I am currently an intern at Department of Psychiatry, National Institute of Mental Health and Neurosciences (Bangalore, India). On May 17, 2011 I spent most of my morning and a bit of the afternoon sitting with a doctor at the OPD (Out Patient Department).
Patients kept coming and going. He is not a consulting doctor. He is a researcher and he was sitting there waiting to see if there were any suitable patients coming that would help him in his research. I was sitting with him, seeing how things were done and talking about various neurological disorders.
He was looking for patients of Schizophrenia who were having auditory hallucinations for at least fifty percent of their waking period in a day. To state it simply, he was looking for Schizophrenia patients who thought they were hearing voices for half of the period during which they were awake. Tough call...we had no patients for the entire time.
While conversing with him, the topic somehow moved on to movies that show Schizophrenic patients. Interestingly, only in rare of the rarest cases do patients with this disorder show visual hallucinations (see things that are not there). Well...so much for the popularization of this belief...(including the very famous "A Beautiful Mind")
We talked for a few hours briefly dwelling on topics like Obsessive Compulsive Disorder (OCD), Mathematics, Programming, and others. One of the interesting details he told me about hallucination (auditory) was that the patients usually hear things that are either very insulting or almost always very negative. This I found was pretty interesting. Some random neurons in your brain spike up and you end up hearing things...and then you become distressed about it.
There are two theories to explain hallucinations, he went on. One of them says that because of some already present disorder or defect in the brain, certain signals or sensory inputs get wrongly processed with the result being that people believe that they are hearing voices. In another perspective, we all have our own inner voice. We usually keep talking to ourselves. However, our brain is capable of understanding that it is talking to itself and so the person does not really feel distressed. However, in patients with Schizophrenia (or hallucination problem in general) the brain is unable to distinguish its own voice from somebody else talking to itself. So it ends up believing that the thoughts that are passing through the patients' mind are actually voices of people. A Freudian way of looking at it would be (in my opinion) that there are thoughts and beliefs that are there in our mind and some of these thoughts are too chaotic or disturbing to be expressed in the social environment. In certain people these thoughts end up being manifested as the patient hearing voices.
No theory so far has been able to explain why hallucinations take place but it is a very fascinating and ongoing field of research in the field of neuroscience.
As previously said, we also talked about OCD. He mentioned that OCD is characterized by two things: one is obsession with a thought and the second is a compulsion to do something to feel released from the obsessive thought. It is something very similar to a person having an obsession that he has not locked the door of his room. Because he is having this obsessive thought, he will feel distressed. In order to relieve himself of this distress he will be compelled to do something. What would the person do? He would go and check if the door is locked or not. This is the cycle of OCD. There are lots of examples of the common obsessions that people develop. For example a person might feel that his hands are dirty and all the time he will be compelled to go and wash them in order to get temporary relief.
Well so much for the primer on some psychiatric disorders...will catch up later...got to leave...may be there is a patient around the corner!
Patients kept coming and going. He is not a consulting doctor. He is a researcher and he was sitting there waiting to see if there were any suitable patients coming that would help him in his research. I was sitting with him, seeing how things were done and talking about various neurological disorders.
He was looking for patients of Schizophrenia who were having auditory hallucinations for at least fifty percent of their waking period in a day. To state it simply, he was looking for Schizophrenia patients who thought they were hearing voices for half of the period during which they were awake. Tough call...we had no patients for the entire time.
While conversing with him, the topic somehow moved on to movies that show Schizophrenic patients. Interestingly, only in rare of the rarest cases do patients with this disorder show visual hallucinations (see things that are not there). Well...so much for the popularization of this belief...(including the very famous "A Beautiful Mind")
We talked for a few hours briefly dwelling on topics like Obsessive Compulsive Disorder (OCD), Mathematics, Programming, and others. One of the interesting details he told me about hallucination (auditory) was that the patients usually hear things that are either very insulting or almost always very negative. This I found was pretty interesting. Some random neurons in your brain spike up and you end up hearing things...and then you become distressed about it.
There are two theories to explain hallucinations, he went on. One of them says that because of some already present disorder or defect in the brain, certain signals or sensory inputs get wrongly processed with the result being that people believe that they are hearing voices. In another perspective, we all have our own inner voice. We usually keep talking to ourselves. However, our brain is capable of understanding that it is talking to itself and so the person does not really feel distressed. However, in patients with Schizophrenia (or hallucination problem in general) the brain is unable to distinguish its own voice from somebody else talking to itself. So it ends up believing that the thoughts that are passing through the patients' mind are actually voices of people. A Freudian way of looking at it would be (in my opinion) that there are thoughts and beliefs that are there in our mind and some of these thoughts are too chaotic or disturbing to be expressed in the social environment. In certain people these thoughts end up being manifested as the patient hearing voices.
No theory so far has been able to explain why hallucinations take place but it is a very fascinating and ongoing field of research in the field of neuroscience.
As previously said, we also talked about OCD. He mentioned that OCD is characterized by two things: one is obsession with a thought and the second is a compulsion to do something to feel released from the obsessive thought. It is something very similar to a person having an obsession that he has not locked the door of his room. Because he is having this obsessive thought, he will feel distressed. In order to relieve himself of this distress he will be compelled to do something. What would the person do? He would go and check if the door is locked or not. This is the cycle of OCD. There are lots of examples of the common obsessions that people develop. For example a person might feel that his hands are dirty and all the time he will be compelled to go and wash them in order to get temporary relief.
Well so much for the primer on some psychiatric disorders...will catch up later...got to leave...may be there is a patient around the corner!
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