Hallucinosis

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HALLUCINOSIS

"Hallucinosis" is a term coined by Wilfred Bion in "Transformations" (1965) to denote the mental state of the psychotic part of the personality. Psychotic panic is the experience, the O, which impels the personality to hallucinosis. Psychotic panic arises from a primitive disaster between infant and mother in which the infant's emotional contents fail to find a container, that is to say, a mother with reverie. Undue envy and greed in the infant are significant factors in this disaster. In an effort to escape overwhelming anxiety, the infant evacuates ego functions capable of the experience of psychotic panic, along with other related contents, including space, time and meaning. Such events are in stark contrast to the normal situation where alpha-function creates a container for violent emotions.

In transformations in hallucinosis there is a failure of realistic projective identification; instead there is an explosive projection in an unrestricted mental space. In a metaphor that has become well-known, Bion compares the emotional experience of psychotic space to surgical shock, in which the dilation of capillaries so increases the space in which blood circulates that the patient is at risk of bleeding to death in his own tissues.

In the mental space of hallucinosis, words and images float without limits, either as debris, or, in an attempt at synthesis, as conglomerates which are bizarre objects. Such beta-elements and bizarre objects indicate a place where the object should be, but, as the container is destroyed, is not. This place feels very threatening. In transformations in hallucinosis, sense organs, instead of being used for perception, become channels for the evacuation of unwanted mental products; the musculature is also used in this way in the form of acting out. Words, too, become vehicles of evacuation rather than conveyers of meaning. Manifest hallucinations may be visual, auditory, tactile, and olfactory. If the sensorial component has been violently fragmented or pulverized during its expulsion, the hallucinations of the psychotic patient will be evanescent or even what Bion calls "invisible."

Transformations in hallucinosis should be contrasted with transformations in thought. This contrast is of clinical importance. In the area of thought, frustration and the absence of the object facilitate the construction of symbols. In hallucinosis there are no symbols, only representations of concrete things for the psychotic part of the personality. A sentence uttered by a psychotic patient, though it may have the same words as a sentence uttered by a neurotic patient, has a different significance. As Leon Grinberg and others remark in their overall exposition, ". . . words like yesterday, later, or some years ago may not be representations but residues of destructive dispersing attacks on time." (1993, p. 94).

The psychotic patient believes that his method of transformation in hallucinosis is superior to transformations in thought in that his universe provides him with freedom from reality—its restrictions, its pains—especially of frustration and absence of the object, and its threats of panic and annihilation. In analysis, hallucinosis is viewed as especially superior to the transformations in thought offered by the analyst.

Edna O'Shaughnessy

See also: Bizarre object; Hallucinatory, the; Psychotic panic; Psychotic part of the personality; Transformations.