Pseudo Hallucinations

Patients with pseudohallucinations perceive sensory impressions that are not preceded by an external stimulus. The unreality of their perception is known to them differently than with an actual hallucination. Fever and fatigue are some of the most common causes of pseudohallucinations.

Pseudo Hallucinations

What are pseudohallucinations?

Perception determines the reality of man. Humans use their sensory systems to gain an impression of external reality and are ultimately able to react appropriately to the environment. The first instance of every perception is the binding of a stimulus molecule to the free nerve endings of the sensory cells. See whicheverhealth for Bone Marrow Carcinosis Meanings.

Pathological perceptions need not be preceded by an external stimulus. Hallucinations, for example, are perceptions that are not based on any environmental stimulus. The binding of the external stimulus molecule to the sensory cell does not occur for hallucinations, although the affected person perceives them as genuine perceptions. Hallucinations can be substance-related or psychologically related and are in principle conceivable for every sensory area.

Physically non-existent objects can be seen in hallucinations. Nonexistent voices can be heard, nonexistent touches can be felt, and nonexistent smells and tastes can be perceived. A similar phenomenon occurs in pseudohallucination. In contrast to the hallucinator, however, the pseudo-hallucinator knows that the perceived sensory impressions do not correspond to the real perception.


Unlike true hallucinations, pseudohallucinations are not usually caused by psychosis or substance abuse. The supposed sensory perceptions often occur when falling asleep or when waking up and in this case are referred to as hypnagogic or hypnopompic hallucinations.

In addition, trance states and meditation can give context to the pseudohallucination. The same applies to states of exhaustion with severe fatigue or clouding of consciousness due to pathological processes such as fever. A subvariant of pseudohallucination called hysterical pseudohallucination may also occur in affective states.

Some disease syndromes cause a special case of pseudohallucination. At this point, the Charles Bonnet syndrome should be referred to, which leads to visual hallucinations due to a visual impairment. Sometimes real hallucinations turn into pseudo-hallucinations in the regression phase. In principle, there are fluid transitions between the two phenomena. A clear demarcation is difficult under certain circumstances.

Symptoms, Ailments & Signs

The nature and context of the pseudohallucination determine the symptoms experienced by the individual pseudohallucinator. Depending on the context, visual, auditory, gustatory, or tactile pseudohallucinations can occur. From perceived voices to whole objects, tastes or touch, pseudohallucination can affect all sensory systems.

The most important feature of pseudohallucination and at the same time the only reliable criterion for distinguishing it from real hallucination is the conscious assessment of what is perceived as unreal, which is carried out by the patient himself. Which accompanying symptoms are present in addition to the pseudohallucinations depends on the larger scope of the hallucinatory event.

In the context of physical exhaustion, symptoms such as headaches, persistent tiredness or exhaustion can occur. The concomitant symptomatic context of Charles Bonnet syndrome, on the other hand, is visual disturbances. In the case of pseudohallucinations due to disease processes, unspecific symptoms such as fever or signs of infection are to be expected.

Diagnosis & course of disease

The diagnosis of pseudohallucinations is often a balancing act. In many cases, the phenomenon overlaps with manifest hallucinations, or at least can easily blend into them. The anamnesis gives the first clues and gives the assessor important information about the mental state of the patient.

When diagnosing pseudohallucinations, evidence must be provided that the patient considers what he has perceived to be unreal. If, on the other hand, he assesses the apparent sensory perceptions as real, the diagnosis amounts to manifest hallucinations.

The cause of the phenomenon is clarified for both pseudo hallucinations and real hallucinations in the context of further diagnostics and may require organ-specific tests. Patients with pseudohallucinations have a significantly better prognosis than those who are hallucinating. However, the fact that pseudo-hallucinations often turn into real hallucinations turns out to be prognostically unfavorable.


Those affected suffer from a significantly reduced quality of life as a result of the pseudohallucinations. In most cases, this leads to the perception of sensory impressions that are not present. This can lead to social difficulties. It is not uncommon for patients to suffer from depression or other mental disorders as a result of the pseudohallucinations. Those affected can also put their lives in danger.

Furthermore, there are severe headaches and a significant exhaustion and reduced resilience. The patients themselves are permanently tired and often suffer from visual disturbances. The pseudohallucinations are usually associated with an underlying disease, so that the further course of this disease depends very much on the underlying disease and its treatment.

As a rule, however, those affected suffer from fever or other infections and inflammations. Pseudohallucinations are treated by treating the underlying disease. Whether this will be successful cannot be universally predicted. In some cases, however, the pseudohallucinations also occur due to psychological complaints, so that psychological treatment is necessary.

When should you go to the doctor?

As soon as psychological abnormalities appear, there is cause for concern. If the affected person perceives things, smells, noises or people in their environment that are not present when viewed objectively, this phenomenon should be observed. In most cases, it is a short-term irritation that does not last or have a recurring character.

If there are permanent or repeated irregularities in the sensory impressions, there is a need for action. A doctor’s visit is necessary as soon as perceptions occur in which there is basically no external stimulus. If the person concerned begins to communicate with imaginary people in the firm belief that they are real, a doctor must be consulted. If there are sudden inspirations, hearing voices or tactile irregularities, a medical examination should be carried out. If you have a fever, persistent overexertion, headache or tiredness, you should see a doctor. If there are sleep disorders, behavioral problems, disorders of the sensory organs or a state of exhaustion, the person concerned needs help.

Disorders of consciousness, restlessness or a depressive mood should be examined and treated. If the person concerned seems absent, if his or her participation in social life decreases, if there are more interpersonal conflicts or an aggressive appearance, a visit to the doctor is advisable. If everyday obligations can no longer be met, a doctor must be consulted.

Treatment & Therapy

Whether a pseudohallucination requires treatment and how the phenomenon is ultimately treated depends on the circumstances of the hallucinatory event. For example, if it occurs once, no treatment is indicated. The patient observes himself after the pseudohallucinatory event.

If other events of the same nature occur, or if the line between reality and unreality becomes blurred, treatment may be needed. In principle, the patient’s quality of life is the top priority. Treatment makes sense as soon as the pseudohallucinatory events noticeably impair quality of life. The type of treatment in this case depends on the context of the pseudohallucinations.

Pseudo-hallucinations caused by physical exhaustion can be easily counteracted, for example, by the person concerned paying attention to their sleep schedule and, if necessary, taking forced leave. If the patient feels very worried about the perceived scenarios, although or precisely because he recognizes their unreality, conservative medical treatment can be given at short notice.

In this case, sedatives are suitable for symptomatic relief of the problem. However, the sustained administration of medication in the context of the pseudohallucination should be avoided, as otherwise a drug addiction could develop with a later transition to real hallucinations. More appropriate for persistent pseudohallucinations with a distressing effect on the patient is cognitive-behavioral therapy, in which the patient learns to let go of his or her distress about the perceptions.


Pseudohallucinations cannot be completely prevented, since the phenomena can occur in the context of fever or fatigue, both of which are part of the physiological body reactions of every human being.


The sufferer lacks the power to distinguish between truth and the imaginary when an actual hallucination is present. In the case of a pseudo-hallucination, the person affected is fully aware that what is being experienced is not real. His power of judgment remains present. Aftercare for pseudohallucinations is carried out at the behavioral level. The aim is for the patient to have as unrestricted a life as possible. To do this, he learns how to deal with the disease appropriately under the supervision of a psychotherapist.

His ability to continue to differentiate the real from the hallucinated is decisive for a favorable prognosis. This ability should be retained even after the aftercare has been completed. It is ‘practiced’ with the help of jointly developed methods in therapy sessions and later in everyday life. This procedure is particularly advisable after a stay in psychiatry. The patient needs to be guided step by step while returning to their familiar environment.

The follow-up care should also prevent the development of an actual hallucination. The address of the treating therapist becomes the point of contact for the person concerned. There, the sick person receives advice and support if they are not yet able to cope with everyday tasks on their own. In the case of an unexpected deterioration after a stable phase, the patient should definitely visit the psychotherapeutic practice. The specialist can intervene and, if necessary, arrange for hospital admission.

You can do that yourself

Everyone knows the mental antics that our mind makes before falling asleep. Suddenly, images appear that are surreal and indicate to the subject that they are drifting off to sleep. Something similar often happens when you wake up: the surreal images slowly become real perceptions and the person concerned wakes up.

Fortunately, patients with pseudohallucinations are aware that their perceptions are not real. So they’re generally fine with it, maybe even enjoying it. However, the pseudohallucinations may be due to a visual disorder, Charles Bonnet syndrome. A hallucinatory migraine attack or a particular form of dementia could also trigger the pseudohallucinations. Those affected should definitely have this clarified and treated by a specialist doctor.

No further action is required for those affected unless they are suffering from the pseudohallucinations. Then a psychological treatment is recommended, in which, among other things, relaxation techniques are used. Group therapy sessions have also proven effective in the treatment of pseudohallucinations. Various self-help groups also offer advice, action and support online. In more severe cases, it is advisable to ask the treating psychologist about antipsychotics, anticonvulsants or serotonin antagonists. These drugs can relieve symptoms.