What are the six kinds of hallucinations?


By David Joel Miller.

Auditory, Visual, Tactile, Olfactory, Gustatory and Proprioceptive Hallucinations.

Of the six types of hallucinations, one is a characteristic of mental illness, two are most commonly found coupled with drug use or abuse and the others are rare occurrences.

Auditory hallucinations:

Hearing voices is one of the commonly reported symptoms of psychosis. For perfectly normal people hearing all sorts of sounds and not being able to find a source is common. Mostly this happens at night or when there some sort of sensory deprivation. Many people have had the experience of thinking they heard someone calling their name only to look around and find no one there. But if someone has psychosis the sounds they hear occur when others are present who don’t hear them.

People with schizophrenia have described the progression of these sounds to me. No one pattern seems to be consistent but here is the way in which auditory hallucinations might develop.

In the early stages, the person might hear humming sounds. They may get their hearing checked and there is nothing wrong. Later on, the sounds become voices. But the voices are mumbling, the person can’t make out what they say. The voices may get louder over time.

There may be one voice or many. The voices can be men, women or a group of people. Occasionally the voice will sound just like someone from the persons past.

The voice may comment on them – say “you’re no good” or “you will never be anything.” The voice may tell them to do or not do something. The most troubling auditory hallucinations are the “command” hallucinations when the voice or voices tell the client to harm themselves or others.

Occasionally the voices may be experienced as good or helpful voices. Sometimes the person experiencing auditory hallucinations can’t tell the difference between their own thoughts and “voices” as their thoughts become more negative and persecutory.

An occasional “hear your name and no one is there” or “hear chains rattling in the night” can be written off, but voices that recur or say negative things about the person are a sign of a serious mental illness and they need immediate treatment.

Visual hallucinations:

Seeing wisps or shadows can happen from lack of sleep, low light levels or other physical problems. Most of the more elaborate visual hallucinations are the result of drug use, intoxication or withdrawals. Seeing things when withdrawing from alcohol is life threatening and needs immediate medical treatment.

A few people with mental illness only and no reports of substance abuse see things but most of the time if someone sees things they are doing drugs. Seeing things on drugs is so common that if the client knows that the drugs caused this we don’t diagnose it as a psychosis.

Three types of drugs cause visual hallucinations. Hallucinogens like LSD etc are a well-known cause. High levels of stimulants especially methamphetamine can cause Amphetamine-Induced Psychotic Disorder.  Collectively all the psychosis caused by stimulants is referred to as “Stimulant Psychosis.”

Meth users are familiar with “petting the shadow puppy” and being chased by the giant green meth monster.

Drug-induced visual hallucinations often persist even after the eyes are closed.

Alcoholic Delirium Tremens (D. T’s) also involve visual hallucinations.  This is life threatening and is usually a lot more terrifying that the prosaic references to “pink elephants.”

Tactile hallucinations

These involve feeling things on your skin and body that aren’t there. These are almost exclusively drug induced.

Alcoholics may report the sensation of snakes crawling over their legs, mostly associated with restless leg syndrome.

Stimulant abusers are all familiar with Meth or cocaine bugs. They feel these sensations so often and scratch so much the characteristic scabs appear.

Olfactory hallucinations

Some people smell dead people, even before the people die. This makes good horror flick material but in real life, olfactory hallucinations are a lot rarer than auditory or visual hallucinations.

Smelling things that are not there and hypersensitivity to smells may have a physical cause or more rarely it may be a mental illness.

Gustatory hallucinations

This one makes me think I need a doctor, sometimes for the client, sometimes for me. If the client thinks they taste metal or poison this may be a medical issue, side effect of meds. Some clients have delusions of being poisoned and anything can taste like poison to them.

This is also a relatively rare issue in my experience.

Proprioceptive hallucinations:

This was covered under the category of sleep paralysis. These sensations of floating, flying, out-of-body experiences and other dissociative movement events are most likely when in bed before and after sleeping.  They have also been reported under the influence of anesthetics and other hospital related incidents.  There are some historical references to this type of hallucination being caused by certain herbs and potions but most likely it is the result of sleep disruptions. I can think of no mental illness that features these sorts of hallucinations.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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14 thoughts on “What are the six kinds of hallucinations?

  1. Proprioceptive hallucinations are seen among some dissociative cases. In fact, DID in particular can cause all these types of hallucinations and even do so regularly. Also, visual hallucinations are more common among psychotic cases, even without drug use, than you imply.

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  2. Pingback: Emotional problem or mental illness | counselorssoapbox

  3. Hello. Thank you for your web site about hearing voices, it was good to hear some down to earth thoughts. I have been hearing voices for the past year and it only started after 8 months of chemo for leukemia. My doctor referred me to a psychiatrist who said i was depressed ( i also had to move home at the same time because of bullying and harassment from the neighbours who lived above me and they wouldn’t let me sleep it went on for 3 years and all through my chemo I was on my own all this time and just after the chemo put my furniture in storage and went to stay with an old friend it was then when i felt safe it all started.The voices are not in my head but in the room and at first there were loads of them all calling me and i had some pretty horrific out of body experiences. being a spiritualist i at first thought i had got into a bad crowd of spirit people and went to church to try to get them moved on it didn’t work. i went to see a shaman but it didn’t work i tryd all kinds of healing and talked to many many mediums it didn’t work. i eventually found myself a counsellor and have attended weekly for 18 months she persuaded me to see my doctor and i plucked up courage to go she was very helpfull and put me on an anti psycotic drug olazapine and tramadol it it helped but now dosn’t work much there are 3 people left calling me all day long and although they are not so they hound me and have a running commentary about what i am thinking and doing all the time they say they are earth people and won’t go to the spirit world. the last time i went to the doctor (I go 3 monthly she said she wasn’t convinced it was a psycotic illness and wasn’t sure what it was the psychiatrist didn’t want to see me again as she didn’t think it . I’m now so confused and just want them to stop tormenting me as i never have any peace. thank you for talking about it I would like to hear from you as to your thoughts on voices out your head and any help you can give . i an 69 years old quite compass mentas and am very happy where i live now my eldest son has a similar problem and lives in the flat below me he is a computer programer and very bright. best wishes thanks again for discussing it Look forward to hearing from you. Barbara

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    • Hi Barbara thanks for sharing your experience. My suggestion is that you probably need to see another doctor. Preferably a psychiatrist. Long term and high use of street drugs like Methamphetamine can alter the connections in the brain. In effect the drugs rewire the brain and afterwards your brain will work differently. Trauma can do this also. I have to wonder if the chemo did not also make some changes to your the way your brain works. Medication can help reduce or eliminate the voices for people who damage their brains with street drugs and it just might help you. My suggestion to you is keep trying and get a second or even a third opinion if need be.

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  4. Pingback: Most read mental health blog posts 2015. | counselorssoapbox

    • That is a really interesting question. I do not recall ever seeing a list of “types” of auditory hallucinations. There are a number of ways we could classify them. Books on assessment describe certain forms that are more of a worry than others and tell us which to count as symptoms and which to disregard. Command type are certainly a worry. I did a quick literature search and came up with over 4,000 articles on auditory hallucinations. If time permits I will take a look at some of these articles and see what I can find out. Beyond research most professionals have had clients describe auditory hallucinations and based on what they say I have some theories but can’t be sure the sample I have seen would match what other clinicians see. Let me try to write a blog post on this topic. Have you found any other material on this?

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  5. i’m still searching, but i need confirmation. As long as i know that auditory hallucination have 3 type, 1st person, 2nd person and 3rd person. Is that true? But others people said auditory hallucination only have two type, 2nd person and 3rd person only, and i still searching about the legality about 1st person.

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    • First person hallucinations have been described. Mostly this is in young children or those under extreme stress. As I remember the research this type of hallucination is likely to go away with time even without medication.

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    • See:
      The relationship between metacognitive beliefs, auditory hallucinations, and hallucination-related distress in clinical and non-clinical voice-hearers
      Katy Hill1, Filippo Varese1, Mike Jackson1,2 and David E.J. Linden1,2,3∗
      British Journal of Clinical Psychology (2012), 51, 434–447 C 2012 The British Psychological Society
      For some discusssion of First person voices.

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  6. Pingback: Top Mental Health Blog Posts – counselorssoapbox.com 2015 | counselorssoapbox

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  8. Pingback: Hallucinations Are More Common Than We Think – Diashmond

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