I see very little difference between dreams and hallucinations. One just involves being animated to some degree. This is likely not what MRI's would tell us, although I have no real reason to think that or otherwise. It just seems to me that we've seen things we mistook for being something else whether it's misreading a note that was hastily scrawled, or that time you just KNEW you still had cheese in the fridge, missing an appointment, or going into work on your day off. These are all sort of on a scale with hallucinations being on one end of it, simple mistakes in thought on the other. I could be reaching here, but it's not my intention to be argumentitive. I feel as if there is a link, however tenuous that is bugging me in it's dimly lit manner.
Perhaps it's a manifested form of comforting when nobody else is there to do so. Our subconscious way of telling ourselves it will be ok. Maybe even it's simply the way our mind makes sense of things that we proportionally aren't equipped to deal with emotionally. I do not know for sure, obviously. But it is interesting.
Ryan, your reflection on how our minds help us cope with what we cannot easily face is spot on. Darian Leader suggests that when the world feels unbearable, the mind builds its own structure. One that makes sense, even if it does not always align with external reality. Fascinating, isn’t it?
As for the connection you made between dreams and hallucinations, they share some features like vividness or internal generation. However, they come from different neural bases (as you pointed out) and conscious states. Dreams arise in sleep, while hallucinations, occur during waking states and are processed as if they were part of external reality. That said, there are interesting transitional states, like hypnagogic & hypnopompic hallucinations, which happen as we fall asleep or wake up and can be quite vivid.
Regarding the cheese-in-the-fridge example, this can be better explained by things like memory errors or simple misremembering. Basically, through cognitive processes quite different from the sensory vividness and immediacy we see in true hallucinatory experiences :)
It's likely because I do not work in the field and do not have much of a standard in my knowledge about the topic. Philosophically though, I do not think because a different region of the brain is responsible for the processing or manifesting of one vs the other is enough to discount them being related in some way meaningful enough to allow us understanding of one from the other.
Everything is relative if we look hard enough. This is more of a hope that I put to practice than any real world thing I can point to and say, "there it is". But I fear one day that I'll have just these types of issues to deal with, and I'd hope there will be some way for me to understand them other than medication that largely results in my mind and body moving half speed. I was never much for taking the medication. Common though, amongst people who need them most I hear.
You’re right that philosophically, it’s interesting to explore how different kinds of experiences might connect or inform each other, even when the underlying brain processes differ. From a scientific perspective, though, those distinctions help us understand what we’re looking at more precisely, especially when it comes to how people experience or respond to these phenomena :)
It was my view with a few moments thoughts after having never considered it before. It's been a bit since, and I've thought more, but my view remains unchanged. I had also thought in the moment, but didn't include it because it was more of like someone in the background trying to get your attention when youre working on something else, but synthesia already seems to me as if hallucinations manifest reality for the person who has it. For me, I cannot conceptualize in the same way numbers being color as they would. I suppose its a matter of perspective. I agree with you whole-heartedly that it's a shame for the people you care for. I have had a similar job environment in my life ( not a crisis center, much less mild ) but on some level I can relate. Hits your empathy right in the feels.
Ryan, thank you for your openness and for reflecting further on this :) You’re right that synaesthesia, where senses cross over (like seeing numbers as colours), shapes an individual’s subjective reality. But it’s a distinct phenomenon from hallucinations, as synaesthetic experiences are typically consistent, non-distressing, and internally recognised as part of one’s normal perception, whereas hallucinations are perceived as external and can often be surprising or intrusive.
I would imagine upon the discovery of having synthesia, or maybe that the way one perceives the world is far different than someone elses, can be quite surprising,as well as maybe not intrusive, but certainly very shocking.;) Maybe its human adaptability in action. Deal with something long enough, it's less shocking, less unbearable.
A side note however: normally i consider myself to have a fairly high ability to see nuance, so it's strange that in this, where you are proscribing just that, I inclined to avoid that nuance. Curious.
Ryan, I love how you are teasing apart the layers here :) You are right that discovering synaesthesia, or any deeply personal perceptual difference, can be surprising, even if not necessarily intrusive or distressing. And yes, human adaptability plays a huge role. What initially feels startling or unfamiliar can, over time, settle into something integrated and even ordinary within one’s own experience. Habituation, remember?
Your side note made me smile. It is curious, isn’t it, how sometimes we resist nuance right when it is most called for. That tension between seeing complexity and wanting to simplify is such a unavoidable push and pull. I guess no ones escapes it !
JAK, thank you for such a thoughtful and heartfelt reflection! I really appreciate your openness here, especially coming from someone working so closely with people in crisis.
Just a quick, friendly clarification: when we recall something incorrectly (like thinking there’s cheese in the fridge when there isn’t) we can typically explain this as a memory error or a misremembering process. Not a hallucination. Hallucinations involve vivid sensory experiences that are perceived as real in the moment, without an external trigger. For example, hearing a voice or seeing something that isn’t there. So, while they both remind us that the brain is an active interpreter of reality, they arise from quite different processes.
That said, you make such an important point about empathy. For people experiencing clinical hallucinations, this is their reality, and recognising that can open the door to a much more compassionate, human conversation, which is exactly what I hoped to encourage in this piece :)
Thank you again for sharing your insights. They add a valuable dimension to the conversation <3
I have had two hallucinations in my life that I recall. One in a club when I was 18 when I saw skeletons dancing around me. I was aware that they were not actual skeletons or people dressed as skeletons but I put it down to lack of sleep or being "spiked" I hadn't taken anything knowingly and it was around 4am. I quite enjoyed it to be honest.
Then more recently, maybe a year ago I was stood at the urinal in an empty public bathroom at work and I heard someone ask "Are you alright", in the British greeting way, rather than actually enquiring about my wellbeing. It startled me as I knew I was alone. Then I checked and confirmed I was alone. That freaked me out a bit, I was checking for speakers or radios and everything!
Hey Mark, thanks for letting me know about your hallucinatory experiences! They can be really unsettling. Isn't it fascinating that you could recognise the skeletons were not objectively real, but you still saw them? This ability (to self-monitor) is actually one of the ways clinical hallucinations differ from non-clinical ones.
Last year I was on the bus, and a man kept pacing up and down, completely immersed in a conversation, waving his hands, stopping to shrug his shoulders. I felt for him because he was clearly upset. We got off at the same stop and both headed towards Maudsley Hospital, him still debating away.
Situations like this remind me how these experiences are not just neuropsychological presentations on research papers, but part of someone’s lived reality, shaping how they move through the world. It's fascinating to me, and often, very moving.
The skeletons felt like a special effect, but I checked and nobody else could see them, I was safe, I knew they weren’t real and not out to get me so I just enjoyed it. It does make me think though, that when you see things that are so real, what if it hadn’t been actual skeletons, but people instead. I wouldn’t have even known and if that’s possible then that’s the scary part.
If your man on the bus had earphones in, would you just have assumed he was on the phone? It’s a fine line between what can look normal and what might be cause for concern over someone. You’re right that what we see in textbooks, or sometimes heavily dramatised on TV, some people are living with daily.
This is tangential, and I’m going to absolutely butcher this research, but your piece reminded me of a study where they had people with schizophrenia in an fMRI while having auditory hallucinations. The conclusion was something like when people have thoughts, we can attribute them to being OUR thoughts. In the schizophrenic group, they were missing whatever activation lets you know your internal monologue is YOURS so they attribute it to coming from somewhere else. The classic “they’re putting thoughts in my head” feeling. That’s probably a bastardization of the conclusion, but something like that!
Dr. Brittany, thank you for bringing this up! You’re referring to disrupted self-monitoring processes, particularly in brain regions involved in distinguishing self-generated thoughts from external stimuli. This is quite close to my heart!
Studies using fMRI and EEG have shown that in people with schizophrenia (I don't have them here right now), there is often reduced connectivity or abnormal activation in the corollary discharge system, the neural mechanism that helps signal “this action or thought came from me.” Without that intact feedback loop, internally generated speech (like inner monologue) can be misattributed as coming from an external source, which can manifest as hearing voices.
This is such an intricate area of research (and one that I'm greatly interested in), and you’re right to point out how it illuminates the experience behind statements like “they’re putting thoughts in my head.” Thank you for adding this thoughtful layer to the discussion :)
I see very little difference between dreams and hallucinations. One just involves being animated to some degree. This is likely not what MRI's would tell us, although I have no real reason to think that or otherwise. It just seems to me that we've seen things we mistook for being something else whether it's misreading a note that was hastily scrawled, or that time you just KNEW you still had cheese in the fridge, missing an appointment, or going into work on your day off. These are all sort of on a scale with hallucinations being on one end of it, simple mistakes in thought on the other. I could be reaching here, but it's not my intention to be argumentitive. I feel as if there is a link, however tenuous that is bugging me in it's dimly lit manner.
Perhaps it's a manifested form of comforting when nobody else is there to do so. Our subconscious way of telling ourselves it will be ok. Maybe even it's simply the way our mind makes sense of things that we proportionally aren't equipped to deal with emotionally. I do not know for sure, obviously. But it is interesting.
Ryan, your reflection on how our minds help us cope with what we cannot easily face is spot on. Darian Leader suggests that when the world feels unbearable, the mind builds its own structure. One that makes sense, even if it does not always align with external reality. Fascinating, isn’t it?
As for the connection you made between dreams and hallucinations, they share some features like vividness or internal generation. However, they come from different neural bases (as you pointed out) and conscious states. Dreams arise in sleep, while hallucinations, occur during waking states and are processed as if they were part of external reality. That said, there are interesting transitional states, like hypnagogic & hypnopompic hallucinations, which happen as we fall asleep or wake up and can be quite vivid.
Regarding the cheese-in-the-fridge example, this can be better explained by things like memory errors or simple misremembering. Basically, through cognitive processes quite different from the sensory vividness and immediacy we see in true hallucinatory experiences :)
It's likely because I do not work in the field and do not have much of a standard in my knowledge about the topic. Philosophically though, I do not think because a different region of the brain is responsible for the processing or manifesting of one vs the other is enough to discount them being related in some way meaningful enough to allow us understanding of one from the other.
Everything is relative if we look hard enough. This is more of a hope that I put to practice than any real world thing I can point to and say, "there it is". But I fear one day that I'll have just these types of issues to deal with, and I'd hope there will be some way for me to understand them other than medication that largely results in my mind and body moving half speed. I was never much for taking the medication. Common though, amongst people who need them most I hear.
You’re right that philosophically, it’s interesting to explore how different kinds of experiences might connect or inform each other, even when the underlying brain processes differ. From a scientific perspective, though, those distinctions help us understand what we’re looking at more precisely, especially when it comes to how people experience or respond to these phenomena :)
It was my view with a few moments thoughts after having never considered it before. It's been a bit since, and I've thought more, but my view remains unchanged. I had also thought in the moment, but didn't include it because it was more of like someone in the background trying to get your attention when youre working on something else, but synthesia already seems to me as if hallucinations manifest reality for the person who has it. For me, I cannot conceptualize in the same way numbers being color as they would. I suppose its a matter of perspective. I agree with you whole-heartedly that it's a shame for the people you care for. I have had a similar job environment in my life ( not a crisis center, much less mild ) but on some level I can relate. Hits your empathy right in the feels.
Ryan, thank you for your openness and for reflecting further on this :) You’re right that synaesthesia, where senses cross over (like seeing numbers as colours), shapes an individual’s subjective reality. But it’s a distinct phenomenon from hallucinations, as synaesthetic experiences are typically consistent, non-distressing, and internally recognised as part of one’s normal perception, whereas hallucinations are perceived as external and can often be surprising or intrusive.
I would imagine upon the discovery of having synthesia, or maybe that the way one perceives the world is far different than someone elses, can be quite surprising,as well as maybe not intrusive, but certainly very shocking.;) Maybe its human adaptability in action. Deal with something long enough, it's less shocking, less unbearable.
A side note however: normally i consider myself to have a fairly high ability to see nuance, so it's strange that in this, where you are proscribing just that, I inclined to avoid that nuance. Curious.
Ryan, I love how you are teasing apart the layers here :) You are right that discovering synaesthesia, or any deeply personal perceptual difference, can be surprising, even if not necessarily intrusive or distressing. And yes, human adaptability plays a huge role. What initially feels startling or unfamiliar can, over time, settle into something integrated and even ordinary within one’s own experience. Habituation, remember?
Your side note made me smile. It is curious, isn’t it, how sometimes we resist nuance right when it is most called for. That tension between seeing complexity and wanting to simplify is such a unavoidable push and pull. I guess no ones escapes it !
JAK, thank you for such a thoughtful and heartfelt reflection! I really appreciate your openness here, especially coming from someone working so closely with people in crisis.
Just a quick, friendly clarification: when we recall something incorrectly (like thinking there’s cheese in the fridge when there isn’t) we can typically explain this as a memory error or a misremembering process. Not a hallucination. Hallucinations involve vivid sensory experiences that are perceived as real in the moment, without an external trigger. For example, hearing a voice or seeing something that isn’t there. So, while they both remind us that the brain is an active interpreter of reality, they arise from quite different processes.
That said, you make such an important point about empathy. For people experiencing clinical hallucinations, this is their reality, and recognising that can open the door to a much more compassionate, human conversation, which is exactly what I hoped to encourage in this piece :)
Thank you again for sharing your insights. They add a valuable dimension to the conversation <3
I have had two hallucinations in my life that I recall. One in a club when I was 18 when I saw skeletons dancing around me. I was aware that they were not actual skeletons or people dressed as skeletons but I put it down to lack of sleep or being "spiked" I hadn't taken anything knowingly and it was around 4am. I quite enjoyed it to be honest.
Then more recently, maybe a year ago I was stood at the urinal in an empty public bathroom at work and I heard someone ask "Are you alright", in the British greeting way, rather than actually enquiring about my wellbeing. It startled me as I knew I was alone. Then I checked and confirmed I was alone. That freaked me out a bit, I was checking for speakers or radios and everything!
Hey Mark, thanks for letting me know about your hallucinatory experiences! They can be really unsettling. Isn't it fascinating that you could recognise the skeletons were not objectively real, but you still saw them? This ability (to self-monitor) is actually one of the ways clinical hallucinations differ from non-clinical ones.
Last year I was on the bus, and a man kept pacing up and down, completely immersed in a conversation, waving his hands, stopping to shrug his shoulders. I felt for him because he was clearly upset. We got off at the same stop and both headed towards Maudsley Hospital, him still debating away.
Situations like this remind me how these experiences are not just neuropsychological presentations on research papers, but part of someone’s lived reality, shaping how they move through the world. It's fascinating to me, and often, very moving.
The skeletons felt like a special effect, but I checked and nobody else could see them, I was safe, I knew they weren’t real and not out to get me so I just enjoyed it. It does make me think though, that when you see things that are so real, what if it hadn’t been actual skeletons, but people instead. I wouldn’t have even known and if that’s possible then that’s the scary part.
If your man on the bus had earphones in, would you just have assumed he was on the phone? It’s a fine line between what can look normal and what might be cause for concern over someone. You’re right that what we see in textbooks, or sometimes heavily dramatised on TV, some people are living with daily.
This is tangential, and I’m going to absolutely butcher this research, but your piece reminded me of a study where they had people with schizophrenia in an fMRI while having auditory hallucinations. The conclusion was something like when people have thoughts, we can attribute them to being OUR thoughts. In the schizophrenic group, they were missing whatever activation lets you know your internal monologue is YOURS so they attribute it to coming from somewhere else. The classic “they’re putting thoughts in my head” feeling. That’s probably a bastardization of the conclusion, but something like that!
Dr. Brittany, thank you for bringing this up! You’re referring to disrupted self-monitoring processes, particularly in brain regions involved in distinguishing self-generated thoughts from external stimuli. This is quite close to my heart!
Studies using fMRI and EEG have shown that in people with schizophrenia (I don't have them here right now), there is often reduced connectivity or abnormal activation in the corollary discharge system, the neural mechanism that helps signal “this action or thought came from me.” Without that intact feedback loop, internally generated speech (like inner monologue) can be misattributed as coming from an external source, which can manifest as hearing voices.
This is such an intricate area of research (and one that I'm greatly interested in), and you’re right to point out how it illuminates the experience behind statements like “they’re putting thoughts in my head.” Thank you for adding this thoughtful layer to the discussion :)
Wow! I love that you know what I’m talking about! Especially after interpreting the little bits that remain in my memory when learning about that
This is what my MSc was mostly on :) specifically the Ultra High Risk (UHR) population for psychosis. This is home <3