You will not live. You will not live. "

With a reflex hallucination of Kalbaum (K. Kahlbaum), the stimulus acts on another analyzer:

The patient listens to music and sees purple paths in front of his eyes that move up and down.

Psychogenic hallucinations arise under the influence of acute psychotrauma and reflect its content. Most often these are visual and auditory hallucinations. Their development is accompanied by anxiety and fear.

Often, within the framework of reactive psychoses, the associated hallucinations of J. Seglas develop. A logical sequence of appearing images is characteristic - the “voice” announces a fact that immediately happens:

Induced hallucinations arise under the influence of suggestion, belief. For their development, a pronounced emotional involvement of the subject in the experiences of the inducer is required. In the vast majority of cases, these are visual deceptions. It is characteristic that after breaking the connection with the inducer, the hallucinations quickly disappear.

Sources of induced hallucinations can be:

A large number of people - for example, with massive religious or mystical visions.

Special effects - hypnosis, etc. Hallucinations induced in a state of hypnotic trance are usually amnestied upon leaving it.

Hypnagogic hallucinations (from the Greek hypnos - sleep and agogos - causing) - occur when falling asleep, at the time of transition from wakefulness to sleep. Usually these are visual, auditory, tactile deceptions. There are visions of individual objects, people, animals, a voice is heard, or the subject has the feeling that he is getting up, going somewhere.

They are observed at the initial stage of acute psychosis, for example, with alcoholic delirium, as well as with an asthenic state.

Hypnopompic hallucinations (from the Greek. Pompos-accompanying) - observed upon awakening. They are less common than hypnagogic ones within the same conditions. Visual and auditory deceptions prevail.

M.I. Rybalsky classifies hypnagogic and hypnopompic deceptions as a group of illusions and hallucinations that occur with dim consciousness, along with hallucinations in hysterical and epileptic twilight states, amentia, oniric states, delirious and oneiric syndromes, as well as pseudohallucinosis. In some cases, they are hallucinoids.

Hallucinations of the imagination of Dupre (E. Dupre) - a sudden perception in the form of a real object of those images that were previously actively and for a long time presented by the subject in the imagination. Usually these are visual or auditory deceptions, short-term, fragmentary. For the development of hallucinations of the imagination, a high emotional significance of images is required. They often arise in response to a traumatic event, reflecting it in their content.

They develop most easily in persons with a well-developed imagination (including the norm) - children, artists, musicians, as well as in persons with hysterical character traits.

The ability to experience normally unusually bright and sensual (sensory) images is called eidetism (from the Greek eidos - view, image). Eidetic images are perceived as arbitrary, differ from hallucinations by the preservation of criticism, the absence of a feeling of violence and accompanying disturbances in thinking.

With hallucinations of the imagination, the high sensory nature of images and their extraprojection is complemented by their visualization, as a result of which they are perceived as real.

Hallucinations of Charles Bonnet (Ch. Bonnet) are associated with pathological activation of sensory receptors or a decrease in external sensory stimulation. So, in patients with cataracts, retinal detachment, etc. there are visual hallucinations (visions of people, animals, landscapes), with damage to hearing, neuritis of the auditory nerve - auditory.

Under conditions of sensory deprivation (limitation of sensory stimuli), visual, auditory, and motor deceptions develop.

Usually, Bonnet's hallucinations have a relatively simple structure and are accompanied by a critical attitude, however, with their high intensity and a pronounced anxious component, criticism can be lost.

Lermitt's peduncular hallucinations are characteristic of lesions of the brainstem in the region of the legs. Lilliputian visual deceptions appear, mainly in the evening, most often against the background of disturbed consciousness. Patients see moving animals, birds, painted in natural colors. In cases of low intensity of deception, criticism of them may persist.

Plato's hallucinations occur with neurosyphilis. These are loud verbal deceptions, often with the addition of delusional interpretations, behavioral disturbances, and the loss of a critical attitude.

Hallucinations of Van Bogart (L. Van Bogaert) are characteristic of leukoencephalitis - multiple color visions of various animals (animals, birds, fish, butterflies), arising against the background of anxiety and anxiety, in the intervals between bouts of drowsiness. Usually preceded by the development of delirium.

With J. Berze's hallucinations, patients see luminous phrases on the wall, as if written by an invisible hand. These deceptions are characteristic of alcoholic psychosis and, less commonly, schizophrenia.

Peak hallucinations occur when the brain stem is affected in the region of the fundus of the fourth ventricle. Patients see people and animals through walls. During hallucinations, nystagmus and diplopia develop.

4. In the fourth group, depending on the clinical and psychopathological structure, one distinguishes between true hallucinations, pseudo-hallucinations and Bayarget's mental hallucinations.

True hallucinations - have an external projection, are identified with real perception and are experienced as really existing. The images are usually brightly sensually colored. Patients are convinced that the perception of these images is available to others. Emotional reactions and behavior of the patient correspond to the content of hallucinations.

A patient with alcoholic delirium saw "guests" at his home, talked with them, laid the table, invited his family to join the company.

A patient with an acute hallucinatory-delusional state saw that under the windows “Dwarfs were standing in white robes, and their skulls were lying in the snow, and a hearse. They were waiting for me to die. " I was anxious, restless.

While on the street, a patient with cerebrovascular disease heard people say about her: “That woman? No, not that one. " I heard phrases addressed to her: "You are selling guys, infection." She stopped leaving the house, felt fear for herself and her loved ones.

Pseudo-hallucinations were first identified and described by V.Kh. Kandinsky. Unlike true hallucinations, pseudo-hallucinations:

are not identified with real objects and phenomena;

have the character of involuntary, violent ("made") images as a result of outside influence;

have intraprojection, arise in subjective space;

characterized by an attitude both to real perceptions and at the same time as to artificial images;

lack of criticism.

According to V.Kh. Kandinsky, pseudo-hallucinations are very lively and sensual images that differ from true hallucinations in that they do not have the character of objective reality. On the contrary, they are perceived as subjective, but at the same time abnormal, new, different from ordinary images of memories and fantasies. In addition, he designated them as a pathological variety of these images, reproduced sensory representations.

Pseudohallucinations occur mainly with clear consciousness and are associated with a disorder of thinking (the sensorial form of this disorder, according to MI Rybalsky).

Pseudo-hallucinations, like true ones, are subdivided according to the sense organs.

Pseudo-hallucinations of vision are one of the most common options.

Reality. Indistinguishable from other perceived images. As a rule, they are adequately blended into the environment. They are perceived as images of a different origin, “a different reality”.

Made. Images are perceived as existing on their own, without the participation of outside influence. Characterized by a feeling of made-up images, outside influence.

Projection Extra-projection, images are perceived as being outside, in objective space. Intraprojection, images arise directly in the subjective mental or bodily space (the "voice" sounds inside the head, in the stomach, etc., the picture appears "in consciousness", sees it with the "brain", "third eye").

Sensory (sensual brightness). They have "ordinary" sensory features (loudness, timbre, color), in their sensory brightness do not differ from real objects. They have an "unusual" sensory character ("artificial", "metallic" "voice"). They have a qualitatively different brightness - more often dull, ghostly, disembodied ("soundless voice"), less often unusually bright and clear (vision in extremely bright, "unearthly magical colors").

Behavior. It is determined by the content of hallucinations (they talk with an imaginary interlocutor, shake something off themselves, run away from someone). They are immersed in their inner experiences, are indifferent to the environment, or suddenly show aggression or auto-aggression.

There is no criticism. A high degree of confidence in the actual existence of images. We are convinced that the images are "made" artificially and are perceived in a different, unusual way. There is no criticism.

Auditory pseudo-hallucinations are no less common.

The same patient Lashkov once heard a loud voice uttering syllables: "Pe-re-me-no subordination!"

Another patient heard that “various reproaches are meaningfully expressed: as if I were guilty of such and such a sin, and I needed to impose fasting and repentance on myself, I hear how the following words did not cease to me mentally : "Stay above yourself if you want to avoid eternal destruction!"

Tactile, olfactory and gustatory pseudo-hallucinations are to a lesser extent delimited from true ones. However, they are also perceived by the patient as images that differ from the real ones and are artificially evoked from the outside.

In schizophrenia, pseudo-hallucinations are most often combined with mental automatisms and delusions of influence in the structure of the Kandinsky-Clerambo syndrome.

However, in schizophrenia, true hallucinations are also observed, and within the exogenous organic group of psychoses and epilepsy, pseudo-hallucinations are possible. In particular, V.Kh. Kandinsky gave a description of pseudo-hallucinations with fever, narcotic intoxication with drugs of opium, hemp, and belladonna. In these cases, pseudo-hallucinations usually have extreme brightness and excessive sensory reality.

One of the important clinical signs of the presence of hallucinations is the nature of the patient's behavior. So, with true visual hallucinations, patients stare at something intently, turn away with fear, close their eyes, or begin to catch something in the air or on the floor.

With auditory deceptions, they listen to something, look around, and suddenly become silent during a conversation, as if listening to something coming from the side. In addition, they can talk without an interlocutor, during a conversation they periodically throw phrases aside or suddenly look under the table, start looking for something.

With olfactory hallucinations, they close their nose or sniff at something, often refuse to eat.

With tactile hallucinations, they shake something off themselves, catch someone on their skin.

With pseudo-hallucinations, patients, on the contrary, are immersed in themselves, as if focused on their inner experiences, listening to their thoughts. Often they are inhibited, do not answer questions, however, they can suddenly become agitated, show aggression or auto-aggression, especially in case of imperative deception.

Bayarget's mental hallucinations (intellectual perceptions, according to J. Baillarger; made thoughts, suggested thoughts, abstract hallucinations of Kalbaum) in their structure are closest to pseudo-hallucinations, since they have a feeling of being made, alienated, unreality. However, they are distinguished by greater intra-projection and the absence of a sensory component.

Patients hear "soundless thoughts", "secret inner voices." Deceptions are so closely related to thinking disorders that they often merge with the latter. Patients find it difficult to determine what they are experiencing - "sounding thought" or "voice".

Mental hallucinations

Hallucinoids

The clinical assessment is mixed. V.P. Osipov considered some of the phenomena of mental automatism as hallucinoids ("sound of thoughts", "mental speaking", "repetitions of thoughts", "violent thinking", etc.). E.A. Popov described hallucinoids as an intermediate phenomenon between normal ideas and hallucinations, which later develops into true hallucinations. PC. Ushakov understood hallucinoids as visual hallucinations that occur in healthy individuals against the background of asthenia in the waking state, but with closed eyes.

M.I. Rybalsky attributed hallucinoids to incomplete pseudo-hallucinations, a phenomenon intermediate between true and pseudo-hallucinations. Hallucinoids arise against the background of an unclouded consciousness, have a close connection with disturbances in thinking, are characterized by extraprojection and at the same time the absence of a certain localization in space, indistinctness and lability of images. Hallucinoids do not fit into their surroundings and are judged to be unreal.

In other words, hallucinoids do not have the basic properties of true hallucinations (reality, sensory, extraprojection), but they are not complete pseudo-hallucinations either - fleeting obscure pictures or voices, vague images without specific content and localization that disappear when trying to peer into them. The common clinical signs are fragmentation, neutrality and usually critical attitude. Often, hallucinoids are a transitional stage in the development of hallucinations.

Hallucinosis

Hallucinosis is a condition, the clinical picture of which is characterized by an influx of hallucinations against the background of clear consciousness. The term "hallucinosis" was proposed by K. Wernicke.

Acute and chronic hallucinosis are distinguished, depending on the type of hallucinations - verbal, visual and tactile.

Currently, the syndrome of hallucinosis has a fairly definite meaning.

Hallucinosis develops against the background of clear consciousness, and, as a rule, is characterized by a critical attitude towards deception of perception and the absence of disturbances in thought. The appearance of images is accompanied by the affect of anxiety, fear, especially in cases of acute hallucinosis. Delusional disorders are rudimentary, reflect the content of hallucinations, occur mainly in chronic hallucinosis, or, in acute hallucinosis, immediately after hallucination. Hallucinosis with an influx of both true and pseudo-hallucinations is possible.

Among the clinical variants of hallucinosis, the following are most common:

Verbal hallucinosis - an influx of true auditory or pseudo-hallucinations, can be acute and chronic.

Acute verbal hallucinosis is accompanied by a pronounced affective component (anxiety, fear). The images are often sequential, scene-like - patients hear "voices" talking about developing events (scenes of accusation, execution, acquittal, etc.).

Chronic hallucinosis is characterized by stability, less variety of deceptions (up to monotonous repetition of the same "voice" of the same phrases), as well as resistance to therapy.

Among the nosological forms in which verbal hallucinosis develops, one can distinguish acute and chronic alcoholic hallucinosis, chronic atherosclerotic hallucinosis.

A patient with acute alcoholic hallucinosis suddenly heard the voice of her cousin from the street, swearing at her. She opened the door, invited her sister to come in.

A patient with chronic alcoholic hallucinosis constantly hears two female "voices" that "repeat everything, no matter what I do, wherever I go," for example, "I go to the store, and the voices repeat:" I went to the store. " The voices are discussing her, "they scare, threaten, they say:" Anyway, we will bring you, we are not alive, you will not get us anywhere. " He hears dialogues: "The voice of Gali's cousin and some Tamara", expresses ideas of persecution against them, but the latter are rudimentary and directly reflect the content of the hallucinations: "Everyone sees what I am doing, they got even more angry when I went to church."

Visual hallucinosis is an influx of visual hallucinations. As well as verbal, it can be acute and chronic. The most common etiology is exogenous-organic (acute alcoholic hallucinosis, intoxication, infectious psychoses).

A patient with an acute alcoholic hallucinosis, being at the dacha, "saw two fireflies on the logs, they were talking:" Is she or is not she? "

Olfactory hallucinosis is an influx of olfactory hallucinations, often of unpleasant content. In some cases, it is accompanied by delirium of poisoning, damage. As a rule, it is associated with organic pathology of the brain.

A 53-year-old patient with Huntington's chorea complained of being bitten and tortured by flies. He took them off his face, neck, hands. I hung up the whole room with Velcro.

A 52-year-old patient began to feel itching in the perineum, then extremely painful itching and burning all over the body, on the neck, and on the face. Then I felt that some insects were crawling on the skin and under the skin. After defecation, small creatures the size of a chicken louse scattered from the anus, reached the face, felt them in the mouth, on the eyelashes, felt them pouring from the body. I experienced severe pain, biting, burning, felt that they make their way under the skin, accumulate in the nose, ears, on the eyelashes. She shook them off her, scratched herself. She constantly took a bath, washed away insects, got a job in a bath, close to the water. Dermatozoal delirium is characteristic of late age psychoses (atherosclerotic psychoses, hypochondriacal and late schizophrenia, involutional depression), and is also observed with alcohol and cocaine intoxication. In addition to hallucinations, senestopathies play an essential role in the formation of dermatozoal delirium. Characterized by the sudden appearance and persistence of delusional ideas, the lack of criticism, as well as the difficulty of qualifying violations of perception attributed to tactile hallucinosis or to illusory-tactile representations.

In schizophrenia, dermatozoal delirium is more complicated than in organic diseases of the brain, but it rarely develops further:

A 45-year-old patient, against the background of a toxic-allergic reaction, began to notice external changes in her: "My face is not mine, my lips have become thin as strings, my chin is not mine, my eyes are angry, my legs and arms have become longer." Then there were painful sensations of the presence of a "snake" under the skin of the chest, spine and head, which "crawled", "squeezed" the spine and head. The patient repeatedly examined her body, tried to find the "snake". In the oral cavity and in the larynx I felt "stuck lips", in the feces I saw "pupae". Experiences were accompanied by pronounced anxiety, fear, was afraid to go out into the street, asked for help, believed that she was "going crazy." The sensations intensified at night, criticism was lost, anxiety grew.

The comparative age aspect of hallucinations

In childhood, single true hallucinations can appear from the age of 2-3. Their identification presents significant difficulties, since it is necessary to differentiate with dream and eidetic images. Unlike the latter, hallucinations arise involuntarily, have an extraprojection and are experienced with the character of objective reality. Additional features include the repetition of images and the impossibility of dissuasion.

Visual and tactile deceptions prevail, elementary in content (the child sees flies flying around him, crawling snakes, spiders, etc.). Hypnagogic hallucinations are often observed.

A 2.5-year-old child, against the background of a feverish state, saw a “big black fly”, covered it with his hands, and asked to drive it away.

A 3.5-year-old girl complains that before falling asleep, "bees fly over her and they want to sting."

At an older age - at 5-8 years old - visual and tactile hallucinations are accompanied by a rudimentary delusional interpretation (the child sees scary people and says that they want to attack him, do something bad). Elementary auditory deceptions are observed (they hear knocking, crying, clock striking, etc.) and, less often, more complex verbal hallucinations (incomprehensible voices, "conversation in the ears").

In addition, there are "oral hallucinations -" painful sensations of foreign bodies in the oral cavity:

"There is paper and iron in the mouth."

Hair in the mouth.

Imperative auditory hallucinations appear (orders “don't eat!”, “Don't go to school!”).

In prepubertal and pubertal age, hallucinations are an integral part of delirium - peers "ridicule the shortcomings", "agree to beat them." Olfactory hallucinations (feeling the smell of one's own intestinal gases) are a component of body dysmorphic syndrome.

Hallucinosis is rare. Verbal hallucinosis is observed, in the form of phrases pronounced in one or more voices. Visual hallucinosis is much less common.

Pseudo-hallucinations, as a more complex phenomenon, appear in children later than true ones - from 3-4 years old, often combined with rudimentary ideas of influence. Visual deceptions prevail, auditory deceptions are less common.

Children see strange little people with long arms, bizarre animals, dead people, aliens. They say that "they are not like the real ones"; "They do it like in the movies."

In childhood, specific forms of deception of perception are observed in the form of hallucinations of the imagination, hypnagogic and dream hallucinations.

The emergence of hallucinations of the imagination in children is associated with eidetism, deceptions arise directly from the images of fantasy:

A patient with sluggish schizophrenia represented funny little penguins. At times these ideas were projected outside: "I see - the lamp is hanging, and right there I see the penguins."

Hypnagogic hallucinations arise spontaneously, have extraprojection and unusual (fantastic) content:

A 10-year-old patient, while falling asleep with her eyes closed, sees black cells along which a ball is rolling. Sometimes in fear he sees "a wiggling ball of men and snakes."

In schizophrenia, hypnagogic hallucinations are accompanied by a dissociation between the frightening nature of the images (the child sees dark frightening figures, eyes, heads) and the absence of a corresponding reaction.

Dream hallucinations are a type of pseudo-hallucinations that appear at the time of falling asleep and awakening ("I had dreams").

Compared to hypnagogic hallucinations, they are more vivid, stage-like, and are often accompanied by a feeling of outside influence (“I am not asleep, but occupy an intermediate position”).

Deceptions of perception are observed in infectious diseases (delirious confusion) and schizophrenia.

An incorrect, distorted perception of objects and phenomena is called an illusion. Certain types of illusions occur in healthy people. However, in contrast to patients, these illusions do not violate the generally correct recognition of the object in healthy people, since a healthy person has sufficient capabilities to check the correctness and clarify his first impression. Many types of various illusions have been described, which are noted in almost all healthy people.

Illusions can also be a manifestation of mental disorders. Thus, in mental illness, a syndrome of derealization is observed, the basis of which is a distorted perception of objects in the surrounding world (“everything is frozen, glazed”, “the world has become like a scenery or a photographic picture”). These distortions of perception can be quite definite in nature and relate to certain features of objects - shape, size, weight, etc. In these cases, they speak of metamorphoses. The latter include, in particular, macropsia, when objects seem to be enlarged, micropsia - objects are perceived as reduced. With porropsia, the distance assessment is violated - the patient thinks that objects are farther than they are in reality.

Peculiar illusions in the form of a disturbance in the perception of one's own body ("disorder of the body scheme") are observed in the syndrome of depersonalization, characterized by a distortion of the perception of one's own personality ("a feeling of loss or fragmentation of the I", "alienation of the I", etc.). In case of violations of the body scheme, patients experience a peculiar sensation of an increase or decrease in the whole body and its individual parts: arms, legs, head (“hands are very large, thick”, “the head has increased dramatically”). It is characteristic that these distortions in the perception of body parts are often critically assessed by patients, they understand their painful, false nature. Disorders of the body scheme also include a violation of ideas about the ratio of body parts, about the position of the body ("the ears are now placed side by side - on the back of the head," "the body is turned 180 °," etc.).

Some forms of anosognosia, in which the patient does not notice that his limbs are paralyzed, and claims that he can get out of bed and walk at any moment, also belong to disturbances in the perception of his body. Anosognosia of this type is usually observed with paralysis of the left extremities caused by damage to the right fronto-parietal region of the brain.

The character of an illusory perception is also polyesthesia - the sensation of several injections in the circumference of the point on the skin surface into which the needle was pricked. With synesthesia, the injection is felt in symmetrical areas of the body. For example, when an injection is made in the area of ​​the dorsum of the right hand, the patient simultaneously feels the injection at the corresponding point of the left hand.

Hallucinations differ from illusions in that false perception arises here in the absence of the subject. Hallucinations rarely occur in healthy people. For example, during long crossings through the desert, when people are thirsty, they begin to think that they see an oasis, a village, water ahead, while in reality they are not.

In the vast majority of cases, hallucinations are observed in mentally ill patients. The most common are auditory hallucinations. Patients hear the whistle of the wind, the noise of motors, the creak of the brakes, although in reality these sounds are not present in their environment. Auditory hallucinations are often verbal. It seems to the patients that they are being hailed, they hear snatches of a non-existent conversation. Under the influence of verbal hallucinations of an imperative, commanding nature, such patients can commit wrong actions, including attempts to commit suicide. With visual hallucinations, various pictures appear in front of the eyes of patients - they see terrible, unusual animals, frightening human heads, etc. Olfactory, gustatory hallucinations are also observed. In some cases, especially with visual hallucinations, they are combined with hallucinations in the sphere of other sensory organs, for example, with auditory and verbal hallucinations.

Hallucinations can be neutral and devoid of emotional coloring. Patients perceive such hallucinations calmly, often even indifferently. However, in a number of cases, hallucinations have a sharp emotional connotation, most often negative. Fearful hallucinations also belong to deceptions of the senses.

In some observations, hallucinations can be a source of positive emotions for patients. Thus, M.S. Lebedinsky described a mother who lost her son, with a severe pathological reaction to his death. This patient often "saw" the deceased in hallucinations and rejoiced at these "meetings".

The false nature of perception usually goes unnoticed for patients suffering from hallucinations of yami. They are convinced of the truth of their perception, it seems to them that incorrectly perceived objects and phenomena really exist in the environment.

Unlike the so-called true hallucinations described above, with pseudo-hallucinations, patients are aware of their false nature. The hallucinatory image is localized not in the external environment, but directly in the ideas of the patients themselves. Pseudo-hallucinatory experiences include, in particular, the sounding of their own thoughts, often experienced by patients with schizophrenia.

The mechanisms of illusions and hallucinations are still poorly understood. The reasons for the violation of the active, selective nature of perceptions that are revealed in illusions and hallucinations are still not clear enough.

Some illusions observed in healthy people can be explained by the so-called attitude, i.e., a distortion of perception that arises under the influence of immediately preceding perceptions. This phenomenon has been widely studied by the Soviet psychologist D. N. Uznadze and his school. An example of the formation of a set is the following experiment: a subject is placed in both hands 15-20 times in a row a large and a small ball of the same weight. Then two balls of the same volume are presented. Some subjects usually rate one of the balls as smaller with the hand in which the small ball was lying; other subjects find the opposite (contrasting) setting and evaluate a ball of equal volume with the same hand as large.

It is possible that the pathology of the installation mechanisms explains some of the illusions of the size of objects observed in patients. With regard to the pathogenesis, the origin of hallucinations, the most probable assumption seems to be their connection with the pathological, increased excitability of certain areas in the human brain. This point of view is supported, in particular, by the experiments of the famous Canadian neurosurgeon V. Penfield, who caused visual and auditory hallucinations by electrical stimulation of areas of the temporal and occipital lobes of the cerebral cortex during operations for epilepsy.

Hallucinations are pathological symptoms that occur in mental disorders, in which a person feels (sees, hears, etc.) that which does not actually exist in the surrounding space. Hallucinations are a clear pathological manifestation. mental disorder, since normally, with an unchanged psyche, they are absent in people of all ages of both sexes.

This pathological symptom refers to disorders of perception of the surrounding reality. Depending on the analyzer in which the disorder of perception of the surrounding reality occurs, hallucinations are divided into auditory, visual, olfactory, tactile, gustatory, visceral, speech and motor hallucinations.

Hallucinations of any nature can be caused by mental illness, as well as brain damage (traumatic brain injury, meningitis, encephalitis, etc.) or severe pathologies of internal organs. Hallucinations in case of severe somatic diseases (internal organs) or brain damage are not a sign of a person's mental illness. That is, a person suffering from, for example, heart failure or having suffered a traumatic brain injury, may experience hallucinations, but at the same time he is completely healthy mentally, and a violation of the perception of the surrounding reality occurred due to a serious illness.

In addition, hallucinations can appear in perfectly healthy people under the influence of substances that affect the functioning of the central nervous system, such as alcohol, drugs, psychotropic drugs, toxic substances, etc.

Brief description and essence of the symptom

An understanding of the essence and a scientific definition of hallucinations was made in the course of researching this problem within the framework of the general development of psychiatry. So, the translation of the Latin word "allucinacio" means "pipe dreams", "empty chatter" or "nonsense", which is quite far from the modern meaning of the term "hallucinations". And the term "hallucinations" acquired its modern meaning only in the 17th century in the work of the Swiss physician Plater. But here is the final formulation of the concept of "hallucination", which is relevant today, was given only in the 19th century by Jean Eskirol.

So, Eskirol gave the following definition of hallucinations: "a person is deeply convinced that he has some kind of sensory perception at the current moment, and there are no objects within reach." This definition is relevant to this day, since it reflects the main essence of this psychiatric symptom- violation of the sphere of perception of the surrounding reality, in which a person feels objects that are absent in reality and at the same time is completely convinced that he is right.

In short, hallucinations are the perception of something that is actually absent at the moment. That is, when a person feels smells that are not in reality, hears sounds that are also absent in reality, sees objects absent in the surrounding space, etc., then these are hallucinations.

At the same time, mirages do not belong to hallucinations, since this phenomenon is not a consequence of a violation of mental activity, but a natural phenomenon, the development of which is based on the laws of physics.

Hallucinations must be distinguished from pseudo-hallucinations and illusions, which also relate to disturbances in the sphere of perception of the surrounding world that occur in severe mental disorders.

So, the main difference between hallucinations and pseudo-hallucinations is their pronounced outward orientation and connection with objects that actually exist in the surrounding space. For example, a hallucination is that a person sees a spot sitting on a real-life chair, or hears sounds from behind a real existing door, or smells coming out of a ventilation existing in reality, etc. And pseudo-hallucinations, on the contrary, are directed inward, that is, on the perception of various non-existent objects inside the human body. This means that with pseudo-hallucinations, a person feels non-existent objects in his body, for example, voices in the head, cockroaches in the brain, a beam of radiation in the liver, the smell of blood in the vessels, etc. Pseudo-hallucinations are very intrusive, often have a threatening, imperative or accusatory character and little depends on the thoughts of the person himself.

Illusions, in contrast to hallucinations, are a distorted perception of real-life objects and objects. Illusions are typical for all people of any age and gender, and they are due to the peculiarities of the work of the senses and the laws of physics. An example of a typical illusion is a hanging coat, which appears to be a lurking figure in low light conditions. Also, an illusion includes a distinct hearing of the voice of a familiar person in the rustle of foliage, etc.

That is, summing up, we can briefly say that:

• Hallucination- this is a "vision" of a non-existent object on an object actually existing in the surrounding space.
• Pseudohallucination Is a "vision" of a non-existent object inside one's own body.
• Illusion- this is a "vision" of real-life objects distorted, with characteristics that are actually missing from them (a coat is perceived as a lurking person, a chair is seen as a gallows, etc.).

The line between all these psychiatric terms is quite thin, but very significant from the point of view of the mechanisms of their development and the degree of disorders of the mental sphere, which corresponds to each variant of the disorder of the perception of the surrounding world.

What are hallucinations?

Currently, there are several classifications of hallucinations, which subdivide them into types depending on the various characteristics of the symptom. Let's consider the most important classifications for understanding the characteristics of hallucinations.

So, depending on the nature and the analyzer involved, hallucinations are divided into the following 4 types:

1. Associated hallucinations. They are characterized by the appearance of images with a certain logical sequence, for example, a stain on a chair predicts the appearance of flies from a water tap if a person tries to open water.
2. Imperative hallucinations. They are characterized by the appearance of a commanding tone emanating from any surrounding objects. Usually, such an imperative tone commands a person to perform some action.
3. Reflex hallucinations. They are characterized by the appearance of hallucinations in another analyzer in response to the effect of a real stimulus on any analyzer (auditory, visual, etc.). For example, turning on the light (a stimulus for the visual analyzer) causes an auditory hallucination in the form of voices, orders, noise from a laser aiming device, etc.
4. Extracampal hallucinations. They are characterized by going beyond the field of the given analyzer. For example, a person sees visual images that are hallucinations behind the wall, etc.

In addition, there is a historically developed and most frequently used classification of hallucinations according to the sense organs in the sphere of activity of which they arise. So, according to the analyzers of feelings available to a person, hallucinations are divided into the following types:

Moreover, hallucinations are divided into the following types, depending on their complexity:

True hallucinations - video

Pseudohallucinations - video

Hallucinations - causes

The following conditions and diseases can be the causes of hallucinations:

1. Mental illness:

• Hallucinosis (alcoholic, prison, etc.);
• Hallucinatory delusional syndromes (paranoid, paraphrenic, paranoid, Kandinsky-Clerambo).

2. Somatic diseases:

• Tumors and injuries of the brain;
• Infectious diseases affecting the brain (meningitis, encephalitis, temporal arteritis, etc.);
• Diseases occurring with severe fever (for example, typhus and typhoid fever, malaria, pneumonia, etc.);
• Syphilis of the brain;
• Cerebral atherosclerosis (cerebrovascular atherosclerosis);
• Cardiovascular diseases in the stage of decompensation (decompensated heart failure, decompensated heart defects, etc.);
• Rheumatic diseases of the heart and joints;
• Tumors localized in the brain;
• Tumor metastases to the brain;
• Poisoning by various substances (for example, tetraethyl lead - a component of leaded gasoline).

3. The use of substances that affect the central nervous system:

• Alcohol (hallucinations are especially pronounced in alcoholic psychosis, called "delirium tremens");
• Drugs (all opium derivatives, mescaline, crack, LSD, PCP, psilobicin, cocaine, methamphetamine);
• Medicines (Atropine, drugs for the treatment of Parkinson's disease, anticonvulsants, antibiotics and antiviral drugs, sulfonamides, anti-tuberculosis drugs, antidepressants, histamine blockers, antihypertensive drugs, psychostimulants, tranquilizers);
• Plants containing toxic substances that act on the central nervous system (belladonna, dope, pale grebe, fly agaric, etc.).

4. Stress.

5. Chronic prolonged sleep deprivation.

Hallucinations: causes, types and nature of the symptom, description of cases of hallucinations, connection with schizophrenia, psychosis, delirium and depression, similarity to a dream - video

Treatment

Treatment of hallucinations is based on the elimination of the causative factor that provoked their appearance. In addition, in addition to therapy aimed at eliminating the causative factor, drug relief of hallucinations with psychotropic drugs is carried out. Antipsychotics are most effective for stopping hallucinations (for example, Olanzapine, Amisulpride, Risperidone, Quetiapine, Mazheptil, Trisedil, Haloperidol, Triftazin, Aminazin, etc.). The choice of a specific drug for the relief of hallucinations is carried out by the doctor in each case individually, based on the characteristics of the patient, the combination of hallucinations with other symptoms of a mental disorder, previously used therapy, etc.

How do you induce hallucinations?

To cause hallucinations, it is enough to eat hallucinogenic mushrooms (pale toadstool, fly agaric) or plants (belladonna, dope). You can also take drugs, alcohol in large quantities, or drugs with hallucinogenic effects in large doses. All this will cause hallucinations. But simultaneously with the appearance of hallucinations, poisoning of the body will occur, which may require urgent medical attention, including resuscitation. In case of severe poisoning, a fatal outcome is also quite likely.

The safest way to induce hallucinations is with involuntary sleep deprivation. In this case, a person will only face the consequences of lack of sleep, hallucinations will appear, but there will be no poisoning of the body with toxic substances.

Semantic hallucinations

Semantic hallucinations are the name of a popular musical group. There is no such thing in medical terminology. Before use, you must consult a specialist.

MOSCOW, September 13 - RIA Novosti, Alfiya Enikeeva. In an unusual habitat, a perfectly healthy person sometimes experiences tactile illusions, loses orientation in space. This applies to those who operate in extreme conditions: pilots, astronauts, athletes. The habit of trusting the senses can be disastrous in some situations.

Loss of orientation

But even basic sensations, which, it would seem, can be completely trusted - tactile ones, often deceive us. For example, the distance between equidistant points on the skin feels different depending on where they are located, and stroking the tip of the nose with two fingers crossed gives the person the impression that they have two noses.

According to scientists from King's College London, such tactile illusions arise from the peculiarities of the structure of the skin. The surface of the human body is divided into so-called receptive fields - areas of the skin dotted with receptors from one nerve cell and stretched along the limbs. In more sensitive areas (for example, at the fingertips) these fields are many and small in size, in less sensitive areas the fields are larger, but they are smaller. The distance between two points is estimated by the brain by the number of these receptive fields lying on the line connecting them. This point of view was confirmed by an experiment in which volunteers perceived the lengths of the segments marked on different parts of the forehead as different, although in fact they were the same.

People with a breakdown in the SCN9A gene, which encodes a protein that forms sodium channels in cell membranes, becomes hostages of tactile illusions. Through them, pain is transmitted to the brain. If the channel is not working properly, no signal is generated and the brain has nothing to process. People in this case do not feel pain at all and do not notice even a very serious injury. According to the testimony of a professor at Cambridge University Jeffrey Woods, one of the carriers of this rare mutation in Pakistan jumped from the roof of a house, deciding that he was invulnerable. Of course, a 14-year-old teenager crashed to death, but his numerous relatives with the same genetic abnormalities later helped researchers understand the mechanisms of pain.

Channeling

We do channeling sessions with Higher Forces on various topics.

Illusions and hallucinations. Types and causes of hallucinations and illusions. Agnosia.

Illusions

Wrong, distorted perception illusion

Illusions and hallucinations.

Illusions

Wrong, distorted perception objects and phenomena is called illusion... Certain types of illusions occur in healthy people. However, in contrast to patients, they do not interfere with the generally correct recognition of the object in healthy people, since a healthy person has sufficient capabilities to verify the correctness of clarification of his first impression.

Many different illusions observed in almost all healthy people. The illusion of non-parallelism occurs when other lines intersect parallel lines. One of the types of illusion is also the transfer of the properties of the whole figure to its individual parts. A line segment that is part of a large figure appears to be longer than an equal line that is part of a small figure.

Illusions can also be a manifestation of mental disorders. So, with mental illness, there is derealization syndrome the basis of which is a distorted perception of objects of the surrounding world ("Everything is frozen, glazed", "The world has become like a scenery or a photographic snapshot").

These distortion of perception can be quite definite in nature and relate to certain attributes of objects - shape, size, weight, etc. In these cases, they talk about metamorphoses... The latter include macropsia when objects appear to be enlarged, micropsia- objects are perceived as reduced. At porropsia the assessment of distance is disturbed: the patient thinks that objects are further away than they are in reality.

Peculiar illusions in the form of a violation of the perception of one's own body("body schema disorders") are observed when depersonalization syndrome, characterized by a distortion of the perception of one's own personality ("The feeling of loss and split I," "Alienation of the I", etc.).

In case of violations of the "body scheme", patients experience a peculiar sensation of an increase or decrease in the whole body and its individual parts: arms, legs, head ("Hands are very large, thick", "The head has increased dramatically"). It is characteristic that these distortions in the perception of body parts are often critically assessed by patients, they understand their painful, false nature. Disorders of the "body scheme" also include a violation of the idea of ​​the ratio of body parts, the position of the body ("The ears are now placed side by side - on the back of the head," "The body is rotated 180 °," etc.).

Some forms of anosognosia are also related to disturbances in the perception of one's body., in which the patient does not notice that his limbs are paralyzed, and claims that he can get out of bed and go at any moment. Anosognosia of this type is usually observed with paralysis of the left extremities caused by damage to the right fronto-parietal region of the brain.

The character of illusory perception is also polyesthesia- sensation of several angles in the circumference of the point on the skin surface, into which the needle was pricked. With synesthesia, the injection is felt in symmetrical areas of the body. So, with an injection in the area of ​​the dorsum of the right hand, the patient simultaneously feels the injection at the corresponding point of the left hand.

Hallucinations

Hallucinations differ from illusion in that false perception arises in the absence of the subject. Hallucinations rarely occur in healthy people. So, during long crossings through the desert, when people are languishing with thirst, it begins to seem to them that there is an oasis, a village, water ahead, while in reality they are not.

In most cases, hallucinations are observed in mental patients. Most common auditory hallucinations... Patients hear the whistle of the wind, the noise of motors, the creak of the brakes, although in reality these sounds are not present in their environment. Auditory hallucinations are often verbal. It seems to the patients that they are being hailed, they hear snatches of a non-existent conversation. Under influence verbal hallucinations of an imperative, commanding nature, such patients can commit wrong actions, including attempts to commit suicide.

At visual hallucinations various pictures appear before the eyes of patients: they see terrible, unusual animals, frightening human heads, etc. Also observed olfactory, gustatory hallucinations... In some cases, especially with visual hallucinations, their combination is observed with hallucinations in the sphere of other organs, for example, with auditory and verbal hallucinations.

Hallucinations can be neutral and devoid of emotional coloring. Patients perceive such hallucinations calmly, often even indifferently. However, in a number of cases, hallucinations have a sharp emotional connotation, most often negative. Fearful hallucinations also belong to deceptions of the senses.

In some observations hallucinations can be a source of positive emotions for the sick. So, M.S. Lebedinsky described a mother who lost her son with a severe pathological reaction to his death. This patient often "saw" the deceased in hallucinations and enjoyed these "meetings".

The false nature of perception usually goes unnoticed for patients suffering from hallucinations. They are convinced of the truth of their perception, it seems to them that incorrectly perceived objects and phenomena really exist in the environment.

Pseudohallucinations

Unlike the so-called true hallucinations with pseudohallucinations patients are aware of their false nature. The hallucinatory image is localized not in the external environment, but directly in the ideas of the patients themselves. Pseudo-hallucinatory experiences include, in particular, the sounding of their own thoughts, often experienced by patients with schizophrenia.

Causes of hallucinations and illusions

The mechanism of illusions and hallucinations is still poorly understood. The reasons for the violation of the active, selective nature of perceptions that are revealed in illusions and hallucinations are still not clear enough.

Some illusions observed in healthy people can be explained by the so-called attitude, i.e. distortion of perception arising under the influence of immediately preceding perceptions. This phenomenon has been widely studied by the psychologist D.N. Uznadze and his school. The following experience can serve as an example of the formation of an attitude. The subject is placed in both hands 15-20 times in a row a large and a small ball of the same weight. Then two balls of the same volume are presented. Some subjects usually rate one of the balls as smaller with the hand in which the small ball was lying. Other subjects find an opposite (contrasting) attitude and evaluate a ball of equal volume with the same hand as large.

It is possible that the pathology of the installation mechanism explains some illusions of the size of objects observed in patients. With regard to the pathogenesis of the origin of hallucinations, the most probable assumption is about their connection with the pathological, increased excitability of certain areas in the human brain. This point of view is supported, in particular, by the experiments of the famous Canadian neurosurgeon V. Penfield, who caused visual and auditory hallucinations by electrical stimulation of areas of the temporal and occipital lobes of the cerebral cortex during operations for epilepsy.

Agnosia.

Agnosias is called a violation of visual, auditory and kinesthetic perception in local lesions of the cerebral cortex caused by vascular diseases, trauma, tumors and other pathological processes. At subject agnosia the violation of the generalized perception of objects comes to the fore: patients cannot recognize the images of a table, chair, teapot, key and other objects, but in the case when they recognize an object, they can also indicate its individualized reference. So, having learned that this is a person's face, patients can say whether they know this person, remember his surname. Having recognized the chairs in the doctor's office, patients with object agnosia can indicate the same type or other chairs in shape and decoration located in the wards, corridors of the clinic.

In some patients, visual impairments are observed, in which the generalized perception of objects remains relatively intact and the disorder of individualized perception comes to the fore. Such patients have difficulty in recognizing specific single objects that they have seen before. These violations are especially clearly revealed when it is necessary to recognize familiar faces. Patients do not know whether they have seen this face before or not, a woman's or a man's face in front of them, they hardly distinguish facial expressions, do not catch expressions of joy, fun, laughter, sadness, crying. This form of visual agnosia is called facial agnosia, or agnosia of individualized signs.

One of the forms of visual gnosis disorders is called optic-spatial agnosia... With this form of visual agnosia, patients' perception of the spatial arrangement of individual objects is disturbed, patients cannot correctly perceive spatial relationships. Once in the clinic, they cannot learn to find their way to the doctor's office, to the dining room, to the toilet. They recognize their ward only by indirect signs - by the number above the entrance to the ward or by the characteristic color of the ward door. These patients also have great difficulty trying to find their bed in the ward. They forget the layout of the streets of the city in which they have lived for a long time, they cannot tell about the plan of their apartment.

Agnosia causes

Usually, visual agnosias are observed with lesions of the occipital or partially lower-posterior parts of the parietal lobes of the brain.

With the defeat of the lower anterior parts of the parietal lobes of the brain, disorders of the higher forms of tactile perception, called astereognosis, are noted. Feeling with closed eyes any object (key, coin, pencil, feather, comb, etc.) "patients cannot determine the shape and size of this object, recognize it. At the same time, with visual perception, patients recognize this object quickly and unmistakable.

Observations with auditory agnosia, noted with damage to the temporal regions of the brain. In patients with this form of agnosia, auditory perception is impaired. They cannot recognize the characteristic noise of the wind, airplane, car, sounds made by different animals, rustle of paper, etc.

Agnosia is apparently based on disturbances in the processes of separating a signal from noise, isolating the characteristic features of objects and comparing these features with those samples, standards that are stored in the memory of patients.

Illusions and hallucinations.

Correct, distorted perception of objects and phenomena is called an illusion. Certain types of illusions occur in healthy people. However, in contrast to patients, they do not interfere with the generally correct recognition of the object in healthy people, since a healthy person has sufficient capabilities to verify the correctness of clarification of his first impression.

Many different illusions have been written, which are noted in almost all healthy people. The illusion of non-parallelism occurs when other lines intersect parallel lines. One of the types of illusion is also the transfer of the properties of the whole figure to its individual parts. A line segment that is part of a large figure appears to be longer than an equal line that is part of a small figure.

Illusion can also be a manifestation of mental disorders. For example, in mental illness, a syndrome of derealization is observed, the basis of which is a distorted perception of objects in the surrounding world ("Everything froze, glazed over", "The world has become like a scenery or a photographic photograph").

Distortions of perception can be quite definite in nature and relate to certain features of objects - shape, size, weight, etc. In these cases, they speak of metamorphoses. The latter include macropsia, when objects seem to be enlarged, micropsia - objects are perceived as reduced. With porropsia, the distance assessment is disturbed: the patient thinks that objects are farther than they are in reality.

Speculative illusions in the form of a disturbance in the perception of one's own body ("disorder of the body scheme") are observed in the syndrome of depersonalization, characterized by a distortion of the perception of one's own personality ("Feeling of loss and split I," "Alienation of the I", etc.).

Ri violations of the "body scheme", patients experience peculiar sensations of an increase or decrease in the whole body and its individual parts: arms, legs, head (<Руки очень большие, толстые>, <Голова резко увеличилась>). It is characteristic that these distortions in the perception of body parts are often critically assessed by patients, they understand their painful, false nature. Disorders<схемы тела>Also includes a violation of the concept of the ratio of body parts, the position of the body (<Уши теперь помещаются рядом - на затылке>, <Туловище повернуто на 180°>etc.).

Some forms of anosognosia, in which the patient does not notice that his limbs are paralyzed, and claims that he can get out of bed and walk at any moment, also include impaired perception of his body. Anosognosia of this type is usually observed with paralysis of the left extremities caused by damage to the right fronto-parietal region of the brain.

The character of illusory perception is also carried by polyesthesia - the sensation of several angles in the circumference of a point on the surface of the skin into which a needle was pricked. With synesthesia, the injection is felt in symmetrical areas of the body. So, with an injection in the area of ​​the dorsum of the right hand, the patient simultaneously feels the injection at the corresponding point of the left hand.

Hallucinations

Allucinations differ from illusion in that false perception arises in the absence of the subject. Hallucinations rarely occur in healthy people. So, during long crossings through the desert, when people are languishing with thirst, it begins to seem to them that there is an oasis, a village, water ahead, while in reality they are not.

Most cases of hallucinations are observed in mental patients. The most common are auditory hallucinations. Patients hear the whistle of the wind, the noise of motors, the creak of the brakes, although in reality these sounds are not present in their environment. Auditory hallucinations are often verbal. It seems to the patients that they are being hailed, they hear snatches of a non-existent conversation. Under the influence of verbal hallucinations of an imperative, commanding nature, such patients can commit wrong actions, including attempts to commit suicide.

In visual hallucinations, various pictures appear before the eyes of patients: they see terrible, unusual animals, frightening human heads, etc. Olfactory, gustatory hallucinations are also observed. In some cases, especially with visual hallucinations, their combination is observed with hallucinations in the sphere of other organs, for example, with auditory and verbal hallucinations.

Allucinations can be neutral and devoid of emotional coloring. Patients perceive such hallucinations calmly, often even indifferently. However, in a number of cases, hallucinations have a sharp emotional connotation, most often negative. Fearful hallucinations also belong to deceptions of the senses.

In some observations, hallucinations can be a source of positive emotions for patients. So, M.S. Lebedinsky described a mother who lost her son with a severe pathological reaction to his death. This patient often<видела>in the hallucinations of the deceased and rejoiced at this<встречам>.

The fiery nature of perception usually goes unnoticed for patients suffering from hallucinations. They are convinced of the truth of their perception, it seems to them that incorrectly perceived objects and phenomena really exist in the environment.

Pseudohallucinations

Difference from the so-called true hallucinations with pseudo-hallucinations, patients are aware of their false nature. The hallucinatory image is localized not in the external environment, but directly in the ideas of the patients themselves. Pseudo-hallucinatory experiences include, in particular, the sounding of their own thoughts, often experienced by patients with schizophrenia.

Causes of hallucinations and illusions

The echanism of illusions and hallucinations has been poorly studied so far. The reasons for the violation of the active, selective nature of perceptions that are revealed in illusions and hallucinations are still not clear enough.

Some of the illusions observed in healthy people can be explained by the so-called attitude, i.e. distortion of perception arising under the influence of immediately preceding perceptions. This phenomenon has been widely studied by the psychologist D.N. Uznadze and his school. The following experience can serve as an example of the formation of an attitude. The subject is placed in both hands 15-20 times in a row a large and a small ball of the same weight. Then two balls of the same volume are presented. Some subjects usually rate one of the balls as smaller with the hand in which the small ball was lying. Other subjects find an opposite (contrasting) attitude and evaluate a ball of equal volume with the same hand as large.

It is possible that the pathology of the installation mechanism explains some illusions of the size of objects observed in patients. With regard to the pathogenesis of the origin of hallucinations, the most probable assumption is about their connection with the pathological, increased excitability of certain areas in the human brain. This point of view is supported, in particular, by the experiments of the famous Canadian neurosurgeon V. Penfield, who caused visual and auditory hallucinations by electrical stimulation of areas of the temporal and occipital lobes of the cerebral cortex during operations for epilepsy.

Agnosia.

Gnosias are called impairments of visual, auditory and kinesthetic perception in local lesions of the cerebral cortex caused by vascular diseases, trauma, tumors and other pathological processes. With subject agnosia, a violation of the generalized perception of objects comes to the fore: patients cannot recognize the images of a table, chair, teapot, key and other objects, but in the case when they recognize an object, they can also indicate its individualized reference. So, having learned that this is a person's face, patients can say whether they know this person, remember his surname. Having recognized the chairs in the doctor's office, patients with object agnosia can indicate the same type or other chairs in shape and decoration located in the wards, corridors of the clinic.

Some patients have visual impairments, in which the generalized perception of objects remains relatively intact and the disorder of individualized perception comes to the fore. Such patients have difficulty in recognizing specific single objects that they have seen before. These violations are especially clearly revealed when it is necessary to recognize familiar faces. Patients do not know whether they have seen this face before or not, a woman's or a man's face in front of them, they hardly distinguish facial expressions, do not catch expressions of joy, fun, laughter, sadness, crying. This form of visual agnosia is called facial agnosia, or agnosia of individualized signs.

The bottom of the forms of disorders of visual gnosis was called optical-spatial agnosia. With this form of visual agnosia, patients' perception of the spatial arrangement of individual objects is disturbed, patients cannot correctly perceive spatial relationships. Once in the clinic, they cannot learn to find their way to the doctor's office, to the dining room, to the toilet. They recognize their ward only by indirect signs - by the number above the entrance to the ward or by the characteristic color of the ward door. These patients also have great difficulty trying to find their bed in the ward. They forget the layout of the streets of the city in which they have lived for a long time, they cannot tell about the plan of their apartment.

Agnosia causes

Usually visual agnosias are observed with lesions of the occipital or partially lower-posterior parts of the parietal lobes of the brain.

If the lower anterior parts of the parietal lobes of the brain are damaged, disorders of the higher forms of tactile perception, called astereognosis, are noted. Feeling with closed eyes any object (key, coin, pencil, feather, comb, etc.)> patients cannot determine the shape and size of this object, recognize it. At the same time, with visual perception, patients recognize this object quickly and accurately.

There are also known observations with auditory agnosia, which occurs when the temporal regions of the brain are affected. In patients with this form of agnosia, auditory perception is impaired. They cannot recognize the characteristic noise of the wind, airplane, car, sounds made by different animals, rustle of paper, etc.

The basis of agnosia is, apparently, disturbances in the processes of separating a signal from noise, isolating the characteristic features of objects and comparing these features with those samples, standards that are stored in the memory of patients.