Auditory hallucinations in old age: causes, symptoms, treatment

Urgent hallucinations are extraneous sounds and noises that the patient hears. They can be quite varied - abrupt, unclear sounds or entire phrases, a scratching sound, knocking, a cacophony of voices or a lone voice. The level of noise that sounds in the head can be barely audible or very loud, familiar or unfamiliar. In most cases, such sounds frighten the patient. They can threaten him, force him to carry out their orders. Such psychological pressure breaks the victim. He begins to carry out the commands that sound in his head.

Causes of imperative hallucinations

In various neuroses, auditory delirium is usually absent. Therefore, when imperative hallucinations appear, this indicates serious disorders that may affect certain parts of the brain. By studying the clinical picture in each specific case, a qualified specialist tries to determine the source that became the catalyst for the disease.

At the moment, doctors can name only a few reasons for the development of the disease, but some of them remain beyond understanding.

The main known causes of imperative hallucinations are:

1. Alcoholism. People suffering from such an illness (especially for a long time) are highly susceptible to auditory hallucinations. They are expressed in the appearance of voices in the alcoholic’s head that turn to him and call him to talk. There may be several or one such voice, they can communicate with each other, discussing the patient, commenting on his actions, and causing panic in the patient. Against the background of such a mental disorder, it becomes almost impossible to guess a person’s further actions.
2. Urgent hallucinations often occur in schizophrenia, which is a psychotic personality disorder. Auditory transformation in such cases is directed directly to the patient. The voice begins to communicate with him, giving orders.
3. Addiction. People taking drugs are in an altered state of consciousness and, accordingly, can hear a variety of noises in their heads.

This is why imperative hallucinations occur.

Features of diagnosis and treatment

The main task facing the specialist is to identify the provoking factor of the pathology. The first stage of diagnosis is an examination of the patient and a special interview, which allows you to compile an anamnesis of everyday life. In some cases, the interview is carried out in the presence of relatives, since the patient cannot always adequately perceive what is happening.

This is followed by laboratory and clinical tests: blood tests, MRI, CT. “Voices in the head” themselves are not an independent disease; they are a consequence of one or another disease. Therefore, you should never self-medicate. Only a well-made diagnosis will help determine further actions.

A specialist usually prescribes medications that need to be taken in courses. In addition to medication, it is important to surround the patient with care and attention during the treatment process. In a favorable emotional environment, recovery is much faster and more effective.

Sexually transmitted diseases and paranoia

The above reasons are the most common. However, in reality there are many more of them. For example, some sexually transmitted diseases (syphilis) can cause similar symptoms. People who use various medicinal substances can also suffer from severe auditory cacophonies.

We have described the main causes of imperative hallucinations, but we must not forget that the human body ages, numerous pathological changes occur in it, leading to the emergence of senile paranoia, which also causes similar symptoms in people.

Amentia

In the list of root causes of imperative hallucinations, it is necessary to note amentia - an extremely severe type of clouding of consciousness, which is expressed in a negative change in the speech output of sounds, “curvature” of world perception and thinking. The danger of such a pathological condition is that a multifaceted distortion can lead the patient to suicide.

Experts attribute imperative hallucinations to deviations of a verbal nature. Having established the main cause of these pathological changes, a qualified doctor is able to predict the outcome of therapeutic measures.

Symptoms

So, imperative hallucinations are what the patient hears, but in reality these sounds do not exist. Translated from Latin, imperare means “to order,” so the terminology under consideration means pathological sounds that are perceived by the patient as orders that force him to carry out this or that action. In most cases, the symptoms of imperative hallucinations are represented by the patient receiving orders that are sadistic-criminal in nature, making the patient dangerous not only to his environment, but also to himself. The voice in the patient’s head, as a rule, addresses him directly, giving commands: “take a knife, cut off your hand...”, “climb onto the windowsill, jump...”, “find a rope and throw it around the neck of the demon who is standing nearby...”.

Imperative hallucinations may vary in content.

Symptoms and types

Auditory hallucinations often occur spontaneously. Depending on their type, one can judge the possible diagnosis and the degree of risk to the patient’s health. These can be monotonous or short sounds, such as ringing or hissing, music, or even clearly articulated speech.

Auditory hallucinations belong to the group of subjective sounds, since only the patient hears them. This complicates their identification and diagnosis of specific causes.

The following types of sounds that arise in the patient’s consciousness are distinguished:

• Tinnitus. This is a common noise that occurs in the ears: buzzing, whistling, ringing, hissing, clicking, etc. Its causes are mainly related to problems with the health of the hearing organs, but can also indicate disruptions in the blood flow system.
• Acoasmas. This is an anomalous phenomenon, expressed in the occurrence of specific sounds: drops of water, music, scratching, creaking, etc.
• Phonemes. The most dangerous manifestations, since they have a semantic load and influence on the patient’s actions: voices and meaningful phrases.

Classification also involves distinguishing true and false sounds. The first type fits into the environment, so often a person does not even realize the unreality of these phenomena. In the second case, the sounds come from the patient’s body, that is, the presence of their source is felt in the head, stomach, etc.

According to the principle of influence and characteristics of manifestation, phonemic anomalies are classified separately:

• Imperative. The most dangerous type of phonemes, since the voice has a commanding character, orders a person to perform certain actions, sometimes even against his will. This is a clear sign of schizophrenia, and in religious circles it is called obsession.
• Commenters. This is the so-called “imaginary friend”. A person can conduct a dialogue with a voice in his head, hear comments about himself, discuss the environment, etc.
• Contrasting. These are antagonistic sounds. Two or more voices may argue with each other, or signals may appear that contradict each other.
• Hypnagogic. Auditory hallucinations occur during the period when a person’s consciousness turns off when falling asleep or, conversely, during awakening. The subconscious mind works here, so even a healthy person can experience anomalies associated with the functioning of the brain, that is, “daydreams.”

Fears

Patients who have not yet completely lost their minds share their fears with a specialist. As a rule, they are afraid that during the next attack the voices will order to cause physical harm to someone around them, since during such an attack the person loses the ability to control his thoughts and actions. His will is so suppressed that he is unable to resist what is happening to him.

Mostly the voices directly address the patient, but they do not call him by name. Quite rarely, voice orders can relate to abstract or long-term actions; as a rule, such instructions affect exclusively the “here and now”.

Diagnostic methods for detecting pathology

If those around the patient or loved ones have suspicions that he suffers from the pathology discussed in this article, it is necessary to seek advice from a psychiatrist.

Diagnosis of this type of hallucination, as a rule, begins with the fact that the specialist makes sure that the patient suffers from this particular pathology and his conversations and stories do not represent an illusion or ordinary fantasy.

Imperative auditory hallucinations or auditory induction are specific sound structures that arise in the patient’s mind in the absence of external stimuli. People who have a history of similar diseases differ from dreamers in that it is easy to convince the latter of the opposite, while this is impossible for patients.

When diagnosing, a psychiatrist suggests that the patient undergo special tests that help determine the presence of imperative hallucinations.

An important diagnostic technique for this disease is visual observation by a specialist of the patient’s behavior. Such monitoring allows you to confirm the pathological condition and determine the type of its manifestation.

Pathological attacks can occur sporadically; with severe mental disorders, people can completely immerse themselves in this state. It is extremely important to prevent such a transition.

The psychiatrist carefully monitors changes in the patient’s facial expressions, since the patient’s emotional manifestations, which are expressed by changes in facial expressions, are not commensurate with the real situation in which he finds himself. For example, against the background of complete grief, the patient is able to have fun, laugh, or against the background of complete calm, he is in a state of fear, panic, and anger.

The most common symptom of auditory hallucinations is the desire of the patient to cover his ears or cover his head with a pillow so as not to hear a frightening whisper or voice. At the same time, reality does not provide prerequisites for such actions.

There are cases when patients suffering from imperative hallucinations, covering their ears with their hands, rushed to run away in horror, without clearing the road, and in doing so fell under cars and were thrown out of windows. Such manifestations are observed, as a rule, in isolation, but more often there are complex disorders in which auditory pathologies are combined with other symptoms, for example, a delusional state.

There are also healthy people who are susceptible to illusions, while the occurrence of hallucinating sounds is considered a specific indicator of mental pathologies that require urgent medical attention.

High attentiveness to your loved ones will allow you to diagnose the disease in a timely manner, since a person, finding himself in a similar situation, is afraid of being misunderstood and is stopped by the fear that he will be admitted to a psychiatric hospital. He tries to hide his condition, but sooner or later it makes itself known again.

A hallucinating patient becomes focused and alert, constantly on guard so as not to reveal his illness. However, when the early stage of pathology progression is missed, he gradually begins to communicate with an imaginary interlocutor, answering his questions out loud.

When diagnosing, a doctor may prescribe an MRI or CT scan of the brain to identify structural abnormalities, which can also cause the development of imperative hallucinations.

It happens that the patient experiences pain. Imperative hallucinations can be their causes, or these causes are hidden in serious mental disorders or a certain neurological pathology. Such symptoms should not be taken lightly. A complete and competent comprehensive examination will help establish an accurate diagnosis, after which the doctor will prescribe special medications for hallucinations or therapy for the underlying disease (vascular pathology, brain tumor).

To exclude the organic nature of the pathology, the patient may be prescribed laboratory tests of blood, urine, and spinal cord. Elderly patients who use devices to amplify sounds need to check the correct operation of such an electronic device.

Ekzamen_psikhiatria_1 / 27. Principles of classification of hallucinations

Classification of hallucinations:

1. By analyzers: visual, auditory, olfactory, gustatory, tactile, general sense, or bodily - senestopathies, motor (kinesthetic), vestibular, proprioceptive and anteroceptive (visceral).

2. According to the completeness of development: functional, reflex, hallucinoids, true hallucinations and pseudohallucinations (including true hallucinoses and pseudohallucinoids).

3. By complexity: simple and complex, associated, synesthetic, scene-like, static, “cinematic”.

4. According to the sensory component: clear, pale (vague), quiet, loud, familiar, unfamiliar, polyphonic, colorless, shadow, single and multi-colored.

5. In relation to the individual: neutral, threatening, condemning, commenting, imperative, prophetic (apocalyptic).

6. By direction, one- and two-sided, above, below, near, from afar, out of sight (extracampal).

7. By time of occurrence: hypnagogic, hypnopompic.

8. For developmental reasons: “exogenous” and “endogenous”, suggested (hypnotic), psychogenic, situational, affective, ideogenic, neurological (hemianopsic, peduncular, Charles Bonnet type).

Hallucinations

- imaginary perceptions, perceptions without an object.
Due to disturbances in mental activity, the “hallucinant” (a person experiencing a hallucination) “sees,” “hears,” “feels” something that does not exist in reality. The occurrence of hallucinations is associated with a general mental disorder; their specific manifestations depend on the state of consciousness, thinking, intelligence, emotional sphere and attention, and on the characteristics of the relationship between hallucinations and the patient’s personality. There are many approaches to the classification of hallucinations (etiological, phenomenological, dynamic, etc.); in practice, the topical, receptor-localization principle is more often used, according to which hallucinations are divided, like illusions, according to the senses, as well as into true and pseudohallucinations.
True hallucinations

are characterized by an external projection of a hallucinatory image (projection into the surrounding space, “outside”), they are associated with a real, concrete situation, sensually - extremely alive, bright and have such a degree of objective reliability that the hallucinant completely identifies them with reality: hallucinations are also natural for the patient, like real things. Also characteristic is a focus on the physical “I”, corporeality, objectivity and behavioral reactions (their division, characteristics)

Pseudohallucinations

, first described by V.Kh. Kandinsky (1890), are projected, in contrast to the true ones, into subjective space (inside the head, in the body, “inside”). Beyond the capabilities of the analyzer. They lack the character of objective reality and have little connection with the environment; they are perceived by patients as something alien to their consciousness and mental activity. Pseudohallucinations are not characterized by sensory brightness and liveliness; on the contrary, they are accompanied by a feeling of violence, “doneness,” influence from the outside; they are distinguished by a special character in comparison with the images of perception of really existing objects and phenomena, “monotony and melancholy” (Kandinsky), there is no sense of one’s own activity; P. are aimed at the psychic “I”, they reveal closeness to the “I”, to the inner world. The patient is usually inactive.

As a rule, hallucinations are a symptom of a mental disorder, although in some cases they can occur in healthy people (suggested in hypnosis, induced) or with pathologies of the organs of vision (cataracts, retinal detachment, etc.) and hearing. A critical attitude during hallucinations is usually absent; it is very important to take into account the objective signs of hallucinations (changes in facial expressions, gestures, behavior). The content of hallucinations is extremely varied.

Auditory hallucinations

are divided into
acoasms
(individual sounds, rustles, noises - non-speech) and
phonemes or “voices”
- pathological perception of some words, phrases, conversations, speech. Verbal pseudohallucinations are “thoughts in a sensory shell.” The content can be neutral towards the patient, commentary (statemental), indifferent (informational), threatening or laudatory. Of particular danger to the condition of the patient and those around him are imperative, “commandative”, “imperative” hallucinations, when orders are “heard” to remain silent, to hit or kill someone, to cause self-harm, etc. With antagonistic (contrasting) hallucinations, the patient is at the mercy of two “voices” or two groups of “voices” with contradictory meanings; these “voices” seem to argue among themselves and fight for the patient (in schizophrenia). Musical – alcoholic psychosis, epilepsy.

Visual hallucinations

can be elementary (so-called
photopsies
- in the form of flies, sparks, zigzags) or
objective
(“visions” of various animals that do not exist in reality (
zoopsies
), people (
anthropomorphic
),
cinematic and demonomaniacal
(during intoxication),
micro-, macropsis
(with organic lesions of the central nervous system) or entire scenes (plot), panoramas of fantastic content) can cause curiosity, or anxiety, fear.
Sometimes the patient “sees” something behind him, out of sight ( extracampal
hallucinations - in schizophrenia) or observes his own image (
autoscopic
hallucinations - in severe brain pathology). They indicate a deeper defeat than verbal ones.

Tactile hallucinations

are expressed in the sensation of an unpleasant touch on the body (
thermal
hallucinations), the appearance of moisture, liquid on the body (
hygric
hallucinations), and a sensation of grasping (
haptic
hallucinations).
Visceral
hallucinations are also a type of hallucinations - a feeling of the presence of animals, some objects, or foreign organs in one’s own body.
Erotic
tactile hallucinations.

Olfactory and gustatory hallucinations

sometimes it is difficult to distinguish from illusions and delusions. Hallucinatory experiences of this kind are characterized by extremely unpleasant content (“cadaverous, putrid smell”, “disgusting taste”), they are persistently retained in various real situations. Dysmorphomania - body odor, delusions of poisoning - from the outside, Cotard's delusions - from the inside. Taste - can be inside the body.

Hallucinations of general feeling

(interoceptive) – foreign bodies, living beings, devices. The difference from senestopathies is physicality, objectivity. Delirium of obsession.

Prognostic unfavorability increases from true to pseudo and from visual to olfactory and gustatory hallucinations. Reflex hallucinations are rare hallucinations.

, arising in the sphere of one analyzer during the action of an objective stimulus on another,
kinesthetic, motor and speech motor
(in addition to the will, the tongue pronounces words and individual phrases),
hypnagogic and hypnopompic
- visual perceptions with closed eyes before falling asleep and, accordingly, final awakening,
functional hallucinations
, appearing against the background and simultaneously with the action of a real external stimulus (“voices” heard only during the murmur of water from a switched on tap).
There may also be complex, combined (combined) hallucinations, when a hallucinatory image is simultaneously “heard”, “seen”, “touched”, “smelled”, etc. Hallucinations that occur in conditions of information deficiency, sensory isolation (bathyscaphe, sound chamber, spaceship), i.e. in a closed system they are designated as reactive-insulating. Caused by
G. - pathological suggestibility (Lipman, Reichardt, etc.).
Induced
- collective G.

The presence of hallucinations is judged not only by what the patient himself talks about them, but also by his appearance and behavior. For auditory hallucinations, especially those that occur acutely. The patient listens to the plague, his facial expressions and pantomime are changeable and expressive. In some psychoses, for example, alcoholic, when a doctor speaks verbally to a patient, he can use a gesture or a short phrase not to interfere with his listening. The presence of auditory hallucinations can be indicated by the fact that sick people around them communicate any unusual facts, for example, about the start of a war. Very often, with auditory hallucinations, patients try to find out the source (place) from which the “voices” are heard. With hallucinations of threatening content, patients can flee by committing impulsive acts - jumping out of a window, jumping off a train, etc., or, on the contrary, go on the defensive, for example, barricading themselves in the room in which they are currently located (a state of siege situation), providing stubborn resistance, sometimes associated with aggression, directed against imaginary enemies or themselves. Some patients, usually with long-term auditory hallucinations, plug their ears with cotton and hide under a blanket. However, many patients with long-term auditory hallucinations behave, especially in public, absolutely correctly. In some cases, some of these patients are able to perform professional duties for years, requiring significant mental and emotional effort to acquire new specialized knowledge. Usually we are talking about mature patients suffering from schizophrenia.

With visual hallucinations, especially those accompanied by confusion, the patient’s behavior is always disorganized to one degree or another. More often, the patient becomes restless, suddenly turns around, begins to back away, brushes off something, shakes something off. Motor immobility appears much less frequently, or motor reactions are limited only to variable facial expressions: fear, amazement, curiosity, concentration, admiration, despair, etc., appearing either separately or replacing one another.

The behavior of patients with intense tactile hallucinations changes especially dramatically. In acute cases, they feel themselves, throw something off or shake it off their body or clothes, try to crush it, take off their clothes. In some cases, patients begin to disinfect the objects around them: they wash and iron their underwear or bed linen, disinfect the floor and walls of the room in which they live in various ways, etc. They often undertake repairs to their premises.

With olfactory hallucinations, patients pinch or plug their nose with something.

With taste hallucinations, refusal to eat is common.

Pseudohallucinations were most fully described by V. X. Kandinsky (1952). He presented the essence of pseudohallucinations as follows: “As a result of the excitation of certain (cortical) sensory areas of the brain, very vivid and extremely sensual certain images (that is, specific sensory representations) appear in consciousness, which, however, differ sharply, for the perceiving consciousness itself, from true hallucinatory images in that they do not have the inherent character of objective reality, but, on the contrary, are directly recognized as something subjective, however, at the same time as something anomalous, new, something very different from ordinary images of memory and fantasy.” This is a pathological variety of memory and fantasy images, “reproduced sensory ideas, but only extremely distinct and, in most cases, extremely intense.” Pseudohallucinations do not have the “objectivity” inherent in hallucinations; they can be visual or auditory. In the sphere of other senses, it is difficult to distinguish them from true hallucinations. Patients treat them as artificial phenomena caused by some mysterious influence.

V. X. Kandinsky considered the characteristic signs of pseudohallucinations to be sensual liveliness, completeness, stability and continuity of the image, a relatively small dependence on thinking and will; spontaneity; lack of receptivity, sense of internal activity; the presence of an experience of imposition, doneness. A person sees an image with the “inner eye,” hears with the “inner ear,” and perceives it in “subjective space.”

Pseudo-hallucinations differ from true hallucinations by insufficient stability, volume and sensual vividness of the image, lack of objectivity, corporeality and extraprojection, a sense of subjectivity, violence (mental automatism), alienation from the individual; a critical attitude is usually absent, although the hallucinator, as a rule, distinguishes hallucinatory images from real images. Pseudohallucinations are more like imaginations. True hallucinations and pseudohallucinations in the vast majority of cases are accompanied by delusional ideas and affective reactions. In chronic diseases, hallucinatory experiences become systematized, stable and long-lasting (hallucinosis and pseudohallucinosis).

Treatment of imperative hallucinations

If a person encounters such a pathological situation for the first time, it usually plunges him into stupor and horror. However, it should be remembered that what is happening for a hallucinating patient is a manifestation of reality. Therefore, the first thing his close relatives should know is how to behave in such a situation and what help they can provide to the patient.

Under no circumstances should you try to convince a person that everything that happens to him is a reality transformed by the psyche. It is necessary to behave tactfully, show patience, and, in many ways, imagination in order to initially calm a shocked and excited person. For example, if a patient is absolutely sure that werewolves are trying to get into his window, you should not laugh - you just need to take an active part in finding ways and means to physically protect yourself from an illusory threat. It is necessary to try to create such an atmosphere and environment so that imperative hallucinations do not cause horror in the patient, that is, if possible, smooth out the emotional severity of the phenomenon. Also, in no case should you convince a hallucinating person that the sounds he hears are the fruit of his sick consciousness. You should not focus on the problem and try to find out who is talking to him and what the sound source is.

During an attack, you should not raise your voice or talk loudly to the patient. During this period, he should be given the illusion that those around him are doing everything possible to help him.

Calm music, a change of environment, and, in some cases, medications that should only be prescribed by a qualified specialist will help reduce agitation. But no matter how attentive the patient’s loved ones are, he needs medical help.

At the moment, therapy for imperative hallucinations is carried out using several techniques, and all of them are aimed at eliminating the occurrence of pathological attacks and removing the patient from a delusional state.

How to treat hallucinations: basic principles

Important! If hallucinations occur in one of your relatives and friends, before qualified treatment is started, make every effort to ensure the safety of the patient and those around him. Often, patients with hallucinations perform actions that are dangerous both for them and for people nearby.

Often, patients with hallucinations perform actions that are dangerous both for them and for people nearby.

Treatment of acute hallucinations is unconditionally carried out in a hospital. The patient is first examined by a neurologist, narcologist and, of course, a psychiatrist. The list of consultations and related examinations may vary depending on the individual characteristics of a particular case.

The procedure for treating hallucinations is also determined taking into account the patient's condition. Elderly people undergo therapy aimed at eliminating the causes that prompted the appearance of hallucinations. If the latter are caused by any disease, its treatment is carried out in parallel.

Typically, neuroleptics and antipsychotic drugs are used to treat hallucinations in the elderly. Taking these may cause the following side effects:

• extrapyramidal disorders. These include, first of all, akathisia, dyskinesia, and dystonia;
• anticholinergic effects;
• disturbances in the processes of defecation and urination;
• postural hypotension;
• hypersalivation;
• changes in the function of the liver, gastrointestinal tract, digestive system;
• rapid weight gain;
• dysfunction of the pancreas, up to pancreatic necrosis and acute pancreatitis.

The doctor conducts the necessary examinations and draws up a program specifically for the patient, taking into account the individual characteristics of his condition.

Additionally, drugs from the group of detoxifiers, tranquilizers and sedatives can be used to treat hallucinations. During the period of remission, patients are usually recommended cognitive-behavioral and psychosocial therapy.

Medicines

Treatment is usually carried out with the help of medications, the list of which usually includes the following drugs:

• "Tizercin";
• "Plegomazin";
• "Thorazine";
• "Gibanil";
• "Largactil";
• "Aminazine";
• "Chlorpromazine";
• "Ampliaktil";
• "Megafen";
• "Amplictil";
• "Contamine."

One of the most prescribed medications for imperative hallucinations is Aminazine, which is used for intramuscular or intravenous administration.

Treatment for this disease depends on the causes of the problem. These can be sedatives, antipyretics, anti-inflammatory, neurostimulating medications, as well as medications for the treatment of central nervous system pathologies and mental disorders.

The patient may be prescribed auxiliary therapy, for example, electrical stimulation treatment is often used, which specifically affects specific sections.

Treatment

In most cases, hallucinations stop with the help of neurological or antipsychotic medications, as well as the body's safe detoxification from stimulants or depressive medications.

Some tips and types of counseling therapy at home can also reduce the impact of symptoms.

Atypical antipsychotics

Antipsychotic drugs block neurotransmitters such as dopamine and slow or suppress nerve signaling and brain activity.

Atypical antipsychotics used to treat hallucinations include other psychotic symptoms:

• lukewarm
• aripiprazole
• olanzapine
• ziprasidone
• Gianni
• pimavanserin
• clozapine

Adjusting medication dosages or changing medications

Some medications, especially those used to treat Parkinson's disease, carry a risk of hallucinations. To prevent hallucinations, you may need to reduce your dosage or stop using these medications.

Withdrawal or depressive medications

When delusional tremors, alcoholic hallucinations, or drug use occur, withdrawal medications are often used to help the body safely rid itself of the stimulating substance. Benzodiazepines are commonly used to treat delirium tremors.

Transcranial magnetic stimulation (TMS)

Slow, repeated bursts of TMS may reduce brain excitability in people with schizophrenia who experience hallucinations, including auditory hallucinations.

Coping Strategies

Some people can minimize the frequency of hallucinations and the severity of their symptoms by using coping strategies.

People who experience hallucinations as a result of neurological diseases tend to benefit from commonly used tricks such as:

• recognizing triggers and avoiding them.
• engage in hobbies, listen to music or watch TV.
• be physically active
• go to bed or go to sleep.
• looking for the company of friends and family.
• meditation and relaxation techniques
• speak out loud or in your head.
• telling yourself that the hallucinations will eventually disappear and will not be real.
• to a quiet or peaceful place.

Cognitive Behavioral Therapy (CBT)

CBT focuses on reducing the risk of social disability and relapse by helping people understand their psychosis, become active in treatment, and engage with society. This usually also involves developing individual coping strategies.

Surgery

If imperative hallucinations are provoked by a tumor process in the head, the patient is prescribed surgical treatment. Removal of a tumor, cutting or splitting of the auditory nerve, installation of a hearing aid or implant, plastic surgery and prosthetics of ear elements are all possible options for surgical treatment of this pathological condition.

In certain cases, it is enough to eliminate the symptoms of intoxication of the body, restore its activity, and stop using alcohol, drugs and other substances that have a similar effect.