Chapter
Fourteen
Reality and imagination
Far more common, however, are hallucinations that are combined with the per-
ceived world, as happens to lone explorers and climbers who see or hear imagined
companions, and to people who become blind through either retinal or brain
damage. These ‘visual release hallucinations’ attributable to partial blindness or as
part of the adaptation to severe blindness are known as Charles Bonnet syndrome
and are very common in older people who have cataracts, macular degenera-
tion, or retinal damage through diabetes. The images are usually clear and well-
defined, often featuring ‘lilliputian’ characters, animals, or rows of objects that are
smaller than usual, and rarely threatening or scary. Sometimes sufferers don’t tell
anyone about their experiences for fear that they are going mad, and they can be
much reassured by knowing that their situation is common (Ramachandran and
Blakeslee, 1998; Menon, Menon, and Dutton, 2003).
A similar phenomenon happens with encroaching deafness when people may
hear hallucinated sounds, such as hymns and ballads, choirs singing, or even
whole orchestras playing. Others hear meaningless melodies, rumbling noises, or
isolated words and phrases. Occasionally the sounds can be so realistic that the
deaf person tries to find the source and stop them. People with tinnitus, whether
temporary or long-lasting, may also sometimes hear music or voices in addition
to the usual ringing sounds or white noise.
Auditory hallucinations are one of the main symptoms of schizophrenia, and here
it is rare to have visual hallucinations without auditory ones too. Usually, however,
FIGURE 14.3 • The four form constants are found in decorations and works of art all over the world. Here spirals and lattices
form part of a Peruvian textile design. The anthropomorphised plants in the lower corners are a cactus that
produces hallucinogenic sap used for inducing visions.