VOLUME 1, ISSUE 2 PSYCHNEWS INTERNATIONAL May, 1996
SECTION B: DEBATE "HALLUCINATIONS"
NOTE: The following section (i) contains
a contribution of Dr. Jan Weimar in
response to the article "Psychosis"
in the PsychNews International, 1(1),
Section B. (ii) A reply by the author,
Dr. Jeff A. Schaler (independent
columnist) follows. The full text of the
original article can be accessed at one
of our www sites (see Section A., 2.).
HALLUCINATIONS AND PSYEUDO-HALLUCINATIONS
by Jan Weimar, M.D.
Excerpt of the orginal article by J. Schaler (starts here)
> People are labeled psychotic when they refer to mental
the world (thinking) as if they were
>substantive and real. Magritte addressed this concept in his
>painting of a pipe entitled "Ceci n'est pas une pipe" ("This is
>not a pipe"). Another example of confusion is the
>description of the "voice of conscience" as the literal voice
> of another being (known as "hearing voices"). [..]
> People are also labeled psychotic when they claim that
>something metaphorical is literally true. An example of this
>is a person who makes a certain kind of false claim, i.e., a
>socially unacceptable one. Such claims might include
>statements such as, "I am Jesus," "the tree is crying," or
>"the dog is speaking to me." To ascribe this type of
>confusion to mental illness is tautological; the confusion is
>considered the putative "illness" by those who view the mind
>as capable of being literally sick.
> Moreover, the failure to differentiate between the
>symbolic and the real may be inte
ntional (artistic license)
>or strategic (lying). [..]
> Qualitatively, there is no difference between psychosis
>considered mental illness and psychosis considered mental
>health. Schizophrenia is said to be characterized by
>hallucinations, i.e., self-reported imaginings.
> Another example of self-reported imaginings, i.e.,
>hallucinations, is the popular belief in the existence of
>angels. This belief is considered normal by mentally
Belief in the existence of aliens is
>considered abnormal and is a sign of mental illness. Yet,
>insofar as angels and aliens are both hallucinations (that
>is, self-reported imaginings), there is no difference between
>believing in angels and believing in aliens.
Excerpt of the orginal article by J. Schaler (ends here)
What I am missing in this whole discussion
is the differentiation between hallucinations and
Hallucinated voices, f.i., are thought (by the
hallucinator) to be heard by others as well. If the
person is aware that the voices are in his own head
and cannot be heard by others they are pseudohallucinations.
At least in the medical-psychiatric literature in Europe,
since at least a hundred years.
This differentiation is essential to the question "am I
psychotic" when I see angels or hear voices. Someone
with a dissociative disorder, who hears voices from
sexual offenders, for instance (a common occurrence),
knows that others cannot hear these voices. Therefore
we do not speak of psychosis in this case, but of
dissociative disorder (or if there is no disorder, of
dissociative experiences). We speak of
psychosis if the
description of the (internal and external) behaviour
of a person points to hallucinations and/or delusions.
Not when there are pseudohallucinations. If I see angels
(which I usually don't) and know that others cannot see
them and I call it a vision, or a perception of another
level of reality, or whatever, it still is a
pseudohallucination and not a hallucination:
I know others cannot see the angel.
Depending on my belief system perhaps
there could be SOME
others that have that special perceptive ability, but
still I am aware of the distinction between 'regular'
physical reality which can be perceived by everyone with
'regular' senses and this 'other' phenomenon. The same
counts for aliens, divine or diabolic appearances. The
distinction between the experience of regular physical
reality that we remember as being perceived by our senses
and experiences of phenomena that we do not classify as
belonging to the regular physical reality as we know it
(remembered as being perceived by our 'used to' senses)
makes or breaks psychological 'health'.
We do not consider it as healthy if someone hallucinates
an angel, i.e. adamantly professes the belief that it is
there as physical as you and me and that I should be able
to see the angel as well. It is generally not directly
believed as unhealthy, though, if someone claims to see
an angel and UNDERSTANDS the distinction between awareness
of physical reality and 'awareness' (c.q. imagination,
depending on the belief system that is used as the context
of the communication) of possible other dimensions, and
UNDERSTANDS that someone elses belief system about
reality does not necessarily incorporate the existence of
other dimensions (especially if the person has the
ability, which a lot of people have in these postmodern
times, to communicate within the context of several,
varying, belief systems about reality).
Insanity is, at least in this case, just lack of
understanding, I would say. Or perhaps in words that
suit the writer of the article, confusion (which is
essentially the same as lack of understanding).
What I am trying to convey is that the writer calls a lot
of people with 'hallucinations' 'psychotic' that do not
have hallucinations (but pseudohallucinations) and
therefore do not meet the criteria for the term 'psychotic'.
Excerpt of the orginal article (starts here)
> The December 27, 1993 issue of TIME magazine depicts an
>angel on its cover with the following caption beneath it:
>"The new age of angels. Sixty-nine percent of
>believe they exist. What in heaven is going on?" Answer:
>Most people in the United States are psychotic.
Excerpt of the orginal article (ends here)
The answer is not correct. They do not have hallucinations,
at most a delusion. Delusions, however, are defined in a
context of others that believe differently. Sometimes the
delusion is only made up of incorrect interpretations of
physical facts. In most cases of delusion hallucinations
(and not pseudohallucinations) are the basis of the belief
that makes up the delusion. People who believe in angels
are therefore not by definition psychotic (again, the
same counts for believing in aliens, 'astral beings',
Excerpt of the orginal article (starts here)
> because people hear voices does not mean that they have to
> obey them. There is a choice. And _you_ are in charge of
> making the choice."
Excerpt of the orginal article (ends here)
I wholeheartedly agree to this. The belief system around
the voices is important though: are these voices imaginings
or real? If they are 'real' in some other way than
'physically present', then are they still a threat to
my - physical - safety? If I think they can be threatening
my safety, then what is the proof? Especially the belief
system of the helper is important: is every alleged
hallucination an imagining? Or is it an unusual experience
that is not understood, that the experiencer is confused
about? Is there a difference between a hallucination and
a pseudohallucination, and is the presence or absence of
confusion the differentiating factor?
I do not know why this differentiation
and pseudohallucination is not mentioned in the article,
I suspect however that the distinction is less well known
in America. I hope this addition sheds
some light on the whole, interesting, subject.
Psychiatrist, Bergen op Zoom (Netherlands)
REJOINDER TO WEIMAR
by Jeffrey A. Schaler, Ph.D.
Dr. Schaler responds: I appreciate Dr. Weimar's
response, and the storm of discussion my essay continues to
generate elsewhere. I have collaborated with Amos Gunsberg, a
colleague of mine in New York City, in my response.
Dr. Weimar, a psychiatrist in the Netherlands, asserts
hallucinations and pseudo-hallucinations are different:
"Hallucinated voices...are thought (by the hallucinator) to be
heard by others as well. If the person is aware that the
voices are in his own head and cannot be heard by others they
are pseudo-hallucinations." Dr. Weimar suggests
hallucinations characterize what we classify as psychosis and
pseudo-hallucinations do not. The difference is described in
European medical-psychiatric literature.
That differentiation appears false to us. We submit both
hallucination and pseudo-hallucination characterize psychosis.
The basic position in both cases is this: "What _I_
magine is what is real. I may imagine I alone hear the
voices -- which is proof I am chosen. I may insist others
must hear them -- which then raises the ante of how powerful I
am." The basic position is the same: "What _I_ imagine is
That position is not unusual. Many people confuse what
they imagine to be real with reality.
There is a simple exercise to demonstrate this. Place a
clear glass of water on a table. (About 3/4 full works best.)
Ask the subject to continue looking at that stationary glass
of water while imagining taking the glass in hand and drinking
the water. Some people will admit the sensation of drinking
is "more real," but OF COURSE they KNOW
the glass on the table
is the reality. However, when you delve further, you discover
this _knowledge_ does not interfere with their base of
operations. Their base is: the (imagined) sensation of
drinking comprises their EXPERIENCE of what IS real...and is
the basis for their behavior. Seeing the glass on the table
is experienced as something they imagine. (The glass is
supposed to disappear if they turn away and stop _seeing_ it.
They are very annoyed if they happen to notice it's still
there, without their having imagined it into existence.)
A pseudo-hallucination, according to Dr. Weimar, occurs
when a person "seeing" angels "knows" others cannot see them.
That person classifies this as "perception of another level of
reality." We submit classifying the experience in that way is
a defense of the basic position. Furthermore, the phrase
"level of reality" is misleading. Reality is. The
accuracy of our lens is in the perceiver.
Although we disagree with Dr. Weimar's premise, we view
his effort as a sincere and well-reasoned attempt to
contribute and clarify. Please, therefore, consider the
following as a request for clarification.
Dr. Weimar states, "...and UNDERSTANDS that someone elses
(sic) belief system about reality does not necessarily
incorporate the existence of other dimensions..."
Is there an implication that a BELIEF system ABOUT
reality is to be accepted as having the full weight OF
reality? If a BELIEF system ABOUT reality POSITS the
existence of other dimensions which the believer is privy to,
does that mean these dimensions do exist...and, in the way the
belief system posits? (Example: "God told me to do this."
Response: "I spoke with God. God told me your behavior is
totally unacceptable. God said you've been doing the work of
Satan." We submit that anyone can claim God spoke to them.)
Another request for clarification. Dr. Weimar refers to
the quote from TIME magazine. "The new age of angels. Sixty-
nine percent of Americans believe they exist. What in heaven
is going on? Answer: Most people in the United States are
psychotic." Dr. Weimar comments: "The answer is not correct.
They do not have hallucinations, at most a delusion...In most
cases of delusion, hallucinations (and not pseudo-
hallucinations) are the basis of the belief that makes up the
delusion. People who believe in angels are therefore not by
Question: If hallucinations are the basis of the belief
that makes up the delusion, and if hallucinations merit the
classification of psychosis, how is the answer wrong?
(Note: Amos M. Gunsberg, 61 W. 74th Street, New York, N.Y.