From TLS, a discussion of Oliver Sack's new book on hallucinations:
In the 1960s, Sacks extended his neurophenomenological explorations by taking a variety of recreational drugs; not only amphetamines but also pot and, of course, LSD. The results were occasionally ecstatic, sometimes merely strange and often terrifying. Conversations with a friendly spider – with whom, after an opening exchange of pleasantries, he discussed whether Bertrand Russell had irreversibly damaged Frege’s system of thought with his famous paradox – and studying key moments from the battle of Agincourt enacted on his dressing gown sleeve, were not atypical episodes in the pharmacological dramas unfolding in his head. He fought off panic by carefully transcribing the “craziness” inside himself, writing “for dear life” as “wave after wave of hallucination” rolled over him. These were not quite as crazy as the experience of the student Daniel Breslaw, a subject in a formal study of LSD, who, entering an elevator, passed “a floor every hundred years” and, when back in his room, swam “through the remaining centuries of the day. Every five eons or so a nurse arrives (in the aspect of a cougar, a differential equation, or a clock radio) and takes my blood pressure”. As if this were not enough, Breslaw experienced synaesthesia, or a fusion between the senses, reporting such gems as “the smell of a low B flat, the sound of green”.
The varieties of hallucinations are protean. While vision predominates, hearing, smell, taste, touch, memory, altered body image and strange emotions seeking an object, often figure. Phantosmia (hallucinations of smell), analogous to the Charles Bonnet syndrome, may occur in people who have lost this sense. Auditory hallucinations, in addition to those bothersome, frightening voices, take many forms. The unremitting mental junk of tinnitus is a huge source of suffering, but musical hallucinations following damage to the brain may be just as distressing. Imagine hearing Bing Crosby, friends and orchestra singing “White Christmas” for days on end: a thousand times worse than the musical phrases or “earworms” that stick like limpets to the normal mind. Tactile hallucinations can be compelling, as in the case of one of Sacks’s subjects on drug treatment for Parkinson’s disease. The surfaces of objects seemed to be covered by a film of peach fuzz, cotton candy, or spider’s webs, and the film sometimes became very “lush” as if the items were submerged under a pile of “stuff”. Hallucinations can sometimes be multisensory. When ninety-year-old Rosalie became ill and thought she was dying, she had visions of her mother and heard her welcoming her into heaven. These were completely different from her usual hallucinations: as well as being multisensory, “they were personal, addressed to her, and steeped in warmth and tenderness”. The most “respectable” hallucinations are those we are all prone to on a daily or more usually nightly basis – associated with sleep. They, too, however, are not without their terrors, as Sacks describes. Hypnagogic hallucinations, seen on the threshold of sleep, may take the form of faces or presences charged with malign intent. And hypnopompic hallucinations, which occur on waking, are often seen with open eyes, the terrified gaze populating the darkness with evil faces, spiders, snakes and devils. For some people, “night hags”, sometimes associated with abnormal propensity to dream sleep – narcolepsy – may interfere with their waking life. Occasionally they become a dark secret they dare not share with others.
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