Authors: Oliver Sacks
Total visual deprivation is not necessary to produce hallucinations—visual monotony can have much the same effect. Thus sailors have long reported seeing things (and perhaps hearing them, too) when they spent days gazing at a becalmed sea. It is similar for travelers riding across a featureless desert or polar explorers in a vast, unvarying icescape.
Soon after World War II, such visions were recognized as a special hazard for high-altitude pilots flying for hours in an empty sky, and it is a danger for long-distance truckers focused for hours on an endless road. Pilots and truckers, those who monitor radar screens for hours on end—anyone with a visually monotonous task is susceptible to hallucinations. (Similarly, auditory monotony may lead to auditory hallucinations.)
In the early 1950s, researchers in Donald Hebb’s laboratory at McGill University designed the first experimental study of prolonged perceptual isolation, as they called it (the term “sensory deprivation” became popular later). William Bexton and his colleagues investigated this with fourteen college students immured in soundproof cubicles for several days (except for brief time out for eating and going to the toilet), wearing gloves and cardboard cuffs to reduce tactile sensation and translucent goggles which allowed only a perception of light and dark.
At first the test subjects tended to fall asleep, but then, on awakening, they became bored and craved stimulation—stimulation not available from the impoverished and monotonous environment they were in. And at this point, self-stimulation of various sorts began: mental games, counting, fantasies, and, sooner or later, visual hallucinations—usually a “march” of hallucinations from simple to complex, as Bexton et al. described:
In the simplest form the visual field, with the eyes closed, changed from dark to light colour; next in complexity were dots of light, lines, or simple geometrical patterns. All 14 subjects reported such imagery, and said it was a new experience to them. Still more complex forms consisted in “wall-paper patterns,” reported by 11 subjects, and isolated figures or
objects, without background (e.g., a row of little yellow men with black caps on and their mouths open; a German helmet), reported by seven subjects. Finally, there were integrated scenes (e.g., a procession of squirrels with sacks over their shoulders marching “purposefully” across a snow field and out of the field of “vision”; prehistoric animals walking about in the jungle). Three of the 14 subjects reported such scenes, frequently including dreamlike distortions, with the figures often being described as “like cartoons.”
While these images first appeared as if projected onto a flat screen, after a time they became “compellingly three-dimensional” for some of the subjects, and parts of a scene might become inverted or pivot from side to side.
After being initially startled, the subjects tended to find their hallucinations amusing, interesting, or sometimes irritating (“their vividness interfered with sleep”) but without any “meaning.” The hallucinations seemed external, proceeding autonomously, with little relevance or reference to the individual or situation. The hallucinations usually disappeared when the subjects were asked to do complex tasks like multiplying three-figure numbers, but not if they were merely exercising or talking to the researchers. The McGill researchers reported, as many others have, auditory and kinesthetic hallucinations as well as visual ones.
This and subsequent studies aroused enormous interest in the scientific community, and both scientific and popular efforts were made to duplicate the results. In a 1961 paper, John Zubek and his colleagues reported, in addition to hallucination, a change in visual imagery in many of their subjects:
At various intervals … the subjects were asked to imagine or visualize certain familiar scenes, for example, lakes, countryside, the inside of their homes, and so forth. The majority of the subjects reported that the images which they conjured up were of unusual vividness, were usually characterized by bright colours, and had considerable detail. All these subjects were unanimous in their opinion that their images were more vivid than anything they had previously experienced. Several subjects who normally had great difficulty visualizing scenes could now visualize them almost instantly with great vividness.… One subject … could visualize faces of former associates of a few years back with almost picture-like clarity, a thing which he was never able to do previously. This phenomenon usually appeared during the second or third day and, in general, became more pronounced with time.
Such visual heightenings—whether due to disease, deprivation, or drugs—can take the form of enhanced visual imagery or hallucination or both.
I
n the early 1960s, sensory deprivation tanks were designed to intensify the effect of isolation by floating the body in a darkened tank of warm water, which removed not only any sense of bodily contact with the environment but also the proprioceptive sense of the body’s position and even its existence. Such immersion chambers could produce “altered states” much more profound than those described in the original experiments. At the time, such sensory deprivation tanks were sought out as avidly as (and sometimes combined with)
“consciousness-expanding” drugs, which were more widely available then.
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There was a great deal of research on sensory deprivation in the 1950s and 1960s (a 1969 book edited by Zubek entitled
Sensory Deprivation: Fifteen Years of Research
listed thirteen hundred references)—but then scientific interest, like popular interest, started to peter out, and there was relatively little research until the recent work of Alvaro Pascual-Leone and his colleagues (Merabet et al.), who designed a study to isolate the effects of pure visual deprivation. Their subjects, though blindfolded, were able to move around freely and “watch” TV, listen to music, walk outside, and talk to others. They experienced none of the somnolence, boredom, or restlessness the earlier test subjects had shown. They were alert and active during the daytime, when they carried tape recorders so they could take immediate note of any hallucinations. They enjoyed calm, restful sleep at night, and each morning they dictated what they could remember of their dreams—dreams that did not seem significantly altered by their being blindfolded.
The blindfolds, which allowed the subjects to close or move their eyes, were worn continuously for ninety-six hours. Ten of the thirteen subjects experienced hallucinations, sometimes during the first hours of blindfolding, but always by the second day, whether their eyes were open or not.
Typically the hallucinations would appear suddenly and
spontaneously, then disappear just as suddenly after seconds or minutes—although in one subject, hallucination became almost continuous by the third day. The subjects reported a range from simple hallucinations (flashing lights, phosphenes, geometrical patterns) to complex ones (figures, faces, hands, animals, buildings, and landscapes). In general, the hallucinations appeared full-fledged, without warning—they never seemed to be built up slowly, piecemeal, like voluntary imagery or recall. For the most part, the hallucinations aroused little emotion and were regarded as “amusing.” Two subjects had hallucinations which correlated with their own movements and actions: “I have the sensation that I can see my hands and my arms moving when I move them and leaving an illuminated trail,” said one subject. “I felt like I was seeing the pitcher while I was pouring the water,” said another.
Several subjects spoke of the brilliance and colors of their hallucinations; one described “resplendent peacock feathers and buildings.” Another saw sunsets almost too bright to bear and luminous landscapes of extraordinary beauty, “much prettier, I think, than anything I have ever seen. I really wish I could paint.”
Several mentioned spontaneous changes in their hallucinations; for one subject, a butterfly became a sunset, which changed to an otter and, finally, a flower. None of the subjects had any voluntary control over their hallucinations, which seemed to have “a mind” or “a will” of their own.
No hallucinations were experienced when subjects were engaged in challenging sensory activity of another mode, such as listening to television or music, talking, or even attempting to learn Braille. (The study was concerned not only with hallucinations but with the power of blindfolding to improve and
heighten tactile skills and the ability to conceive of space and the world around one in nonvisual terms.)
Merabet et al. felt that the hallucinations reported by their subjects were entirely comparable with those experienced by patients with Charles Bonnet syndrome, and their results suggested to them that visual deprivation alone could be a sufficient cause for CBS.
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B
ut what exactly is going on in the brains of such experimental subjects—or in the brains of pilots who crash in cloudless blue skies, or truckers who see phantoms on an empty road, or prisoners watching their enforced “cinema” in darkness?
With the advent of functional brain imaging in the 1990s it became possible to visualize, at least in gross terms, how the brain might respond to sensory deprivation—and, if one was lucky (hallucinations are notoriously fickle, and the inside of an fMRI machine is not an ideal place for delicate sensory experiences), one might even catch the neural correlates of a fugitive hallucination. One such study, by Babak Boroojerdi and his colleagues, showed an increase in the excitability of the visual cortex when subjects were visually deprived, a change that occurred within minutes. Another group of researchers, in the neuroscience lab led by Wolf Singer, studied a single subject, a visual artist with excellent powers of visual imagery (an article on this by Sireteanu et al. was published in 2008).
The subject was blindfolded for twenty-two days and spent several sessions in an fMRI machine, where she was able to indicate the exact times her hallucinations appeared and disappeared. The fMRI showed activations in her visual system, both in the occipital cortex and in the inferotemporal cortex, in precise coincidence with her hallucinations. (When, by contrast, she was asked to recall or imagine the hallucinations using her powers of visual imagery, there was, additionally, a good deal of activation in the executive areas of the brain, in the prefrontal cortex—areas that had been relatively inactive when she was merely hallucinating.) This made it clear that, at a physiological level, visual imagery differs radically from visual hallucination. Unlike the top-down process of voluntary visual imagery, hallucination is the result of a direct, bottom-up activation of regions in the ventral visual pathway, regions rendered hyperexcitable by a lack of normal sensory input.
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he deafferentation tanks used in the 1960s produced not only visual deprivation but every other sort of deprivation: of hearing, touch, proprioception, movement, and vestibular sensation, as well as, to varying degrees, deprivation of sleep and social contact—any of which may in themselves lead to hallucinations.
Hallucinations engendered by immobility, whether from motor system disease or external constraints, were frequently seen when polio was rampant. The worst afflicted, unable even to breathe by themselves, lay motionless in coffinlike “iron lungs” and would often hallucinate, as Herbert Leiderman and his colleagues described in a 1958 article. The immobility produced
by other paralyzing diseases—or even splints and casts for broken bones—may likewise provoke hallucinations. Most commonly these are corporeal hallucinations, in which limbs may seem to be absent, distorted, misaligned, or multiplied; but voices, visual hallucinations, and even full-blown psychoses have been reported, too. I saw this especially with my postencephalitic patients, many of whom were, in effect, enclosed in immoveable parkinsonism and catatonia.
Sleep deprivation beyond a few days leads to hallucination, and so may dream deprivation, even with otherwise normal sleep. When this is combined with exhaustion or extreme physical stress, it can be an even more potent source of hallucinations. Ray P., a triathlete, described one example:
Once, I was competing in the Ironman Triathlon in Hawaii. I was not having a good race, I was overheated and dehydrated—miserable. Three miles into the marathon portion of the race, I saw my wife and my mom standing on the side of the road. I ran over to them to say I would be late to the finish line, but when I reached them and began telling my tale of woe, two complete strangers who did not even remotely resemble my wife and mother looked back at me.
The Hawaiian Ironman Triathlon, with its extreme temperatures and long hours of monotony under grueling conditions, can provide an athlete with a fertile venue for hallucination, much the same as the vision quest rites of passage of Native Americans. I have seen Madame Pele, the Hawaiian Volcano and Fire Goddess, at least once out there in the lava fields.
Michael Shermer has spent much of his life debunking the paranormal; he is a historian of science and the director of the
Skeptics Society. In his book
The Believing Brain
, he provides other examples of hallucinations in marathon athletes, like those of the mushers competing in the Iditarod dogsled race:
Mushers go for 9–14 days on minimum sleep, are alone except for their dogs, rarely see other competitors, and hallucinate horses, trains, UFOs, invisible airplanes, orchestras, strange animals, voices without people, and occasionally phantom people on the side of the trail or imaginary friends.… A musher named Joe Garnie became convinced that a man was riding in his sled bag, so he politely asked the man to leave, but when he didn’t move Garnie tapped him on the shoulder and insisted he depart his sled, and when the stranger refused Garnie swatted him.
Shermer, an endurance athlete himself, had an uncanny experience while competing in a grueling bike marathon, which he later described in his
Scientific American
column:
In the wee hours of the morning of August 8, 1983, while I was traveling along a lonely rural highway approaching Haigler, Neb., a large craft with bright lights overtook me and forced me to the side of the road. Alien beings exited the craft and abducted me for 90 minutes, after which time I found myself back on the road with no memory of what transpired inside the ship.… My abduction experience was triggered by sleep deprivation and physical exhaustion. I had just ridden a bicycle 83 straight hours and 1,259 miles in the opening days of the … transcontinental Race Across America. I was sleepily weaving down the road when my support motor home flashed its high beams and pulled alongside, and my crew entreated me to take a sleep break. At that moment a distant memory
of the 1960s television series “The Invaders” was inculcated into my waking dream. In the series, alien beings were taking over the earth by replicating actual people but, inexplicably, retained a stiff little finger. Suddenly the members of my support crew were transmogrified into aliens. I stared intensely at their fingers and grilled them on both technical and personal matters.