If you have read anything from Oliver Sacks before you will be familiar with his engaging and informative writing style; he just grabs you and takes you on a journey that seems simple at first but as you look back across the traverse there is a strong sense of how good a teacher he must be. In the current title he performs no less a feat, taking us as he does through an exploration of hallucinations. This is a fascinating subject of which I have something more than a passing acquaintence, mostly from my past career as a psychiatric nurse. Having some knowledge might be detrimental to making an honest evaluation of the book, but I have hopefully managed this and can honestly say that this book will go a long way to informing anyone who has even a passing interest in the subject to gain a fascinating insight to its history and the experiences of those people who have first hand experience of hallucinations.
In my opinion one of the sengths that Oliver Sacks has in abundance is the ability to dispel fear; it is understandable that most people fear the idea of most forms of mental disorder, but through sharing information about the subject under cosideration Sacks helps to cure the most damaging effect of mental disorder, ignorance.
Alan Bennett once commented, probably thinking of the sad experiences of his mother and aunt, that common mental problems don't attract much interest, and that you get more attention if you do something bizarre like mistaking your wife for a hat. This might be a fair criticism of some of Sacks' earlier books, but I have to suspend judgment, as it's some time since I read the book in question.
In Hallucinations, Sacks casts his net far and wide. Some of the types of hallucination he describes are rare and exotic , e.g. Charles Bonnet syndrome in which people who were once sighted but are now blind experience vivid visual hallucinatuions. Others, however, are associated with well-known conditions, such as migraine or Parkinson's, and there is even a chapter on hallucinations which any of us could experience ("On the threshold of sleep"). We tend to think of hallucinations as visual, but Sacks covers the other senses too; for example, with hearing he covers tinnitus and then moves on to more obscure conditions.
Sacks is able to draw on his own personal experiences in two of the topics he covers. One is migraine, as he has suffered from this. The other is use of hallucinogenic drugs. He describes, with remarkable candour, how in the mid 1960s, during the postgraduate phase of his career, he would "spend the whole weekend so high that images and thoughts would become rather like controllable hallucinations." His motivation was a mixture of scientific research and opening "the doors of perception". [It must have been a tough job, but someone had to do it ...] An older psychoanalyst friend suggested to him that this behaviour "surely testified to some intense inner needs or conflicts", and this led Sacks to see a therapist.
I found the chapter on Parkinson's particularly poignant, as it accords completely with the experiences of an elderly friend who is a long-term sufferer. The title of this chapter, "illusions of Parkinsonism", relies on a distinction which recurs throughout the book: "illusions" which the subject knows to be unreal, and "hallucinations" which at the time appear genuine perceptions.
There is a fascinating contrast between those who enjoy, and even yearn for, the images produced by their condition (for someone with Charles Bonnet syndrome, you can fully understand this, as it is their only chance of reliving their sense of sight) and those who tend through shame or pride to censor the experience. For example:
"By the late 1980s, physicians had begun to realise (only in response to careful enquiry, for patients are often reluctant to admit it) that perhaps a third or more of those being treated for Parkinson's experienced hallucinations."
I have only one minor gripe: Sacks defines the technical terms used, but sometimes the definition occurs several chapters after the term's first use.
As always, Sacks, now pushing 80, manages to inform and entertain in equal measure.
The human brain works in ways we are only just beginning to understand. We tend to trust what we see as being what is actually happening but this book shows how the brain can be fooled into thinking something is there when it's actually happening inside itself. Hallucinations can happen when we're tired, half asleep or just waking up. They can happen when our eyesight has gone and when it is in some way defective. If we have a limb amputated we are still convinced the limb is there.
But hallucinations can be auditory as well as visual. People can hear music all the time or hear voices speaking to them or talking in the background. There's a tendency to think it is only schizophrenics who hear voices telling them to do things but the majority of people who hear voices are not schizophrenic. The author quotes many examples from his own patients and the case histories make fascinating reading. He also tells of his own experiences with licit and illicit drugs.
I enjoyed reading this well written and interesting book and would recommend it to anyone who wants to better understand themselves and the way their brain works. There are notes on each chapter, a bibliography which gives the reader an opportunity to read more on the subject and an index.
This is an important book.
By helping to reduce the stigma of hallucinations (including voices) that many people associate with madness (including, unfortunately, some doctors, according to Sacks), this book makes clear that hallucinations can be almost normal, and certainly much commoner than expected.
Time after time, patients don't admit to hallucinations until a doctor, with the right approach, asks. Generally, it seems, the question is not asked and so there is a general ignorance, which this book helps put to rights.
The brain is an amazing organ, and builds a picture of reality. I'd rather Oliver Sacks went into greater detail on how the brain does this - but obviously much is unknown and arguable. If sensory input is lacking, the brain tries to compensate, and may over do it. Almost anyone can experience this - just by looking at a blank wall in silence for long enough ("the prisoner's cinema"). Sensory input can be considered "bottom up" - there's also lack of "top down" control that can occur in epileptic fits, trauma (including loss of a long-loved spouse) that also can cause hallucinations. Sacks pretty much destroys transcendental effects (as in religions, meditation, near-death experiences etc) on this basis.
When freed of sensory input, hallucinations can go beyond worldly perceptions, such as the vividness and range of colours being greater than ever seen. Although frequently spoken of by those who've experienced hallucinations, they can be easily dismissed by those who've not experienced them. Not Sacks though - as he gives an unfettered account of his drug-taking years in the 1960's. It takes a strong mind to have survived as he did. Possibly he should have balanced this with the damage drugs can do and did to others - he does so in passing, but I feel the warnings could have been stronger. Some of the drugs were legal at the time (not clear which were and were not, though).
Although aimed at the general reader, it's not always an easy book to read, indeed is sometimes quite formal. There are copious footnotes, often fascinating.
I couldn't help thinking "what???" when a few times people had hallucinations while driving, and apparently continued driving despite knowing they could have further hallucinations, or driving and developing the skill to ignore them. Scary.
Overall though, a book crying out to be read, to bring better awareness and understanding of hallucinations.
on 15 January 2013
The early chapters of this book with the descriptions and explanations of the various types of hallucination suffered by people with Charles Bonnet Syndrome were most interesting. Then there were descriptions of the authors own experiments with hallucinogenic drugs, then hallucinations connected with various other states such as narcolepsy. Somehow the book didn't seem to hold together for me. I was also disappointed that there was little in depth discussion of the hallucinations and delusions associated with dementia though the subject was referred to. Perhaps my expectations were at fault. A large portion of the book is devoted to notes and references so would be useful to the psychology / medical student
I'm in two minds about this book. On the one hand, Sacks writes in his signature engaging, accessible manner to demystify more than a dozen types of auditory, olfactory and visual hallucinations. He presents us with interesting snippets of numerous people's lives together with recent and not-so-recent historical context and shows, once again, that the mind is endlessly fascinating.
On the other hand, the book's premise that nice, normal people can have hallucinations for all sorts of rational, medically-explained reasons quite separate to mental illness perpetuates the sense of otherness surrounding diagnoses like schizophrenia. Rather than portraying mental illness as a part of the human continuum, just like any other illness, schizophrenia is banished from the book as if to a modern day leper colony.
If you've read Oliver Sacks' work before, you'll be familiar with his style and thorough treatment of his subject matter. If you haven't, then take a look in the nifty "Look inside" feature, where you'll also find all the chapter headings.
As a popular science book, it does a does a good job of demonstrating that all kinds of people experience hallucinations. These range from people with migraine, epilepsy and alcoholism to those taking (or suddenly stopping) street and prescription drugs. There are the hallucinations that can accompany loss of eyesight, hearing and limbs. Examples are taken from Sacks' own patients as well as history. As a neuroscientist, Sacks looks at the brain mapping technologies that can help us peer inside to gain a partial insight into what's happening when the brain hallucinates.
One example from recent history referred to in the book is the infamous Rosenhan experiment in the 1970s, reported at the time as "On being sane in insane places". It's a fascinating story, which caused a furore and lead to a major revision in how psychiatric diagnoses were arrived at.
Overall, the book is a interesting read. If it encourages people who experience troublesome hallucinations to seek help without fearing they will be automatically labelled mentally ill, that's a good thing. It's just a shame that the book's premise that, "Hallucinations don't belong wholly to the insane" should be so stigmatising; however I can see that, from a marketing point of view, it makes perfect sense to focus on what could be called "Hallucination Lite".
Reading endless accounts of other people's hallucinations is a bit like hearing other people narrate their dreams in great detail. Day after day. I found the explanations about why people experience hallucinations both interesting and illuminating, and from that standpoint this is an important book and deserves to be widely read. But I got pretty bored with yet another zig-zag pattern or little people wandering around the ceiling or disembodied voices giving instructions. I understand a lot more now, and for that I am grateful, but oh my goodness, please never tell me your latest hallucination. I've most likely already heard it.
I admit I wanted this book solely as I experience migraine aura, and I wanted to see if the author had any new opinion on them since his 1992 book Migraine (now republished and remains the best book I've ever read on the subject). I don't have an interest in hallucinations generally, so expected to read the migraine chapter and skim the rest. It didn't work out that way.
After reading the migraine chapter (short but brilliant) I was so engrossed that I went back to the start and read the whole book. Just like the Migraine book, this book is fabulously engaging and relates directly to every day life, not simply to people around those who experience hallucinations for health reasons, but for everyone that's ever made a face out of shadow in a doorway or been haunted by repeatedly `seeing' a fear.
Oliver Sacks has an amazing way of presenting medical/biological writing in an accessible way without dumbing down the subject matter (although I could have done with a note about what "magtnetoencephalography" was!), and taking what would seem to be a field of limited interest and turning it into a book relevant to day-to-day life.
(NB, the migraine aura conclusions in this book are pretty much the same as in the Migraine book.)
on 22 June 2013
I'm a great Oliver Sacks fan anyway - he's such a humane writer on mental 'otherness' - and I wasn't disappointed by his foray into hallucinations. It seems to be a vastly under-researched and under-reported phenomenon, associated strongly with debilitating mental illness when, in fact, many 'sane' people experience hallucinations - and know them for what they are - without ever reporting what they experience. Well worthy reading - as ever from Dr Sacks.
on 9 April 2016
Quick delivery and looks a really good book. If you are interested in the unconscious mind this is a must have book. I have to finish the book I'm on but had a quick look and Oliver has a way of drawing you in. So I'm now rushing my present book that I'm on to enjoy this new one.