Hallucinations must have some innate structure in the nervous system underlying them. We can see this clearly by studying the matter in those who have been profoundly deaf since birth or very early childhood. For even they can — somehow — experience auditory hallucinations. This is commonly seen in deaf schizophrenics. In one study, 16 out of 22 hallucinating, profoundly deaf schizophrenics insisted they had heard some kind of communication.10 One thirty-two-year-old woman, born deaf, who was full of self-recrimination about a therapeutic abortion, claimed she heard accusations from God. Another, a fifty-year-old congenitally deaf woman, heard supernatural voices which proclaimed her to have occult powers.
The Visual Component
Visual hallucinations in schizophrenia occur less commonly, but sometimes with extreme clarity and vividness. One of my schizophrenic subjects, a vivacious twenty-year-old writer of folk songs, had been sitting in a car for a long time, anxiously waiting for a friend. A blue car coming along the road suddenly, oddly, 10 J. D. Rainer, S. Abdullah, and J. C. Altshuler, "Phenomenology of hallucinations in the deaf" in Origin and Mechanisms of Hallucinations, Wolfram Keup, ed.
(New York: Plenum Press, 1970), pp. 449-465.
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slowed, turned rusty brown, then grew huge gray wings and slowly flapped over a hedge and disappeared. Her greater alarm, however, came when others in the street behaved as if nothing extraordinary had happened. Why? Unless all of them were somehow in league to hide their reactions from her. And why should that be? It is often the narratization of such false events by consciousness, fitting the world in around them in a rational way, that brings on other tragic symptoms.
It is interesting that profoundly deaf schizophrenics who do not have auditory hallucinations often have visual hallucinations of sign language. A sixteen-year-old girl who became deaf at the age of eight months indulged in bizarre communication with empty spaces and gesticulated to the walls. An older, congenitally deaf woman communicated with her hallucinated boyfriend in sign language. Other deaf patients may appear to be in constant communication with imaginary people using a word salad of signs and finger spelling. One thirty-five-year-old deaf woman, who lost her hearing at the age of fourteen months, lived a life of unrestrained promiscuity alternating with violent temper outbursts. On admission, she explained in sign language that every morning a spirit dressed in a white robe came to her, saying things in sign language which were at times frightening and which set the pace of her mood for the day. Another deaf patient would spit at empty space, saying that she was spitting at the angels who were lurking there. A thirty-year-old man, deaf since birth, more benignly, would see little angels and Lilliputian people around him and believed he had a magic wand with which he could achieve almost anything.
Occasionally, in what are called acute twilight states, whole scenes, often of a religious nature, may be hallucinated even in broad daylight, the heavens standing open with a god speaking to the patient. Or sometimes writing will appear before a patient as before Belshazzar. A paranoid patient saw the word poison in the air at the very moment when the attendant made him take
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his medicine. In other instances, the visual hallucinations may be fitted into the real environment, with figures walking about the ward, or standing above the doctor's head, even as I suggest Athene appeared to Achilles. More usually, when visual hallucinations occur with voices, they are merely shining light or cloudy fog, as Thetis came to Achilles or Yahweh to Moses.
The Release of the Gods
If we are correct in assuming that schizophrenic hallucinations are similar to the guidances of gods in antiquity, then there should be some common physiological instigation in both instances. This, I suggest, is simply stress. In normal people, as we have mentioned, the stress threshold for release of hallucinations is extremely high ; most of us need to be over our heads in trouble before we would hear voices. But in psychosis-prone persons, the threshold is somewhat lower; as in the girl I described, only anxious waiting in a parked car was necessary.
This is caused, I think, by the buildup in the blood of breakdown products of stress-produced adrenalin which the individual is, for genetical reasons, unable to pass through the kidneys as fast as a normal person.
During the eras of the bicameral mind, we may suppose that the stress threshold for hallucinations was much, much lower than in either normal people or schizophrenics today. The only stress necessary was that which occurs when a change in behavior is necessary because of some novelty in a situation. Anything that could not be dealt with on the basis of habit, any conflict between work and fatigue, between attack and flight, any choice between whom to obey or what to do, anything that required any decision at all was sufficient to cause an auditory hallucination.
It has now been clearly established that decision-making (and I would like to remove every trace of conscious connotation from the word 'decision') is precisely what stress is. If rats have to
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cross an electric grid each time they wish to get food and water, such rats develop ulcers.11 Just shocking the rats does not do this to them. There has to be the pause of conflict or the decision-making stress of whether to cross a grid or not to produce this effect. If two monkeys are placed in harnesses, in such a way that one of the monkeys can press a bar at least once every twenty seconds to avoid a periodic shock to both monkeys' feet, within three or four weeks the decision-making monkey will have ulcers, while the other, equally shocked monkey will not.12
It is the pause of unknowingness that is important. For if the experiment is so arranged that an animal can make an effective response and receive immediate feedback of his success, executive ulcers, as they are often called, do not occur.13
So Achilles, repulsed by Agamemnon, in decision-stress by the gray sea, hallucinates Thetis out of the mists. So Hector, faced with the decision-suffering of whether to go outside the walls of Troy to fight Achilles or stay within them, in the stress of the decision hallucinates the voice that tells him to go out. The divine voice ends the decision-stress before it has reached any considerable level. Had Achilles or Hector been modern executives, living in a culture that repressed their stress-relieving gods, they too might have collected their share of our psychosomatic diseases.
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We must not leave this subject of the hallucinatory mechanism without facing up to the more profound question of why such 11 W. L. Sawrey and J. D. Weisz, "An experimental method of producing gastric ulcers," Journal of Comparative and Physiological Psychology, 1956, 49: 269—270.
12 J. V. Brady, R. W. Porter, D. G. Conrad, and J. W. Mason, "Avoidance behavior and the development of gastro-duodenal ulcers," Journal of the Experimental Analysis of Behavior, 1958, 1: 69-72.
13 J. M. Weiss, "Psychological Factors in Stress and Disease," Scientific American, 1972, 226: 106.
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voices are believed, why obeyed. For believed as objectively real, they are, and obeyed as objectively real in the face of all the evidence of experience and the mountains of common sense.