One Person's Description of Schizophrenia's Visual Hallucinations

One of the most informative experiences in psychotherapy I have had was working with a person with schizophrenia who possessed an unusual amount of insight and deep reservoirs of compassion and empathy. The following is based on her account of her experience with psychosis and managing social reality, using a picture to convey the imagery she experienced everyday.

She began one session by telling me and her mother that the boundaries of an image of any object she sees is a blended version of its background and foreground. She said that a three-dimensional object appears two or three dimensions, without any set rule. While she sees the object clearly, the object does not register with a pre-established schematic, categorized image in her mind, so she needs to make guesses on the object's importance and relevance.

For example, a ceramic dog is seen, but its blue color is blended with the background of the brown shelf, and the contours of the ceramic do not appear separate from the background.

In the foreground of the woman's perceptual field are the hallucinatory objects, and those objects have substance that resembles what she remembered as reality prior to her psychotic break. She knows the surrounding images in her perceptual field are real, despite their distortion, but the clear, definitive shape of the hallucination seems to have greater relevance to her reality, causing confusion and anxiety.

The discussion about her psychotic visuals were prompted by a meme she found online. She provided the image and asked us (myself and her mother) what we can identify in the image. After looking over the image, we were unable to accurately identify many objects. She tells us "this is what I see when my psychosis is high." This is the photo

As I mentioned, this individual has amazing insight into her condition, and helped us understand her experiences because she is highly verbal and accurate in her descriptions.

We surmised that in periods of high stress, activation of idle neurons begin to interfere and cross the occipital area of her brain, travelling from the amygdala into the pre-frontal cortex, leading to the production of specific, transparent visual hallucinations.

Her hallucinations are exclusively visual, but she also has uncomfortable anxiety - both of which are treated successfully with medication.

Prior to finding the right medication dose and type, her difficulties with purported crossed neuronal activation also effected the localization of bodily sensations of pleasure in uncommon parts of her body that were often accompanied by distortions of areas of a person's face. Facial distortions complicates social interactions, since a person's facial expressions serve as social cues for appropriate behavior, and with the distortions she experienced, she rightfully believed that her behavioral responses were unreliable, leading to anxiety and withdrawal.

Nevertheless, she remained a caring and compassionate person. An example of her insight was evident by a statement related to her years of pain. She stated that because of the pain she experienced early in her psychotic break, she feels for people who are suffering and wants to help them. I only wish more people could possess her compassionate attributes.