Hallucinations can involve any one of the five senses, either individually or in combination. The more we understand about how hallucinations are formulated, the greater our chances are of finding more effective ways of treating them.
Over the past decade or so there has been something of a resurgence of interest in hallucinations and some of the other thought processes associated with schizophrenia. Developments in software technology, for example, have provided psychologists the means to construct virtual environments in which to study the thought processes of people more closely and with a greater degree of accuracy than ever before. In one such example the user walks through a virtual library where they come across both male and female characters who adopt neutral or open expressions. During experiments it has been noted that some users react positively to the characters, some with indifference, but some display reactions consistent with paranoid thinking by stating the characters were hostile or rude. It has been found that the people who display paranoid reactions in the experiment have more paranoid thoughts generally and seem prone to greater sensitivity and anxiety.
The previous example focuses on paranoid thinking but this has a number of parallels with the way in which hallucinations appear to be formulated. Hallucinations are believed to be a form of ‘internal' misinterpretation which then assume an ‘external' source. For example, inner speech is not recognized for what it is and is therefore interpreted as an external voice.
The breakdown in the ability to self-monitor internal processes has itself been the subject of some new experimental techniques. In one experiment participants are asked to put on earphones and to read out a list of words. The words are then played back through the earphones using the persons own voice, with or without a distortion, or someone else's voice. The person then has to say whether the voices they hear are their own or whether they belong to someone else. It is noticeable that people who experience auditory hallucinations also tend to attribute their own ‘distorted' voice to someone else, suggesting an inability to self-monitor.
It appears to be the case that hallucinations have more than one cause. Hallucinations that cause distress are the main focus of psychological intervention. As with any interpersonal relationship, people who hear voices can experience easy going or very hostile associations. Cognitive behavioral therapy is a collaborative approach to dealing with the distress that can be caused by hallucinations. The priority is always to do with finding ways to reduce the distress and then finding ways to understand how the hallucination is constructed by the person. This is invariably within a context of learning more about the persons' self-esteem, self-worth, anxieties and life circumstances.
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