I thought I Understood Hallucinations… Until I Had One

    Working with people in mental health residential programs, I have seen my fair share of psychosis and psychotic disorders. Hallucinations are pretty common, usually auditory but sometimes visual or even tactile. Clients with a psychotic disorder will often reality check to see if you heard or saw something they did. I’ve always noticed that they seemed to trust me more than believe me.

     We’ve all heard it: hallucinations feel real, and that’s why our clients believe them. Most of us have never experienced them, so we take this information for granted.

     People with narcolepsy can struggle with hallucinations. From what I understood at the time, these are typically when you are falling asleep or waking up (called hypnagogic and hypnopompic hallucinations). I only started to experience them outside of these times this past year and now I can say that I absolutely understand why people believe in them so strongly.

Example 1: the package

    I was washing dishes and talking to Mr. TPPT. It was about 5pm and in autumn, so it was getting dark. I hadn’t had a nap yet but I felt fine. Well enough to finish the dishes, anyway.

    There was an Amazon package that was going to be delivered later that day. Typically, the delivery driver puts the package by the main door.

    I heard a scrape against the door and a thud toward the bottom, like a package had been put there. Something I realized after the fact was that I did not hear anyone go up or down the stairs. Sometimes I don’t hear people go up the steps though, so it wasn’t that strange.

    Mr. TPPT did not respond to the sounds at the door. I told him I heard the delivery person set the package down and asked him to grab it. He was surprised and said that he hadn’t heard anything. That didn’t really surprise me - he was standing further from the door and closer to the television - so it was likely that he didn’t actually hear anything.

    I asked him to get the door. He did not. He insisted that there was no one at the door and backed this claim with the fact that he did not see the Amazon van out front.

    Hmm. How could he have gotten here to drop off the package if the van isn’t outside? My Echo Show had not indicated that there was a package delivered and did not do so until a few hours later… when the package actually arrived.

    I trust Mr. TPPT with everything. He’s my ride or die, my best friend, my truest love. I didn’t check the door. He wouldn’t say that if it wasn’t true.

    BUT. I would be lying if I said that I completely believed him. Honestly, there’s still a part of me that believes that there was a package at the door, even though all the evidence says otherwise.

    It slowly dawned on me that I had been hallucinating. I have never had something like that happen when I was fully awake. Maybe I wasn’t fully awake. That was my cue to go take a nap, which I did.

Example 2: the bug

    Mr. TPPT and I were driving back from a vacation in Kentucky. I like to drive because it keeps me awake. I have never been told that I am not allowed to drive because I have never fallen asleep while driving. If I get tired, I let someone else drive. I always nap before I drive somewhere, and if I do get tired while I’m the only one in the car, I have some safe spots that I can park for a quick 15 minute refresher.

    One thing to know about me: I HATE bugs. Even butterflies. Long story short, I was traumatized by a previous job that kept getting bedbugs. Now all bugs can go to hell where they belong. (I kid, I just don’t like them crawling on me.)

    I felt a bug on my left arm while I was driving. I brushed it away and could feel its little feet scratching lightly on my skin. Naturally, I yelped because ew. Mr. TPPT asked what happened, and I told him there was a bug on my arm.

    Mr. TPPT looked gravely concerned and asked me to pull over at a gas station, which I did. He told me that there was no bug on my arm and that he thought I might have been falling asleep. I felt fine (maybe a little more tired than usual, sometimes it’s hard to tell a difference from baseline tired) but maybe I WAS too tired to drive. I spent a few minutes looking for the bug. My thought was that it was a stink bug. After some time, I admitted that there was no bug. I got into the passenger seat, where I promptly fell asleep.

    The bug felt so realistic that it really made me think. I have seen clients look for something that they insisted existed but that I knew did not.

    In that moment, I understood my clients with psychosis and psychotic disorders on a deeper level than I ever had before. My brain tricked me just like their brains trick theirs. I was ready to open the door and show Mr. TPPT the package that clearly could not have been there yet based on evidence I knew. I insisted on looking for a bug that only existed in my mind.

    It was an eye-opening set of experiences.

    Just remember, when you have clients who are hallucinating, the hallucinations are absolutely real to them. If the hallucinations are scary, comfort them. They probably will trust you but not completely believe you. That’s okay.

    It means a lot that someone would trust your word against their experience. That is a very high compliment.