Transcript for Oliver Sacks on "Hallucinations"

Jim Fleming: Do you think you have to be crazy to see or hear something that's not there? Hallucinations can be the result of mental disease. But they can also be caused by injuries, intoxication, or even just falling asleep. Neurologist Oliver Sacks' new book, "Hallucinations," explores his patients' and his own experience of seeing things. Sacks tells Steve Paulson how he defines a hallucination.

Oliver Sacks: The old term apparition, I think, gives a sense of the sudden appearance of a person or an object in front of one in the outside world, coming without one's consent, without one willing it, and in a way which is extremely different from imagination. With imagination, you build up an image, you know that you're the one who is imagining, whereas a hallucination seems to come from outside, or from nowhere, and it suddenly bursts into your consciousness, whether it's a hallucination of a sight, a sound, a smell. And hallucinations often are very much more detailed than images, and they resemble perceptions.

Steve Paulson: Can you give me some sense of the range, the variety of hallucinations?

Sacks: Yes, there may be very simple ones like blobs of color or geometrical patterns. There may be more complex ones like seeing people, or faces, or animals, or landscapes. There may be even more complex ones with a mystical or religious component, and sort of everything in between.

Paulson: You are a neurologist, so you have a professional interest in these matters. But my sense is that the whole business of hallucinations is of great personal interest to you as well, because you've had some intense experiences of your own. What kinds of hallucinations have you had?

Sacks: Probably the first I had, and which I continue to have occasionally, are attacks of migraine, visual migraine, but here the hallucinations are of a very simple, repetitive sort in which you tend to see brilliant zigzag, scintillating crescents in the visual field, and often patterns of lattices or other geometrical patterns. In the 1960s when I was in California and doing my neurology residency I had some experience of various drugs.

Paulson: Which you write about in some detail, and I have to say, it's quite fascinating to read about your experiences with hallucinogens. When did this start?

Sacks: It started in '63, and naturally ended in '67. I tried a range of substances then, partly out of curiosity, and partly recreationally, because I wanted pleasure, and I think partly in the hope of kick-starting some sort of change in myself, because I felt like my imagination and intellectual energy was not good. I felt it had been good when I was a youngster and I had a passion for chemistry, and I knew all sorts of intellectual and other incandescences then, and I wanted some incandescence back.

Paulson: So you tried LSD, mescaline, and other things as well? Sacks: And amphetamine, and opioids, and a strange drug usually used for treating Parkinson's disease called Artane, except I took 20 times the dose which a Parkinsonian patient would take.

Paulson: So you were serious about this, and in fact, you write that you often took these drugs weekly, sometimes even more than that.

Sacks: I would tend to stick to weekends. I didn't want to be stoned at work, but I think I was always alone and I think I often took large doses, and I think I was lucky to survive. And I do not recommend such behavior to anyone else.

Paulson: Caveat taken. So what kinds of experiences did you have?

Sacks: Well, with things like cannabis and LSD and mescaline and Morning Glory seeds I had the usual, the often described heightening of visual perception, and the sense often of great beauty and sometimes a mystical or luminous beauty of everything around me, the sort of thing which Aldous Huxley describes so well in his books. But there were some other sorts of hallucination as well. When I took a large dose of morphine, which I especially do not recommend, I had a very elaborate hallucination of witnessing a battle. I saw thousands of soldiers drawn up for contest, and silken tents, and I "realized" that I was seeing Agincourt, the Battle of Agincourt, in 1415. I completely lost the sense that I was lying on my bed stoned. I somehow seemed to, felt like a historian seeing Agincourt from a celestial viewpoint.

Paulson: So you felt like you were there, not on the battlefield, but you felt like you had lost your sense of being in your own place, and, I mean, you had been transported to Agincourt?

Sacks: Yeah, I was transported to an aerial viewpoint above Agincourt. Then the experience faded. I thought it had only lasted a few minutes, but it turned out that it had lasted 13 hours, and this frightened me. I realized how one could get into an opium stupor for days at a time, and I never took morphine again. But I'm glad I took it once, so I knew what it would be like.

Paulson: How do explain those visions, I mean, that sort of conjuring up the image of watching over the Battle of Agincourt?

Sacks: well, I think this was in my mind somewhat because I'd just been reading "Froissart's Chronicles," the chronicles by this French medieval historian. I'd also been reading "Henry V" and so I think this was the realm from which my hallucination was constructed. But this was not ordinary imagination. It was absolutely real, and I think in this sort of hallucination you find that the sensory parts of the brain, and the emotional parts of the brain, the visual system, whatever, are being highly stimulated, as they would be if one were actually observing the scene.

Paulson: Of course it seems to me that the great mystery is why you would come up with the particular visions that you had. I mean it's one thing to take the drug and even if you've been reading about this particular period in history, it still begs the question, why those images, why did they get conjured up in your mind?

Sacks: I don't know that one can always give an explanation. There's a particular form of hallucination which I talk about a lot, in fact, at the very beginning of the book, in which people with impaired vision or blindness get visual hallucinations. These were originally described in the 18th century by a naturalist called Charles Bonnet. His grandfather had these visions. His grandfather dictated a very detailed account of them, and when the grandfather's book was lost for 150 years, but it was found and published in the beginning of the 20th century, and psychiatrists were fascinated, and they thought this would be like dreams, and they might be able to make detailed interpretations of the hallucinations, see them as a royal road to the unconscious. But this didn't work, and it tends not to work with most hallucinations, although it may work in relation to schizophrenic hallucinations, which are intimately tied to all the fears and hopes and thoughts and complexes of a person. But I don't really talk about those in my book. I think they need a separate book.

Paulson: Now you said that one of the reasons why you tried hallucinogens over this period of several years is you wanted to experience the numinous, the transcendent. Do you feel like you had those experiences?

Sacks: Yes and no. I'd been thinking about indigo, and the way in which no two people agree as to what indigo looked like. I made a sort of chemical launch pad with amphetamine and acid and cannabis, and said I want to see indigo now. Suddenly, as if thrown by a paint brush, this trembling blob of luminous, numinous indigo appeared on the wall. Amongst other things I thought to myself, this is the color of heaven. This is the color which Giotto tried to get when getting heaven. Now I'm an old Jewish atheist, and at the time I was a young Jewish atheist. I have no belief in heaven, or anything else supernatural or paranormal. But the feeling was there and it was a wonderful feeling.

Paulson: You also write about one auditory hallucination that you had that you say may have saved your life. You were climbing a mountain in Norway. Can you explain what happened?

Sacks: Yeah, well, I had a nasty accident and tore off the great muscle mass from the front of the thigh on one leg, and this was more disabling than a broken leg. I was alone, no one knew where I was. I improvised a sort of splint and started to push myself down the mountain. There was one point where I got very exhausted and thought I would like to sleep a little bit, and a rather clear voice said "that would be fatal," and "get up, get going, find a pace you can keep up, and do it." And this clear, commanding, incisive, almost emotionless voice was something which I felt I had to obey, and which I think, in a sense, saved my life. Paulson: When you say a voice, it's something you heard? I mean, it was a voice? Sacks: It was an auditory experience. It was sensuous, as if someone outside had spoken to me and shouted it in my ear, whereas of course I realized it was a hallucination, but it was a very beneficent hallucination.

Fleming: Neurologist Oliver Sacks is the author of "Hallucinations."  He spoke with Steve Paulson.

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