Hallucinations (29 page)

Given this isolation of traumatic memory, the thrust of psychotherapy must be to release the traumatic events into the light of full consciousness, to reintegrate them with autobiographic memory. This can be an exceedingly difficult and sometimes nearly impossible task.

The idea that different sorts of memory are involved gets strong support from the survivors of traumatic situations who do not get PTSD and are able to live full, unhaunted lives. One such person is my friend Ben Helfgott, who was incarcerated in a concentration camp between the ages of twelve and sixteen. Helfgott has always been able to talk fully and freely about his experiences during these years, about the killing of his parents and family and the many horrors of the camps. He can recall it all in conscious, autobiographic memory; it is an accepted, integrated part of his life. His experiences were not locked away as traumatic memories, but he knows the other side well—he has seen it in hundreds of others: “The ones who ‘forget,’ ” he says, “they suffer later.” Helfgott is one of the contributors to
The Boys
, a remarkable book by Martin Gilbert that relates the stories of hundreds of boys and girls who, like Helfgott, survived years in concentration camps but somehow emerged relatively undamaged and have never been subject to PTSD or hallucinations.

A
deeply superstitious and delusional atmosphere can also foster hallucinations arising from extreme emotional states, and these can affect entire communities. In his 1896 Lowell Lectures (collected as
William James on Exceptional Mental States
) James included lectures on “demoniacal possession” and witchcraft. We have very detailed descriptions of the hallucinations characteristic of both states—hallucinations which rose, at times, to epidemic proportions and were ascribed to the workings of the devil or his minions, but which we can now interpret as the effects of suggestion and even torture in societies where religion had taken on a fanatical character. In his book
The Devils of Loudun
, Aldous Huxley described the delusions of demonic possession that swept over the French village of Loudun in 1634, starting with a mother superior and all the nuns in an Ursuline convent. What began as Sister Jeanne’s religious obsessions were magnified to a state of hallucination and hysteria, in part by the exorcists themselves, who, in effect, confirmed the entire community’s fear of demons. Some of the exorcists were affected as well. Father Surin, who had been closeted for hundreds of hours with Sister Jeanne, was himself to be haunted by religious hallucinations of a terrifying nature. The madness consumed the entire village, just as it would later do in the infamous Salem witch trials.
⁸

The conditions and pressures in Loudun or Salem may have been extraordinary, though witch-hunting and forced confession have hardly vanished from the world; they have simply taken other forms.

S
evere stress accompanied by inner conflicts can readily induce in some people a splitting of consciousness, with varied sensory and motor symptoms, including hallucinations. (The old name for this condition was hysteria; it is now called conversion disorder.) This seemed to be the case with Anna O., the remarkable patient described by Freud and Breuer in their
Studies on Hysteria
. Anna had little outlet for her intellectual or sexual energies and was strongly prone to daydreaming—she called it her “private theater”—even before her father’s final illness and death pushed her into a splitting or dissociation of personality, an alternation between two states of consciousness. It was in her “trance” state (which Breuer and Freud called an “auto-hypnotic” state) that she had vivid and almost always frightening hallucinations. Most commonly she would
see snakes, her own hair as snakes, or her father’s face transformed into a death’s-head. She retained no memory or consciousness of these hallucinations until she was again in a hypnotic trance, but this time induced by Breuer:

Anna’s “trance” personality became more and more dominant as her illness progressed, and for long periods she would be oblivious or blind to the here and now, hallucinating herself as she was in the past. She was, at this point, living largely in a hallucinatory, almost delusional world, like the nuns of Loudun or the “witches” of Salem.

But unlike the witches, the nuns, or the tormented survivors of concentration camps and battles, Anna O. enjoyed an almost complete recovery from her symptoms, and went on to lead a full and productive life.

That Anna, who was unable to remember her hallucinations when “normal,” could remember all of them when she was hypnotized, shows the similarity of her hypnotized state to her spontaneous trances.

Hypnotic suggestion, indeed, can be used to induce hallucinations.
⁹
There is, of course, a world of difference between
the long-lasting pathological state we call hysteria and the brief trance states which can be induced by a hypnotist (or by oneself). William James, in his lectures on exceptional mental states, referred to the trances of mediums who channel voices and images of the dead, and of scryers who see visions of the future in a crystal ball. Whether the voices and visions in these contexts were veridical was of less concern to James than the mental states which could produce them. Careful observation (he attended many séances) convinced him that mediums and crystal gazers were not usually conscious charlatans or liars in the ordinary sense; nor were they confabulators or phantasts. They were, he came to feel, in altered states of consciousness conducive to hallucinations—hallucinations whose content was shaped by the questions they were asked. These exceptional mental states, he thought, were achieved by self-hypnosis (no doubt facilitated by poorly lit and ambiguous surroundings and the eager expectations of their clients).

Such practices as meditation, spiritual exercises, and ecstatic drumming or dancing can also facilitate the achievement of trance states akin to that of hypnosis, with vivid hallucinations and profound physiological changes (for instance, a rigidity which allows the entire body to remain as stiff as a board while supported only at the head and feet). Meditative or contemplative techniques (often aided by sacred music, painting, or architecture) have been used in many religious traditions—sometimes to induce hallucinatory visions. Studies by
Andrew Newberg and others have shown that long-term practice of meditation produces significant alterations in cerebral blood flow in parts of the brain related to attention, emotion, and some autonomic functions.

T
he commonest, the most sought, and (in many cultures and communities) the most “normal” of exceptional mental states is that of a spiritually attuned consciousness, in which the supernatural, the divine, is experienced as material and real. In her remarkable book
When God Talks Back
, the ethnologist T. M. Luhrmann provides a compelling examination of this phenomenon.

Luhrmann’s earlier work, on people who practice magic in present-day Britain, involved entering their world very fully. “I did what anthropologists do,” she writes. “I participated in their world: I joined their groups. I read their books and novels. I practiced their techniques and performed in their rituals. For the most part, I found, the rituals depended on techniques of the imagination. You shut your eyes and saw with your mind’s eye the story told by the leader of the group.” She was intrigued to find that, after about a year of this practice, her own mental imagery became clearer, more detailed, and more solid; and her concentration states became “deeper and more sharply different from the everyday.” One night she became immersed in a book about Arthurian Britain, “giving way,” she writes, “to the story and allowing it to grip my feelings and to fill my mind.” The next morning she woke up to a striking sight:

Later, Luhrmann embarked on a study of evangelical religion. The very essence of divinity, of God, is immaterial. God cannot be seen, felt, or heard in the ordinary way. How, she wondered, in the face of this lack of evidence, does God become a real, intimate presence in the lives of so many evangelicals and other people of faith? Many evangelicals feel they have literally been touched by God, or heard his voice aloud; others speak of feeling his presence in a physical way, of knowing that he is there, walking beside them. The emphasis in evangelical Christianity, Luhrmann writes, is on prayer and other spiritual exercises as skills that must be learned and practiced. Such skills may come more easily to people who are prone to being completely engaged, fully absorbed, by their experiences, whether real or imaginary—the capacity, Luhrmann writes, “to focus in on the mind’s object … the mode of the novel reader and the music listener and the Sunday hiker, caught up in imagination or appreciation.” Such a capacity for absorption, she feels, can be honed with practice, and this is part of what happens in prayer. Prayer techniques are often focused on attention to sensory detail:

And one day the mind leaps from imagination to hallucination, and the congregant
hears
God,
sees
God.

These yearned-for voices and visions have the reality of perception. One of Luhrmann’s subjects, Sarah, put it this way: “The images I see [in prayer] are very real and lucid. Different from just daydreaming. I mean, sometimes it’s almost like a PowerPoint presentation.” Over time, Luhrmann writes, Sarah’s images “got richer and more complicated. They seemed to have sharper borders. They continued to get more complex and more distinct.” Mental images become as clear and as real as the external world.

Sarah had many such experiences; some congregants might have only a single one—but even a single experience of God, imbued with the overwhelming force of actual perception, can be enough to sustain a lifetime of faith.

E
ven at a more modest level, all of us are susceptible to the power of suggestion, especially if it is combined with emotional arousal and ambiguous stimuli. The idea that a house is “haunted,” though scoffed at by the rational mind, may nonetheless induce a watchful state of mind and even hallucination, as Leslie D. brought out in a letter to me:

C
hildren not uncommonly have imaginary companions. Sometimes this may be a sort of ongoing, systematized daydreaming or storytelling, the creation of an imaginative and perhaps lonely child; in some cases it may have elements of hallucination—a hallucination that is benign and pleasant, as Hailey W. described to me:

And yet “imagination” may not be an adequate term here, for imaginary companions may seem intensely real, as no other products of fantasy or imagination do. Perhaps the difficulty of fitting our adult categories of “reality” and “imagination” to the thoughts and play of children is not surprising; for, if Piaget is right, children cannot consistently and confidently distinguish fantasy from reality, inner from outer worlds, until the age of seven or so. It is usually at this age, or a little later, that imaginary companions tend to disappear.