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LSD
Are hallucinations real?
Abou Farman
In 1838, jean-étienne-dominique esquirol, a French psychiatrist who ran an asylum, became interested in certain odd kinds of perception. He called these “hallucinations” and defined them as follows: “A person is said to labor under a hallucination…who has a thorough conviction of the perception of a sensation, when no external object, suited to excite this sensation, has impressed the senses.” Prior to the nineteenth century, the concept as we know it did not exist. The Latin verb from which the word likely derives, alucinari, means something like “to wander mentally,” which could be interpreted two ways: either your mind wandered off on its own or you took your mind for a nice outing. After Esquirol, it was your mind taking you on a trip.
Despite variations and controversies, Esquirol’s definition has lasted—at least in the clinical context. Esquirol was distinguishing between illusions, which he thought of as misperceptions that had some sort of source outside oneself (for example, seeing the Virgin Mary in a water stain on a subway tile), and hallucinations, which had no external stimuli. In hallucinations, the internal world of sensation and the external world of things were entirely disembedded. That stark opposition has been challenged, especially by thinkers who understand all sensory perception to be mediated—that is, distorted by the media (including our senses) through which information about the world is received. To refer to this idea, Roland Fischer coined the term perception-hallucination continuum in a 1971 article about ecstatic and meditative states in the journal Science.
More recent studies show that significant portions of nonclinical populations (up to 25 percent) regularly have altered perceptions and delusions, prompting psychologists to consider a psychosis continuum. In other words, a whole bunch of people reading this regularly see, feel, hear, and believe things that are not there. Of course, these sorts of studies take for granted the idea of a normal state of perception; they do not ask what it means in the first place to say that someone is perceiving something that is really there.
“Really there” means, I think, that other minds can refer to it too. Given how immensely flexible and varied our perceptual apparatuses are, how is it that we come to share reality? In Synesthesia: A Union of the Senses, Richard E. Cytowic’s book about the phenomenon in which the senses are indistinct enough that a sound may be sensed as a color, he writes, “The question, then, should not be, ‘Why don’t all synesthetes agree?’ but rather, ‘Why do the rest of us agree so well? Why do we all have common illusions?’”
When reality testing fails, mourning descends into melancholia.
With the rise of secular, scientific, democratic societies, seeing what is “really there” became an essential test for citizens, those subjects of a rational public sphere in which problems can be discussed and resolved through a common perception of a shared world. Over the course of his life, Freud developed ideas about the mind’s capacity for “reality testing,” most clearly in his essay on mourning. Successful reality testing was, for Freud, the sign of healthy mental functioning, where internal and external realities correspond to each other. Mourning, for example, involves successful reality testing, at least after a brief, acceptable period of losing it. Following the death of a loved one, there may be a period of “hallucinatory wishful psychosis” in which we need to imagine that the person we love is still really around. But, eventually, “respect for reality gains the day,” and after the “work of mourning is completed the ego becomes free and uninhibited again.” When reality testing fails, mourning descends into melancholia—today understood as depression, psychosis, and so on.
On the other side of reality, you are prescribed drugs or locked up. Around half of incarcerated folks are said to have “mental health problems.” The free and uninhibited ego may itself be a nice hallucination, an artifact of the power to make others unfree. Meanwhile, one in six American adults take psychotropic drugs, and 45 million SSRIs are prescribed every year to more firmly orient American minds toward reality. It is worth noting that many scientific sources define psychoactive drugs (consumed recreationally) and psychotropic drugs (prescribed medically) as the same thing; at best, the line separating them is not so straightforward. There are no good stats on the use of psychedelics like psilocybin and LSD, though more than eleven thousand people showed up to the 2023 Psychedelic Science Conference in Denver.
Psychedelics reveal a paradox in Freud’s formulation: It is not at all clear how an ego conforming to a sense of reality can be free and uninhibited. While for some, hallucinations seem harmful because they make people lose their sense of a shared reality, for the counterculture of the 1960s, hallucinations made one free and uninhibited precisely by loosening the reality-monitoring capacity. In Darwin’s Pharmacy, Richard M. Doyle goes so far as to suggest that there is an evolutionary imperative to hallucinate. Hallucinations, especially those induced by plants with which we have coevolved, seduce the mind beyond the real in order to realize its full potential. The Nobel Prize–winning chemist Kary Mullis credited LSD-induced hallucinations with inspiring some of his breakthroughs.
esquirol’s 1838 definition includes another interesting turn: to “labor under hallucination” is “to be a visionary,” though not exactly in the sense we mean today. Esquirol used “visionary” to mean someone who could see things that were not there, while we use the word to mean someone who sees things that are yet to be there—someone who sees ahead of time, or into time (the future is always a kind of hallucination). The experimental filmmaker Stan Brakhage thought of visions as “an increased ability to see.”
Images, I think, or more generally percepts (i.e., what is perceived, or concepts and objects that form as a result of perception), are key to the strange interaction between mind and world. It is almost funny today to remember that the photograph was once the epitome of the real. Light was turned into the pencil of nature, in the words of William Henry Talbot Fox, who published the first commercial book of photographs in six installments from 1844 to 1846.
Given how immensely flexible and varied our perceptual apparatuses are, how is it that we come to share reality?
It’s no longer light that burns an image onto a surface; it’s the algorithm. Some 34 million AI-generated images are created every day. People still take 5 billion photos of their own each day—or about 57,870 per second—of which 92 million are selfies. All of these are taken, transmitted, and watched on billions of computer monitors, VR headsets, and smartphones around the world. A significant percentage of the inputs that our eyes and ears receive now come from the screen’s reality-making capacity.
In some ways, cinematic or media images might stand in contrast to pathologizing notions of hallucination. For if hallucinations are dismissed as meaningless, involuntary biochemical tricks of the brain that fall outside culture, media images are crafted and controlled, surfacing through a shared reality of cultural meanings. Unlike hallucinatory images, they reach our senses via a clear external source, like reality itself. They are not “really there,” but the distinction is hard to uphold: according to current neuroscience, the process by which the mind perceives an object is largely the same as the one for imagining it. Mental images, like memories, overlap with visual perceptions of the so-called real world.
We constantly find ourselves on the perception-hallucination continuum, trying, literally, to decide what is “really there”—or trying to escape beyond it. Screens prey on the tenuous connection between mental imagery and the world, and through the conjuring powers of screen realities, corporations and states have gained direct access to our nervous systems and captured our capacity for and evolutionary need to hallucinate. What might happen, then, if we were to read hallucinations not just as the liberation of the senses, but as a counterhistory of the real?