childhood trauma and hallucinations

   An early hypothesis formulated by the Austrian founder of psychoanalysis Sigmund Freud (1856-1939) suggests that hallucinations can be best understood as re-experiences of childhood trauma. Freud later abandoned this hypothesis in favour of his wish-fulfillment theory of hallucinations, but the hypothesis of a possible relation between hallucinations and childhood physical or sexual trauma was revisited by various groups of researchers from the 1980s onwards. As summarized by the Dutch hallucination experts Marius Romme (b. 1934) and Sandra Escher (b. 1945), studies carried out among voice hearers with a clinical diagnosis of * schizophrenia or a related psychotic disorder indicate that 70-98% of the individuals with these diagnoses have a history of emotional neglect, physical abuse, and/or sexual abuse. An analysis of the relationships between types of abuse and specific psychotic symptoms carried out by the New Zealand psychologists John Reid and Nick Argyle suggests that hallucinations may be more prevalent than delusions or formal thought disorder among individuals with a history of incest or other types of sexual abuse, while delusions may be more prevalent in those with a history of physical abuse. A retrospective study carried out by the Dutch psychologist Bernardine J. Ensink (b. 1951) among 97 women with a history of sexual abuse by older family members or family friends yields a lifetime prevalence of 34% for hallucinatory * flashbacks, of 42% for * visual hallucinations, and of 43% for * auditory hallucinations. Although the opera-tionalization of terms such as emotional neglect, physical abuse, and sexual abuse is not univocal across these various studies, and studies of this kind may be somewhat flawed by false memories or so-called * hallucinations of memory, the prevalence rates reported in these studies indicate that childhood trauma as a pathoplastic and possibly pathogenetic factor in the mediation of certain types of hallucinations may be a severely underexposed issue.

   References

   Ensink, B.J. (1992). Confusing realities: A study on child sexual abuse andpsychiatric symptoms. Amsterdam: VU University Press.

   Freud, S. (1893-1896). Studien über Hysterie.In: Freud, S. (1952). Gesammelte werke. Erster Band. Werke aus den jahren 1892-1899. Frankfurt am Main: S. Fischer Verlag. Read, J., Argyle, N. (1999). Hallucinations, delusions, and thought disorder among adult psychiatric inpatients with a history of child abuse. Psychiatric Services, 50, 1467-1472.

   Romme, M.A.J., Escher, A.D.M.A.C. (2005). Trauma and hearing voices. In: Escher, A.D.M.A.C. Making sense of psychotic experiences. Thesis University of Maastricht.