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Oliver Sacks on neuropsychiatric weirdness and ‘Hallucinations’

"Hallucinations" by Oliver Sacks

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Dr. Oliver Sacks is a physician, professor of neurology, and best selling author. His books, notably “The Man Who Mistook His Wife For a Hat,” “Musicophilia,” and “The Mind’s Eye” have captivated large audiences because of their ability to combine the intrigue of neuroscience and psychology with engaging narratives and stories.

Sacks’s latest, “Hallucinations,” explores peculiar sensations of things that aren’t really there, not as a sign of madness but as a commonplace occurrence in humans. According to Publisher’s Weekly, Sacks approaches the weird neuropsychiatry “as both a brain scientist and a humanist,” a tactic that makes “Hallucinations” a fascinating read for a wide audience.

He spoke with Larry Mantle about his expertise on the subject of hallucinations, including diving into his personal experimentation and the method to his not so-called madness.

Interview Highlights:

On Sack’s introduction to drug culture while he was doing his neurological residency at UCLA in the 1960s:
“Well, you know, this was a time when we were getting a lot of new knowledge about chemistry in the brain, and transmitters, and it also coincided with something of a drug culture in California. I wasn’t quite a youth. I was 30 when I first tried some pot, some cannabis. And I took one breath. I’d been gazing at my hand and it seemed, somehow, to occupy the whole visual field, but also to get, to retreat from me and to get larger all the while until it was like a cosmic hand across the universe. I found that very astonishing and I think I said in the book, it was like a mix of neurology and divinity.”

On the aftermath of Sack’s drug experimentation and his orientation to the surrounding world:
“Well, I think it certainly made me sensitive to lots of things my patients would tell me about, what they had experienced in migraines, or with seizures, or what awakenings my patients experienced. But that was sort of a bonus. I took the drugs out of curiosity. And I suppose because I wanted to explore other states of consciousness. There was one experience, right at the end, when I had been reading an old book from the 1860s under amphetamine, and the book seemed to me wonderful beyond measure. And I felt, I was sort of gazing into the neurological heavens, and migraine was shining there. And I know this sounds like nonsense, it sounds like nonsense to me now, but that was how the vision seemed. And that tipped me into writing and writing my first book, which was on migraine. And basically, I think, tipped me into a sort of imagination and creativity, which on the whole has been with me ever since. And so I never took drugs again. I think this would have happened anyhow, but I think the drug made it more sudden and dramatic.”

On the functional aspect on whether hallucinations are a sensory or ecstatic expression as a type of coping mechanism:
“Well, I think there is a sort of continuum between the simple perceptions and sensory hallucinations and sort of, ecstatic ones. Some people with epilepsy have ecstatic seizures and in this same way get a sudden feeling of bliss, of rapture, they may feel they are in heaven, they may feel they are communing with God, and this may also even happen in someone who apparently didn’t have a single jot of religious disposition before. And certainly that sort of experience can lead to a conversion and sometimes, one enraptured convert will convert others. As seems to have happened with Joan of Arc.”

On the different kinds of hallucinations:
“Well, I don’t say much about all the hallucinations of schizophrenics. They really need a separate book. But these accusations, what they hear are often accusations, or jeerings, they are personally directed. And they are mostly very very pleasant. And they are associated with fantasies of the mind. It much commoner to have a fantasy to have a sort of benign auditory hallucination, like hearing one’s name or sometimes hearing a phone ring. And probably about 10% of the population have simple auditory hallucinations like this. There may also be auditory voice hallucinations, which are very protective. One of the cases histories in my book is of a young woman with a broken heart about to commit suicide with a bottle of sleeping pills in one hand, she suddenly heard a voice saying, “don’t do that” and adding, “you won’t always feel as you’re feeling now.” And she didn’t recognize the voice. It was a man’s voice. It was a glimmering figure that appeared for a few seconds. But basically, I think she was saved from suicide from this. And there are many stories of this sort.”

On the explanation of certain hallucinations, like one woman saved from suicide:
“Well, although she jokes and says this was her guardian angel, she really knows this must have been some very deep part of her, which took charge. But, one can’t have hallucinations on command. They come in their own way. Sometimes, from sensory areas in the brain, where there is no particular meaning. But sometimes from a very deep level, and they save a life.


Oliver Sacks, M.D., author of "Hallucinations," physician, professor of neurology at NYU School of Medicine.  His previous books include "The Man Who Mistook His Wife for a Hat," "Musicophilia" and "Awakenings."