Common Hallucinations in Psychosis

Both psychosis and psychotic disorders such as schizophrenia and schizoaffective disorder are often characterised by hallucinations. I have wrote about hallucinations briefly in the past, if you would like to view that article please click here. Hallucinations are defined as an experience where the apparent perception of something is not present, a hallucination would be when an individual hears, sees, smells, tastes or feels something that doesn’t exist outside of their mind. Hallucinations can vary drastically from person to person, but one thing will stay the same, they are all incredibly difficult to deal with in one way or another. Although hallucinations can be greatly varied, there are some which appear to be more common than others, which is what I am going to write about in this article. However, I want to make an important statement to verify that you do not have to experience any of the following or similar hallucinations to qualify as psychotic or mentally ill. Your hallucinations and your illness will always remain valid, regardless of the commonness of your symptoms.

The following are what I believe to be the most common hallucinations that individuals with psychosis experience.

Visual Hallucinations

Shadow People

The most common and well known hallucination experienced by individuals with psychosis is the apparent appearance of shadow people. The shadow people can appear anywhere, sometimes they may appear as a typical shadow against the surface of objects such as the walls and floors, or they can present themselves as actual shadow beings, existing in a three dimensional world just like the rest of us. It is also common for them to follow the individual who is experiencing the hallucination, which can cause a large amount of distress.

Morphing Shadows

Another common visual hallucination that sticks with the shadow theme, is the hallucination of shadows morphing and turning into objects or people that are not really there. These shadows may appear out of nowhere, or they may morph from already existing shadows.

Audible Hallucinations


Not only is hearing voices the most common audible hallucination, but also the most common hallucination in general. This hallucination is when an individual hears a voice or voices which are not the result of external stimuli.  These voices are typically of a critical and negative nature, and can be extremely difficult to live with. This type of hallucination becomes most dangerous when the voice or voices begin commanding the individual to perform certain tasks, which may cause harm to the individual or those around them.


Many people who experience psychosis may hear footsteps when no one is actually present. This hallucination may occur when one is walking, sounding as if a person is walking behind them. Others may hear footsteps when they are idle. This hallucination can occur at any given time, and it can cause a vast amount of paranoia as the affected individual may believe they are being followed by a person for sinister reasons, which is not the case, although it would appear very real to the individual at the time.


Musical hallucinations are actually as uncommon as they are frustrating; yet they still deserve a mention in this list, as I have found them to be quite common amongst those with a chronic psychotic disorder. An individual may hear various genres of music, including those they strongly dislike. Others may only hear an instrument or a certain combination of instruments. This hallucination may be constant or come and go at different times.

Physical Objects Banging/Moving

Another common hallucination is the sound of windows and doors banging, or just physical objects moving, often in a rather aggressive manner. This type of hallucination can be particularly frightening as it can cause an individual to believe that there is either an intruder in the home, or some form of paranormal activity occurring; which is incorrect in each case.

Tactile Hallucinations (External)

Crawling Feeling On or Under Skin

This hallucination is typically common amongst users of hard drugs such as crack cocaine and methamphetamine, although, anyone with a form of psychosis can experience this delusion. The crawling sensation often leads the individual who is experiencing the hallucination to believe that there are bugs on or under their skin. This hallucination can become dangerous as many people who have experienced this hallucination will scratch at their skin until they bleed, whereas others may even go to the lengths of a more severe form of self-mutilation in order to remove the bugs.

Visceral Hallucinations (Internal)

Movement of Internal Organs

During this type of hallucination an individual will experience the feeling of their internal organs moving. This may mean experiencing the sensation that an organ is moving around your body, the feeling that the organ is palpitating, that pressure is being applied to that organ, or the feeling that it is being stretched. This may cause extreme distress to an individual, or cause them to self-mutilate. Therefore this type of hallucination does have the possibility of being dangerous for the individual.

Olfactory Hallucinations

An olfactory hallucination is when an individual can smell something which does not really exist within the present environment. The odours detected may vary greatly from person to person. Olfactory hallucinations are typically unpleasant as many describe, however this is not always the case. As they differ so greatly, there would be no common ones to identify, other than those which are unpleasant. Olfactory hallucinations tend to be less common that both visual and audible hallucinations, but once again this may differ from person to person.

Overall, this should provide you with a good idea of what people with psychosis experience, and why these hallucinations could make day to day life very difficult, as well as put them in danger. If you or someone you know has experienced any of the hallucinations above and you are not receiving treatment, please seek professional help immediately.



Psychosis is a mental health problem which causes impairment in both thoughts and emotions making the sufferer lose contact with reality. Although the sufferer loses contact with reality, what occurs during this experience is very real to that individual. Psychosis is triggered by other conditions, such as schizophrenia, bipolar, and schizoaffective disorder. However, it is a symptom of many different mental illnesses which can make it difficult to identify which condition the said individual is suffering from. Symptoms of psychosis may also appear if an individual has used a substance such as alcohol, stimulants and psychedelics. However these symptoms tend to cease once the consumption of the substance stops. Some people may only experience one psychotic episode in their life time, but for others it can be a chronic and reoccurring condition.

Psychotic Episodes


There are many different triggers and factors that can cause psychotic episodes. The most common is other mental health conditions and substance abuse. Although, factors such as simple as stress can also cause a psychotic episode. Other triggers that can cause psychotic episodes are traumatic experiences, physical conditions such as Parkinson’s Disease and brain tumours.

Symptoms of Psychosis

The most identifiable and main symptoms of psychosis are hallucinations and delusions. There are many different types of delusions and hallucinations which I have gone into detail over in a previous article called The Positive and Negative Symptoms of Schizophrenia: In Detail. Delusions and hallucinations can severely disrupt an individual’s thoughts, emotion, behaviour, and perception. This can make day to day life extremely difficult for those suffering from psychosis.

When an individual experiences psychosis, they will have their own unique experience and set of symptoms as psychosis effects each individual differently. An example of this is those who suffer from psychosis in third world countries often experience positive hallucinations and delusions which are uplifting rather than frightening, whereas in the western world hallucinations and delusions are typically of a negative stance.

Psychotic episodes can last for any duration of time, and those episodes which are severe enough often end in the individual being hospitalized in order to stabilize them before they are release. The duration and how often an individual experiences psychosis for often depends on the underlying cause of the psychotic episode.

Treating Psychosis

There are a few different methods used to treat psychosis. An immediate intervention is typically the use of antipsychotic medication, however, this is very much trial and error as medication effects each individual differently and those who find a medication that works for them, may not work for other people.

As previously said, hospitalization is a common treatment for psychosis.

In the long term, it is important for the individual to recognize what triggers a psychotic episode, so they can be prevented. However, this does not always work as psychosis is a very complicated issue which can leave the said person with a lack of insight, making them unaware of the fact that they are currently experiencing psychosis.

Psychological therapy such as CBT (Cognitive Behavioural Therapy) can also be used in treating and preventing psychosis from reoccurring. Family therapy is also a useful tool as it decreases the chance of the individual needing to be hospitalized as their family now know how to cope with and help treat the psychosis.

Social support is another factor in treating psychosis, this can include things such as accommodation, work, education and any other social needs.

Paranoia or Intuition?

Lately, I have found it to be extremely difficult to differentiate between the two. Personally, I think a little paranoia is always a good thing, however, when it gets to the point that it is debilitating, it is far from being a good thing.

I’ve never had an experience where my intuition has been wrong, therefore I have relied on my intuition in many situations, and still do. My intuition has saved myself from many sticky situations, and got me out of the wrong places at just the right time to avoid consequence. When I’ve ignored my intuition, I’ve ended up in some pretty bad places. This makes my paranoia all that more worse; it can be almost impossible to tell when I’m being intuitive, or just straight up paranoid.

The Differences between Paranoia and Intuition

Intuition is the ability to understand or foreshadow something instinctively, without the use of conscious reasoning. Whereas paranoia is unjustified suspicion, and the mistrust of other people.

Intuition tends to come from a non-emotional neutral position, and often inspires a person to take action. Intuition quite often will not make sense, however, it will feel right; or wrong, depending on the situation you are in. The feeling of intuition typically persists.

Paranoia often comes from a negative emotion such as fear, anger or sadness, which often instigates a reaction of the said person, rather than compelling them to take action about whatever it is they are currently worrying about. Paranoia can come in waves; you may be extremely paranoid one day, and see how ridiculous it was the next.


These are the greatest differences I have found between the two, however, this does not stop the line from being blurred; especially when you suffer from a mental disorder in which paranoia can become crippling so to speak. At times, every glance, every word you hear, will all hold some significant meaning, which will seem very real at the time. Hallucinations may also add to the paranoia, particularly auditory hallucinations. Hearing voices telling you that yes, these people are following you, can be absolutely terrifying.

Paranoia is intuitions ugly sister, and when she hits, she hits hard.

Disorganized Thoughts and Behaviour

Disorganized thoughts are something I’ve been struggling a lot with lately; making it increasingly difficult to write, communicate, or do anything for that matter.

What are Disorganized Thoughts?

When a person is experiencing disorganized thinking it can be extremely difficult to concentrate as thoughts can come and go rapidly. Resulting in the person being easily distracted and unable to focus. At times, thoughts cannot be organized into logical sequences, therefore making the thoughts become disorganized and fragmented.

Disorganized thinking becomes noticeable to others during conversation. This is because those affected by disorganized thinking will often lose their train of thought during conversations, or they may jump from subject to subject at random even when the subjects are not associated with each other, as well as speech becoming that disorganized that it may not make sense at all.

What is Disorganized Behaviour?

There are four key noticeable areas when looking at disorganized behaviour. These include a decline in daily functioning, a lack of inhibition and impulse control, unpredictable or inappropriate emotional responses, and behaviour that appears to be bizarre or have no real purpose. However, the range of severity of disorganized behaviour can be drastic. Whereas disorganized behaviour can involve a neglect of self-care behaviours, it can also include things such as not dressing according to the weather, or they may continuously mutter to themselves. With disorganized behaviour almost anything is possible.

A decline in daily functioning may cause the person to become unhygienic, stop eating or drinking and such behaviours; rendering them unable to look after themselves. A lack of inhibition and impulse control can lead to dangerous or risk taking behaviours, which can threaten the affected person’s safety.  Unpredictable and inappropriate emotional responses may cause the person to appear happy when receiving bad news, and seem sad when receiving good news. This can affect the person’s relationships with others as they may appear to be rude and arrogant, when this is not the case. Bizarre behaviour, or behaviour with no real purpose can include almost anything; such as any of the things that were previously mentioned (continuously muttering to themselves).

Coping with Disorganized Thoughts and Behaviour

Coping with disorganized thoughts and behaviour can be particularly difficult as well as distressing for the affected person. It also comes with the obstacle of a lack of insight, making us unaware as to what is really going on. This can also lead to isolation if others do not respond well to the way we are currently behaving. Therefore I do not have any methods of coping with disorganized thoughts and behaviour, other than mindfulness meditation. I previously mentioned this in another article; mindfulness meditation allows the affected person to deal with their thoughts and feelings in a healthier way. Furthermore, the more mindfulness meditation is practised, the more effective it will become.