In Dr. Sack's Musicophilia, one individual compares her already present musical imagery against a stronger hallucinatory process that started to happen to her after a trial of prednisone was attempted due to worsening hearing problems. Her hallucinations, she emphasized, were unlike anything she had ever experienced before. They tended to be fragmentary...
"...A few bars of this, of few bars of that - and to switch at random, sometimes even mid-bar, as if broken records were being turned on and off in her brain. All of this was quite unlike her normal, coherent, and usually "obedient" imagery - though it did have a little resemblance, she granted, to the catchy tunes that she, like everyone, sometimes heard in her head. But unlike catchy tunes, and unlike anything in her normal imagery, the hallucinations had the startling quality of actual perception."(Musicophilia)
The individual feared that she was becoming mentally ill, but Dr. Sacks pointed out that she was having release hallucinations that were neurological and not psychotic.
The individual's aforementioned thoughts about her hallucinatory process cause me to consider a part of my young daughter's own experience. At times I have attempted to describe the development of clinically verified hallucination with regard to her autism journey. I have tried to relate the staging type of developmental process for my daughter that went from; simple echolalic phrases in her earliest years, to sometimes ruminating content of differing cartoons as she became older, to motor movements' accompaniment of the echolalic process that eventually represented a variant of catatonia.
All of the above symptoms reached a crescendo -- causing an almost void of my daughter's previously fragile perception of reality. That fragile perception present due to her initial autism that was identified at three years of age; at the time of her symptomatic crescendo at around ten years of age, schizophrenia needed to be ruled out. For my daughter, hallucinations were proposed by some to be an improbability due to her already present autism. It was a mincing of diagnostic criteria because, perhaps the doctors wanted it to be a predominantly psychological concern without elements of the neurological. They wanted to see my daughter's hallucinations as ones willfully created by her psyche due to her initial autism, and not ones that were from neurological cause. A diagnostic bias against children who have the autism label seems to prevail since the doctors seem to think that autism is predominantly psychological.
Years ago I was asked about personal perceptions of my daughter's psychosis. I related some concerns to a well-known doctor:
"I wanted to clarify about the question I was asked today. I was asked about the different words Sarah uses being related to cartoons. This was the same interest that one of the local doctors had. They had been curious if Sarah was just echoing in delayed fashion for some reason, or ruminating. I would have to agree that she has done this in the past with the different content of animated cartoons or movies that she has watched throughout the years. In the context of how she is doing it now, it is not scripted in a way that makes it relate to the content of the cartoons and movies in which she previously had interest. It is now used in a fashion that makes absolutely no sense, in relation to how she had previously felt...
I remember one local doctor pointing out how schizophrenic hallucinations have to relate to things that are going on in society at the time. Like my Great Uncle Pat who was schizophrenic. He would think that loud speakers were going off in the city when they were not. He would think that the secret service was listening in on him at all times; he had issues with electronics of that time and may have heard voices from them. He had been a courier for the secret service and had actually suffered head injury during one of his assignments. At any rate, the local doctor was trying to make the point that Sarah could not be hallucinating but rather was delusional. His point was lost on me because cartoons have been Sarah's world, her society, for all of her life. She has not paid close attention to the paradigms of our day".
As things have transpired for my daughter, I conclude that it seems possible that worsening that is experienced by some within the autism spectrum is a result of a gradually building imagery process that causes complicated repertoires; ones that eventually, internally overtake and relentlessly over stimulate in the form of pretty constant hallucinatory release. Thus, what may have started as a type of mental imagery -- more easily distracted or controlled -- became hallucination with the startling quality of actual perception. This might actually be considered a separate form of autism, from others who do not enter in to this type of process.
Medications alongside a steady delivery of redirection away from the thoughts that became her captors have wrestled my daughter away from of her profound psychosis.
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About our journey with autism... At the very beginning I figured, no big deal, we'll get our daughter normalized in no time and pretty soon she would be asking for the car keys. It didn't quite work out that way and as my entire family and I continued to work through the ebb and flow of her unique walk, we fell madly in love with her in all her glory. For a real life look at one case of severe autism, just Google "Hello, Dr. Wells". It is a sixteen year account of autism that turned to schizophrenic like psychosis.
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