Differences between hallucination, pseudohallucination and hallucinosis

Consciousness is a function of the mind that is responsible for receiving and processing both external and internal information. Various processes such as memory, perception, imagination, emotion, reasoning, etc. converge in it. A characteristic of this phenomenon is its intentionality, that is, it always refers to an object. All consciousness is consciousness of something.

However, that something that we are aware of through perception is not always real, and it can arise as a product of the disturbance of the normal functioning of the mind.

In these cases, when we talk about consciousness or the perception of something that has no real basis for its existence, we may be dealing with one of these three phenomena: a hallucination, a pseudohallucination or a hallucinosis.

Next, we will see what each one is and how they differ. Let’s dig deeper.

The hallucination

In psychopathology, hallucination is a sensory perception disorder that is characterized by the perception of something that has no basis in the subject’s external reality. It is, therefore, a perception without external stimulus. It appears in the external world of people and is perceived as something that comes from outside.

Classic examples of hallucinations are voices (auditory hallucination) that motivate people to act. You can also see colors, shadows or human figures that are not really out there (visual hallucination), but the person perceives them as real as if their senses were really reporting it.

The key to hallucinations is that they are real to the subject (there is no awareness of abnormality). The person is not aware that something out of the ordinary, normal is happening to them.

We can see this clearly in schizophrenia, in which the person assumes that their hallucinations are completely real. Let’s look at an example that we have extracted from Bayona (2013):

-Are you still there?

There was a moment of silence.

Then he heard several voices speaking at the same time, faint, as if suffocated by a pillow: We are here. We are still here.

That calmed him down. You have to keep us hidden, Francis.

He nodded. It seemed obvious. She felt an inner dilemma. The voices that had guided him had also gotten him into this predicament, and there was no doubt in his mind that he had to keep them hidden at all times if he ever wanted to leave the mental hospital.

In this case, we see how the person assumes the reality of their voices and can perceive them as something outside of them that comes from the outside world.

The pseudohallucination

It is a sensory perception disorder characterized by perception without external stimulation.. The person understands that the location of the object is inside, in his or her subjectivity, not outside of it. -as in the case of hallucinations-. Pseudohallucinations are understood as special forms of imagination.

The object of the pseudohallucination comes from the subject himself, in the sense that he perceives it as an appearance in his own mind. For example, the person may claim that they hear a voice inside their head that insults them. She does not maintain that the voice comes from outside, like when another person speaks to her, but that it is in her head, inside.

According to Seglas (1914), this type of sensory-perceptive disorders can be explained as the exacerbation of the internal verbalization of thought that, by possessing so much clarity and sensory precision, becomes unknown to the subject.

Pseudohallucination is experienced, then, in the interior dimension of the subject.. Let’s look at another example taken from Bayona (2013).

And then he entered the room.

Not like a neighbor or a friend, not even like a stone guest, but like a ghost. No door was opened, no seat was offered, no introductions were made. But still, he was there. I turned, first to one side and then to the other, to try to distinguish it from the air around me, but I couldn’t.

In the example we see how there is no clear perception of something. There is no real basis for it to be present, out in the world. Everything seems to happen internally. “I turned, first one way and then the other, to try to distinguish it from the air around me, but I couldn’t.”.

hallucinosis

It is a sensory perception disorder characterized by perception without an external object. Person He is able to recognize the atypical nature of the phenomenon, he realizes the abnormality of his perceptions.

This phenomenon is generally accompanied by anxiety, since the person does not know the cause. Let’s look at an example (Bayona, 2013).

“(…) something similar to a trance suddenly came over me. I was overcome by a sensation of being immersed in the supernatural. Even the air, even the light, were penetrated with exactness. (…) perhaps it was merely “accidental”. From the front, a light had attacked me. The squalor disappeared, and I heard a voice, similar to the sound of the organ, as if the rocks themselves were trying to tell me something. It only lasted a moment. Then the same old boredom came back to haunt me. “I woke up dizzy, dazed and unhappy.”

Differences between hallucination, pseudohallucination and hallucinosis

These disorders can be differentiated by:

1. The degree of consciousness

Hallucination, pseudohallucination and hallucinosis are differentiated, first of all, by the degree of awareness about the reality of what is happening.

In hallucination and pseudohallucination, perception is taken as something very real, what is perceived is believed to be really happening. On the other hand, in hallucinosis there is an awareness that what is perceived is not real, which is why, at times, it can be distressing.

2. The location of the perceived object

The perceived object varies depending on the sensory-perceptive disorder. In hallucination the stimulus is located outside, for example, a schizophrenic patient can see a man in a black suit who is chasing him. In pseudohallucination, the object of perception is in your mind, inside you, That’s why they can maintain that they hear a voice inside their heads. Finally, in hallucinosis, the stimulus is located outside, as in hallucination.

3. The degree of knowledge of the abnormal

Another difference between hallucination, pseudohallucination and hallucinosis is that in the first two there is a very poor or no knowledge about the abnormality of the situation.

The person does not believe that what happens to them is something abnormal, pathological. On the contrary, the person with hallucinosis is able to recognize that what is happening to them is not normal and may even be pathological.

4. The origin of the disorder

Hallucination and pseudohallucination tend to be linked to psychiatric problems, while hallucinosis is associated with neurological problems. In the first two, psychological functioning is more impaired than in hallucinosis, which is why, to a certain extent, they are unable to recognize the abnormality of their situation.

5. The degree of affectation

Another difference between hallucination, pseudohallucination and hallucinosis is that in the latter The degree of impact is not as general as in the case of the first two.

In hallucination and pseudohallucination the structural and functional change of personality is much more marked, the way in which the person changes their way of relating to the world and to themselves changes in a very substantial way.

Finally, caution must be exercised when using the concept of pseudohallucination, as there are many opinions and disagreements around it. The term itself seems to suggest that the person is inventing what is happening to him, since the perception of the object, although false, is not as obvious as in the case of hallucinations.

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