Category Archives: Schizophrenia & Psychosis

Types of auditory hallucinations – hearing voices.

Posted on by
23

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

All radios

Hearing voices.
Photo courtesy of Pixabay.com

How many types of auditory hallucinations are there?

Hearing voices or sounds that no one else hears occurs in people both with and without a diagnosable mental illness. Originally this question came in from a reader who asked about types of voices. What that reader was asking about was, voices that speak in the first, second, or third person, a very different discussion from what we are talking about here. Their question got me thinking that all those things that get referred to as “auditory hallucinations” can be quite different experiences.

Since these auditory events can vary so much it may be useful to consider some types of auditory hallucinations, “hearing voices” as the auditory hallucinations are often referred to, and we can see just how different these auditory hallucinations might be. Some of these events are easily explained and other sound events are reasons to suspect a long-term mental illness is present.

Some “voices” are misinterpreted sounds.

Hearing voices or other sounds and then finding out that others did not hear what you heard, happens more often than most people realize. At several times in the human lifespan, this is so common that it appears normal. In children and adolescents and then again among the elderly these auditory hallucinations type “hearing voices” are common enough that we are inclined to think this is a normal developmental event.

Mistaking one sound for another is a type of auditory hallucination.

Say you are sitting at a table eating lunch and then you think you hear someone calling your name. You look around and no one is there. Leaving out religious or supernatural interpretations here, you have just had an “auditory hallucination.”  If you hear an indistinct sound, your brain is likely to interpret this sound as something familiar, like your own name.

We have limited information on what these auditory hallucinations are like.

Auditory hallucinations are very individual experiences. Since part of the definition of auditory hallucinations is that they are heard by one person and not others we have only two sources of information most of the time. We, as in counselors, can rely on the reports of those who hear them or we can have observers who see people they believe are having auditory hallucinations describe how this is affecting the person who presumably is hearing voices. More information is coming in from brain scans but it will be some time before this begins to be widely used for diagnosis.

This more “objective” evidence of auditory hallucinations based on professional’s observations is subjective and involves a lot of guesswork and inferences. Clinicians may refer to a client as “internally preoccupied” and the presumption is that the client is listening to voices but they may also be lost in thought or because of concussions or dementia be unable to think coherently.

The experience of having an auditory hallucination has many personal features. The voice can vary in frequency from one time only to constant running commentary that never stops. Voices or other sounds can vary in intensity. Some voices are louder than others. Those hearing voices report varying degrees of ability to control the voices.

A person hearing voices may develop unique or special relationships with the voices for good or bad. Young children, especially those who have been under stress or traumatized, can begin to hear voices.

Here are some of the possible auditory hallucinations that have been reported by both clinical and non-clinical populations. Auditory hallucinations have been described in many ways and this list is far from inclusive.

Hearing hums or rhythmic sounds.

People who later develop distinct voices sometimes have told me that the “voices” began as indistinct humming or tapping sounds. For some people, this progresses and for others, it does not. Hearing issues, tinnitus, and hearing loss have similar symptoms.

Non-word sounds are more commonly heard by seniors, which does not automatically mean they are developing a psychotic condition. One research study I read recently reported that an imbalance in hearing between the two ears increases the risk that sounds will be miss-attributed. This is more pronounced if the left ear has less hearing ability than the right.

For this reason and a bunch of others, seniors are getting prescribed a lot of sedating antipsychotic medication.

Mumbling, whispers, or indistinct conversations or laughter.

Clients whose auditory hallucinations went on to become distinct voices have told me that in the early stages this was more like whispering or several people talking at once. Over time the voices are likely to get more distinct and clearer.

Positive voice or voices.

This kind of voice may be a departed relative or friend, guardian angel, or other spiritual force offering you encouragement. Clients have reported that they hear their grandfather, grandmother, or other relative telling them they can do something.

This coincides with research that reports hearing voices does not appear to make you mentally ill or worsen an existing mental illness if you take the voices to be positive things. Your beliefs about hearing voices determine how much it will bother you when you do hear those voices (Hill, et. al., 2012)

A recognizable person who is known to the client.

Young children especially those who have been under stress or traumatized can begin to hear voices. These voices are often someone who has been negative, criticizing, or even abusive. These kinds of voices may well be more a matter of memory failure, not being able to remember who said this to you in the past, than a current auditory hallucination.

A single unknown voice.

These voices do not appear to be anyone the person recognizes having heard in the past. This voice may be good, bad, or may vary over time. What this voice says and how the person hearing it interprets this experience is important in how it will affect them.

Male only or female-only voices.

This may be a part of a single voice as above or multiple voices described next. Sometimes this connects to a specific life experience and sometimes not. Freudian psychoanalysts can have a field day with these kinds of voices.

Multiple voices speaking at the same time or taking turns.

These voices may be talking to each other or they may be talking to the hearer. What they are talking about is sometimes significant. With this one and most of the ones to follow medication is highly indicated if it has not been tried yet.

A malevolent threatening voice.

This is a bad sign. Especially if the person hearing this voice has lost the ability to shut the voice up.

God or religious figure can talk to you.

Some people find this comforting, others think the devil is in their head and freak out.

Voices from inside the head.

It has been suggested this is the result of an “attribution” error. If you lose track of when you are having internal thoughts and your own thoughts begin to sound like voices this is a problem.

Voices from outside the head.

More problematic, less likely the person hearing these voices will accept that these are their own thoughts or misinterpretations of sounds.

Voices that are only heard in certain situations.

Some people only hear voices when they are very depressed or when they are very anxious. These can be their own depression and anxiety taking on the role of speaking to them or we might interpret this as problems with the brain as a result of a deficit in a neurotransmitter. Treat the depression and these kinds of voices usually go away.

Voices giving commands – command hallucinations.

This is very worrisome to me. How can the person who hears the voices all the time resist these commands? Anyone having command hallucinations, even potentially good commands, needs treatment. If the voices never stop, people will act on the voices, sometimes giving in and sometimes self-harming just to get the voices to shut up.

Voice is part of re-experiencing a past event.

Sometimes voices are the result of re-experiencing the past. An abuser said bad things about you and you remember their voice calling you names. But then again I tell my students that when they take licensing exams I hope they will remember my voice telling them the answers. A good teacher hopes their student will take their voice with them. Bad teachers find the student can’t get that critical voice out of their head.

Hearing voices is not always a bad thing.

I should also mention that not everyone agrees that hearing voices, is a bad nor an abnormal event. Take a look at some of the things that the Hearing Voices Movement has to say about their perspective on hearing voices.

If you have experienced voices or have talked with someone who does feel free to comment. I will get to the comments as quickly as I can and this time of year that may take a while but rest assured eventually I will respond to your comments.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Do people really need to stay on anti-psychotic medications over the long haul?

Posted on by
Reply

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Drugs

Medications.
Photo courtesy of Pixabay.com

Are psychiatric meds for life?

The conventional wisdom has been that one you were put on an anti-psychotic you were going to be on it for life. People who stopped taking their meds were at high risk for a relapse.

Now comes a blog post, from no other than the director of the National Institute of Mental Health, reporting that we may have been wrong about this.

You can read the full director’s report at the link below.

http://www.nimh.nih.gov/about/director/2013/antipsychotics-taking-the-long-view.shtml

Please do not read my post or even the Director of NIMH and stop taking your meds. Talk to your doctor first.

But consider that meds and meds alone may not be what you or others with a mental illness really need.

You might also want to talk a look at Aaron Beck’s book on cognitive therapy and schizophrenia. The link is below.

Schizophrenia: Cognitive Theory, Research, and Therapy

“Counselorssoapbox is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com.” We recommend only books we think are good and maybe occasionally make a buck.

So as with all other treatments, one size, one method is not the right approach for everyone.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What sense of smell – odors – tells us about mental illness?

Posted on by
18

By David Joel Miller MS, Licensed Therapist & Licensed Counselor.

Sense of smell.
Photo courtesy of pixabay.

Is there a connection between the sense of smell and mental illness?

There is a body of research that tells us that there is a connection between the sense of smell, your ability to recognize and identify odors, and the chance you have or will develop a mental illness. There are also cases of olfactory hallucinations; smelling things that everyone else is sure is not there.

While this research suggests some connections, to me the articles I have read are short of conclusive.

An altered sense of smell has been linked to disorders as divergent as Schizophrenia, Bipolar disorder, autism, and eating and feeding disorders.

Smelling it does not mean you can identify the smell.

One thing we do know is that the ability to identify an odor is not the same thing as the ability to detect one. People are more likely to like a smell they can identify and unknown smells are more likely to be considered unpleasant. Memory and its connection to smells are important for many reasons.

Smells trigger memories.

This is significant because smells are powerful memory cures. People who have a poor ability to notice smells or to remember them are at a disadvantage in remembering things that might be associated with those smells.

Schizophrenia and odors.

The disorder most cited as having olfactory (odor or smell) impairment is Schizophrenia. More interesting yet is the repeated observation that males with schizophrenia are far more likely to have olfactory disruption than females (Nguyen et al, 2010.) These males with schizophrenia had disruption of odor identification, memory, odor detection abilities, and poor odor discrimination, the ability to tell one smell from another.

Females in these studies rather than not being able to recognize or identify smells were more likely to smell foul or unpleasant things that were in fact not detectable to others. The conclusion was that women have more olfactory hallucinations and men more loss of ability to smell.

Schizophrenia is characterized by negative symptoms, which are the loss of some abilities others have, as well as positive symptoms such as hallucinations. Someone with schizophrenia will likely have or experience social withdrawal, attention problems, difficulty making decisions, and perceptual problems.

People with schizophrenia also have high rates of olfactory identification problems, discrimination of smells, olfactory memory, and olfactory detection errors, principally in males. Poor olfactory discrimination is also found in close relatives of people who have been diagnosed with schizophrenia even when those relatives have not received the diagnosis themselves.

Olfactory identification problems do not appear to be found in people with Bipolar disorder, Major depressive disorder, other related psychosis, or anorexia nervosa.

Alzheimer’s, and Parkinson’s diseases and smells.

Olfactory hallucinations and discrimination deficits are seen in those with Alzheimer’s, and Parkinson’s diseases in addition to Schizophrenia.

One researcher reports that people with Bipolar Disorder have some olfactory impairment but that they are less bothered by unpleasant smells that those people who have Schizophrenia (Cummings et al., 2010.)

Autism and odors.

In Autism olfactory identification is reported as impaired. Individuals who had been diagnosed with Autism preferred Lemon and Orange smells, to lavender. They disliked most other strong smells. In Autism strong smells are linked to perceptions of taste and result in high rates of food refusal and selectivity (Hrdlicka et al., 2010.)

Olfactory hallucinations.

One condition of note is olfactory hallucinations. Some patients reported a foul-smelling order coming from themselves. This odor was not detected by staff. This olfactory hallucination is referred to as Reference Syndrome and was reported in patients with temporal lobe epilepsy. Other olfactory hallucinations have been reported in clients with substance-induced Psychotic Disorder, Hypomania with Alcohol dependence combined with hypomania (Luckhaus et al., 2003.)

There does not appear to be any connection between depression and olfactory dysfunction (Scinska et al., 2008.)

Migraines and odors.

Olfactory dysregulation has also been linked to people who have frequent migraines, with over 45% of people experiencing migraines reporting odors are triggers for those migraines. In migraine suffers, almost 25% had a fear of a particular odor, and an equal number reported taste abnormalities when having a migraine episode. MRI’s showed that women were eight times more likely to have brain activation from odors. This makes one wonder if many of the issues with odor detection, memory, and discrimination are more linked to gender than to a particular psychiatric diagnosis.

Other studies have reported significant episodes of visual hallucinations during migraine attacks and make the point that visual and auditory hallucinations are so pronounced and readily identifiable most people are not asked about and do not report either olfactory (smells) or gustatory (taste) hallucinations.

In people with schizophrenia, 75% reported auditory hallucinations, 37% reported somatic hallucinations while olfactory hallucinations were reported by 18% of the patients which is slightly more than the 14% who reported visual hallucinations. Despite being so common, few clients report olfactory hallucinations and clinicians are not generally looking for them.

While people with schizophrenia may experience hallucinations in all modalities, providers frequently stop asking about hallucinations after the first or second reported hallucinations.

Stress and hallucinations.

Researchers find that people who report being under “stress” are more likely to have experienced olfactory hallucinations and one study concludes that stress may lower the threshold for hallucinations of any type.

Because the major part of the olfactory sensing part of the brain is on one side of the brain researchers have suggested that there may be a difference in the way in which left-handed and right-handed people experience olfactory hallucinations.

While olfactory hallucinations are readily identifiable in people who have migraines they are less identifiable but more likely to be described as unpleasant in those with epilepsy.

While we still can’t use olfactory or gustatory hallucinations or dysfunction as makers for a particular mental illness, we know abnormalities in the sense of smell and taste may be factors in the development of a mental or emotional problem.

Have you experienced an alteration in your sense of smell or taste and no medical reason has been found? Care to share?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Delusions are a leading cause of homicides; if you were delusional would you know?

Posted on by
1

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Brain

Mental illness.
Photo courtesy of Pixabay.com

What exactly is a delusion and why are they so hard to recognize beforehand?

One particular delusion has been implicated as a leading cause of homicides. Related delusions may also play a major role in other violent acts even though professionals have such a hard time recognizing them.

Delusions are one of those things like art or pornography we have great difficulty in defining but we all think we will recognize it when we see it. Unfortunately, it often goes unrecognized until way too late.

While not necessarily a particular mental illness, Delusions are a symptom of a number of mental illnesses. In practice professionals rarely seem to pick out the delusion first. The person gets diagnosed with a particular mental illness and then the descriptor with delusions gets tossed in later like that tells us much about what is going on.

Some mental status exam forms and assessment forms include checkboxes to mark off delusions. Since deciding if someone is delusional is such an extreme judgment call, this decision often comes after the diagnosis not before. Also, note that the one delusion that results in many homicides is not usually included in the list of delusions that we are presented to check off.

The commonly considered delusions are, Paranoid, Grandiose, Religious, and Persecutory. Let’s look at these one at a time and see why they can be problematic. Some of these examples are slightly exaggerated and embroidered for effect. Can you tell which are which?

When paranoia is not a delusion.

A client told me that he was being followed; that the police were out to get him and that it was not safe to walk the streets. Clearly, he was sounding paranoid. On Monday I learned that he had been arrested after the police responded to a shooting at his house. The police were quick to respond as they were only a couple of blocks down. They had been watching his house. He was found in possession of a large quantity of drugs.

Was he paranoid? As I tell students in the substance abuse counseling program, if the client thinks people are watching him and he has a kilo of dope in the trunk of his car this is not paranoia, it is common sense.

How Grandiose is Grandiose.

If I told you that an African-American though he could run for president and have a chance of winning in this the 21 century that would sound Grandiose wouldn’t it?  And if that Black man was a first-term Senator from the mid-west – any psychiatrist worth his salt would know right off that this person was Grandiose.

Thank goodness no one told President Obama those things. Or if they did, it is a good thing that he did not listen. Whatever your political affiliation, it is clear that President Obama ought not to be diagnosed as Grandiose, not since he won anyway.

So it is not grandiosity if you are actually able to do something. This makes me nervous when I put down that someone is having grandiose delusions. How do I know for a fact that they are delusional? In my mind, any doubt goes to the client.

Your religion is delusional mine is doing what God wants.

All religions are based on Beliefs. They customarily urge you to act on faith and have belief. Unfortunately, they all seem to have a different group of these essential beliefs.

In mental health, if something occurs to you and most of the other people in your community think this is correct, we do not diagnose this as a mental illness.

If a Catholic believes that they see the Virgin Mary we let that go.
Where this becomes a problem is if you move to a country where no one believes in the Virgin Mary and now if you keep seeing her they can lock you up as delusional. That whole community values thing is a rabbit hole down which the truth can disappear in an instant.

If you are now thinking of sending me a nasty comment or e-mail about how far off I am about your religious beliefs please read the next section before hitting send.

Persecutory Delusions.

It is not persecutory if people are after you. Like paranoid this one is a matter of degree and judgment.

If you think that people are out to get you and then you start getting written death threats, that is probably not a persecution delusion.

This like all the others is a matter of fact and judgment.

Which major delusion is not on a lot of forms?

We don’t like to look for and may miss jealousy delusions. People who believe that their partner is cheating on them can and do frequently get violent. Sometimes after they shot or kill someone they discover that their partner was not in fact cheating on them but at the time the evidence looked to them like that partner was clearly cheating.

One article I read recently reported that someone killed a man he believed was cheating with the client’s wife. He was arrested. The victim now dead was clearly not having an affair with the client’s wife. This belief was called a delusion.

Later it came out that the wife was, in fact, having an affair, the client just got the identity of the man she was cheating with wrong.

Was he delusional? I let you decide that.

Certain groups are far more likely than others to be described as delusional. I worry that if you do not agree with the assessor you will get called delusional.

Say you are sent for an evaluation and the assessor is a member of the Church of the Religious Egg. They teach that you should cover yourself with plastic and surround yourself with plastic objects three times a day to meditate. You report that this whole idea is crazy. The assessor reports that you are having religious delusions because you believe in some other deity.

At this point who are we thinking is delusional?

Please do not misunderstand here. I do believe that people, with or without mental illness, can and do have delusions, some more bizarre than others. My point is that we need to be careful about what we call a delusion and what we let go.

So in some future posts, we will need to talk about the research on delusions and why certain groups get that label more often than other groups.

Until next time, stay happy.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Every day is April Fools’ Day when you are fooling yourself

Posted on by
5

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Fool.

Fool.
Photo courtesy of Pixabay.com

Do you know what is real and what is a hoax?

Today is April First. In many places, people will be celebrating April Fools’ Day. This day is dedicated to a whole lot of fun practical jokes and good times. Not everyone should be laughing.

The challenge in life is to tell the difference between the truth and things that are not true, regardless of the label we choose to put on those less-than-true thoughts and comments. Today you may be able to get away with some untruths if you can tell the difference, but not every day.

The falsehoods told today in the course of the April Fools’ Day festivities are in the medieval tradition when Fools were jokesters, comedians, and the like. When we know things are exaggerated and overblown they can be laughable and a bit of silly fun. Not all untruths are innocent.

The most dangerous type of lies is the kind we tell ourselves. People in recovery, from whatever they chose to call their problem, may find that they have been telling lies, giving people stories, so much they have begun to believe their own dishonesty. Substance abusers, required to be dishonest to continue their addiction are at special risk to have stopped seeing the distinction between the true and the false in their own minds.

If you have been telling yourself things that are not true and have started to believe those stories they can be a huge obstacle to overcome on your road to recovery.

People in recovery need to stop worrying about who they told what and begin to get honest with themselves. The most important person to tell the truth to is you.

Some recovering people have been told a lot of things that were not true. Those lies create a lot of pain and sometimes separating the true from the false can be a chore. When the addict starts to get honest the others around them are at risk to become confused about what is true and what is false.

Some people have families who have kept deep dark secrets. Those families can’t stand, to tell the truth. They pressure the other family members to deny things happened and to continue to rely on the make-believe family tale

Lie, falsehoods, and the like are not the only untrue information that takes up residence in our heads. False memories and beliefs, delusions, and hallucinations are also traps for the unwary.

There are technical distinctions between hallucinations and things that are really there. There is a realm of in-between things that the profession has to call in or out. Did you really see that or were you hallucinating? There are reports of things that look like a hallucination but are not.

People with addiction and mental illness may have seen and experienced things that other people tell you never happened.

Sometimes we see something and we decide what that means. If we are correct in our apprised that is all well and good. But what if you are mistaken in what you think this means or what has happened? We might call these false beliefs or even delusions.

It is likely that we can tell when someone else around us is delusional but can you tell when you are delusional? Are there things that kind of look like delusions but are not?

So while walking the road to recovery we need to take a look at hallucinations, false memories, and delusions and try to find ways to understand why our own mind may trick us into believing things that just are not so.

This whole area of what is true what is false and what you think you know is a lot confusing. In some posts over this month I want to explore delusions, hallucinations both true and pseudo, and some other aspects of getting honest with ourselves. Since psychologists and therapists call some of these phenomena by different names and understand it differently I want to start by looking at how these two professions get such different answers and then proceed to some thoughts about why your brain and our survival may have benefited at times from believing things that turn out to not be true.

Stay tuned for more on the subject of the real and the false, truth, and lies over the coming month. These posts will be interspersed with some other topics as they come up so as not to put all the readers to sleep at the same time.

Have a great day fooling around and we will return to the search for reality and recovery tomorrow.

Related articles

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What are the six kinds of hallucinations?

Posted on by
20

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

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

Six types of Hallucinations.
Photo courtesy of pixabay.

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 person’s 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 than 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.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Not everyone who hears voices is psychotic

Posted on by
6

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

All radios

Not everyone who hears voices is psychotic.
Photo courtesy of Pixabay.com

Did you hear that?

People in our society tend to think that hearing voices means you are crazy. We tell stories about this and we laugh at jokes, sometimes not too nice stories and jokes. It makes some of us feel safer to think that those who hear voices are not like us. We say that, even when we have heard the voices.

The truth is that most people hear voices. Sometimes we count the voices towards a mental illness and sometimes we don’t. The counting makes something a problem and other things, not so much.

The majority of all teenagers hear and have heard voices. One author says as many as 70% of all teens hear voices. Don’t be so quick here.

Have you ever thought you heard someone calling your name, looked over your shoulder, and saw no one there? Did you shrug it off? Did you pretend it didn’t happen? Some people think if they don’t admit they have symptoms then they are all right.

Truth is our brains sometimes try to help us out and sometimes they are wrong when they do it. You hear a sound. You can’t make it out. Your brain turns it into the closest thing to something it recognizes, tells you someone is calling your name. Sometimes it may only be your own thoughts but if you are concentrating on something you forget which is in your head and which is in your ear. Your brain makes up a story to help you out. Sometimes the brain is wrong.

Sometimes we get thoughts in our head. It is like someone is telling us to do this – no don’t. Some people interpret this as an angel on one shoulder and the devil on the other or maybe it was your conscience. For a moment the voices sound real. But when you try to get them to stop can you make them shut up? People with a psychosis like schizophrenia can’t make the voices stop when they try.

Ever see or hear a dead relative come back to talk with you? How about an angel or a religious figure? One rule psychologists follow is if this thing you see or hear is religious in nature or if you are grieving then we tend to disregard that experience. It happens a lot, you should get over it on your own. If not seek help.

If the thing you see or hear is all good and encourages you to do well, we are not so worried here. Unless it bothers you or the voices get too loud for you to think. But if the voice in your head tells you to kill people or break laws, we think this may be a big problem.

Ever been lying in bed and thought you saw or heard something in the room? When you are about to fall asleep or if you are asleep and start to wake up, images, and experiences from your dream world can get dragged into the conscious world. We have special names for this, hypnogogic and hypnopompic hallucinations. We don’t count those experiences as a mental illness either, not most of the time because most normal people have these.

I should also mention that most hallucinations involve hearing things. Most of the time when people see things it is drug or alcohol-induced. People with mental illness usually hear things, at least in the early stages.

We should also mention here that auditory hallucinations caused by mental illness are about the rarest kind of mental illness. There is much more depression and anxiety out there than schizophrenia. Not all people with schizophrenia are paranoid and not all people with paranoia have schizophrenia. Not by a long shot.

So aren’t people with schizophrenia violent and scary. No, not really. People with a mental illness are no more likely to get violent than anyone else. If someone is hearing voices give them some room, don’t crowd them, and for sure call for some professional help.

So don’t people who hear voices scare me? Not half as much as the person who just found out their spouse was cheating on them and now they have brought their gun to work to fix this situation.

There is a great training on what to do if you encounter someone with a mental health crisis. That program is called Mental Health First Aid. Have I mentioned that before? Check my other posts for more info. This was just a quick look at the whole area of hallucinations and mental illness. If you or someone you know has a problem in these areas please seek out professional care.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel