Auditory hallucinations. Treatment methods for auditory hallucinations. Possible causes and types of the disease. “Inner voice”: norm and pathology

Such a phenomenon as auditory hallucinations makes not only the person who encountered them nervous, but also his loved ones. Some cases can be serious because they indicate mental disorders. Minor noises that do not carry a semantic load may be associated with, but this does not mean that they can be ignored; treatment is required in each case.

Symptoms and types

Auditory hallucinations often appear spontaneously. Depending on their type, one can judge the possible diagnosis and the degree of risk to the patient’s health. These can be monotonous or short sounds, such as ringing or hissing, music, or even clearly articulated speech.

If a hallucination carries a specific meaning, most likely we're talking about about mental problems.

Auditory hallucinations belong to the group of subjective sounds, since only the patient hears them. This complicates their identification and diagnosis of specific causes.

The following types of sounds that arise in the patient’s consciousness are distinguished:

Tinnitus. This is a common noise that occurs in the ears: buzzing, whistling, ringing, hissing, clicking, etc. Its causes are mainly related to problems with the health of the hearing organs, but can also indicate disruptions in the blood flow system.
Acoasmas. This is an anomalous phenomenon, expressed in the occurrence of specific sounds: drops of water, music, scratching, creaking, etc.
Phonemes. The most dangerous manifestations, since they have a semantic load and influence on the patient’s actions: voices and meaningful phrases.

Classification also involves distinguishing true and false sounds. The first type fits into the environment, so often a person does not even realize the unreality of these phenomena. In the second case, the sounds come from the patient’s body, that is, the presence of their source is felt in the head, stomach, etc.

According to the principle of influence and characteristics of manifestation, phonemic anomalies are classified separately:

Imperative. The most dangerous type of phonemes, since the voice has a commanding character, orders a person to perform certain actions, sometimes even against his will. This is a clear sign of schizophrenia, and in religious circles it is called obsession.
Commenters. This is the so-called “imaginary friend”. A person can conduct a dialogue with a voice in his head, hear comments about himself, discuss the environment, etc.
Contrasting. These are antagonistic sounds. Two or more voices may argue with each other, or signals may appear that contradict each other.
Hypnagogic. Auditory hallucinations occur during the period when a person’s consciousness turns off when falling asleep or, conversely, during awakening. The subconscious mind works here, so even healthy person Anomalies associated with brain function, that is, “daydreaming,” may occur.

Causes

To find out the type of anomaly and its principle further treatment, it is necessary to find out the causes of auditory hallucinations. The following factors can provoke such phenomena:

Overwork, nervous tension. Malfunctions in the functioning of the brain occur due to overstrain, consciousness turns off, for example, with prolonged lack of sleep.
Heat. Fever and increased temperature cause dysfunction various systems body. A person may experience not only auditory, but also visual hallucinations or mistake dreams for reality.
Ear diseases. Tinnitus occurs when the ear becomes inflamed, the sound conduction chain is disrupted, and its individual elements are irritated. Earwax, exudate in the middle ear and similar phenomena can cause noise at the conductive level, and effects on hair receptors and the auditory nerve - at the perceptual level.
Tumors. Pressure is applied to areas of the auditory system, the brain and nerve roots.
Neurodegenerative pathologies. Disturbances in the functioning of the brain and nervous system due to the failure of individual elements, the death of neurons, etc. The most well-known problems of this kind are senile dementia and Alzheimer's disease.
Mental disorders. They cause phonemes and acoasms. These are depression, schizophrenia, psychopathy, various syndromes.
Malfunctions hearing aids. In rare cases, the reasons lie in failures of implants and removable hearing aids.
Taking medications psychotropic drugs. Drugs and treatment with special groups of drugs can affect brain function in a similar way.
Alcohol delirium. Attacks of delirium tremens cause not only acoustic, but also other types of hallucinations.

To find out the reasons, a diagnosis is carried out taking into account the patient’s complaints, medical history, information from relatives and friends. The most difficult thing to identify is mental disorders. In addition to standard laboratory tests and hearing examinations, more detailed hardware examinations and tests may be needed.

Treatment methods

Treatment of auditory hallucinations that occur largely depends on their type and causes. The easiest way to cope with the consequences of intoxication and inflammatory diseases. But malfunctions in the brain and hidden mental pathologies can become an impossible task. Some patients spend years in intensive care in the hospital, but there is no improvement in their condition.

The danger of any auditory hallucinations is that the consequences can be unpredictable. Monotonous sounds cause irritability and depression, semantic signals drive people crazy, drive them to despair, and sometimes push them to crimes and suicide.

Treatment of hallucinations themselves is impossible, it is necessary to direct efforts to their causes.

Treatment is carried out in the following ways:

Drug therapy. Depends on the specific causes of the problem. These can be anti-inflammatory, antipyretic, neurostimulating, sedative drugs, as well as special medications for the treatment of central nervous system problems and mental disorders.
Assistive therapy. Physiotherapy methods, electrical stimulation treatment, targeted effects on specific areas of the brain.
Operation. Tumor removal, splitting auditory nerve or its cutting off, installation of a high-quality hearing aid or, prosthetics and plastic surgery of ear elements, brain surgery.

In some cases, it is enough to eliminate the intoxication of the body, restore its normal activity, and stop using substances that have a similar effect. This applies to drugs, alcohol, and some medications. It is necessary to establish a rest regime and generally monitor your health and psycho-emotional state. Then the risk of similar problems will decrease significantly.

A fairly common problem caused by hallucinations is tinnitus, the occurrence of sounds of unknown origin that do not exist in reality. It should be noted that such phenomena are not as harmless as is sometimes believed. Constant or periodic sounds can represent symptoms of disorders, and sometimes quite serious ones. In patients with auditory hallucinations, noise manifests itself in different ways. In the mild form of the disease, the phenomenon is especially pronounced in silence; in other situations, the sounds present in the environment cover up the hallucinations. Patients often complain that strange sounds arise at the moment when a person changes body position or makes certain movements.

Sometimes, upon additional examination, it turns out that such a condition is associated with a change in pressure in blood vessels, muscles, nerves. As a rule, patients usually say that sound hallucinations can be compared to a low-frequency whistle, or the person hears hissing, buzzing, creaking, and other sounds. Moreover, low-frequency noises are observed less frequently during auditory hallucinations. Such noise is often mistaken for the sounds produced by operating ventilation or other household electrical appliances. If you hear noise, but are not sure that it comes from an external source, you should clarify this circumstance with those around you.

Another type of sound hallucinations are various sounds that can be classified as musical. Such phenomena are typical for people with partial hearing loss; in patients with normal hearing they are quite rare, and if they are observed, they quickly pass. Sound hallucinations called pulsating are also known. Their peculiarity is that the patient hears rhythmic sounds that sound in time with the heart. In most cases, they are caused by changes in blood flow in the vessels that are located near the ears. Such hallucinations are very annoying for the patient, and can lead to an extremely agitated state when immediate medical attention is required.

Causes of auditory hallucinations

When auditory hallucinations occur, one of the common causes of the disease is a damaged inner ear. IN in this case, the sounds that a person hears fall into it, then, using the auditory nerves, information about the existing sounds is transmitted to the brain. If there is any damage to the inner ear, information access to certain parts of the brain may be impaired. Thus, these areas begin to persistently “demand” the missing information from parts of the inner ear that continue to function normally. But under such conditions, their signals are distorted, creating auditory hallucinations.

If such a disorder occurs in elderly patients, then sound hallucinations may accompany the aging process, during which hearing becomes worse. Young people often suffer from inner ear damage caused by regular exposure to excessive noise. Also, many diseases can be among the causes that damage the inner ear and lead to sound hallucinations. For example, middle ear infections, otosclerosis, Meniere's disease, anemia, Paget's disease. It happens that sound hallucinations are caused by the accumulation of earwax, which has a blocking effect on the ears.

Rarer causes of tinnitus and non-existent sounds include traumatic brain injury, a consequence of exposure to unexpected and excessive loud noise such as an explosion or a gunshot. In some cases, auditory hallucinations are caused by acoustic neuroma, a rare benign education affecting the auditory nerve. In clinical practice, there are cases where auditory hallucinations are side effects caused by an overdose of certain medications. People who abuse drugs or suffer from alcoholism are also at risk and often experience various types of auditory hallucinations.

Treatment of auditory hallucinations

Audible hallucinations are a very good reason to seek help from a specialist. Do not forget that this condition is a clear danger, since it may turn out that these are symptoms of diseases that require immediate treatment. To identify the cause of noise and strange sounds in the ears, a special hearing test is used, the functioning of the vestibular apparatus is assessed, and an X-ray of the ears and a blood test are also performed. Sometimes the doctor prescribes magnetic resonance imaging or computed tomography.

When treating sound hallucinations, the therapeutic effect is on the immediate disease that needs to be cured to get rid of tinnitus and eliminate sounds that do not exist in reality. Sometimes the treatment is simple and the patient only needs special drops. In some cases, your doctor will prescribe procedures to remove earwax. But, of course, such simple cases, unfortunately, are rare, and sound hallucinations cannot be easily cured. In addition, there are no drugs that can quickly eliminate the symptom.

Minor noises that do not carry a semantic meaning may be associated with diseases of the hearing organs, but this does not mean that they can be ignored; treatment is required in each case.

Symptoms and types

Auditory hallucinations often occur spontaneously. Depending on their type, one can judge the possible diagnosis and the degree of risk to the patient’s health. These can be monotonous or short sounds, such as ringing or hissing, music, or even clearly articulated speech.

If a hallucination carries a specific semantic meaning, most likely we are talking about mental problems.

Auditory hallucinations belong to the group of subjective sounds, since only the patient hears them. This complicates their identification and diagnosis of specific causes.

The following types of sounds that arise in the patient’s consciousness are distinguished:

Tinnitus. This is a common noise that occurs in the ears: buzzing, whistling, ringing, hissing, clicking, etc. Its causes are mainly related to problems with the health of the hearing organs, but can also indicate disruptions in the blood flow system.
Acoasmas. This is an anomalous phenomenon, expressed in the occurrence of specific sounds: drops of water, music, scratching, creaking, etc.
Phonemes. The most dangerous manifestations, since they have a semantic load and influence on the patient’s actions: voices and meaningful phrases.

According to the principle of influence and characteristics of manifestation, phonemic anomalies are classified separately:

Imperative. The most dangerous type of phonemes, since the voice has a commanding character, orders a person to perform certain actions, sometimes even against his will. This is a clear sign of schizophrenia, and in religious circles it is called obsession.
Commenters. This is the so-called “imaginary friend”. A person can conduct a dialogue with a voice in his head, hear comments about himself, discuss the environment, etc.
Contrasting. These are antagonistic sounds. Two or more voices may argue with each other, or signals may appear that contradict each other.
Hypnagogic. Auditory hallucinations occur during the period when a person’s consciousness turns off when falling asleep or, conversely, during awakening. The subconscious mind works here, so even a healthy person can experience anomalies associated with the functioning of the brain, that is, “daydreams.”

Causes

To find out the type of anomaly and the principle of its further treatment, it is necessary to find out the causes of auditory hallucinations. The following factors can provoke such phenomena:

Overwork, nervous tension. Malfunctions in the functioning of the brain occur due to overstrain, consciousness turns off, for example, with prolonged lack of sleep.
Heat. Fever and increased temperature cause disruption of the functioning of various body systems. A person may experience not only auditory, but also visual hallucinations or mistake dreams for reality.
Ear diseases. Tinnitus occurs when the ear becomes inflamed, the sound conduction chain is disrupted, and its individual elements are irritated. Earwax, exudate in the middle ear and similar phenomena can cause noise at the conductive level, and effects on hair receptors and the auditory nerve - at the perceptual level.
Tumors. Pressure is applied to areas of the auditory system, the brain and nerve roots.
Neurodegenerative pathologies. Disturbances in the functioning of the brain and nervous system due to the failure of individual elements, the death of neurons, etc. The most well-known problems of this kind are senile dementia and Alzheimer's disease.
Mental disorders. They cause phonemes and acoasms. These are depression, schizophrenia, psychopathy, various syndromes.
Hearing aid malfunctions. In rare cases, the reasons lie in failures of implants and removable hearing aids.
Taking psychotropic medications. Drugs and treatment with special groups of drugs can affect brain function in a similar way.
Alcohol delirium. Attacks of delirium tremens cause not only acoustic, but also other types of hallucinations.

Treatment methods

Treatment of hallucinations themselves is impossible, it is necessary to direct efforts to their causes.

Treatment is carried out in the following ways:

Drug therapy. Depends on the specific causes of the problem. These can be anti-inflammatory, antipyretic, neurostimulating, sedative drugs, as well as special medications for the treatment of central nervous system problems and mental disorders.
Assistive therapy. Physiotherapy methods, electrical stimulation treatment, targeted effects on specific areas of the brain.
Operation. Removal of a tumor, splitting or cutting off the auditory nerve, installation of a high-quality hearing aid or implant, prosthetics and plastic surgery of ear elements, brain surgery.

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Causes of auditory hallucinations and their treatment

Auditory hallucinations are considered one of the most common symptoms of various mental and somatic diseases. The patient clearly hears sounds, noises or voices that do not actually exist. Despite the seeming harmlessness of this phenomenon, auditory illusions can cause a lot of problems for the patient, causing many unpleasant situations and even aggressive behavior.

Note! Auditory hallucinations can be classified as subjective sounds. They are audible only to the patient, which makes diagnosing and treating this disease very difficult.

Types of auditory hallucinations

There are several types of extraneous sounds that spontaneously manifest themselves in the patient’s consciousness:

Tinnitus. Standard noise effects resembling buzzing, clicking, whistling, ringing, etc.
Acoasmas. More specific sounds: creaking, drops, music, etc.
Phonemes. The most dangerous hallucinations that can carry a certain meaning and directly influence human behavior. These can be individual words, phrases or voices, which clearly indicates mental problems.

In addition, any illusions (including acoustic ones) are usually divided into true and false:

True hallucinations occur when a person hears all kinds of non-existent sounds in the surrounding space and tries to organically fit them into his worldview. The patient is completely confident in the reality of these sounds and never questions them.

False hallucinations most often come from within for the patient. Moreover, sounds are not always heard in a person’s head. Intrusive and commanding voices can come from the stomach, chest, and any other place on the body. Such illusions are considered to be the most dangerous for the life of the patient and the people around him.

Reasons for appearance

In order to correctly diagnose the type of anomaly and determine approaches to its elimination, it is necessary to understand as clearly as possible the causes of auditory illusions. Various factors can provoke this phenomenon:

Severe fatigue, nervous or physical exhaustion. Overvoltage can cause disruptions in the normal functioning of the brain and changes in a person’s consciousness.
Feverish conditions, heat. They can cause disturbances in certain body systems. In some cases, this manifests itself in the form of auditory or visual illusions.
Tumors in the brain area. The tumor can put pressure on certain areas of the auditory system or brain.
Mental disorders: schizophrenia, psychopathy, all kinds of syndromes.
Ear diseases, inflammatory processes and even sulfur plugs may well disrupt the functioning of sound-conducting channels and cause extraneous noise.
Malfunctions of electronic hearing aids. The most harmless reason, which can be eliminated by replacing or repairing the device.
Use psychotropic substances. Drug addiction or treatment with certain drugs can affect a person's brain activity in a similar way.
Alcohol abuse. Attacks of delirium tremens often result in visual or auditory hallucinations.

Photo 2. It was the appearance of hallucinations that gave rise to the phrase “getting drunk as hell.” Source: Flickr (bluevinas).

When falling asleep

Oddly enough, it is precisely when falling asleep that auditory hallucinations disturb patients most often. It would seem that the body, tired during the day, is as relaxed as possible and is preparing to get a long-awaited rest, but that was not the case. A person begins to hear non-existent sounds or voices.

In medicine, such hallucinations have a separate name - hypnagogic. Their main danger is that at the moment of their appearance the patient, as a rule, is alone and in complete silence. The lack of distractions makes a person more vulnerable and unable to resist the voices giving him orders.

Symptoms and signs of hearing hallucinations

The volume of acoustic illusions depends on their type and the patient’s character traits. Sometimes the patient hears a barely audible whisper, in other cases - loud orders that are almost impossible to resist. IN the latter case The patient most likely develops one of the varieties of schizophrenia.

Sometimes the patient hears voices, but is not the subject of their discussion. It is as if he hears from the outside a conversation between two or more non-existent people on abstract topics. Such hallucinations are considered completely harmless, although they cause a lot of inconvenience to both the patient and those around him.

Disturbances are considered more dangerous when the patient hears voices repeating him own thoughts and beliefs. At the same time, it seems to the patient that these thoughts (often very intimate and impartial) are heard by everyone around him. This can become a reason for aggression.

Note! In some cases, auditory hallucinations can be confused with manifestations of an “inner voice” or actual tinnitus resulting from various diseases.

Diagnostics

Auditory hallucinations are not independent disease, but only a symptom of another disease. The doctor will necessarily begin the diagnosis by collecting an anamnesis. This can be quite difficult to do, since the patient may have an extremely negative and skeptical attitude towards his pathological condition. If the patient does not want to contact the doctor, you can try interviewing the closest relatives.

In order to exclude organic nature pathologies will be assigned lab tests urine, blood, spinal cord. Older patients using hearing amplification devices should additionally check the correct operation of the electronic device.

The presence of acoustic hallucinations can also be guessed from the specific behavior of a person. The patient may hesitate to answer, clearly listening to something. When talking with such a patient, the doctor needs to try to win him over as much as possible and establish a trusting relationship.

Treatment of auditory hallucinations with homeopathy

Along with traditional medicine, modern homeopathy can offer a number of drugs that can help eliminate such an unpleasant and sometimes dangerous disease for the life and health of the patient:

Elaps. Indicated for extraneous noise, clicking, unbearable itching in the ears. It will help eliminate attacks of deafness at night, accompanied by crackling and roaring in the ears.
Curare. Helps eliminate whistling or ringing noises, sounds reminiscent of animal cries.
Valerian (Valeriana). The drug is recommended for patients who have tinnitus, acoustic illusions, hyperesthesia ( increased sensitivity sense organs).
Eupatorium purpureum. Effective for various types of auditory hallucinations, sensations of constant ear congestion, crackling when swallowing.
Galvanism. Suitable for patients who hear the sounds of gunshots, explosions, the playing of a brass band, or the sound of bells.
Anacardium. The drug helps patients who experience voices imposing strange orders or whispering blasphemies.
Carboneum sulphuratum. Helps eliminate burning ears, singing voices or harp sounds.

Contact qualified specialists who can select the most suitable drug for your clinical case and prescribe correct dosage and course of admission.

Everything you need to know about auditory hallucinations

A hallucination is a perception in the absence of an external stimulus that has the quality of a real perception.

Hallucinations can occur in all senses:

Probably the most common type of hallucination involves hearing voices. They are called classroom verbal hallucinations. They are often symptoms psychiatric diseases, for example, schizophrenia. Visual hallucinations may also be associated with pathologies. Although they are less common in schizophrenia, visual hallucinations sometimes occur in neurological disorders and dementia.

Although auditory hallucinations are commonly associated with psychiatric illnesses such as bipolar disorder, they are not always signs of illness. In some cases, hallucinations can be caused by lack of sleep. Marijuana and stimulant drugs can also cause sensory disturbances in some people. It has been experimentally proven that hallucinations can also be caused by long absence sensory stimuli.

In the 1960s, experiments were conducted (which would be impossible now for ethical reasons) in which people were kept in dark rooms without sound or any sensory stimuli. Eventually people began to see and hear things that were not there. So hallucinations can occur in both sick and mentally healthy people.

When patients experience auditory hallucinations—that is, hearing voices—an area of their brain called Broca's area is said to become more active. This area is located in the small frontal lobe of the brain and is responsible for speech production - when you speak, Broca's area works!

One of the first to study this phenomenon were professors Philip McGuire and Sukhi Shergill from King's College London. They showed that their patients' Broca's area was more active during auditory hallucinations than when the voices were silent. This suggests that auditory hallucinations are produced by the speech and language centers of our brain. This led to the creation of “inner speech” models of auditory hallucinations.

When we think about something, we generate “inner speech,” that is, an inner voice that “voices” our thinking. For example, when we think “what will I have for lunch?” or “What will the weather be like tomorrow?”, we generate internal speech and, we believe, activate Broca’s area.

Chris Frith and others have proposed that when we engage in the process of thinking and inner speech, our Broca's area sends a signal to an area of our auditory cortex called Wernicke's area. This signal contains information that the speech we perceive is generated by us. This is because the signal is supposed to dampen the neural activity in the sensory cortex, so it is less activated than by external stimuli, such as someone talking to you.

This model is known as the self-monitoring model, and it suggests that people with auditory hallucinations have a deficit in this monitoring process, causing them to be unable to differentiate between internal and external speech.

Although on this moment The evidence for this theory is somewhat weak, but it has certainly been one of the most influential models of auditory hallucinations of the last twenty or thirty years.

About 70% of people with schizophrenia hear voices to some degree. Sometimes voices “respond” to medications, sometimes they don’t. Usually, although not always, voices have a negative impact on people's lives and health.

For example, people who hear voices and do not respond to treatment have a higher risk of suicide. Sometimes voices tell them to harm themselves. One can imagine how difficult it is for them even in everyday situations, when they constantly hear humiliating and insulting words addressed to them.

Many people who hear voices live active and happy life, so we can't assume that voices are always bad. They are often associated with aggressive, paranoid and anxious behavior mentally ill, but this behavior may be a consequence of their emotional disorder, and not the voices themselves. It is perhaps not so surprising that anxiety and paranoia, often at the core of mental illness, manifest themselves in what the voices say.

People diagnosed with schizophrenia are usually treated with "antipsychotic" medications. These medications block postsynaptic dopamine receptors in an area of the brain called the striatum. Antipsychotics are effective for many patients, and their psychotic symptoms, especially auditory hallucinations and mania, improve to some extent as a result of treatment.

However, many patients' symptoms do not seem to respond well to antipsychotics. Approximately 25-30% of patients who hear voices have little effect on medications. Antipsychotics also have serious side effects, so these medications are not suitable for all patients.

I'm currently leading a study at King's College London to see if we can teach patients to self-regulate neural activity in the auditory cortex.

This is achieved using “real-time fMRI neural feedback.” An MRI scanner is used to measure the signal coming from the auditory cortex. This signal is then sent back to the patient via a visual interface, which the patient must learn to control (i.e., move a lever up and down). Ultimately, it is expected that we will be able to teach voice-hearing patients to control the activity of their auditory cortex, which may allow them to more effectively control their voices. Researchers are not yet sure whether this method will be clinically effective, but some preliminary data will be available in the next few months.

About 24 million people worldwide live with a diagnosis of schizophrenia, and about 60% or 70% of them have heard voices at some point. There is evidence that throughout the population, 5% to 10% of people without a psychiatric diagnosis have also heard voices at some point in their lives. Most of us have ever thought that someone was calling our name, and then it turned out that no one was nearby. So there is evidence that hallucinations may not be accompanied by schizophrenia and other mental illnesses. Auditory hallucinations are more common than we think, although exact epidemiological statistics are difficult to come by.

Science currently does not have a clear answer to the question of what happens in the brain when a person hears voices. Another problem is that researchers don't yet know why people perceive them as foreign from an external source. It is important to try to understand the phenomenological aspect of what people experience when they hear voices.

For example, when people are tired or take stimulants, they may experience hallucinations, but do not necessarily perceive them as coming from external sources.

The question is why people lose the sense of their own agency when they hear voices. Even if we believe that the cause of auditory hallucinations is excessive activity of the auditory cortex, why do people still believe that the voice of God, or a secret agent, or aliens is speaking to them? It is also important to understand the belief systems that people build around their voices.

Causes and treatment of auditory hallucinations

If a person hears voices that other people around him cannot hear, then he has vocal hallucinations. In fact, the threshold of susceptibility may vary from person to person. Therefore, a hallucination can only be called a phenomenon that does not have confirmation of existence outside a person’s consciousness. Another phenomenon of special perception, the mystery of which has yet to be solved, is musical hallucinations.

Types of auditory illusions

Auditory hallucinations are distinguished by the characteristic sound that a person can hear. There are simple and complex auditory illusions.

Simple illusions include abrupt sounds, noises, or parts of words. Complex auditory hallucinations are perceived as musical melodies or speaking voices.

Musical hallucinations, melodies and songs, whether familiar or completely unknown, can serve as a source of inspiration for creative people. The most dangerous forms of auditory illusions are when voices in the patient’s head intrusively order him to do something. Such people pose a social danger, since under the influence of audible voices they are capable of suicide and murder. There are times when voices in the patient's head help him, urging him to do something reasonable, for example, seek help. In such cases, the mental illness is usually not recognized by the patient himself.

There are also pseudohallucinations, hallucinations during sleep and depression. Auditory pseudohallucinations are associated with the inner world of a person. Hearing voices are not perceived as coming from outside, they sound in the head, but the person hearing them considers this normal. Hallucinations during sleep are probably the most harmless of all other types.

Dreams are also a kind of complex illusion, which can be accompanied by the sensation of smells, sounds, vivid visual images, etc. A completely healthy person can dream.

Depression resulting from mental trauma, organic disease in old age, or manic-depressive psychosis is also often the cause of auditory hallucinations.

A person who has lost someone from his family sometimes hears the voice of the deceased or even sees him in a dream. The same thing happens to a person who witnesses a tragedy in which there were casualties.

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Etiology, causes

The occurrence of auditory hallucinations can be due to many reasons. The simplest is intoxication of the body. Poisoning with certain substances (in particular, drugs, alcohol) causes manifestations of other disorders mental activity– confusion, delirium, affective disorders.

In people with mental illnesses, such as schizophrenia, auditory hallucinations are accompanied by structural and functional abnormalities in brain activity.

This is confirmed by tomography. Deviations of mental activity in schizophrenia may be genetically determined.

Auditory hallucinations may be caused by dementia or neurocognitive disorders. These include:

neurodegenerative diseases (Alzheimer's disease, Huntington's chorea, etc.);
vascular diseases of the brain;
dysmetabolic encephalopathies;
neuroinfections;
traumatic brain injuries;
brain tumors, etc.

The cause of auditory illusions may be hidden in the experience of violence. The traumatic effect on the psyche requires the intervention of a psychotherapist. Physical or sexual violence leading to psychosis has a devastating effect on the personality of the victim. Voices appear in the patient’s head, ordering him to harm himself or others. A threatening voice from hallucinations is often associated with the voice of a person who has committed violence.

Symptoms of hallucinations that are not a consequence of a mental disorder

However, the nature of some auditory hallucinations remains unclear. Perfectly healthy children from 7 to 12 years old and elderly people can hear strange sounds that have no visible source. At the same time, mental functions remain normal, and no further mental abnormalities are observed. A clearly audible voice or musical hallucinations in such cases are explained by a violation of the internalization of the inner voice.

Internalization, or the process of mastering the external world by transforming observed phenomena into an internal regulator of mental activity, is the reason for the formation of the inner voice. This process goes through four stages as the child gets older. The baby, mastering the speech heard from adults, repeats words out loud in order to communicate with others. Thus, dialogue appears - the first level of formation of the inner voice.

The second level is the ability to make comments, the third is the ability to conduct an internal monologue, the fourth is the ability to think without the need to express the thought in words in order to internalize its meaning. Disturbance in the perception of the inner voice can occur when perception is confused or expanded. In such cases, a person perceives his inner voice as belonging to someone else, or cannot recognize that the voice in his head is his own thoughts that have moved to the first level of external dialogue.

Treatment involves the use of antipsychotic drugs. Conversations with a psychologist are of great benefit. The first step towards healing in such cases is to realize that the sounding voice is a figment of the imagination. This awareness returns a person to self-confidence and control over his actions, emotions and life.

Diagnostics and treatment methods

Treatment of auditory hallucinations of various etiologies is carried out with the help of medications, non-traditional methods and psychological influence. In some cases, therapy methods cannot help heal the mental disorders or diseases that caused hallucinations, but are intended to alleviate the patient's condition. Antipsychotic drugs that affect dopamine production are the mainstay of treatment.

For affective disorders, antidepressants are used - medications that improve mood and remove negative emotions in the form of anxiety, irritability, and insomnia. Since antiquity, St. John's wort tinctures have been used as an antidepressant. Preparations based on St. John's wort are still used today; they do not cause side effects after discontinuation. It should be remembered that the use of antidepressants improves the quality of life, but is not a cure for the disease.

Method psychological impact A well-established treatment for auditory hallucinations is cognitive psychotherapy. This method is different from the usual psychoanalysis. The task of a psychotherapist who uses cognitive psychotherapy is not only to listen to the patient, but also to teach him to think correctly, without making cognitive errors. If a person's thoughts and the events that occur are very different, this leads to mental illness. Having eliminated the cause of internal dissonance, the psychotherapist achieves a change in the patient’s perception and behavior.

Non-traditional methods of treatment and research include transcranial magnetic stimulation. The cerebral cortex is stimulated by short magnetic pulses that do not cause pain. At joint use with drugs, such therapy in some cases has positive effect when getting rid of auditory hallucinations. Contraindications to its use are the presence of metal foreign bodies in the patient, especially in the head, tumors, treatment with certain antidepressants, and epilepsy.

In ancient times, people considered auditory hallucinations to be demonic possession or a sign of being chosen from above. For modern psychotherapists who study brain activity using encephalograms and tomography, everything seems much simpler.

Audible hallucinations occur during stimulation of the area of the brain responsible for speech production. That is, a person’s internal dialogue is perceived by him as someone else’s voice. But how then can we explain musical hallucinations or the special emotional state that accompanies these phenomena, which are experienced differently by each person? For psychologists and psychotherapists, there are still more questions than answers.

You have memory problems, increased forgetfulness.
You notice that you have begun to perceive information worse, and difficulties in learning have appeared.
You are frightened by your inability to remember certain events or people.
You are worried about headaches, tinnitus, and coordination problems.

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Causes of auditory hallucinations

When auditory hallucinations occur, a person begins to hear various sounds, including voices and conversations, which do not exist in reality. In this case, you should take this violation seriously and seek help from a qualified specialist. As medical practice shows, almost every person has had to talk to himself at least once. For example, having forgotten his phone at home, he may think: “Well, when will I learn to be more collected”! Now imagine that after the phrase has been said, a voice is heard inside the person’s head that says: “Yes, indeed, you are too forgetful.” If something similar happens to a person, then it’s time to suspect that mental health not okay.

In a situation where an individual hears non-existent voices, they say that he has auditory hallucinations, the occurrence of which can be a number of reasons, so without an appropriate examination it is difficult to name the exact cause. First of all, experts suggest that in this case there is a mental disorder of varying severity, as well as a neurological disease. The biggest mistake is that some people take such disorders lightly and put off visiting a doctor until better times.

There is currently a debate among many scientists about the causes of auditory hallucinations. Some experts argue that the auditory hallucinations that sometimes sound in the head are one’s own voiced thoughts, that is, expressed in verbal form. In this regard, the individual begins to perceive this phenomenon as the voice of an unfamiliar and extraneous subject, and sometimes even several. If the cause of an auditory hallucination is a nervous or mental illness, then the patient believes that the voices sounding in his head exist in reality.

What diseases cause auditory hallucinations?

The peculiarity of auditory hallucinations is that a sick person can quite seriously declare that an inner voice ordered him to commit suicide, or gave the order to take the lives of loved ones and acquaintances. The most dangerous thing in this case is that the patient does not consider such orders to be a hallucination, and has no doubt at all that he

obliged to comply with these inadequate instructions. Among the causes of such disorders, schizophrenia is often cited. This is a disease that causes very serious mental disorders. Patients most susceptible to schizophrenia young. At the same time, auditory hallucinations occur in people suffering from Alzheimer's disease, various manias and depressive states.

Among the causes of auditory hallucinations, a factor such as alcohol abuse has been named. This condition may be caused by taking certain medications, especially in case of overdose. Sometimes similar side effects are observed when taking antispasmodics. In this case, when going to see a doctor, it is necessary to make a list of all medications taken in advance in order to show it to the attending physician. But we shouldn’t forget about this trivial reason as a low quality hearing aid. Therefore, if a patient using a hearing aid begins to hear strange sounds, strange voices, noise, then first of all, you should find out whether the hearing aid is in order.

It is known that auditory hallucinations occur not only in mentally ill people who need serious and immediate help from a psychiatrist. Very often, completely healthy people who do not have mental disorders, but are in a state of severe depression, may experience auditory hallucinations. Basically, they are expressed in the fact that when falling asleep they hear voices, supposedly calling them by name. Doctors say that this factor is not a manifestation of mental illness. In this case, the reason may be the usual nervous tension, overwork, stressful situations at work or in the family.

How to identify the cause of auditory hallucinations

To determine what is the real reason this violation, the doctor must carry out a detailed examination, talk with the patient, and ask a number of questions necessary in this case. Only after this does the specialist make a conclusion whether there is a need to send the patient for treatment to a psychiatrist. Sometimes, in order to establish the cause, it is enough for a person to visit a therapist. At present, the mechanism of the occurrence of hallucinations has not been sufficiently studied, and some reasons that are selective in nature are not entirely clear.

There is an assumption that in some cases, auditory hallucinations that occur in a healthy person are caused by a special attitude, a peculiar distortion of perception, which is influenced by previous events. Numerous scientific studies have found that auditory hallucinations are also caused by excessive excitability of certain areas in the brain. To the most simple reasons This pathology includes intoxication with substances of medicinal origin, for example, levodopa, ephedrine, meridil. Drugs used are often to blame

patient. Therefore, by eliminating the appropriate irritants, the problem can disappear quite quickly, even without special treatment. But in most cases, the patient needs to make efforts to get rid of hallucinations.

In searching for the cause of auditory hallucinations, doctors emphasize the special significance of many diseases. For example, attention should be paid if a patient complaining of hallucinations has cardiovascular disease, a tumor of the temporal lobe, various abscesses, temporal arteritis, or migraine. Sometimes auditory hallucinations are associated with diseases of the sensory organs and brain damage.

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Auditory hallucinations

As varied as visual illusions.

Acoasmas are elementary and simple auditory hallucinations of non-speech content. Elementary deceptions are felt as noise in the head or coming from the side, whistling, hissing, gurgling, creaking, crackling and other sounds, as if unrelated to certain objects and often unfamiliar to patients.

Simple auditory hallucinations are usually recognizable, have some clear meaning and are attributed to specific objects. These are, for example, slurping, gnashing of teeth, the sound of breaking dishes, the sound of waves, car horns, knocking on the door, sounds of footsteps, rustling of paper, kisses, coughing, squeaking mice, sighs, barking dogs, phone calls, door calls, etc. Thus, the patient reported that in her childhood, in a dream, she heard a doorbell ring. She woke up. The call was repeated. She went to the door and asked who was there. In response I heard: “It’s me, your death.” There were further calls. At home it seemed like it was her call, at her mother’s house it was different.

Often, up to four times a night, she wakes up to the sound of a bell. Some authors believe that such auditory deceptions can arise psychogenically (Alenstiel, 1960). In some cases, the predominance of sounds made by animals becomes so obvious that one can probably talk about such a type of deception as auditory zoological hallucinations, or zooacusis.

Phonemes are elementary and simple speech deceptions of hearing. These are shouts, groans, screams, exclamations, individual words. Some patients hear an inarticulate stream of sounds of low and incomprehensible speech, reminiscent of muttering - persistent hallucinations. Calls by first and last name are especially common, when patients hear that someone is either calling them or letting them know about their presence. In this case, one voice sounds or over time changes to some other one; the voice may be familiar or belong to an unknown person.

There are “silent” calls or calls that patients attribute to some other person. Calls occur rarely and with long intervals. Often during the entire period of occurrence they occur only 2-3 times. Patients often self-identify hearing deception. Sometimes the call is immediately repeated several times in the same way. The first reaction of patients to the appearance of calls is usually alertness and fear of a possible mental disorder. Then the patients calm down, as if they get used to them, try not to notice them, some think that this happens to everyone and there is nothing special about it.

Thus, in childhood, the patient clearly heard someone “calling” her in an unfamiliar male voice several times in a row. She was “scared”, but still went to see who could be hiding behind the tree. As an adult, a year after her father’s death, she clearly heard his voice from the street, he was calling her. “I was scared and pleased.” Another patient, also in childhood, once heard a call in the voice of his deceased father. “I was scared, I thought that a dead man had come to life.” After that, for a year, it sometimes seemed to him that his father was alive. Once he even recognized his father in an unfamiliar passerby.

Some patients say that when they hear a call or a knock on the door, they “mechanically” approach it and open it even in the middle of the night, as if forgetting that it is unsafe. Apparently, calls are one of the symptoms of the long-lasting prodromal period of the disease. During the same period of time, in addition to phonemes, disorders such as a feeling of an alien presence, a feeling of someone else's gaze, and sometimes nightmares and other abnormal dreams may occur.

Musical hallucinations are deceptions of hearing with the sound of different music and in different “performances”. It could be sublime, spiritual or “heavenly” music, some popular pop melodies, something simple, primitive, associated with something vulgar, cynical, and unworthy. You can hear choirs, solo singing, the sounds of a violin, the ringing of bells, etc. Musical things known to patients sound, long-forgotten ones emerge, and sometimes these are completely unfamiliar melodies in an equally unfamiliar performance. There are patients who are musically literate and who manage to record hallucinatory melodies. We know of a case when one of these patients managed to publish a collection of songs, the words to which she composed to such melodies.

Some patients report that they can “order” musical hallucinations. To do this, they only need to remember the desired melody or words of the song, and it immediately begins to be broadcast from beginning to end. One of the patients heard such “retro-style concerts” for more than six months. It is not at all necessary that such patients be professional musicians. Musical hallucinations are observed when various diseases, mainly, apparently, in schizophrenia, epilepsy, alcoholic psychoses, as well as drug addiction. Drug addicts seem to have a particularly high frequency of listening to psychedelic music, which they willingly listen to in order to modify the picture of intoxication in a desired way.

Verbal hallucinations are deceptions of hearing in the form of speech. Patients hear phrases, monologues, dialogues, incoherent series of words in their own, foreign or unknown languages. Rarely, there are hallucinations in conventional languages known in cryptography. Many patients call verbal deceptions of hearing “voices,” initially surprised by the fact that they hear someone speaking, but do not see anyone. This contradiction does not confuse patients at all, so they do not doubt that someone is really talking, coming up with their own theories about this. It does not bother them that other people do not hear the same “voices” as they do. Usually patients, no matter what the “voices” say, address them to themselves. There are many variations of such hallucinations.

Commentary hallucinations are auditory deceptions in which assessments of the patients’ thoughts, feelings, intentions, and actions are heard. They can also be designated as reflexive deceptions of hearing, since first of all they voice the results of self-observation and the attitude of the patients themselves to various aspects their own self. The comments may, apparently, also reflect assessments of patients by people significant to them.

The content of the comments reveals close connection with the mood of the patients. Mood disorders affect the self-esteem of patients, probably in the same way as is observed in healthy people. Elevation of mood is usually, although not always, accompanied by increased self-esteem. Accordingly, the nature of the comments changes. “Voices” in such cases praise the patients, encourage them, support them, and approve of what they are doing. Depressed mood most often lowers self-esteem and, accordingly, entails derogatory comments. If anger is added to the depression, then the “voices” scold the patients, insult, ironize, mock, and even threaten, not stopping at rude, vulgar abuse. Rapid changes in mood can be identified by changes in the content of comments. A mixed mood may be accompanied by comments of contradictory content, when some “voices” praise and defend, while others, on the contrary, condemn, humiliate, and scold.

In some cases, the comments are so cruel and cynical that one can speak of mocking hallucinations. Sometimes the “voices,” like children, seem to imitate the patients, for example, repeating what they said and distorting words and phrases, speaking in broken language, and reproducing their speech defects in a comic form. V.M. Bleicher tends to identify those who comment on the deceptions of hearing with teleological ones. Aggressive hallucinations can apparently indicate two important things: the presence of aggressive tendencies in the patient himself or his expectations of aggression from someone around him.

There are commentary deceptions in which “voices” in one way or another evaluate what was said or done by someone around the patient - extra-commentary hallucinations. Patients may agree with the content of such comments, be indifferent to it, or it may not coincide with their own opinion at all.

Ascertaining hallucinations are auditory deceptions that represent acts of recording everything that patients perceive or do, as well as events in their inner life. Such deceptions do not contain any comments. Thus, the “voice” names the objects that the patient perceives at the moment: “A chair against the wall. pine tree, next to an anthill. the dog is running. there's an ax on the block. the wife is coming. a policeman is standing. a woman sings. it smells burnt." The patients’ actions are noted in the same way: “He’s standing, looking. went. has stopped. puts on shoes. took it. mug. lit a cigarette hid under the bed." “Voices” also register the thoughts, intentions, and desires of patients: “He wants to drink. going to work. thought about it. angry." Patients often believe that someone is watching them, that they are being “recorded”, “listened to”, “photographed”, they feel open to observation, and are confident that they can no longer hide anything from their pursuers.

Imperative hallucinations are imperative deceptions of hearing, “voices” that often contain unmotivated orders to do something. In some cases, the “voices” motivate their orders in one way or another. In fact, they manifest the painful and often irresistible impulses of the patients themselves, only perceived by them as an external, hallucinatory compulsion. Typically, such impulsive and usually destructive urges are observed in catatonic patients, but in catatonic patients they occur outside of hallucinations. On the other hand, imperative deceptions are close to violent impulses that arise in the structure of mental automatisms; however, such impulses may not be associated with perceptual deceptions. Thus, imperative hallucinations are, as it were, relatively early symptom other, more severe and possible future violations.

Homocidal and suicidal imperative hallucinations pose a particular danger to others and the patients themselves. The following illustrations show this. The patient reports: “The voices ordered to kill his wife, children and himself. They said that otherwise we would all die a shameful and painful death. I hit my wife with an ax, but she dodged. She was wounded and ran away. I killed two daughters, but did not find the third. Then he stabbed himself in the chest twice with a knife, but was unsuccessful. Then I took the knife, put its handle against the wall and was going to drive it deeper into myself. But then they started breaking down the door. I noticed with my peripheral vision that the blanket on the bed moved and the third daughter’s head appeared. I managed to reach the ax and hit my daughter on the head with it. I didn’t have time to stab myself with a knife, they grabbed me.”

Another patient says that, on the orders of the voices, he tried to drown himself several times, but, swimming out to the middle of the Angara, at the very last moment received orders to return to shore. Once he miraculously survived, as he threw himself into the water in winter and became icy on the shore; he was accidentally discovered by fishermen. He also tried to kill himself by stabbing a file into the heart area. The voices ordered him to use a file. But this suicide also failed; it was stopped by acute pain in the chest.

There are sadistic imperative hallucinations that order patients to torture someone around them, torture and even kill, but slowly, cruelly torturing the victim, prolonging her suffering. Torts of this kind are known, but fortunately they are rare. Patients themselves can become the object of sadistic orders. Thus, the “voice” orders the patient to cut off his finger and eat it, forbidding him to bandage the stump; stand under a stream of icy water, jump on all fours and bark at the same time, lie in the snow, hang yourself, throw yourself under cars, go to the morgue and play dead there, etc.

There are deceptions of hearing with prohibitions to do anything required by the situation - these are like catatonic hallucinations. For example, the “voice” forces the patient not to eat, not to take medications, not to answer the doctor’s questions, does not allow him to go to bed, move, get dressed, etc. In some cases, patients, prompted by commanding deceptions, are forced to take actions that are the opposite of what is appropriate: turn away from the interlocutor, stand when they are invited to sit down, tear off clothes, etc. The behavior of such patients is not much different from the behavior of catatonic patients with passive and active negativism. There are “voices” that force patients to pronounce perceived objects and their actions out loud, in some cases they force them to do this several times in a row, as a result of which the patients seem to imitate iterative phenomena.

In some cases, magical hallucinations are observed, forcing patients to perform something like witchcraft, for example, putting things in strictly defined places, stretching ropes around the apartment, washing their hands an even or odd number of times, counting their steps, etc. “Voices” explain that it is necessary to do something like this in order to avoid various troubles for patients, and much less often for themselves.

There are, as it were, indirect orders: “voices” demand that patients force one of the people around them to do something. Relatively rarely, the orders of the “voices” are innocent or even quite reasonable. Thus, under the influence of voices, the patient talks about himself in great detail, without hiding anything, carefully takes medications, and stops smoking. It is quite rare, but it still happens that, on the orders of “voices,” patients go to see a doctor, without realizing that they are sick.

Sometimes imperative orders remain in force even after the hallucinations have disappeared. The patient reports: “They control me, although they are no longer there. I’m still very afraid that they are about to appear and force me to do something terrible.” In this case, the connection between commanding “voices” and the phenomena of mental automatism is clearly visible.

Patients' attitudes toward imperative hearing deceptions vary. In many cases, the orders of the “voices” are carried out without the slightest resistance, no matter how dangerous or ridiculous they may be. Some patients try to resist such orders, sometimes they are quite successful. Some patients find the strength to do the opposite of what their voices demand of them. So, according to the patient, he gets up if the “voice” forces him to sit or lie down, stops if he hears an order to walk, travels by transport when the “voice” orders him to walk, goes in the other direction, and not where the “voice” demands ", walks along right side street, and not on the left, as the “voice” etc. forces him to do. Most often, the imperative voice is one unfamiliar voice, less often - two, which give opposite orders. According to V. Milev, imperative deceptions of hearing can be regarded as schizophrenic symptoms of the first rank.

Suggestive hallucinations are auditory deceptions that contain not orders, but persuasion to do something, as if convincing patients that they should act in one way or another. Often such hallucinations incline patients to commit acts of aggression or self-aggression, and also seem to prepare them to make false judgments. Hallucination words are often perceived by patients as quite convincing, since they express their own motives for planned actions. Delusional hallucinations have been described (Heim, Morgner, 1980), which convince patients of the correctness of their delusional constructions.

Hallucinatory self-incriminations are auditory deceptions with reports of imaginary offenses that patients allegedly committed. It happens that patients accept such messages without hesitation. Moreover, they remember the details of the imaginary event. Thus, the “voice remembered” that three years ago the patient hit women passing along the road in the village, after which two women died. He clearly remembered how it all happened, after which he contacted the police with a statement.

Hallucinatory fictions, or confabulations, are deceptions of hearing when “voices” tell various fables, fantastic stories, for example, about the birth of a patient, his travels, exploits, etc. Some patients may well believe this. Others do not take these fictions seriously and believe that the “voices” are “talking all sorts of nonsense.” Sometimes there are hallucinations in which more or less consistent crazy ideas inventions, reforms - paralogical hallucinations. Thus, the “voices” inform the patient about the causes of schizophrenia, the nature of telepathic influence, the origin epileptic seizures and so on.

Reasonable hallucinations are deceptions of hearing, when “voices” say “smart things”, give “smart” advice, “tell” how to behave in a given situation, adequately assess the well-being of patients, “warn” about possible troubles, “restrain” from rash actions, “remember” past events if patients have forgotten them, etc. Some authors call such voices “angelic”.

Sometimes “voices” help patients find the things they need, or find the right street in an unfamiliar quarter of the city. Thus, the patient says that they notice street signs better than he does, so that he, having gotten lost, returns to the place indicated by the “voice. When someone speaks, but I myself cannot hear, the voice helps me understand what they said. It’s like he has ears and his hearing is better than mine.” Such hallucinations can be designated as subthreshold, since it seems that their threshold of sensitivity is lower than that of patients.

Archaic hallucinations are deceptions of hearing, when “voices” voice the activity of the patients’ paleothinking structures. Such “voices” predict the future, “induce” and “remove” damage, unravel omens and dreams, etc.

Bleuler's teleological hallucinations are deceptions of the ear, as if suggesting how easier or better it is to do something: to commit, for example, suicide. So, the “voice” says that it would be better to jump into the water from the Angarsky Bridge, since no one will have time to prevent this, and it is not difficult to drown in a cold river, especially for a sick person, since he does not know how to swim.

Anticipatory hallucinations are deceptions of hearing, when “voices”, ahead of patients, tell him what will happen to him in a few minutes, what he will think about, what decision he will make: “I start to think about something, and the voice already tells the result. I’m reading a book, and a voice runs ahead and says what is written in the lines below. Before I even have time to figure out what happened, the voice is already reporting it to me. He, this voice, is like my intuition. The voice says what it will smell like or what taste sensation will appear, and exactly, after a few minutes, this is exactly what happens. Voices warn me that there will be a seizure soon, and within an hour or two it happens. They tell me to lie down and hold the fork between my teeth, which I do.”

Echo hallucinations are auditory deceptions when voices repeat what patients have been told by other “voices”, some of the people around them, voice texts that patients read or write, and also repeat their thoughts out loud: “How will I close left ear, the voice begins to repeat after me what I say. I read silently, and the voice reads out loud, it also names punctuation marks. I write a letter and a voice reads it out loud. Otherwise it will tell you where there was a typo or which word would be better.”

Echolalia can manifest itself differently, namely in the speech of the hallucinating patient himself. So, the doctor’s questions are answered by a “voice”, and the patient, completely “without thinking” at this time, only repeats what was said by the “voice”.

Reduplicated or diplacusic hallucinations are double deceptions of hearing, when what is said in one “voice” is immediately repeated by the second exactly and with the same intonation. Both hallucinations almost merge, they are separated by some fractions of a second.

Hypochondriacal hallucinations are deceptions of hearing when “voices” tell what ails them. So, the “voice” complains that his heart is bad, he faints, and his joints hurt. The “voice” of another patient says that he has seizures and that he also hears voices or is tormented by visions.

Iterative hallucinations are deceptions of hearing when “voices” repeat, and can do this many times, what was said by patients or someone around them. Sometimes the “voice” voices and repeats the patients’ thoughts several times. There can be 5-6 or more repetitions. As it is repeated, the “voice” speaks more and more quietly, and sometimes more slowly. Sometimes they repeat last words. Such auditory deceptions are also called palilalic.

Stereotypical hallucinations are deceptions of hearing, when a “voice” appears from time to time and says the same thing. Thus, a patient with Huntington's chorea hears the same “peek-a-boo” for a number of months, believing that someone is “playing hide and seek” with him. There are also recurring hallucinations that are externally similar to them. These are auditory deceptions that are repeated at the beginning of each attack of the disease. Usually, patients report, these are the same “voices” that were in the previous attack or previous attacks of the disease, and they say the same thing. Occasionally, appearing again, such “voices” greet patients as their old acquaintances, and when disappearing, they say goodbye or say that they will return back on time.

Fortune-telling hallucinations are deceptions of hearing, when the “voices” seem to know nothing about the patient and make various, including absurd, guesses about him. So, the “voice,” speaking about the patient for some reason in the third person, wonders: “Who is he, a colonel or a general, will he work in the FSB or the police, who will he vote for, for the right or the left, will he leave his wife or no, he will shave or grow a beard, whether he is for communism or capitalism, it is better for him to become a Buddhist, an Islamist or a Christian. “There are inquisitive hallucinations - deceptions of hearing, when “voices” seem to reveal their own cognitive need. At the same time, they “ask” questions of impersonal content, which patients are nevertheless forced to answer. For example, these are questions of this type: “How does the Universe work? What about an atom, a molecule? What is matter? Does God exist? Is there heaven? And hell? Why are there voices? »

Autobiographical or memoir hallucinations are auditory deceptions that seem to voice such a disorder as a symptom of unwinding memories. The patient reports that one day, while sitting on the shore of Lake Baikal at night, he heard someone approach him. He didn't see who it was. The newcomer began to remember his past, starting somewhere with school years. He also spoke about his service in the army, about what happened during the war in Chechnya.

Mostly he remembered the most unpleasant things, the things that the patient didn’t want to tell anyone and tried to forget. “It was like he knew everything about me. He knew details that no one knew except me. At first I was very scared, even a chill passed through my skin.” The voice was unfamiliar, but there was, however, a moment when it seemed to the patient that once upon a time he had already heard it once and seemed to know this person. Next, there was a dialogue with the “voice”, after which there followed a strict military order to undress, carefully fold your clothes on a stone and swim to the middle of Lake Baikal. The patient hardly remembers what happened next. He only remembered that a seagull’s wing touched his head in the water. The next day, at noon, his comrades found him naked on the shore; they hardly woke him up and brought him to his senses.

Anamnestic hallucinations are auditory deceptions when “voices” question patients in the same way as a doctor collects a life history. Patients obediently answer questions out loud, and sometimes mentally, confident that the “voices” recognize their thoughts.

Echomnestic hallucinations are deceptions of hearing in the form of repeated experiences of some hallucinatory episode (Uzunov et al., 1956), who first described this phenomenon, called it a symptom of reduplicating hallucinations; Some authors call such hallucinations polyacoustic, and if they sound loudly, then polyphine).

Hallucinations in the form of a monologue are deceptions of hearing when the “voice” speaks without stopping and without allowing itself to be interrupted. Here is a small fragment of such a monologue. The patient repeats after the “voice”: “. There is not enough male blood in you, the light in your life has gone out, menstruation is going away. She killed herself without a husband, without male blood. She poisoned her ovaries with theophedrine and took it for nine years. There will be no more children, you won’t be able to work until retirement. To hell with a man, not a pension, you should have thought earlier, not sit at home. " In that short message signs of loosening of associations, depressed mood, and self-aggression are noticeable. In passing, we note that hallucinations represented by a single “voice” are called monovocal.

Hallucinations in the form of dialogue are a type of polyvocal auditory deception, when patients hear two or more “voices” at the same time. In a hallucinatory dialogue, both “voices” speak exclusively to each other, and the subject of the dialogue is usually the patient. The content of the dialogue can be comments, orders, instructions. In cases where such “voices” say exactly the opposite things, they are called antagonistic, which usually indicates the dissociation of the personality into its polar fragments.

For example, one “voice” sounds in the patient’s right ear, another in the back of the head and left ear. The “voice” in the left ear sounds quieter, and hearing loss is also detected on the left. When waking up from sleep, the patient hears a “howl”: this, he believes, is “waking him up.” The “voice” in the back of the head forces the patient to do what he himself considers wrong and unacceptable. The “voices” in the ears simultaneously say something completely different; they, the patient thinks, “support” him. This observation also reveals diplacusic deceptions of hearing: two “voices” of the same content are heard in the ears, but different in sound volume. V.P. Serbsky (1906) even expresses the idea that this kind of auditory deception is caused by the separate functioning of each hemisphere of the brain.

There are three or more “voices”, sometimes there are up to 13–16 of them, some patients “lose counting”. At the same time, each voice says something different, they are not connected with each other, in some cases they act in concert and form something like a “collective”. So, the patient hears three voices, she designates them with the letters A, B and C. “Voices” can tell her something, order, ask for something. They ask, for example, that she read books to them, either “about love” or “on history, philosophy,” which she does. “Sometimes they force me to make faces, stop in place, walk backwards, so that everyone knows that I’m crazy.” It happens that “voices argue among themselves about me or cannot decide what they need.” Some patients report that at times a lot of voices suddenly appear, but usually there are only 1-2. Such “attacks” last for hours.

Open hallucinations are deceptions of hearing with dialogue between “voices” and patients. In this case, patients have the opportunity to “talk to voices”, since the latter “hear” them and react to their speech. Patients speak out loud at the same time, sometimes quite loudly if “the voices are not heard enough.” Thus, the patient constantly “communicates with voices” and calls his head “home”. When hallucinations of unpleasant content are heard, he threatens them that he will commit suicide, and therefore with them. Sometimes “the voices say goodbye” but “don’t go away,” and this surprises him. More often he talks to them in a whisper, but sometimes he becomes indignant and, unable to stand the “nasty” sounds, breaks into a scream. Then the “voices” reproach him in irritation: “Why are you yelling, we are not deaf.”

“Voices” can also be open to the speech of people around patients; they “hear” the latter and often express their opinion about what they “heard,” in turn believing that these people also hear them well. For example, a “voice” interested in a conversation between a doctor and a patient expresses a desire to talk with the doctor alone, without a witness - the patient. So that he does not interfere, the “voice” asks or orders him to leave. Such “voices” can later conduct “debriefings” - an analysis of the conversation between the doctor and the patient.

Through the mediation of patients, it is sometimes possible to “talk to the voices.” The patient transmits the doctor’s questions to the “voice” and repeats the hallucinatory answers. In other words, it becomes possible to study the dissociated and hallucinated part of the patient's personality. She is sometimes able to provide interesting information about herself. It turns out, for example, that she knows something about her origin, provides some biographical information about herself, somehow determines her mood, talks about her relationship with the patient, can say something about his well-being, is able to express her opinion about the fact that the patient is undergoing treatment, as well as an opinion about the patient’s attending physician who prescribed the treatment.

There are cases in which the “voice” considers itself a manifestation of the disease and foresees that under the influence of treatment it will disappear. In some patients, it is possible to conduct a pathopsychological experiment with the “voice”, to test its memory and mental abilities. For example, the ability to count, interpret proverbs and sayings. Most often, it is found that the intellectual functions of the “voice” are significantly reduced compared to those of the patient. For the most part, the answers from the “voice” are incorrect and absurd. “The Voice,” in addition, often behaves rudely, scolds, refuses to answer, and falls silent.

Sometimes the openness of hallucinations is partial. For example, “voices show interest” in what the patient says, hears and sees, but they themselves do not perceive any of this. In this case, the “voices” ask the patient or require him to speak out loud about what he perceives, sometimes they ask again, clarify something.

Perhaps, closed hallucinations are much more common - deceptions of hearing, as if isolated from patients. Such hallucinations do not “hear” either the patient or the people around him, and do not react in any way to their speech. Personifications in such cases apparently concern that part of the patient’s personality that does not manifest itself in any way in their normal state or that arose in illness without having any connection with the rest of the personality.

Stage hallucinations are deceptions of hearing in which “voices” present certain imaginary events with particular detail, as if “the voices saw with their own eyes” what was happening in such events. Thus, the patient reports that some kind of gang has settled in the basement of her house. She calls the members of this gang by name, talks about their appearance, social affiliation, what they are doing at one time or another, how they move, etc.

Poetic hallucinations are deceptions of hearing with speech in the form of poems.

Narrative hallucinations are auditory deceptions in which “voices” talk about certain past events that they allegedly witnessed.

Bilateral Magnan hallucinations are auditory deceptions in which the “voice” coming from one side says the opposite of what the “voice” is saying from the other.

Hyperacusic hallucinations are deceptions of hearing that sound deafeningly loud. In this case, obviously, hallucinations manifest a symptom of mental hyperesthesia.

Hypoacoustic hallucinations are auditory deceptions that sound barely audible, like whispered speech. Some patients call such “voices” “transparent.” Thus, the patient constantly hears whispers at a short distance; he believes that people nearby are speaking. They call him “low-down”, “faggot”. “They talk to each other so that I can’t hear them.”

Hallucinations in the form of verbigeration are deceptions of hearing when “voices” pronounce meaningless series of words, as if stringing them together in consonance.

Hallucinations with neologisms are auditory deceptions when “voices” use new words, often incomprehensible to patients. Apparently, we are talking about sticking together, contamination of parts of known words.

Cryptolalic hallucinations are auditory deceptions when “voices” speak in a language incomprehensible to patients.

Xenolalic hallucinations are auditory deceptions when “voices” sound in a foreign language known to patients or insert many foreign words into their “speech.” Rarely, there are hallucinations that sound in a foreign language forgotten by patients.

Coprolal hallucinations are auditory deceptions when “voices” use or prefer low-level speech, cynical swearing.

Prospective hallucinations are auditory deceptions in which “voices” report future events that patients may well believe. Thus, the patient hears a woman's voice saying that her children will first be raped and then killed.

Autophonic hallucinations are auditory deceptions when, according to patients, their own voice sounds.

Personified hallucinations are deceptions of hearing, when patients confidently identify which of the people they know belongs to this or that “voice.” These are probably still false identifications, in some cases perhaps delusional identifications, for example a hallucinatory version of the positive double symptom.

Hallucinations with symptoms of doubles are deceptions of hearing, when, as patients believe, strangers speak, faking the sound of the voices of familiar people and vice versa. Sometimes, patients are sure, the same voice sounds, but it belongs different people, as if masquerading as one person whom patients know and are not afraid of.

Hallucinations with the symptom of staging are deceptions of hearing, when “voices,” patients believe, for some purpose represent a certain situation that does not exist in reality. This is a “rigged” situation, patients are sure that nothing like this actually exists, but someone is trying to mislead them.

Receding hallucinations are auditory deceptions in which “voices” (other imaginary sounds) that initially sound nearby or somewhere in the patients’ ears then move further and further away until they disappear in the distance. There are approaching hallucinations that appear as if in the distance, and then come closer and even turn out to be heard somewhere inside the patients.

One-sided hallucinations are deceptions of hearing when the “voice” is perceived by one ear. Thus, a patient with alcohol dependence, who had previously suffered from delirium tremens, began to hear “voices” of different content exclusively in the right ear. Recently, the “voices” have moved to the back of the head, heard inside the skull, closer to the right ear. In the past, the patient suffered right-sided otitis media. S.P. Semenov (1965) considers them identical to hemianoptic hallucinations, suggesting that they arise in connection with focal cortical pathology.

Endophasic hallucinations are supposedly deceptions of inner speech, when patients hear “voices” sounding somewhere inside themselves, for example in the stomach, chest. The patient hears, for example, “voices” in the left shoulder or left elbow. The patient clearly hears a “voice” in his head, which sounds and is perceived by him as completely real.

“The voice can bifurcate, multiply, sometimes their number reaches 12. My voice sometimes sounds among them. All voices bear my name, I know this, it is obvious to me. They say different things, each with their own thing, but mostly they talk about me. They talk to each other, address their conversations to me, and I myself often talk to them. Usually they sound quiet, sometimes they are almost inaudible, but sometimes they scream deafeningly loud. I know that these are hallucinations, but at the same time I have no doubt that invisible, microscopically small people live in my head. They are born there, live and die.”

The patient says: “I hear a voice in my head. At first a female voice sounded, then it was replaced by a male one. The woman's voice seemed familiar to me, the man's voice was unfamiliar. He speaks quietly, as if in a whisper, from somewhere in the deep silence. He asks about me, and I somehow involuntarily answer him, often mentally. He asks what my name is, how old I am, where I live, etc. My mother, to whom I told about this, advised him not to answer, which I did. Then the voice began to swear, threaten me, shout at me in anger, swear, I even cried, it was hurtful and scary.”

Tachychronic hallucinations are auditory deceptions when “voices” talk about something at an accelerated pace, sometimes so quickly that patients barely have time to understand the content of what they heard. “It’s as if the record was put on high speed,” explains the patient. Bradychronic hallucinations are auditory deceptions when “voices” speak at a slow pace, stretched out, as if “the record was at a slow speed.”

Specialists always approach the treatment of such a delicate phenomenon as auditory hearing with great caution, since the process in each case is very individual, and depends on what reason caused such a disturbance in perception. That's why,

It is strictly not recommended to self-medicate or take various medications on the advice of a friend. If once upon a time his grandmother “had it too,” and a certain medicine helped her. Assign drug treatment only qualified specialists can do this, who actually sometimes use psychotropic drugs And . But quite often it happens that simple remedies help get rid of auditory hallucinations.

If a patient who consults a doctor with complaints of auditory hallucinations uses a hearing aid, then there is always a solution this issue It begins with the fact that the device itself undergoes diagnostics. Only after making sure that everything is fine with him can you continue the examination. Sometimes it is enough to replace the device, and the obsessive phenomena recede. It is typical for some hearing aids to “catch” radio waves and broadcast them very quietly. An audiologist will help you test the device.

Scientists are currently developing special devices, which stimulate certain nerve endings, and help cure auditory hallucinations. But, while these devices are in the testing stage and are not widely used. It is known that such a device affects the patient’s brain with electricity and sounds. This influence produces an activating effect on the cerebral cortex, causing it to respond to those sounds that exist

in real. Scientists also believe that it is possible to influence brain activity using the vagus nerve, through which impulses go directly to the brain.

To determine right direction treatment of auditory hallucinations, it is necessary to know their cause and features of their occurrence. It is believed that with auditory hallucinations, an incorrect perception of sounds, noise, and the voices of people and animals occurs. This condition is not as harmless as it may initially seem, because it may be a sign mental illness. Basically, auditory hallucinations are characteristic of patients with Alzheimer's disease. Also, do not forget that individuals suffering from alcoholism or abusing certain medications are susceptible to hallucinations of various types.

Therefore, it is not surprising that when starting treatment for auditory hallucinations, the doctor may refer the patient for additional consultation with a narcologist. But what if auditory hallucinations occur in a healthy person who does not suffer from mental disorders, does not abuse alcohol, and leads normal image life? It turns out that similar phenomena can occur in those who have experienced a nervous shock, stressful situation. Hearing disorders are often observed that cannot be explained scientifically, since this issue has not been studied enough and is fraught with many secrets.

In this case, treatment can be difficult, and sometimes the doctor prescribes several methods simultaneously in order to fully influence the cause. That is, in addition to medications, the patient is prescribed a course of psychotherapy and other methods. In any case, make a decision to prescribe or cancel a certain course of treatment

Only a psychiatrist can. Many people, using medications used in connection with diseases unrelated to auditory hallucinations, sometimes do not bother to carefully read the instructions for patients. But often anticonvulsant medications are the reason that a person begins to hear unreal sounds and voices. Naturally, in this case, treatment is the abolition of medications with significant side effects.

Sometimes it actually happens that auditory hallucinations disappear without requiring special treatment. If the patient has suffered surgical intervention, carried out under general anesthesia, then for some time he may experience hallucinations that do not require treatment. As the body frees itself from the influence of anesthesia, the patient’s condition returns to normal. The same can be said about some infectious diseases occurring in chronic or acute form. After the patient is freed from the underlying disease, there is no need to treat hallucinations.

Auditory hallucinations require the closest attention from doctors, as well as serious treatment, if the patient hears non-existent threats addressed to him, or some voices persuade him to commit suicide or take the life of another person. Such phenomena often actually cause real damage, both to the patient himself and to those who are close to him. Therefore, if someone close to you notices that a person is behaving strangely and is talking about non-existent interlocutors, you should immediately take the patient to the doctor.

Many people have heard about hallucinations. Drug addicts call them “glitches,” while doctors mean by this concept an imaginary perception of an object that appears in a person without any specific stimulus. In essence, this is a failure in the interaction of the senses and the brain, a deception of the body itself, in which the patient begins to see, hear or feel something that is not in reality. Scientists have been studying the mechanism of occurrence of these phenomena for a long time, but due to the complexity of the brain, it remains unclear today.

Kinds

Hallucinations are a pathology. Depending on the organ of perception that forms non-existent sensations, there are:

visual disturbances;
auditory hallucinations;
olfactory disturbances;
tactile forms;
taste hallucinations.

It is worth noting that deceptions of the senses, which are based on physical laws, are not considered pathologies. Bright to that an example is mirages in deserts.

Visual type of pathology

Visual hallucinations- the appearance of various images. They can be very bright or very dim, living or inanimate. Sometimes apparent objects or people are motionless, and sometimes they create dynamic scenes in which the patient himself is involved.

Cases when they occur while going to bed or waking up are not violations and do not require consultation with a doctor. If symptoms occur at other times, the person needs qualified medical care.

The causes of such hallucinations may be hidden in illness or acute depressive states. For example, hallucinations are one of the symptoms of schizophrenia. A specific action or phenomenon can provoke a disorder: a sharp increase in body temperature, migraine, taking medications, narcotic substances or alcoholic beverages. Tumors in the brain also lead to hallucinations.

It is worth noting that you should prepare in advance for a consultation with a doctor. Everything needs to be written down medications, which are taken on a regular basis, because many of them (improving heart function, relieving cramps, pain, signs of allergies) are capable of causing non-existent visual images.

Hearing Deceptions

Auditory hallucinations are considered the most common. One of the forms of such disorders is when a person hears non-existent sounds such as crackling, wind or animal howling, whistling, noise. Such phenomena are called acoasms.

If a person hears speech, individual words or syllables, the pathology is called a phoneme - a verbal verbal hallucination. For the patient, these are “voices”, loud or quiet. As a rule, he hears them not far from him - in the room, on the street, on the balcony, on the roof. Voices can be heard from a closet, from any hollow object, or from behind a neighbor’s wall. They are heard from one place, moving away or approaching. In some cases, a person imagines the roar of a crowd, acquaintances or complete strangers addressing him. They can scold him, force him to act, defend him, or simply discuss current affairs with him.

If auditory hallucinations are associated with a specific situation, they are called scene-like. Often such phenomena can be accompanied by affective disorders: increased mood, the appearance of irritability, anxiety or fear. As a rule, at first when hearing different sounds, the person tries to locate the source of the irritation by searching roofs, attics, or nearby rooms.

Alcoholic

Hallucinations in alcoholism are classified as separate group, since they are part alcoholic psychoses. Such psychoses manifest themselves as a result of constant poisoning of the body with alcohol, usually in the second or third stage of chronic alcoholism.

Such phenomena are varied. In this case, a person develops visual, auditory, and sometimes tactile disturbances. The hallucinations themselves can be both primitive and complex, involving a huge number of people.

The plot unites these phenomena. It can be repeated or be similar, and most often a person is tormented by nightmares: the patient seems to feel that his body is growing significantly, and everything around him suddenly decreases, sometimes scary animals and monsters appear before the patient’s eyes. Sometimes these visions give way to erotic images or visions illustrating drunkenness.

Sometimes such hallucinations in alcoholism are combined with delusions. The patient at the moment of its occurrence is in a state of horror, sometimes trying to “dilute” it with primitive humor. At the same time, he hides from persecution, fights, runs away, in a word, behaves in full accordance with the visions that he sees.

If during the day the manifestations of pathology are practically invisible, then at night the person’s condition worsens significantly. It lasts from two to five days, after which the patient becomes depressed.

Senile hallucinations

Hallucinations are also common in old age. They may manifest as hearing, taste, smell, visual or tactile disturbances. The cause of such processes can be mental and physical changes in the body of people observed after 50–60 years. Most often, paranoia develops at this age, however, the situation is aggravated by constant bad mood, pessimism, anxiety, and fear of approaching death.

If such a condition for a long time remains unattended, people develop:

insomnia;
loss of appetite;
pain of unknown localization.

Help

Treatment for hallucinations begins with an examination by a psychiatrist. Often, such patients may need a consultation with a neurologist or the help of a narcologist. To exclude tumor processes that can provoke hallucinations, a consultation with an oncologist is scheduled. Having diagnosed the disease that provoked such disorders, the doctor prescribes therapy. It is worth noting that treatment in a hospital setting is carried out only during periods of exacerbation; the rest of the time you can be treated at home.

Help for the patient from relatives during this period is to ensure his safety, so that in moments of fear he cannot harm either himself or others.