By Nathan Ahlgrim
|Even computer programs, like DeepDream, hallucinate.|
Courtesy of Wikimedia Commons.
Their discussion centered around the work out of Dr. Philip Corlett’s lab , which compared how people with schizophrenia and self-described psychics experience auditory hallucinations. An article in The Atlantic later followed, profiling one of the self-described psychic mediums and her relationship with the voices only she hears. The problem with labels comes to the fore in the very premise of the study: the psychics are labeled non-psychotic even while perceiving sounds in the absence of a noise. Mental health practitioners then must decide whether to pathologize the experience – to label it as a symptom of a disorder. Refraining from pathologizing their experience makes sense with the current definition of a “disorder,” which contains the criterion of causing distress. Because psychics are not bothered by the voices they hear, their hearing voices is not considered to be a symptom of a disorder or psychosis. However, given our society’s negative view on hallucinations and psychosis, how many people are inappropriately pathologized for similar
|Image courtesy of Pixabay.|
Rosenhan would be happy to see the recent changes in how the American medical system treats hallucinations over the intervening decades, with continuing improvements in the Diagnostic Standards Manual (DSM). Qualifying symptoms for schizophrenia are hallucinations, delusions, disorganized speech or behavior, and negative symptoms (social withdrawal, anhedonia, etc.). Beginning with DSM III in 1980, a diagnosis required “significant impairment” associated with at least one of these symptoms. With the publication of DSM V in 2013, a diagnosis now needs at least two of these qualifying symptoms presented with significant occupational or social dysfunction. Therefore, hallucinations are no longer sufficient for a diagnosis of schizophrenia in and of themselves, and healthy voice hearers are free from diagnosis.
|Stephanie Hare describing how the brain acts|
during auditory hallucinations
The concept of non-distressing hallucinations is foreign to those whose only exposure to the phenomenon is in portrayals of schizophrenia. And yet, most healthy voice hearers classify their voices as positive, controllable, and not bothersome . The resulting argument is that if hallucinations do not make the person want to seek help for their condition, we should let them be. But treatment-seeking is not always a prerequisite for a mental disorder; some disorders do not feel out of place to the individual at all. People with personality disorders often fit that category. Although Borderline Personality Disorder causes significant distress and treatment seeking, people with other personality disorders do not perceive their behavior as abnormal and are not distressed by their own behavior, as with Narcissistic Personality Disorder . Overall, people with personality disorders are very likely to push against the need to treat the underlying condition . Diagnoses occur because their disorder causes deleterious effects on the person’s social and professional life, not treatment seeking. But psychics can experience similar ostracization. As the medium interviewed for The Atlantic article states “You just can’t go into a room and say ‘Hey, I’m a psychic medium’ and people are gonna accept you.” Hallucinations can interfere with a person’s life whether they are attributed to schizophrenia or psychic sensitivity, with prejudices stemming from either fear or disdain. How mental health professionals define “significant distress” to accurately account for both experiences will inform how the perception of illness, and the stigma surrounding it, evolves.
Applying Lessons Learned
|People with chromesthesia associate sounds with color.|
Image courtesy of Wikipedia.
To get to a point of similar acceptance, healthy voice hearers would benefit from a spectrum approach. Binary health/illness evaluations are now being replaced with dimensionality assessments. Auditory hallucinations may belong on one end of a spectrum of perceptual vividness, inside the range of normal experience for many people. All these strategies have one common theme: deliberate language. Calling a person ‘schizophrenic,’ ‘crazy,’ and even ‘hallucinating’ instantly pathologizes and strips the person of identity. Replacing that vocabulary with inclusive language like ‘person with schizophrenia,’ ‘psychosis,’ and even ‘nonconsensual reality’ give agency and acknowledge divergent experiences. Such deliberation over language is often accused of being too politically correct; but this is the first step in fostering a safe environment for people within the entire range of sensory experiences. Only in a safe environment can voice hearers seek help if they need it, or be transparent about their experiences if not.
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Want to cite this post?
Ahlgrim, N. (2017). Neuroethics in the News Recap: Psychosis, Unshared Reality, or Clairaudiance?. The Neuroethics Blog. Retrieved on , from http://www.theneuroethicsblog.com/2017/12/neuroethics-in-news-recap-psychosis.html