Hallucinations in adults have been considered a sign of a psychotic disorder. However, in recent times there has been talk of the possibility that hallucinations, especially auditory ones, are not always synonymous with mental illness. In fact, there are some cultures in which this type of hallucination is not frowned upon but is rather part of their idiosyncrasy. In other cases, hallucinations do not have a psychotic character but are triggered by a stressful or traumatic situation that the person cannot cope with.
In children, hallucinations are an even more complex issue, as they can be caused by different problems, not necessarily serious, or they can even be an expression of a specific stage of development. In fact, you know that hallucinations can appear in children with behavioural disorders, adjustment disorders, situations of grief, affective syndromes and anxiety.
Statistics indicate that 8% of children occasionally experience hallucinatory phenomena. However, only 1 in 3 children have an underlying psychiatric problem. It can therefore be said that hallucinations in children may be part of normal development.
How does perception and thinking develop throughout childhood?
Before delving into hallucinations during childhood, it is important to understand how the child’s brain receives and integrates sensations and perceptions from the environment.
At first, when a baby is born, the stimuli in the environment are simply too much, both in intensity and quantity. That’s why babies cry when they are in a noisy environment or when there are too many visual stimuli. The brain simply becomes overloaded.
Little by little, the baby will develop a sensory awareness that will allow him to know and recognize his environment. The transition from a mostly proprioceptive awareness to a predominantly sensory awareness of the outside world is achieved through emotional exchange with the mother. The mother is the one who satisfies the needs and adapts to the child’s level of development, presenting stimuli based on the child’s ability to tolerate them. Therefore, brain maturation is based on a series of experiences that are generated by the mother and that later become representations of the world.
However, before a child is able to differentiate between the external and internal world, years must pass. At first, the child will not be able to distinguish between the objects of the world and the internal objects generated in his mind. Later, he will be able to establish this difference and will understand the symbolic function of thought. Only then will he develop a reflective capacity that will allow him to think about his own and other people’s mental states, and will he begin to distinguish reality from fantasy.
What are hallucinations like in children?
In children, it is important to distinguish hallucinations from dream-related phenomena, which are much more common, and from other developmental phenomena such as eidetic imagery, vivid imagination, and imaginary friends, which serve to alleviate loneliness and cope with various fears. In fact, eidetic imagery and imaginary friends are not considered hallucinations.
It should also be noted that children are often victims of fantasy intrusions into their mental life. Furthermore, immaturity makes them more vulnerable to the effects of the environment and much more susceptible to stressful events and cognitive distortions. On the other hand, children’s cognitive immaturity and illogical thinking often lead them to describe their thoughts as if they were voices.
It is therefore very difficult to determine when a child is actually experiencing hallucinations. However, the presence of hallucinations is inferred from the child’s reaction; it is his or her behaviour that helps to establish the distinction between psychotic and non-psychotic hallucinations.
Acute psychotic episodes usually involve a degree of excitement and loss of control, accompanied by mental confusion, perplexity, and irritable mood. Children often become agitated, have speech disorders, delusional beliefs, and social withdrawal.
Moreover, these hallucinations are often persistent and numerous, and are accompanied by a loss of contact with reality. As the child grows older, he or she is reluctant to discuss them. In fact, age influences the appearance and content of hallucinations.
In preschool children, for example, hallucinatory episodes are brief and are usually related to stressful situations. Hallucinations are usually visual and tactile.
Hallucinations in older children may occur even when there are no other signs of psychosis. However, unlike in younger children, hallucinations in school-aged children are more stable and often predict a serious psychiatric disorder.
In the case of non-psychotic auditory hallucinations , these are usually dissociative phenomena caused by acute or chronic stressors, both personal and family, such as changing schools, hospitalization, separation from parents, the death of a loved one or family violence.
In practice, these children mentally escape from the situation that causes them stress, and the hallucinations are nothing more than the expression of this dissociation. In fact, a study carried out at the University of Maastricht found that, three years after the first episode of auditory hallucinations, 60% of the children stop hearing voices, without the need for any treatment. Obviously, the persistence of the hallucinations would indicate a psychiatric pathology.
References:
Ortiz, P. et. Al. (2012) Las alucinaciones en los niños: de la percepción a la representación. Átopos; 13: 28-38.
Escher, S. et. Al. (2002) Independent course of childhood auditory hallucinations: a sequential 3 -year follow-up study. British Journal of Psychiatry; 43:10-18.
Leave a Reply