from Emma L. Barratt
Most of the research on hallucinations has focused on unimodal hallucinations – hallucinatory experiences that affect only one sensory modality, such as hearing or touch. But for decades there has been evidence that multimodal hallucinations (affecting more than one sense at the same time) can be quite common. However, one of the greatest challenges in their investigation has been to capture and communicate the wide range of characteristics that comprise multimodal experiences.
Thanks to new research in Eclinical medicine by Katie Melvin and colleagues at the University of Leicester, this may soon change. To improve our understanding of the feelings and sensations associated with hallucinations, the team assembled a group of participants to create so-called MUSE cards – visual and written representations of what hallucinations feel like all over your body (and around it). Not only do their results suggest that most hallucinations appear to have emotional and multisensory components, but their new method also provides a more intuitive way to communicate and understand hallucinatory experiences.
For their study, the team recruited twelve participants who had hallucinations on a daily basis and who had received diagnoses of the psychotic spectrum. For a week, these participants kept a visual diary documenting the feelings and modalities associated with their hallucinations.
In the journal entries, participants were encouraged to write down and sketch the details of their hallucinatory experiences. Each day’s diary page included a list of checkboxes of modalities involved in hallucinations, free text boxes to write about the emotions and sensations associated with them, and a body map to show which feelings were experienced in which parts of the body . Participants were able to use any medium to express the lived experience of their hallucinations, although all ultimately chose to give their input in pen or pencil. The data collected from these diaries have been collectively referred to as the Multimodal Maps of Unusual Sensory Experiences (MUSE). Finally, when the week was over, participants came to a clinic to further discuss each of their MUSE cards in a 30-minute interview with the primary researcher.
The participants reported a wide variety of hallucinatory experiences, such as auditory or gustatory hallucinations up to disturbances of the sense of time. All participants shared that they shared physical feelings and sensations with hallucinations and provided detailed diagrams of their experiences on the provided bodymap templates (several of which are reproduced in the published article). Although some preferred words and arrows pointing to different points on the body, others took a more intuitive and artistic approach, illustrating waves of sensation with lines, divided bodies, broken hearts, and literally weighted limbs.
Generally speaking, although hallucinations are typically viewed as unimodal experiences, 10 of the 12 participants in this study said that many of their experiences were multimodal and regularly crossed emotional and sensory boundaries. Each participant typically experienced repetitive sensations in certain areas of their body during hallucinations in various modalities, including feelings of pain, heat, or tension.
Analysis of the written answers revealed 106 terms related to feelings during hallucinations. The authors found that these can be divided into four main groups. All but one participant used emotional language, and most emotions were negative (e.g., fear, fainting), with positive emotions reported in only a minority of cases. Words too Feelings of knowing were employed by half of the participants who reported a wide range of feelings from boredom to wakefulness during hallucinatory experiences. Feelings of reality Affection such as presence, paranoia or disorientation were reported by almost all participants. Participants also reported physical feelings, such as fatigue or heaviness.
Taken together, these data clearly show that many hallucinations are indeed multimodal, are often associated with body sensations, and are often accompanied by unpleasant emotional responses. However, the exploratory nature of MUSE cards means that this approach has some limitations. For example, the team highlights that MUSE cards can overlook some relevant sensations, in part because participants decide for themselves which sensations are relevant without being too prompt. Body maps with a rear view would also be necessary in future studies, in contrast to the pure front view that was used in this study. In addition, the small sample size of this research may not have captured some aspects of multimodal hallucination experiences or even issues with the MUSE card method. Hence, future research is needed into expanding sample size and diversity.
Even so, these results reflect contemporary research on hallucinations, which suggests that multimodal experiences are common, albeit significantly more difficult to communicate. This added difficulty may have led to the common belief that unimodal hallucinations are more common. But, according to the authors, tools like MUSE Maps could help close this understanding gap. The extent of hallucinatory experiences illustrated by the MUSE cards in this study suggests that clinicians expand their assumptions about whether hallucinations are likely to be unimodal, and perhaps even consider modifying their clinical setting to suit Patients with disorders across multiple is more pleasant sense.
– The Feeling, Embodiment, and Emotion of Hallucinations in the First Episode of Psychosis: A Prospective Phenomenological Visual-Ecological Study of Novel Multimodal Unusual Sensory Experience (MUSE) cards
Emma L. Barratt (@E_Barratt) works at BPS Biomedarticles