As a teenager I was fascinated with LSD purely as a consequence of my love of The Beatles and its alleged association with songs such as ‘Lucy in the Sky with Diamonds‘ (I say ‘alleged’ because all Beatle fanatics know that this song got its’ title from a drawing by John Lennon’s son Julian and that lyrically the song was inspired by the writings of Lewis Carroll, the creator of Alice in Wonderland [AIW], a book which gave its’ name to AIW Syndrome that I examined in a couple of previous blogs).
When I first started teaching my ‘Addictive Behaviours’ module back in 1990, almost all my lectures concentrated on drug addictions (as opposed to behavioural addictions which now take centre stage in my teaching), and it was my session on hallucinogenic drugs (also known as psychedelic drugs) that was always the most fun to teach and the topic that students appeared to be most engaged in. Like many of my students, I have always been interested in altered states of consciousness both in my own research into addiction and the topic more generally.
The reason why I mention all these things as that I did a media interview on the hallucinogenic effects of virtual reality products. The interview was based on comments by Microsoft researcher Mar Gonzalez Franco, who said that virtual reality will soon replace the need for hallucinogenic drugs. More specifically, she was quoted as saying:
“By 2027 we will have ubiquitous virtual reality systems that will provide such rich multi-sensorial experiences that will be capable of producing hallucinations which blend or alter perceived reality. Using this technology, humans will retrain, recalibrate and improve their perceptual systems…In contrast to current virtual reality systems that only stimulate visual and auditory senses, in the future the experience will expand to other sensory modalities including tactile with haptic devices“.
Claims that VR products have the potential to induce hallucinogenic experiences have already started appearing in the media. A recent story in the Daily Mail reported that there was already a VR app (SelfSound) that claimed it can reproduce the effects of hallucinogenic drugs and “plays on the neurological phenomena known as synaesthesia” and that a “program is used to promote mediation through creating abstract reality [and] plays face-melting music with synesthetic DMT-style visualizations uniquely generated in response to [a person’s] voice”. (DMT is an abbreviation for dimethyltryptamine, a powerful hallucinogenic drug).
Over the last seven years, I have published a series of studies with Dr. Angelica Ortiz de Gotari (some of them listed in the ‘Further reading’ section below) showing that hallucinations are common among video gamers in our working examining Game Transfer Phenomena (GTP). Therefore, it’s no surprise that VR games can do the same thing. We have reported that visual and auditory hallucinations are commonly experiences by regular videogame players.
For instance, one of our studies published in the International Journal of Human-Computer Interaction found that some video gamers experience altered visual perceptions after playing (e.g., distorted versions of real world surroundings). Others saw video game images and misinterpreted real life objects after they had stopped playing. Gamers reported seeing video game menus popping up in front their eyes when they were in a conversation, or saw coloured images and ‘heads up’ displays when driving on the motorway. Our study analysed 656 experiences from 483 gamers collected in 54 online video game forums. Visual illusions can easily trick the brain, and staring at visual stimuli can cause ‘after-images’ or ‘ghost images’ among videogame players. We found that GTP were triggered by associations between video game experiences, and objects and activities in real life contexts. Our findings also raised questions about the effects of the exposure to specific visual effects used in video games.
We also reported that in some playing experiences, video game images appeared without awareness and control of the gamers, and in some cases, the images were uncomfortable, especially when gamers could not sleep or concentrate on something else. These experiences also resulted in irrational thoughts such as gamers questioning their own mental health, getting embarrassed or performing impulsive behaviours in social contexts. However, other gamers clearly thought that these experiences were fun and some even tried to induce them.
Visual experiences identified in GTP show us the interplay of physiological, perceptual and cognitive mechanisms and the potential of learning with video games even without awareness. It also invites us to reflect about the effects of prolonged exposure to synthetic stimuli and the challenges that the human mind affront due to the technological advances that are still to come. However, because we collected our data for most of our published studies from online video game forums, the psychological profile of the gamers in our studies are unknown. However, different gamers reported similar experiences in the same games. This highlights the relevance of the video games’ structural characteristics but gamers’ habits also appear to be crucial. Some gamers may be more susceptible than others to experience GTP. The effects of these experiences appear to be short-lived, but some gamers experience them recurrently. It goes without saying (but I’ll say it anyway) that more research is needed to understand the cognitive and psychological implications of GTP. Most of these GTP experiences are viewed positively but a small minority of players find them detrimental.
Whether such hallucinations – either in typical videogames or VR videogames – can be induced on demand is debatable. Very few players in our own research said they were able to induce hallucinations. At present, we simply don’t know what the long-term effects of VR gaming will be and that goes for VR-induced gaming hallucinations too. It may be the case that VR induced hallucinogenic states will be ‘safer’ than ones induced by psychedelic drugs as there is no ingestion of a psychoactive substance, but that’s just speculation on my part.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Cawley, C. (2016). Virtual Reality could make you hallucinate; Don’t freak out. Tech Co, December 15. Located at: http://tech.co/virtual-reality-hallucinate-dont-freak-2016-12
Hamill, J. (2016). Windows of perception: Microsoft says virtual reality will soon have same mind-bending effects as LSD. The Sun, December 7. Located at: https://www.thesun.co.uk/news/2347705/microsoft-says-virtual-reality-will-soon-have-same-mind-bending-effects-as-lsd/
Liberatore, S. (2016). That’s trippy! Watch the VR app that claims to be able to reproduce the effects of a hallucinogenic drug. Daily Mail, May 4, Located at: http://www.dailymail.co.uk/sciencetech/article-3572184/That-s-trippy-Watch-VR-app-claims-able-reproduce-effects-hallucinogenic-drug.html
Ortiz de Gortari, A.B. & Griffiths, M.D. (2012). An introduction to Game Transfer Phenomena in video game playing. In J. Gackenbach (Ed.), Video Game Play and Consciousness (pp.223-250). Hauppauge, NY: Nova Science.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. In: Gamification: Concepts, Methodologies, Tools, and Applications (pp.1329-1345). Pennsylvania: IGI Global.
Ortiz de Gortari, A.B. & Griffiths, M.D. (2016). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. International Journal of Human-Computer Interaction, 32, 470-480.
Ortiz de Gortari, A.B., Pontes, H.M. & Griffiths, M.D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, 18, 588-594.
Rothman, P. (2014). Virtual Reality and Drugs – Yes, you should get high before using VR. H Plus Magazine, July 31. Located at: http://hplusmagazine.com/2014/07/31/virtual-reality-and-drugs-yes-you-should-get-high-before-using-vr/
I have to admit that I know relatively little about the neuropsychology of hallucinations. The only time I have written about them in scientific journals is in the context of excessive video gaming where there are case studies of people who appear to display auditory and/or visual game-related hallucinations, and may be part of a wider repertoire of sensory consequences of video game playing that we have coined ‘game transfer phenomena’ (and which I outlined in a previous blog).
However, in a completely different context, I recently came across a really interesting 2011 case study by Dr. Amin Gadit who published a short paper in BMJ Case Reports entitled ‘Insightful hallucination: psychopathology or paranormal phenomenon?’ Dr. Gadit noted that hallucinations are usually indicative of a serious psychiatric problem (i.e., typically some kind of psychosis) and typically require treatment. However, Dr. Gadit described the case of a 26-year old successful Pakistani businessman who was suffering hallucinations but experienced a dilemma as to whether to treat him or not because his hallucinations appeared to be providing some therapeutic benefit to his patient.
The man was married to his first cousin (also from Pakistan) and was described as being “extremely close” to his mother. Dr. Gadit reported that his patient’s wife sometimes got extremely upset (which I interpreted as being jealous) about her husband’s attachment to his mother. Following the mother’s diagnosis of a terminal illness with only a few months left to live, the man (understandably given the relationship with his mother) experienced deep emotional turmoil and upset. Dr. Gadit wrote that according to his patient that:
“[His] mother told him before dying that she would remain in contact with him after death. The patient went through a complicated bereavement period when she died. However, 6 months later, he regained his cheerful mood and started taking an interest in business again. His wife noticed that he was talking to himself for at least an hour each day. When asked, he said that his mother visits him every day and he talks to her. This was his firm belief. There was no deterioration in his personality and no other features worthy of note”.
Following these episodes of speaking to his dead mother almost every night at different times in the evening, the man’s wife persuaded him to seek psychiatric help. Dr. Gadit claimed that his patient resented being in treatment and argued that the regular “contact” with his dead mother was a positive experience and made the man happy and helped bring normality to his day-to-day life. Following initial psychiatric assessment, Dr. Gadit noted that:
“There was no significant medical history or family history indicative of any mental disorder. A thorough clinical history revealed nothing except this hallucination. The patient had retained insight as he believed that this would not happen normally but in his case was a special occurrence. He attributed this to his Muslim belief of God’s blessing in sending his mother back to him in this way. His physical examination was unremarkable and all laboratory results were normal. MRI did not reveal any pathology. His mental state examination revealed normothymic mood, delusion, visual hallucination, psychosis (with no supporting evidence), intact cognitive function and reasonable insight into his problem”.
The man’s mother appeared most evenings wearing different dresses (ones that she used to wear when she was alive) but he said his mother would not allow him to touch her when she appeared. The man was adamant that his mother appeared before him in the real world and refused any medical treatment. Organ pathology (often associated with auditory hallucinations) was ruled out as a cause, and there was insufficient evidence for a diagnosis of schizophrenia (often associated with auditory hallucinations). Ultimately, Dr. Gadit did not reach a psychiatric diagnosis and he sought a second opinion (which also failed to produce a diagnosis). The lack of formal diagnosis posed a dilemma in terms managing the presenting condition. The man had monthly appointments for over half a year with Dr. Gadit but the condition remained constant. In discussing the case, Dr. Gadit wrote that:
“The patient recognises the hallucination (perception without the presence of an external stimulus) as happening in the real world. It is important to differentiate true hallucination from ‘pseudo-hallucination’ and ‘imagery’. A pseudo-hallucination is an involuntary sensory experience vivid enough to be regarded as a hallucination but recognised by the patient as not the result of external stimuli; it would not be considered by the person to be ‘real’. Imagery is a collection of images used to create a sensory experience and is the element in a literary work used to evoke mental images and stimulate an emotional response. In the current case report, the patient believes that he can see and talk to his mother in the real world and that he is not imagining it”.
In discussing the case in relation to previous literature, Gadit made reference to a 2009 paper by H. Haween in the Dartmouth Undergraduate Journal of Science (DJUS) that reported hallucinations following bereavement typically resolve over time. Such hallucinations are most commonly in reported during the grieving process in males aged 25 to 30 years. Other similar non-psychiatric illnesses include Charles Bonnet’s Syndrome (typical sufferers being the elderly) that comprises clear hallucinations experienced among visually impaired individuals. A study dating back to 1971 by Dr. W.D. Rees and published in the British Medical Journal reported ‘widowhood hallucinations’ in 14% of Welsh widows and widowers (n=293). A more recent study in a 2002 issue of the British Journal of Psychiatry, a team led by Dr. L.C. Johns reported a 4% prevalence of hallucinations in white and ethnic minority populations and suggested that hallucinations are not always associated with psychotic disorders.
Gadit claimed that his male case study was “unique” as the persistent hallucinations resulted in no noticeable psychopathology, and appeared beneficial to his patient. He also speculated that the visions might be a paranormal experience or “a case of hallucinosis with a secondary delusional explanation”. Gadit claimed that paranormal phenomena are fairly common in both the developed and the developing world (and typically associated with rituals and myths).
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Gadit, A.A.M. (2011). Insightful hallucination: psychopathology or paranormal phenomenon? BMJ Case Reports 2011; doi:10.1136/bcr.10.2010.3456
Heewan K. (2009). Hallucination: a normal phenomenon? Dartmouth Journal of Undergraduate Science, November 21. Located at: http://dujs.dartmouth.edu/fall-2009/hallucination-a-normal-phenomenon
Johns, L.C., Nazroo, J.Y., Bebbington, P., et al. (2002). Occurrence of hallucinatory experiences in a community sample and ethnic variations. British Journal of Psychiatry, 180, 174-178.
Menon, G.J., Rahman, I. & Menon, SJ, et al. (2003) Complex visual hallucinations in the visually impaired: the Charles Bonnet Syndrome. Survey of Ophthalmology, 48, 58-72.
Ortiz de Gotari, A., Aronnson, K. & Griffiths, M.D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.
Rees, W.D. (1971). The hallucinations of widowhood. British Medical Journal, 4, 37-41.
Spence, S. A. (1993). Nintendo hallucinations: A new phenomenological entity. Irish Journal of Psychological Medicine, 10, 98–99.