Hallucinations... Please don't be under an Illusion !!!!

Question from AIPG(All India PG) 2003 and the related discussion

105. All of the following are features of hallucinations, except:

1.It is independent of the will of the observer.
2.Sensory organs are not involved.
3.It is a vivid as that in a true sense perception.
4. It occurs in the absence of perceptual stimulus.

Ans. 2
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Sensory ORGANS are NOT involved in Hallucination... Only SENSATIONS are involved.......... and only those hallucinations occuring in Delirium Tremens are as vivid as in true perception

Hence the answer can be only 3
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my dear bruno its the choice 4 which is true in this regard AS THERE IS ALWAYS A FALSE SENSORY PERCEPTION IN HALLUCINATION
NOW TAKE THIS THAT IN FRONT OF U A SCOOTER IS MOVING FROM UR R TO UR L BUT IN HALLUCINATORY STAGE U'LL SEE AS IF A TRUCK IS GOING
OR CONSIDER THIS THAT UR STANDING IA TEMPLE & HEARING RINGING BELLS BUT IN HALLUCINATIONS U FEEL THAT U R HEARING DRUM BEATSi.E. FALSE SENSORY PERCEPTIONS
HOW CAN U SAY THAT SENSORY ORGANS R NOT INVOLVED-AS FAR AS I'VE STUDIED IN MBBS EYE & EAR R THE MOST IMP SENSORY ORGANS IN OUR BODY!!!

When You see scooter and think it as a Truck it is Illusion..............
Only when u see a truck WITHOUT there being a Scooter.. It is hallucination

When U R STANDING IA TEMPLE & HEARING RINGING BELLS BUT IN U FEEL THAT U R HEARING DRUM BEATSi.E. FALSE SENSORY PERCEPTIONS --- Its is Illusion
Only when you hear drums without there being a bells ......it is Hallucination

Coming to text book example

When you see a snake when there is a rope, it is Illusion
When you see a snake without there being a snake it is hallucination

Ok!!!

Sad When u see ur roll number against Rank one in the merit list of all india
entrance, Wink Is It illusion Twisted Evil or hallucination Wink

I think...then, Wink its time to wake up!! Idea

When you get some rank.............. your roll number is in the result....... but you see it as rank 1...... it is Illusion

If you see your number as rank 1 even without writing the exam..... it is Hallucination

If it is time to wake up, it is hypnopompic !!
If it is time to go to sleep, it is hypnogogic !!

IN this question we have to SPOT A WRONG STATEMENT. Lets consider each options one by one.
1. This is a TRUE statement as hallucination are independent of observers will, basic part of defination.

2. This is a FALSE statement,SENSORY ORGANS ARE INVOLVED,not structurally but in functionaly(Ref Kaplan and Saddock's Comprehensive Text-book of Psychiatry,pg-810)Hallucination is a false SENSORY perception even in abscence of any perceptual stimulus.Had the sensory organ not been involved we couldnot have been able to type them in to auditory, visual , tactile and etc. types.NOTE THAT THE SENSORY ORGANS ARE NOT STRUCTUALLY INVOLVED BUT THEY ARE DEFINATELY INVOLVED IN A FUNCTIONAL MANNER.
Say for example, for an hallucination to be AUDITORY, observer must be aware that EARS are involved in hearing (true or imaginary), and when person tells that he/she can hear voices in EAR even in absence of any real voice, we term it as AUDITORY hallucination.So for hallucination to be auditory the person must hear them in his/her EARS. so only functional involvement and not structural.
Any perceptions that occur without involvement of sensations are termed as Extra-Sensorial Perceptions(ESP).

3.This is a TRUE statement as they can be vivd as true sense perception.For example person having auditory hallucination can tell very minute details with full description of what he seems to hear from voice, which is comparable to true sense perception.

4. This is a TRUE staement as they occur in abscence of any perceptual stimulus, a basic part of defination.

SO it is obvious that only 2 is a false statement. Hence 2 should be the answer.

quoting the prevoius post ..........they can be vivd as true sense perception.For example person having auditory hallucination can tell very minute details with full description of what he seems to hear from voice, which is comparable to true sense perception.

Thats the problem... only certain hallucinations are as vivid as in true perception........

And sensory organs are involved functionally....... that means the sensations are involved in the absence of a stimulus.......... this definiton of sensory organs is for Illusion where there is a stimulus and sensory organs are involved

Sir,what you want to tell is actually a part of EXTRA SENSORIAL PERCEPTION . If sensory organs are not involved,DO YOU MEAN TO SAY THAT A BLIND PERSON CAN ALSO EXPERIENCE VISUAL HALLUCINATIONS??
I dont agree with you, as you can get it confirmed from any of the psychiatrist close to you.

You can have hallucinations with your eyes closed........... but it is the illusion which needs your eyes............... Sensory organs are not needed for hallucination... only SENSATIONS are involved........... Just tell me whether you understand the difference between sensory organs and sensations or according to you both are same

Sir, there is no meaning of perception of sensations without any sensory organs, even though both dont mean to be same.
And a person can experience a VISUAL hallucination with CLOSED eyes,but NOT if the person is BLIND(congenital or acquired), which clearly indicates that sensory organs(here eyes in visual hallucinations) are involved in perception of hallucination(a false perception)in a functional manner of perception (EITHER TRUE OR FALSE)only without any structural or physiological changes.
THIS is a very clear fact to undrstand.Is not it??

I agree and understand that Visual cortex is involved in hallucination............ Thats clear to me.... but i am not understanding that eyes are involved............

Or let me ask you a question....... are impulses transmitted in optic nerve when a person is experiencing visual hallucination ?

Impulses are transmitted during illusion.... for example the eye sees and the optic nerve transmits a image of rope... and the brain interprets it as snake ......

Sir, I understand that there is no transmission of impulses through optic nerve(suggesting that no physiological changes occurs in reality)in visual hallucination.
But EYES(IN VISUAL HALLUCINATION) ARE INVOLVED FUNCTIONALLY FOR THE PERCEPTION OF HALLUCINATION.AND SINCE HALLUCINATION IS A FALSE PERCEPTION THERE OCCURS NO ASSOCIATED REAL PHYSIOLOGICAL CHANGES IN EYES.And as I had already mentioned in my previous post that a blind cannot perceive visual hallucination, suggesting eyes are involed merely for the function of perception, either true(where physiological changes do occur as in illusion)or false(as in hallucination where no actual physiological changes occurs).
The point lies in the fact that eyes (or any other sensory organ) are required by the observer for perception of visual(or any other sensory type) hallucination.so sensory organs are involved for functional perception without any true physiological changes in the sensory organs.

I hope this is the best possible way to explain the fact

Dear Dr. Bruno,

The hallucination examples are really great....

I enjoyed them a lot.

Rohit

Sir, I understand that there is no transmission of impulses through optic nerve(suggesting that no physiological changes occurs in reality)in visual hallucination. Thats why we say that eyes are not involved........ visual cortex alone is involed in optic illusion..........

But EYES(IN VISUAL HALLUCINATION) ARE INVOLVED FUNCTIONALLY FOR THE PERCEPTION OF HALLUCINATION.No.. This is a wrong Statement

AND SINCE HALLUCINATION IS A FALSE PERCEPTION THERE OCCURS NO ASSOCIATED REAL PHYSIOLOGICAL CHANGES IN EYES.This is correct statement and is the answer

And as I had already mentioned in my previous post that a blind cannot perceive visual hallucination, Which book says so ?? Rolling Eyes May be persons who are congenitally blind may not experience visual hallucinations because thier cortex is not developed suggesting eyes are involed merely for the function of perception, either true(where physiological changes do occur as in illusion) Correct
or false(as in hallucination where no actual physiological changes occurs). No dear......... in this case eyes are not involved.... the cortex perceives images without there being a signal from eyes


The point lies in the fact that eyes (or any other sensory organ) are required by the observer for perception of visual(or any other sensory type) hallucination. No not needed, Hallucinations are the sensations which the observer perceives without the sense organs so sensory organs are involved organs are not involved.. the corresponding regions in the brain are involved for functional perception without any true physiological changes in the sensory organs. correct How are eyes involved without there being a physiological change........ obviously you know the fact.......but you are still confused between the difference between eyes and vision.......

I hope this is the best possible way to explain the fact Me too

Hi Bruno,
Is VISUAL CORTEX in Brain a sensory organ or not Question
WAITING FOR UR REPLY

Visual Cortex in Brain is not a sense organ...........................

In fact one book quotes brain as "senseless" because it has no sensory receptors....... and so we never experience pain when brian is handled

But another book says that brain is not "absolutely senseless" as Retina is said to an extension of brain..............

But Visual Cortex or for that matter any cortex is not a sense organ

Hi again,

If u r saying in HALLUCINATIONS sensory organ involvement is not there,then tell me WHY DO STRUCTURAL DISEASES OF SOME SENSORY ORGANS & CONDUCTING MECHANISM CONTRIBUTE TO THE FORMATION OF HALLUCINATIONS,eg. otitis media often may be associated with tinnitus or an irritative lesion of the visual cortex may produce hallucinoses or temporal lobe damage may show as auditory hallucinations. ALSO, HOW CAN A COCAINE ADDICT ABLE TO LOCALISE THE COCAINE BUGS OR TACTILE HALLUCINATIONS OEVR HIS BODY Question

Do reply back.

Otitis Media / Meniers with Tinnitus... This is not hallucination... In this case, there is transmission of some signals through the nerves!!!!!!! and the brain interprets this as sound and the SENSE ORGAN IS INVOLVED........Only if there is a tinnitus with NO ear pathology (or physiology), it is hallucination

Cocaine bugs...... the patient is able to localise, and there are no bugs........... Again there sense receptors in skin are normal.... there is no transmission in the peripheral nerves........ but the brain assumes that there is a sensory impulse from skin............. This is exactly the definition of hallucination........ Perception without stimulus..... and the perception can be localised too ....... you can see a lion on your right side or you can see a zebra on your left side, just one feet in front of you or 100 feet away when there is nothing in front

Go back to the previous examples

When You see scooter and think it as a Truck it is Illusion..............
Only when u see a truck WITHOUT there being a Scooter.. It is hallucination

When U R STANDING IA TEMPLE & HEARING RINGING BELLS BUT IN U FEEL THAT U R HEARING DRUM BEATSi.E. FALSE SENSORY PERCEPTIONS --- Its is Illusion
Only when you hear drums without there being a bells ......it is Hallucination

Coming to text book example

When you see a snake when there is a rope, it is Illusion
When you see a snake without there being a snake it is hallucination

Who told u that tinnitus is not a type of hallucination??? & FROM WHERE HAVE U READ THAT THERE IS NO PERIPHERAL NERVE TRANSMISSION IN TACTILE HALLUCINATIONS OF COCAINE INTOXICATION OR THE RECEPTORS ARE NORMAL??? HAVE U READ IT IN ANY TEXT THAT NO TRANSMISSION OR PHYSIOLOGICAL CHANGE OCCURS IN PERIPHERAL SENSORY ORGANS IN ALL UR QUOTED EXAMPLES Question
CHECK TABER'S DICTIONARY.
Also seeing rank 1 against ur name without writing the exam is called as dreaming or extra sensory perception AND NOT HALLUCINATION. WAKE UP MATE.

It is given in all pharmacological books , No changes occurs in the cases I quoted.... If there is a change in the receptors and when the receptors are involved, we call them as Illusion!!!!

You are still confusing between Hallucination and Illusion !!!!

Can you give your definition of ILLUSION


Defn:

Tinnitus is a sensation of noise caused by abnormal excitation of auditory apparatus, or its afferent pathways or the cortical area.

Tinnitus from Stedman

Tinnitus Aurium :
Sensation of sound in one or both ears associated with disease in the middle ear, inner ear or the central auditory apparatus

Tinnitus Cerebri :
Subjective sensation of noise in head rather than in ears

Only the latter type comes under hallucination........ and as Stedman says( not me ,Stedman) "heard in head" without involvement of ears.......... This is a typical Hallucination...... Appreciation of a sense without the involvemnt of the sense organ..........

When we appreciate something with the involvement of the sense organs, but there is misperception, we use the terminology ILLUSION

Do TINNITUS CEREBRI & TINNITUS AURIUM differ qualitatively ??? I mean to say whether a pt. can differentiate b/w. the two qualitatively ???

A patient cannot differentiate between the yellow discolouration caused due to hemolysis and the yellow discolouration due to Ca Pancreas !!!!

I just wanna know whether the two types of sensations (regarding tinnitus aurium & cerebri) different ? This is in context to the choice no.3 of the AIPGE question.

he question in AIPG 2003 doesnot ask whether the two sensations are different or not..........

The question was to find the wrong statement regarding hallucinations

The choice 2 given was "Sensory Organs are not involved"

But the fact is that in Hallucinations sensory organs are not involved and sensory organs are involved only in illusion

So Choice 2 is correct and we all know that choice 1 and 4 are also correct.... Hence the answer is Choice 3 which is wrong

Hi Bruno, Smile

I agree with u in all the points. Infact there was never any doubt in my mind about illusion,hallucination,delusion & dreaming (AIPGE rank 1 example). Smile
But the problem here is that even choice 3 is correct because as u urself indicated that true sensory perceptions & hallucinations cannot be differentiated clinically, implying that HALLUCINATIONS ARE AS VIVID AS TRUE SENSE PERCEPTIONS ( eg., as in the case of tinnitus cerebri & tinnitus aurium where qualitatively both of them could not be differentiated neither by the pt. nor the clinician ). No Doubt that it isn't true all the times but happens most of the times

Text books say that of all hallucinations, only the hallucinations occuring in alcoholics are as clear as in normal perceptions..... Others are not as clear !!!!!!!!!!!!

So that point is not true for all hallucinations in general

Hi mate !
Infact all the conditions under ORGANIC HALLUCINOSIS are as vivid, complex & well organised as in true sense perception.
The causes include : Hallucinogenic drugs( LSD, Psilocybin,mescaline,cocaine,cannabis,phencyclidine,so on & so forth...);
Alcohol ; Sensory deprivation ; Release hallucinations ; Migraine ; Epilepsy ; ICSOL ; Temporal arteritis ; Brain stem lesions(Peduncular hallucinosis).
SO I THINK ITS A BIG LIST !
What do u say

Though there is a big list of causes of organic hallucinations, please note that event though there is a big list for the incidence may not be big too........... (like secondary hypertension, for which we again have a big list of conditions like phaeochromocytoma, Cushing, THyroid Storm, Coarctaion etc but the incidence of primary hypertension is still great)

Any how, About the point that all ORAGANIC HALLUCNIATIONS are as clear and as vicid.............Reference Please !!!!!!!!!!!!!

Ahuja says that in Delirium tremens the hallucination are as clear as normal perception

Go thru ORGANIC HALLUCINOSIS in neeraj ahuja.
Also DELIRIUM TREMENS is not as uncommon as Secondary hypertension. Its much more commoner phenomenon.
Moreover its not the question about incidence of organic hallucinations but about whether the particular phenomenon is a part of a syndrome or not.

You might know that Hallucinations can be classified according to

1. Etiology
a. Organic
b. Non-organic/functional

2.Sensation affected
a. Visual
b. Auditory
c. Gustatory
d. Smell
e. Tactile

Types of Hallucination

Organic
a. Visual --> only this is as clear and vivid as normal........... This is an exception; not a rule
b. Auditory
c. Gustatory
d. Smell
e. Tactile
Non-organic/functional
a. Visual
b. Auditory
c. Gustatory
d. Smell
e. Tactile

Now you can find that all the conditions listed under your list form a small part...... in fact in Schizo we have auditory hallucinations and in Temporal lobe epilepsy we have hallucinations of smell........ They are not as clear and as vivid as in normal perception

Hallucinations are as vivid and clear as in normal perception.... This is a wrong statement

A type of Hallucination (as an exception) is as vivid and clear as in normal perception... This only is a true statement

Please refer the question in AIPG 2003