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'Real' or 'pseudo' hallucinations?

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Louise Pembroke

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Did you realise that psychiatrists are taught about 'real' 'and pseudo'hallucinations?

I'm not sure how this is ascertained.
Hallucina-o-meter?!

What's your views on this?

I know for example that people who are labelled as BPD would be viewed as having 'pseudo' hallucinations but what happens when someone is labelled as having BPD and Bi-polar? One alleged condition is supposed to demonstrate real and the other pseudo so how would they tell the difference? Then people who dissociate where do they fit in with their experiences being classified as real or not?
Voices hearers can 'dissociate' so which voice hearers would be viewed as having 'real' or 'pseudo' hallucinations?
 
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Pejay

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Hi, this is all very confusing. From what I can see, there are many different definitions of both hallucinations and pseudo hallucinations. My fear is that pseudo hallucinations are considered less serious, and therefore not deserving of treatment resources, and my question is whether the distinction is in anyway helpful in terms of differences in treatment anyway. My experience has been one of feeling that my very distressing experiences are are not believed and not taken seriously. I cannot see how my experiences differ from those I have met with 'real' hallucinations. I certainly suffer just as much and therefore feel that this is every bit as deserving as 'psychosis'. If they feel that my problems are less serious, like you I wonder at the arrogance of thinking they can compare the severity of one person's experience with another, without the ability to objectively test, and see into the consciousness of others. A hallucinometer is a great idea. At least then I could prove my experience and compare it more effectively with others. In the end I have chosen to go with a pragmatic approach, and used the definition that makes most sense to me, which leads to resources for recovery that work, which helps me to feel less different and alone. If the psychiatrists could talk to me, it would help to understand what they mean by this, as you never know it might be helpful afterall. The key issues for me are whether a diagnosis makes any sense, and feels recognisably like my experience, and whether it leads to treatment which aids my recovery, and access to a network of people with similar experiences so i don't feel alone, and can learn from the recoveries of other people.
 
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itsrubes

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If you are unwell, you can get treatment.

Are you in the UK? Going through the NHS treatment programmes is a torturous form of treatment so I wouldn't recommend going down that road unless these hallucinations are really bothering you.

If you are in the US, as I understand it if you have health insurance any psychiatrist/psychologist will be more than happy to treat you for whatever you problem, no matter how big or small its considered.
 
calypso

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Hey pejay and :welcome: to the forum.

I sometimes have voices inside my head and occasionally outside my head. The Crisis Team seemed to think the internal ones were less serious, but my pdoc thought all of them of equal severity, especially when they were commanding me to self harm regularly. So yes they may be taught this, but it is not really valid, it all depends on how it causes you to feel and act IMO. some people like to think there is a difference, but I know people who hear voices through their ears who are not distressed in the least with them, and others who hear them internally who are hurt by them. xx
 
Rowan

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My psych seemed to think the voices I heard were not that serious either because they weren't commanding me to harm someone.
 
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Lilac

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My psychiatrist thinks the non commanding voices I hear are serious. She hasn't commented on the fact that I say they're a side effect of anti-psychotic meds. My previous psychiatrist's SHO Dr W said they are figments of my imagination but I certainly can't say I imagined them up. I have heard of a Mind worker who has voices and doesn't have to take meds but my psychiatrist wouldn't do that for me, in fact she says she is personally going to make me take them for a minimum of ten - fifteen years which kind of makes her CPN DG a liar as she told me in 2002 it wouldn't be forever.
 
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Pejay

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Hi, I'm in the UK. I'm a member of the Hearing Voices network, which has helped me more than anything else. I so agree that definitions don't necessarily recognise the danger to the sufferer, nor the degree of suffering. It seems very arrogant of professionals to presume that they can categorise us and decide what is serious and what is not. I fear that this is about rationing resources. But it rather depends on what is meant. However, because it means different things to different people I think it is not helpful to use this term. It would be better to put on your notes what is happening as a full description, rather than using terms which change with the wind! One very kind psychiatrist said to me that even though I know I am having hallucinations, I am still psychotic, but that having insight gives me a better chance of recovery. If the definition is used in that way, to give people hope, I have no problem, but I think they need to change the word. Pseudo sounds 'fake', or not as real. It feels like a lower rank of problem. They could call it 'type 2', like with bipolar, to acknowledge it as different kind of hallucination, rather than not one.

I have hallucinations which involve all my senses, including pain. They are external, but invasive. They 'possess me' and insert instructions into my mind, taking hold of my body - I can feel them in my muscles, and moving under my skin. They aim to make me harm myself. In the beginning I didn't know how to stop them and I would harm myself, but their demands became ever more dangerous. I've had several crises, when the fight to stop them killing me became so desperate that I took massive overdoses to stop them. I've been admitted to hospital three times now. I've always felt that the professionals did not believe me, and they have certainly never explained anything to me. I cannot see the difference between my experiences and those of many other people whose 'hallucinations' are considered to be 'non-pseudo'. I know other people cannot see my hallucinations, but I cannot persuade myself that the beings that invade me are not real. Is that insight? I seem to be able to perform some kind of mental gymnastics in terms of accepting the medical terminology, without believing that its 'all in the mind'. Its more about finding a common language to talk about something they have never experienced and therefore can never understand. I know they can help if they choose to. I know people from the hearing voices group and network who have learnt to live with their hallucinations, a few without medication. If yours is not helping you, it might be worth asking the psychiatrist about changing rather than stopping them. They do seem to have this thing where they have to oppose you, but if you seem to be accepting their view you might be able to find a way forward that it better for you. My medication really helps. I could not have survived without it. It has taken me a very long time though to learn to use it properly. I can take it down when I'm feeling better, but if the hallucinations get worse, I have to increase the dose earlier than I used to. They are harder to stop if they become very powerful. My hallucinations seem to become stronger the more distressed, fearful or angry I am. They goad me, to increase those feelings and seem to be finding ever new ways to get me distressed, each time I find a way to stop them. But someone from the group lent me a book which helped me to reduce my distress. When I did that they became weaker, and I felt stronger. I have managed to quieten them down several times now, and each time I do it I feel more confident. As I have become more confiedent, they have changed. They nolonger try to control me, they only torture me. It still hurts, but I am no-longer scared that I will die. I feel that I will never have to go through one of those terrible crises again, never have to endure their terrible power. This is my recovery, my triumph. So what they call it is kind of academic now. However, I would really like it if we could agree about what they are. I just feel so sad to be apparently misunderstood. It might help me deal with the terrible memories I have of what happened to me. That's the worst thing now.

Anyway - enough, my son 'NEEDS' the computer now!!

Thanks for all the response - this discussion is really important.

Love Pejay
 
calypso

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Louise, how do you feel about this now you have read all the replies? Pejay is right, there should not be this distinction, although I have come across it myself. I didn't get the help I needed because they thought mine were inside my head, and so not serious. I attempted suicide in a serious way because of them, and still got told they were not serious!!
 
maxitab

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All the voices I hear are 'outside'. One comes from the computer (but only when it is turned on!). I am supposed to have BPD and Bipolar 2. I also see things, mainly furry animals, but other stuff too. I also dissociate mildly and massively.

I agree with this:
The key issues for me are whether a diagnosis makes any sense, and feels recognisably like my experience, and whether it leads to treatment which aids my recovery, and access to a network of people with similar experiences so i don't feel alone, and can learn from the recoveries of other people.
and to be honest am not bothered who classifies the voices in what way, I will always push for the treatment and support I deserve and need.
 
Blindside

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All the voices I hear are 'outside'. One comes from the computer (but only when it is turned on!). I am supposed to have BPD and Bipolar 2. I also see things, mainly furry animals, but other stuff too. I also dissociate mildly and massively.
Same thing with me i hear the voices outside my head as if i was talking to someone who is physically there and although i dont hear voices often for me these voices are 100% real not like some thought but actual sounds.
I sometimes see things moving at the side of my eye sort of like spiders running across the floor or other objects like cars when im driving but they dont have detail or colours etc it's more like a shadow/silhouette i see but when i look i realise its nothing more than my imagination.
 
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Pejay

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Hi Calipso, I'm sorry if your crisis team weren't as helpful as they might have been. I've been there and its no fun:( Firemonkee's link is to a paper which considers internal and external voices. It says that internal ones are often considered less serious because they are more like normal thought, but that most people report it is harder to fight them and that they are therefore more dangerous. I think the psychiatrists are asking the wrong questions. As far as I can see, it is the content, and how much fear, suffering and risk they cause that determines severity and need for help. So I really agree with what you are saying. luv Pejay
 
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Pejay

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Hi Maxitab, you sound doubtful about your diagnosis? You may be right to wonder. It is quite fashionable nowadays to write off women's mental distress as BPD. Have you had a full psychological assessment? That's worth pushing for, but make sure they record the results. Mine were lost, so even though the assessment concluded I did not have BPD, I am still treated as if I do. So I might just as well not have bothered. Good luck getting what you need. By the way, I love your quotes! Thankx !!
 

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