Module 3 – Section 4
- Hallucinations
Bill: So outside of that, any other difficulties?
Client: No.
Bill: Okay, so if I understand correctly then over the last 8 months you’ve been feeling pretty depressed, but things have been a fair bit worse over the last few weeks because there have been some behavioral things between you and your dad and you’re getting pretty upset a couple of times, but one time in particular, and punching a hole in the wall. One of the things that we’re always checking on in terms of the psychosis program is to find out whether people have difficulties hearing things or seeing things that aren’t there, hallucinations. Ever had anything like that?
Client: A little.
Bill: Okay. Can you tell me what you mean by that, what happened?
Client: Sometimes I can hear things.
Bill: Yeah? Like?
Client: Like what people are saying.
Bill: Okay. When does that happen?
Client: Every other day.
Bill: Every other day, okay. Is it happening today?
Client: A little bit.
Bill: Okay. Even right now as we’re sitting here?
Client: Yeah.
Bill: Okay. That’s not actually uncommon then. I’m asking you a lot of questions and sometimes people get pushed a bit and, do you find that when you’re anxious at all you’re, these things get worse?
Client: Yeah.
Bill: Okay. So are you able to fill me in on what they’re actually saying?
Client: You’re stupid.
Bill: You’re stupid, okay. Any idea who is saying that?
Client: I don’t know.
Bill: No? Sometimes people can actually recognize the voice.
Client: Sometimes, yeah, I can hear my friends.
Bill: Yeah? Okay. So you hear your friends sometimes. Are they the ones saying you’re stupid?
Client: Sometimes they say things like shut up.
Bill: Okay, okay. How long has this been going on for?
Client: A couple of months.
Bill: A couple of months, okay.
Client: I don’t know, a month.
Bill: Okay, hard to keep track of.
Client: Yeah.
Bill: So if I understand correctly every, sorry, every other day you’re hearing some voices, don’t exactly know who they are except sometimes maybe they’re your friends.
Client: Yeah.
Bill: And they’re saying nasty things, you’re stupid….
Client: Mm-huh.
Bill: Any other things they say?
Client: Just mean things.
Bill: Mean things, okay. Sometimes people have voices which seem like they’re two voices talking to each other. Do you ever have that?
Client: No.
Bill: Okay. Or they’ll have a feeling like the voice is not only saying things like you’re stupid but it’s almost commenting on what you’re doing in the day.
Client: Yeah.
Bill: Yeah?
Client: Sometimes.
Bill: Yeah? What does that feel like?
Client: Makes me more anxious.
Bill: Yeah, yeah, it’s often pretty uncomfortable.
Client: Mm-huh.
Bill: Unfortunately sometimes voices even get worse; they’ll tell people to do things or command them to do stuff. Anything like that every happen?
Client: No.
Bill: Okay, good, because that can be pretty frightening at times. So how do you deal with those?
Client: I just listen to music.
Bill: Okay.
Client: Block them out.
Bill: Okay, okay. You were talking about two weeks ago you had an episode with your dad in terms of an interaction, you got angry, you punched a wall. How were your voices around that time?
Client: Pretty bad.
Bill: Pretty bad, okay. Can you tell me about how they got really, pretty bad then?
Client: Whenever he gets mad at me there’s more of them.
Bill: Okay, okay. More voices or more people talking? How is it more?
Client: More voices, more clear.
Bill: Okay. So other than listening to your music do you do anything else that affects them?
Client: Sometimes if I smoke they’ll go away a little.
Bill: So they go away a little when you smoke marijuana?
Client: Sometimes.
Bill: Yeah, that’s interesting because I have other patients who say the same thing; that it seems like they go away a bit when they smoke weed or when they drink alcohol. The down side of that is sometimes it may seem to initially help but it, later on, seems to get a bit worse with the marijuana or with the alcohol. Have you noticed that at all?
Client: Yeah.
Bill: Yeah? Okay, because that can be a real bother; that’s the part that can make things worse. So you’re hearing some voices every now and then, like every other day kind of thing. Anything visual, like other people that have other things that they experience that aren’t there.
Client: Not really.
Bill: Okay cause that can sometimes be pretty frightening; people will see faces or images that bother them, visual hallucinations.
Client: Not really.
Bill: Okay, okay. I’m going to ask you a few other things around hallucinations. Sometimes people have a sense in their body that something is going wrong and they feel like cancer is growing or something bizarre is happening.
Client: No.
Bill: Okay. How’s your physical health overall anyways?
Client: Tired.
Bill: Okay, you’re tired. Do you worry about your physical health in any way?
Client: Yeah.
Bill: Yeah? How so?
Client: What I eat.
Bill: Okay, okay. Anything beyond that?
Client: No.
Bill: Okay, because people can have what we call somatic hallucinations, a physical feeling that there’s stuff on their skin or, nothing like that?
Client: No.
Bill: Okay, okay. How about sense of smell? Ever smell things when nothing’s there?
Client: I don’t think so.
Bill: Okay, okay.