Have you ever been cozy in bed, under your blankets, about to drift off to sleep, when suddenly the pile of clothes in the corner looks like a horrific creature that you’re sure, for a split moment, is real? Well, I have had that experience many times. When I am extremely fatigued while driving home at night, there’s a particular street sign that looks like a really tall man with a hat leaning on a fence. On a quick double-take, though, I realize that there was no man after all and that there was no creature in my room. Sometimes, debris blowing across the street turns into a dog that scampers away. The lady sitting on a windowsill in a house I am passing quickly shapeshifts into a large branch gently illuminated by the streetlight. Seeing things while driving tired has become a recurring experience.
Maybe you’ve experienced something like this, or maybe you haven’t. However, if you’re interested in understanding just how much of what we consider “truth” could be biased, and largely a construction of the mind, then there’s something here for you.
When I first started seeing things in my tired state, I wondered if something was wrong. I thought maybe I was losing my mind. Socially, there are negative attitudes toward hallucinating, as it is stigmatized. There was some self-stigma also with the internalization of those wider societal beliefs. Through the lens of a physician who has worked in the emergency room and seen the structural stigma of how the health care system treats those who have experienced such things, I was even more worried. After putting on my doctor cap, though, I reeled in that train of thought. Mental health conditions have very strict diagnostic criteria. One symptom couldn’t fit me into any specific diagnosis. Remembering that fact gave me some comfort.
The hallucinations that happen when you’re falling asleep are called hypnagogic hallucinations. It is the transitional state of consciousness leading into sleep, which acts as a conductor or guide between wakefulness and rest. It is a liminal space or a thinning of the veil, if you will.
When I think of hallucinations, some words that come to mind are schizophrenia, mental illness, and psychedelics. Since having abnormal perceptual experiences, I began finding ways to conceptualize hallucinations outside of the scope of mental illness and substance use. Could hallucinations be more insidious and woven into our everyday realities? Could I have a normal hallucination?
A hallucination, as defined by the DSM-5, is a perception-like experience that occurs without an external stimulus. Meaning, you see, hear, smell, feel, or taste something that is not actually there. Hypnagogic hallucinations are brief hallucinations that take place while you are falling asleep and are usually visual. These experiences are typically vivid. You can see patterns, shapes, and even people morph out of your environment and take on new, often scary forms.
I got an answer for what was happening. I then needed to know why. Most times, these false perceptions were anthropomorphic. The human mind’s ability to perceive familiar patterns (faces, animals, or objects) in ambiguous stimuli is known as pareidolia, and we do this all the time. This is why a shadow or an unknown figure in the dark takes on human characteristics. Evolution has favored this sort of thing, though. From a survival standpoint, if one correctly assumes a shadow shaped like a man is indeed a man, it could be the difference between life and death.
Outside of falling asleep, there are some other normal hallucinations that also fall outside the realm of illness and substance use. They can often occur in instances of severe dehydration, sleep deprivation, migraine, trauma, severe pain, and grieving. In modern society, the word hallucination is heavily pathologized, much like other words and phrases such as ADHD and autism. Often, the seriousness of the condition is lessened as more people identify as one or the other willy-nilly without any formal diagnosis. What is often framed as an unusual or pathological disruption could in fact be a common feature of neurophysiology.
Being human means that reality has a range of possibilities. Maybe next time you see something or hear a voice that you know is not there, give yourself some slack as you go through this human experience. The boundary between normal and abnormal is not always a fixed biological line. There is room for nuance.
Diagnoses are made only after very specific criteria are met and, when warranted, should be addressed with care and attention. Outside of that, I expand your idea of normal and enjoy the fullness of being human, hallucinations and all.
Chinelle Miller is a multidisciplinary artist and medical doctor working at the intersection of oncology, palliative care, and filmmaking at Hope Institute Hospital in Kingston, Jamaica.
Her passion for medicine lies in the opportunity to immerse herself in diverse narratives while aiding individuals on their unique health journeys. Filmmaking allows her to craft intricate worlds and narratives that explore the margins of society, and her broader artistic practice is a way for her to explore, process, and move through the world. Through her storytelling, she invites others into different perspectives and experiences, fostering empathy and understanding.
Her recent work spans photography, mixed media, and film across venues in Jamaica and the U.S. Exhibitions include Olympia Art Gallery and the National Gallery of Jamaica in Kingston, and the Thou Art Woman: RE/IMAGINE Queer Futures Exhibition in Plantation, Florida, featuring pieces such as “Don Dadda,” “Laundry and Labrish,” and “MissFit.” Her films include the experimental short “Dead Weh,” screened at the Shotlist Film Festival, and the documentary “Grassroots: Legacies of Jamaican Womxn’s Artivism,” shown in the Bob Marley Museum Independent Film Series, which traces the use of art in the Jamaican feminist community from the 1970s to the present.
She shares her work on Linktree.
