Altered perception of real-life objects and phenomena. Symptoms of the disease - visual disturbances

Perception - the mental process of reflecting an object or phenomenon as a whole, in the aggregate of its properties and parts.

In some pathological conditions, especially in mental and nervous diseases, perceptual processes may be disturbed. However, there are also such deviations of perception that can be observed in quite healthy people (for example, illusions). Perceptual disorders can be conditionally divided into three main groups: illusions, hallucinations, and sensory synthesis disorders (psychosensory disorders).

Illusions. An illusion is a distorted perception of a real-life object or phenomenon. Illusions are classified according to the sense organs - visual, auditory, tactile and others. Depending on the main causes underlying the distortion of perception, all illusions can also be divided into physical, physiological and mental.

physical illusions are explained by objective physical laws and do not depend on the person himself. An example of a physical illusion that is also captured by a camera is the perception of a spoon in a glass of water. The spoon seems to be broken due to the different light-refracting properties of water and air.

Physiological illusions find their explanation in the features of the structure and activity of our sense organs. For example, try to press on the eyeball from the side, and immediately the object we are looking at will split in two. Bifurcation of an object occurs due to an increase in the disparity of its image on the retinas of the eyes. Another example of this type of illusion is found in Aristotle: cross two fingers and start rolling a small ball between them, and it will appear double. When an object first comes into contact with the index finger and then with the middle finger, both contacts occur at different points in space familiar to us. Touching the index finger seems to be higher, although the finger is actually lower; touching the middle is lower, although the finger is actually higher. There are many such illusions on the part of the vestibular apparatus - illusions of rolls, counter-rotations, and others.

Psychic illusions are associated both with various mental states of a person, and with some psychological features of our perception.

In diseases, mental illusions are observed most often in states of disturbed consciousness, with excitement (exaltation, ecstasy) in manic patients, or states of fear and anxiety in depression. Their illusions are almost not corrected, and the patient is inclined to consider these errors of perception as a reality. Verbal illusions, when the patient hears abuse, threats and insults instead of neutral speech, are often found on early stages the formation of auditory verbal (speech) hallucinations in some psychoses. They differ from the so-called functional auditory hallucinations by the fact that during illusions a pathologically arisen image absorbs the image of a real object (the patient "hears instead of ..."), with hallucinations, the pathological image does not merge with the real one ("hears along with ...").

In healthy people, against the background of various mental states (expectation, anxiety or fear), mental illusions also often arise. For example, when entering a room, a child will be frightened by a figure at the window, but after that he will laugh, as he will see that he was frightened by a coat and a hat hanging on a hanger. And if in every tree standing by the road we see the person we are waiting for, then we are also talking about mental illusions.

In order for the process of interpreting sensory information to reach the level of consciousness, it is necessary special tricks, and some of them have already been mentioned earlier (image simplification, grouping principles, contrasts, and others). Illusions are often caused by the ambiguity of perception that arises due to a lack of essential information or an excess of irrelevant information in the image. The ambiguity of perception also arises in cases where several significant images can be extracted from the same image.

In the experiment, illusions are used to study various aspects of the organization of the properties of the analyzer system. Visual illusions were often used to feed ambiguous sensory information to the input of the visual system in order to identify the errors that the system makes and thereby reveal some of its hidden properties. Numerous facts and conditions of errors in perception are described - the illusion of an "arrow", railway tracks, overestimation of vertical lines, intersections, concentric circles, "impossible figures" and others.

hallucinations. Hallucinations are disorders of perception, when a person, due to mental disorders, sees, hears, feels something that does not exist in reality. It is a perception which is said not to be based on an external object, otherwise it is an "imaginary, false perception".

We can observe hallucinations in mental illnesses, as well as in healthy people in experiments with sensory isolation or with the use of certain drugs (hallucinogens); hallucinations can also be suggested to a person in deep hypnotic sleep.

Hallucinations are usually classified according to the sense organs: visual, auditory, olfactory, and others. Great importance in psychiatric diagnosis is given to the division of hallucinations into true and false (pseudohallucinations).

true hallucinations characterized by sensuous clarity, they unfold in real spatial or another analyzer and "patients not only think they see and hear, but actually see and hear" (E. Krepelin, 1909). The behavior of patients usually corresponds to the content of hallucinatory experiences, and they are convinced that the people around them see and hear the same thing as they do.

Pseudo-hallucinations differ from true hallucinations in that they do not have complete sensual-bodily clarity of images, and this brings them closer to ideas. Patients talk about what they see and hear, adding "as if", although they insist on the reality of their hallucinations. The pseudo-hallucinatory image unfolds in the imagined, or rather - intrapsychic (subjective) space this or that analyzer, so patients can report the ability to "see" beyond the horizon line or through opaque barriers, and also report sounds and human voices that occur "inside the head". Since false hallucinations are perceived as something subjective and very different from real images, the behavior of patients is almost always dissociated from the content of hallucinations. Pseudohallucinations indicate a more unfavorable course of a mental illness, often become protracted and chronic, and are accompanied by impaired thinking.

In healthy people, against the background of fatigue or exhaustion, sometimes when falling asleep, visual or auditory hallucinations similar to pseudohallucinations, which are called hypnogogic due to their proximity to dreams (hypnopompic- the same, but are noted at the moment of awakening).

Visual and auditory hallucinations often subdivided into simple(photopsia - perception of flashes of light, stars, sparks; acoasma - perception of sounds, noise, cod, whistle, crying) and complex(verbal - perception of articulate speech).

At reflex hallucinations the perceived real image is immediately accompanied by the appearance of a hallucinatory image similar to it (the patient hears a phrase - and immediately a phrase similar to it begins to sound in his head).

Apperceptive hallucinations(auditory or visual) appear after the corresponding volitional effort of the patient who wants to experience them.

Hallucinations of Charles Bonnet(visual, less often auditory) are observed when the peripheral part of the analyzer is damaged (in the blind, deaf), as well as during sensory deprivation or isolation (in prison, in a foreign language environment) in the field of the affected or information-limited analyzer. They should be distinguished from hemianoptic hallucinations in the field of hemianopsia with damage to the cortical end of the analyzer (tumor, trauma, vascular lesion).

Hallucinations that occur as a result of mental trauma are called psychogenic. They are divided into the following varieties:

dominant(auditory and visual) with psychologically understandable content, reflecting mental trauma, and emotionally saturated;

eidetic(usually auditory), which tend to be cliché-like (for example, the constant hallucinatory playback of funeral music and sobs at funerals);

hallucinations of Dupree's imagination, where the plot follows from hysterical dreams and fantasies;

induced hallucinations arise by the type of mutual suggestion and self-hypnosis against the background of emotional stress;

suggested hallucinations often occur with alcoholic delirium during the "lucid window" (daytime clarification of consciousness): Reichardt's symptom (suggested reading on a blank sheet of paper), Aschaffenburg's symptom (suggested imaginary conversation on a switched off phone), Lipman's symptom (suggested visual hallucinations after ten seconds of pressure on the eye apples), etc.

Disorders sensory synthesis. Perception is a complex process of integration, synthesis of the image of a perceived object from sensory signals coming through the senses from external environment and your own body. In some conditions and diseases we meet with various violations the process of synthesis, integration of sensory information in the course of perception. Usually psychosensory disorders include two groups of disorders - derealization and "body schema" disorders.

Derealization - violation of sensory synthesis of information that comes from the outside world. From the association of sensory signals that take part in the formation of the image of external reality, something can "fall out", change, and ultimately the world around us loses its sensory reality - it is distorted.

A person can lose the perception of the depth of space, and then everything around him is seen in a flat, two-dimensional image. Distortions of perception may also concern certain features of an object - shape (metamorphopsia), size (increase - macropsia, decrease - micropsia) or others. With porropsy, the distance estimate is violated - it seems to a person that objects are further away than they are in reality; in dysmegalopsia, the perceptual disturbance concerns elongation, expansion, obliqueness, or twisting around the axis of surrounding objects.

Disorders close to derealization are when the usual, familiar environment is perceived as completely new (phenomenon "never seen" jamais vu), or, conversely, a new environment (area, street, house) is perceived as well known and well-known (phenomenon "already seen" - deja vu). Patients are especially concerned about the distortion of time - its slowdown (bradychronia) or acceleration (tachychronia), as well as the loss of the emotional components of the perception of the environment - "everything is frozen, glassy", and "the world has become like a scenery." Patients almost always retain a critical attitude towards these disorders, they are alien to the personality and subjectively extremely unpleasant.

Body schema disorders characterized by various symptoms of disturbances in the perception of one's own body, peculiar sensations of an increase or decrease in weight, the size of the whole body or its parts (arms, legs, head). Occur when the sensory systems of the upper parietal region of the cerebral cortex are damaged. Body schema disorders also include disturbances in the perception of the relationship between body parts: patients talk about the wrong position of the ears, "twisting" of the body. The patient feels these changes only with his eyes closed, since under the control of vision all misconceptions about his body disappear.

agnosia – non-recognition of the visible or audible with the complete preservation of the elementary functions of perception, which occurs with focal lesions of the brain .

Visual agnosia arise with local lesions of various parts of the visual cortex (mainly secondary and tertiary fields) and are related to violations of the higher organization of visual processes. In this case, the patient does not recognize objects by their visual images. There are six main types of visual gnosis disorders: object, facial, optical-spatial, letter, color and simultaneous agnosia.

Object agnosia is a left hemispheric symptom, but in a more rough form it is associated with a bilateral lesion of the lower part of the "wide visual sphere". With gross impairment of recognition, patients do not stumble upon objects, but constantly feel them and navigate by sounds.

Facial agnosia is associated with damage to the lower-posterior parts of the "broad visual sphere" of the right hemisphere (in right-handers). At the same time, the patient does not distinguish between human faces and recognizes even close people only by voice. The degree of severity can be different: from impaired memory of faces in special experimental tasks to not recognizing relatives and even oneself in the mirror.

Opto-spatial agnosia - associated with a bilateral lesion of the upper part of the "wide visual sphere". In this case, the patient is poorly oriented in the spatial features of the object (left-right orientation suffers especially). If the right hemisphere predominantly suffers, then the drawing is disturbed to a greater extent in patients (they cannot depict further-closer, more-less, left-right, top-bottom in the drawing), and the “posture praxis” is also disturbed - the patient cannot copy the pose (Head's test), and this is associated with difficulties in everyday motor acts (for example, dressing apraxia). The combination of visuo-spatial and movement disorders is called apractoagnosia. Optical-spatial agnosia can impair reading skills, as there are difficulties in reading letters with left-right signs (E-E).

Letter (symbolic) agnosia - occurs with a unilateral lesion of the lower part of the "wide visual sphere" on the border of the occipital and temporal cortex of the left hemisphere (in right-handers). In this case, the patient correctly copies the letters, but cannot read them. The breakdown of the reading skill in this case is called primary alexia.

Color agnosia - possible with damage to the 17th and other fields of the visual cortex, especially the right hemisphere. At the same time, the patient distinguishes colors (there is no color blindness as such, distinguishes colors on cards), but does not know which objects are painted in a given color, cannot remember the colors of even well-known real objects, cannot select the same colors and shades. Thus, in patients with color agnosia, the categorization of color sensations is difficult.

Simultaneous agnosia (eng. Simultaneous - “simultaneous”) was first described by P. Balint (1909) and occurs with bilateral or right-sided lesions of the occipito-parietal cortex. At the same time, a patient with intact visual fields finds it difficult to perceive the entire image and sees only its individual fragments, since he cannot shift his gaze and examine the entire image sequentially. It is especially difficult for him to perceive two images in one drawing at the same time.

auditory agnosia - violation of the musical abilities that the patient had in the past - is divided into motor amuseia, in which the ability to reproduce familiar melodies is primarily impaired, and sensory amuseia, characterized by impaired recognition of familiar melodies. In addition, a patient with auditory agnosia may not identify the voices of animals and birds, and may not distinguish between various noises familiar to him.

At tactile agnosia (astereognosis) the ability to recognize presented objects by touch is lost in the absence of distinct defects in elementary types of sensitivity (superficial and deep). Disorders are observed with local lesions of the sensory zones of the lower parietal region of the cerebral cortex. The following disorders are distinguished:

tactile object agnosia, manifested by a violation of recognition by touch with closed eyes of the size and shape of an object and the definition of its functional purpose;

tactile texture agnosia the object is characterized by the inability to determine by feeling the quality of the material, the surface features of the object and its density;

finger agnosia - the patient does not recognize the fingers of his hand with his eyes closed when touched

test questions

List the 3 main types of perceptual impairments.

Describe the difference between an illusion and a hallucination.

What are the characteristics of pseudo hallucinations.

What types of sensory synthesis disorder do you know?

What brain damage occurs different kinds agnosia?

Psychiatry refers to a disorder of perception as a mental pathology. Perception is a complex of sensations, through which we receive information about the world around us. The senses are made up of five senses: sight, hearing, smell, touch and taste. The result of the process of perception is an integral image of the world, the interaction of objects and the understanding of their qualities and properties. A malfunction of one or more of the senses is a perceptual disorder.

Disorders of perception are represented by the following disorders:

• illusion
• agnosia
• hallucination
• psychosensory disorders

In illusion, the real object is perceived as something else. For example, a bathrobe hanging on a hanger is mistaken for a human figure. There are three types of illusions: physical, physiological and mental. Physiological arise due to external factors often due to the laws of physics. So, a cup in a glass of liquid seems to be broken, while this is an optical illusion. Physiological illusions are associated with the peculiarities of the work of receptors. For example, after a heavy load, a light load seems heavy. Psychic illusions arise from emotional state person. A constantly worried person always hears the steps of the pursuer. A person who is in a state of alcoholic intoxication sees an object in a distorted form. In the same state, people often see pareidolic illusions, when existing objects are replaced by erroneous images. For example, whole pictures or actions similar to theatrical ones are formed from a wallpaper pattern. Illusions are also classified according to the sense organs. Can be visual, auditory, olfactory,gustatory and tactile. However, it should be remembered. That the presence of illusions does not always indicate illness, because they can also occur in mentally healthy people, due to objective reasons.

Psychiatry calls the perception of an object that does not currently exist a hallucination. Patients perceive such objects as really existing and, for their part, treat them critically. Attempts to convince the patient of the absence of an object can only cause irritation, since the person is sure of the opposite. Hallucinations are subject to classification according to certain criteria: content, complexity, interest, etc. According to the complexity, hallucinations are elementary (photopsias - shapeless images and acoasma - unclear noises and calls), simple (any one analyzer is involved) and complex (several analyzers). Most frequent occasions are visual and auditory hallucinations. Visual ones are manifested in the vision of single or multiple images, differing from each other in behavior towards the patient who sees them, mobility or immobility, etc. The image can be perceived by peripheral vision. In this case, it is called extracampal, and if a person sees his double, then this is an autoscopic hallucination. With auditory hallucinations, the patient hears the sound of howling wind, the rustling of trees. Most often, auditory hallucinations are verbal hallucinations, for example, the voices of both familiar and unfamiliar, either one person or a group of people. These voices are divided into neutral, indifferent or threatening to the patient. Voices manifest themselves in different ways, they can scold, ask questions, order, comment on a person’s actions, threaten, offer to improve. The most dangerous for the patient (for those around him, too), are commanding voices (imperative hallucinations). They can be harmless, for example, to order to go to visit, drink tea, or dangerous, for example, an order to kill or commit suicide. Most often, the patient cannot resist these orders and follows them. It happens that the patient asks someone to limit him, so as not to do something terrible.

With tactile hallucinations, there is a sensation of insects crawling on the surface of the skin or under it, while the person can describe these insects in detail. Olfactory and tactile hallucinations are rare. The olfactory ones are manifested in the sensation of an unpleasant smell, and the gustatory ones - in the sensation bad taste regardless of the taste of the food.

There are many other types of hallucinations. Real hallucinations fit very harmoniously into the world have signs of reality. Patients are sure that the people around them also perceive these objects, but for some reason they hide it. Hallucinogenic images influence the behavior of the patient, which becomes appropriate to their content.

Psychiatry is a disorder that differs from true hallucinations in that it does not fit into the environment and does not bear signs of reality, it is projected inside a person, for example, the voice is not heard from the outside, but as if it was built into the head, is called pseudohallucination. Often, pseudohallucinations do not affect a person's behavior, so often people do not realize that there is a hallucinating person next to them.

Psychosensory disorders (disturbances of sensory synthesis) differ from illusions and hallucinations in that a real-life object is perceived as it should, but in a distorted form. There are two forms of psychosensory disorders: derealization and depersonalization. Derealization is a distorted perception of the world. The patient feels that the world has become somehow different, its properties and qualities have changed. This perception is typical for depressed people who say that the world has lost its colors. Derealization can manifest itself in a distorted perception of the properties of an individual object, for example, size, shape, etc. With micropsy, the object is seen reduced, and with macropsy, it is enlarged, with metamorphopsia, the object is distorted.

There are two types of depersonalization - somatopsychic and autopsychic. With somatopsychic depersonalization, an experience occurs, a change in the size and shape of the human body. It may seem to the patient that he has grown significantly or become heavier. With autopsychic depersonalization, changes in one's "I" are experienced. Patients claim that their personal qualities have changed, their character has deteriorated.

The human body is an amazing combination of many organs, tissues, functions, chemical reactions, electrical impulses that allow a person to live, learn and learn about the world around him. Cognition occurs with the help of influences on the human senses - light, sound, taste, smell, tactile and spatial perceptions. All this is the basis of knowledge and existence of a person in the world around him. And perceptual disturbances, whatever they may be and for whatever reasons, are a serious problem.

Perception: reality plus imagination

In the fact that a person can perceive the world around him, the sense organs and imagination are involved. Those knowledge that is obtained with the help of vision, hearing, taste, tactile impact, smell and determining the position of the body in space, are processed by special parts of the brain and, with the help of imagination and previous experience, become ideas about the world around. Disorders of perception in any area do not allow a person to get a complete picture.

far and near

And the perceptions of the received data are closely interconnected. Receptors that receive information about the surrounding reality transmit nerve impulses to the brain, where the analysis and processing of the information received takes place and a response occurs in the form of an idea of ​​an object or phenomenon that affects the receptors. Moreover, some of the receptors should receive such an impact during direct contact with the object, and some - through space. So, for example, taste sensations arise when food enters the oral cavity and on the tongue. But vision allows you to see objects at a distance. Perception of the received information through various bodies senses and receptors - the main mechanism of knowledge of the world by man. Perceptual disorders are a complex physiological and psychological problem.

Sense organs and receptors

In addition to the six sense organs known to everyone from school, the human body perceives much more stimuli. So, there are receptors responsible for the perception of heat - cold, pain, as well as the sensations of your body. So science distinguishes not six, but 9 types of sensations:

• vision;
• hearing;
• smell;
• touch;
• equiprioception - a sense of balance;
• taste;
• nociception - perception of pain;
• thermoception - feeling of warmth;
• proprioception - the spatial sensation of one's body.

Receiving information about the world around us with the help of various receptors, the brain processes them into perceptions of the surrounding reality.

Perceptions and medical practice

If any disturbances occur in the human body, a big problem can arise - perception disorders. Psychiatry, as a scientific and practical field of medicine, studies these disorders and, to the extent possible, helps to correct them. Psychiatrists have been studying perceptual disorders for centuries, helping not only the patients themselves, but also the people around them, to live with such problems. Violations of the work of one or more sense organs are not always disorders of a complex analysis of the surrounding world. A person who has lost his sight knows how objects and colors look in reality, and with the help of the work of other senses, he can present a real picture of the world around him. In psychiatry, disorders of the perception process are a whole complex of disorders caused not so much by problems in the work of receptors, but by changes in the processes of processing the information received and obtaining the final result.

How do perceptual disturbances manifest themselves?

The field of psychiatry is a special field of medicine that studies various mental disorders and their manifestations. This is a very specific area of ​​​​human knowledge, which operates with the concepts of "disease", "health", "norm" and "pathology" in relation to mental state. One of the areas of work of a psychiatrist is perceptual disorders. Psychiatry considers such problems to be mental pathologies. Disorders of sensation and perception are manifested by several conditions:

• Anesthesia is manifested by the inability to perceive tactile sensations, taste and smell. In its manifestations, it is similar to medical anesthesia, which is called to turn off the sensitivity of pain receptors in patients during medical interventions.
• Hyperesthesia is a disorder of sensitivity caused by an apparent increase in smell, light, sound. Very often, hyperesthesia manifests itself in patients who have suffered a traumatic brain injury.
• Hypothesia is the opposite of hyperesthesia, a change in sensitivity. Sensory perception reduces natural stimuli. Patients suffering from hypoesthesia depressive disorders to whom the world seems dull, boring.
• Paresthesias are expressed in sensations of itching, burning, tingling, "goosebumps" due to impaired blood supply and innervation. Often, paresthesias occur in the Zakharyin-Ged zones: problems of internal organs manifest themselves in the form of unpleasant, painful sensations in certain areas of the surface of the human body.
• Senestopathy - discomfort that occur inside the human body, they are difficult to describe in words, most often the patient uses vivid comparative images to talk about these sensations.

"Wrong" sensations sometimes coincide with the clinical manifestations of some disease, and not only from psychiatric practice. Competent or condition - this is the basis of quality treatment.

Major Perceptual Disorders

Psychiatry as a field clinical medicine operates with the concepts of methodology, diagnosis, treatment and prevention. To make a diagnosis, it is necessary to clearly know the manifestations of the disease, this helps clinical tests, history taking, laboratory and instrumental research. Categorical judgments allow correctly interpreting the data obtained in order to make an adequate diagnosis. To refer to certain mental health problems in psychiatry, two main categories of perceptual disorder are distinguished:

• illusions;
• hallucinations.

Both concepts cause quite negative feelings in most people, but the patient himself has no power over them, although in many cases such disorders occur due to conditions in which a person drives himself, for example, drug or alcohol poisoning. Some types of perceptual disorders can occur in perfectly healthy people in terms of psychiatry.

Blue Caterpillar from Wonderland

"What you see, but what is not really" - that's it, a hallucination. Problems in the perception of reality as it really is are manifested by the appearance of pseudo-real images. Psychiatry, studying perceptual disorders, defines hallucinations as an image that has appeared in the mind and is defined as really existing, but without an external stimulus that affects human receptors. These images appear from scratch, so to speak, due to a perceptual disorder. Hallucinations by psychiatrists are divided into several varieties:

• - are vivid images, for the patient having certain shapes, color, smell, emitting specific sounds. True hallucinations are perceived by the patient as a manifestation of reality through his senses, he tries to manipulate them, as if the phenomena or objects he sees exist in reality. In addition, according to the patient experiencing true hallucinations, all the people around should perceive them in the same way as he does.
• Pseudo-hallucinations are perceived by the patient as something unnatural, but really existing, it is devoid of brightness, often incorporeal, it can occur either from the body of the patient himself, or from areas that are not subject to his receptors. Often, false hallucinations are considered by the patient to be forcibly inserted into his body with the help of special devices, apparatus, machines, or because of the mental impact exerted on him.

In addition to these two types of hallucinations, they are also divided according to the sense organs with which they can be caused:

• visceral;
• taste;
• visual;
• olfactory;
• auditory;
• tactile.

Each such type of hallucination has its own scientific definition and can be decomposed into several subspecies, which is important for clinical psychiatry.

By the way, hallucinations can be inspired and caused. One of the methods of psychiatry uses the Aschaffenburg symptom, when the patient is allowed to listen to a previously turned off telephone, thus checking his readiness for auditory hallucinations. Or the symptom of Reichardt is a symptom of a blank slate: the patient is given a completely white sheet of paper and is invited to talk about what is depicted on it. Hallucinations can also be functional, arising against the background of irritation of certain receptors and disappearing after the removal of the stimulus. By the way, the image of the Blue Caterpillar smoking a hookah on a mushroom cap from Lewis Carroll's fairy tale "Alice in Wonderland" is regarded by many as a classic hallucination.

Such a beautiful illusion

In psychiatry, another type of perceptual disorder stands out - illusions. Everyone is familiar with this concept, even those who do not suffer from psychiatric perception disorders. People often use the expression "beautiful illusion, terrible illusion". So what is it? The scientific definition of one type of perceptual disorder sounds like an incorrect, erroneous perception of objects that exist in reality. Deception of the senses - that's what an illusion is. For example, an illusion can occur when the level of stimulus is insufficient - in the dark it is very easy to mistake the outline of a bush for a human figure. So the emergence of illusions is not always the area of ​​psychiatry. The hallmarks of an illusion are:

• an object or phenomenon subject to sensory distortion: a figure, voice, tactile or spatial sensation;
• distortion, misperception and evaluation of a real object;
• illusion based on sensory perception, that is, human receptors are actually affected, but it is perceived somewhat differently than it actually is;
• the feeling of the false as real.

Disorder of visual perception is one of the frequent illusions of healthy people. Moreover, such an error can be physical or physiological in nature. The physical nature of illusions has nothing to do with psychiatry; the same mirage in the desert has a rationale, albeit not too simple, but proven by the exact science of physics. Clinical Psychiatry considers psychopathological illusions:

• affective, arising against the background of fear or nervous excitability about imminent danger;
• verbal, that is, verbal, illusions - individual words or phrases that are heard by a person;
• pareidolic illusions - visual illusions that arise against the background of a real image by conjecturing images, for example, a drawing on a wallpaper can become an illusion of the frightening content of a picture; most often, such illusions are observed in creative personalities, for example, scientists have found that Leonardo da Vinci suffered from pareidolia.

The basis of illusions is a disorder of perceptions and ideas about the world around. They don't always wear pathological character. Often they are caused by a distortion of perception against the background of an incorrect assessment of the work of receptors.

Thinking and memory in perceptual disorders

What distinguishes Homo sapiens from all other living beings? The ability to think. Thinking - basic cognitive process, which unites the world around a person into a logical picture. Thinking is inextricably linked with perception and memory. All the processes that characterize man as a rational being have changed, developed and transformed for thousands of years. And if for a start it was only necessary to apply physical force in order to satisfy their natural needs (food, reproduction and self-preservation), then over time a person learned to build logical chains - to think in order to get the necessary result with less physical effort and harm to one's health and life. To consolidate the favorable result obtained, memory began to develop - short-term, long-term, as well as other mental functions characteristic of people - imagination, the ability to see the future, self-awareness. Symbiosis of disorders of perception and thinking - psychosensory disorders. In psychiatry, these disorders are divided into two main types:

• depersonalization can also be manifested by incorrect sensations of one's body, the so-called mental depersonalization, and distorted concepts of one's own "I" - mental depersonalization;
• derealization is manifested in a distorted perception of the surrounding world - space, time, dimensions, forms of the surrounding reality are perceived by the patient as distorted, although he is absolutely sure that his vision is correct.

Thinking is a feature of a person. Reasonable thinking is subjected to refutation with perceptual disturbances. Psychiatry, as a field of clinical medicine, seeks to find ways to resolve the controversy caused by perceptual disturbances in mental patients. With disorders of perception, patients also show a disorder of thinking - delusions, obsessions, or which become the meaning of the life of such a person.

Psychiatry is a complex science of mental illness a person whose area is both disorders of perception, and memory, and thinking, as well as other mental functions. Moreover, any problems with mental health are most often associated with a whole range of mental functions - from the work of the senses to short-term or long-term memory.

Why is the perception of reality disturbed?

When faced with problems of a psychiatric nature, the question arises: what are the causes of perceptual disorders? There can be a whole complex of them: from alcohol and drug poisoning to a pathological state of the human psyche. Mental illnesses are quite difficult to diagnose, often this is due to the fact that a person cannot accurately describe his feelings, the events that happened to him or are happening, and initial stages diseases are not always visible to others. Perception disorders can develop as a result of any diseases of the internal organs or systems, as well as due to a violation of the processing of the information received, its analysis and obtaining a specific result. Psychiatric practice at the moment cannot absolutely accurately determine the causes of the development of a perceptual disorder, except for intoxications, when the pathology mechanism is precisely determined by a poisonous substance. Disturbances in the perception of reality can and should cause alertness among people around, since often the patients themselves are in no hurry to turn to specialists, not considering these violations to be something pathological. A timely identified problem with the perception of the surrounding reality can help the patient avoid serious problems. Distorted reality is a huge problem both for the patient and for the people around him, both mentally and physically.

Childhood Fantasies and Perceptual Disorders

Child psychiatry and psychology is a special kind of medicine. Children are great dreamers and inventors, and the increased reactivity of the child's psyche and little life experience do not give the child the opportunity to independently correct false sensations in time. That is why perceptual disorders in children are a special area of ​​pedagogy, psychology and psychiatry. Visual and auditory illusions are one of the components of the childhood of every person. A scary tale told at night becomes a real nightmare for the baby, hiding under the bed or in the closet. Most often, such disorders occur in the evening, the child's fatigue and drowsiness affect. Scary tales and stories, especially told to the baby at night, can become the basis for development neurotic state. Hallucinations occur in children most often against the background of somatic and infectious diseases as a result of an increase in body temperature. The age of the most frequent manifestation of such disorders is 5-7 years. Hallucinations of this nature are elementary - sparks, contours or images of people, animals, and from the sounds children hear shouts, knocking, voices of birds or animals. All these visions are perceived by the child as a fairy tale.

Children different ages may also suffer from manifestations of schizophrenia. In this case, all hallucinations acquire a complex, often sinister character. The plot of hallucinations is complex, often dangerous for the health or even the life of the baby. For older children adolescence, and this is 12-14 years old, the development of gustatory and tactile hallucinations is characteristic, the child begins to refuse previously favorite food, his character and behavior change.

Pediatrics and child psychiatry distinguishes children with congenital disorders of perception into a special group. In these cases, the child grows and learns to compensate for the lack of some sensations by enhancing the development of other sensory abilities. A classic example - a child with congenital hearing loss has excellent vision, notices the smallest details, pays more attention to minor details of the surrounding reality.

Perception is the basis of knowledge of the surrounding world in all its manifestations. In order to feel, a person is given six sense organs and nine varieties of receptors. But in addition to sensations, the information received must be transmitted to the appropriate parts of the brain, where it must go through the process of processing and analysis, compiling a general picture of reality based on a complex of sensations and life experience. The result of perception is a picture of the surrounding reality. Violations in at least one link in the chain of obtaining a picture of the world lead to a distortion of reality. Psychiatry as a field of clinical medicine studies the causes of occurrence, stages of development, signs and symptoms, methods of treatment and prevention of perceptual disorders of both individual phenomena and components of general human health problems.

6.1. Perceptual disorders

Perception is the initial stage of the highest nervous activity. Thanks to perception, external and internal stimuli become facts of consciousness, reflecting individual properties of objects and events.

Stimulus? feeling? perception? performance.

Sensation is the simplest mental process, consisting in the reflection of individual properties of objects and phenomena, arising in the process of their impact on the senses.

Perception is the mental process of reflecting objects and phenomena as a whole, in the aggregate of their properties. Does not depend on the will of the individual.

Representation - an image of an object or phenomenon, reproduced in the mind on the basis of past impressions. Depends on the will of the individual.

Symptoms of Perceptual Disorders

Hyperesthesia – hypersensitivity to normal stimuli. Often occurs with exogenous organic lesions of the central nervous system (intoxication, trauma, infection), manic states.

hypoesthesia(hypoeesthesia) - decreased sensitivity to stimuli. Often observed in disorders of consciousness, organic disorders of the central nervous system, depressive states. Anesthesia is the extreme degree of hypoesthesia. Painful mental anesthesia is a subjectively seemingly very painful weakening of some kind of sensitivity, due to a decrease in emotional tone ( anesthesia psychica dolorosa). Seen in depression.

agnosia- non-recognition of the stimulus, occurs with organic lesions of the central nervous system, hysterical sensitivity disorders.

Paresthesia- subjective sensations that occur without an irritant (tingling, crawling, numbness, etc.). Disorders have localization, clearly limited by zones of innervation. They are a symptom of a neurological disorder.

Senestopathy(illusions of a general feeling) - vague, difficult to localize, unpleasant, painful bodily sensations. They have peculiar descriptions by patients (pulling, pouring, stratification, turning over, drilling, etc.). Sensations do not have a real basis, "non-objective", do not correspond to the zones of innervation. Often found in the structure of the senesto-hypochondriac syndrome (senestopathies + ideas of "imaginary" illness + affective disorders), with schizophrenia, depression.

Illusions- an erroneous perception of real-life objects and events.

Affectogenic illusions occur with fear, anxiety, depression, ecstasy. Their occurrence is facilitated by the fuzzy perception of the environment (poor lighting, slurred speech, noise, remoteness of the object). The content of illusions is associated with affective experiences. For example, with a pronounced fear for one's life, a person hears threats in the conversation of far-standing people.

Physical- associated with the peculiarities of physical phenomena (a spoon in a glass of water seems crooked).

Pareidolic illusions- visual illusions, in which patterns, cracks, tree branches, clouds are replaced by images of fantastic content. Observed with delirium, intoxication with psychomimetics.

With illusions, there is always a real object (as opposed to hallucinations) or a phenomenon of the surrounding world, which is reflected incorrectly in the mind of the patient. Illusions in some cases are difficult to differentiate from the patient's delusional interpretation of the environment, in which objects and phenomena are correctly perceived, but absurdly interpreted.

Edeitism- a sensually vivid representation of the immediately preceding sensation (especially a vivid memory).

Phantasm- sensually vivid, distinctly fantastic daydreams.

hallucinations- a disorder of perception in the form of images and ideas that arise without a real object.

Simple hallucinatory images arise in one analyzer (for example, only visual ones).

Complex(complex) - two or more analyzers are involved in the formation of images. The content of hallucinations is connected by a common plot. For example, in alcoholic delirium, the patient "sees" the trait, "feels" his touch, and "hears" the speech addressed to him.

According to the analyzers (by modalities), the following types of hallucinations are distinguished.

visual hallucinations. Elementary (photopsies) are devoid of a clear form - smoke, sparks, spots, stripes. Completed - in the form of individual people, objects and phenomena.

Depending on the subjective assessment of the size, there are:

1) normoptic - a hallucinatory image corresponds to the real size of objects;

2) microoptical hallucinations - reduced sizes (cocainism, alcoholic delirium);

3) macrooptical hallucinations - gigantic.

Types of visual hallucinations:

1) extracampal hallucinations - visual images appear outside the field of view (from the side, from behind);

2) autoscopic hallucinations - vision of the patient's own double.

Visual hallucinations usually occur against the background of clouded consciousness.

Hallucinatory images can be painted in one color (with epilepsy they are often monochrome, red), they can be mobile and motionless, scene-like (with oneiroid), persistent and fragmentary.

Auditory (verbal) hallucinations. Elementary (acoasms) - noise, crackling, calls by name. Phonemes are individual words or phrases. Hallucinatory experiences are most often presented in the form of voices. It can be one particular voice or several (chorus of voices).

1) imperative, or commanding, hallucinations (are indications for hospitalization in a psychiatric hospital);

2) commenting (an imaginary interlocutor comments on the actions and thoughts of the patient); threatening, insulting;

3) antagonistic (the content is opposite in meaning - either accusing or defending).

Tactile (tactile) hallucinations unlike senestopathies, they are objective in nature, the patient clearly describes his feelings: “cobwebs on his face”, “insect crawling”. characteristic symptom for some intoxications, in particular cyclodol, there is a “symptom of a disappearing cigarette”, in which the patient clearly feels the presence of a cigarette sandwiched between his fingers, but when he brings his hand to his face, the cigarette disappears. For non-smokers, this may be an imaginary glass of water.

Thermal- sensation of warmth or cold.

Hygric- sensation of moisture on the surface of the body.

Haptic- sudden sensation of touching, grasping.

Kinesthetic hallucinations- sensation of imaginary movement.

speech motor hallucinations- the feeling that the speech apparatus makes movements and pronounces words against the will of the patient. In fact, it is a variant of ideational and motor automatisms.

hallucinations of general feeling(visceral, bodily, interoceptive, enteroceptive) are manifested by sensations of presence inside the body foreign objects or living beings.

For the patient, sensations have precise localization and “objectivity”. Patients clearly describe their sensations (“snakes in the head”, “nails in the stomach”, “worms in the pleural cavity”).

Taste hallucinations- feeling in oral cavity unusual taste sensations, usually unpleasant, not associated with eating. Often they are the reason for the patient's refusal to eat.

Olfactory hallucinations- an imaginary perception of odors emanating from objects or from one's own body, often of an unpleasant nature. Often coexist with taste.

They can be observed in the form of a monosymptom (Bonner's hallucinosis - an unpleasant smell from one's own body).

The division into true and false hallucinations is clinically important.

true hallucinations- the patient perceives hallucinatory images as part of the real world, the content of hallucinations is reflected in the patient's behavior. Patients “shake off” imaginary insects, flee from monsters, talk with imaginary interlocutors, plug their ears, which may be an objective sign of their presence. Extra projection is characteristic, i.e., images are projected outward or into real space within reach. The course is usually acute. Characteristic of exogenous psychoses (poisoning, trauma, infection, psychogeny). Criticism of the patient to experiences is absent.

False hallucinations (pseudo hallucinations) Patients lack a sense of objective reality. The patient perceives images of the inner "I". It clearly distinguishes between reality and hallucinatory image. Interoprojection is characteristic, voices sound "inside the head", images appear before the inner eye, or the source is inaccessible to the senses (voices from space, telepathic communication, astral, etc.). There is almost always a sense of accomplishment, of violence. The patient "understands" that the images are transmitted only to him. The course is usually chronic. There may be a critical attitude to experiences, but at the height of psychosis there is no criticism. Observed in endogenous psychoses.

Hypnagogic hallucinations Most often visual hallucinations. They appear when the eyes are closed at rest, often precede falling asleep, and are projected onto a dark background.

Hypnapompic hallucinations- the same, but when waking up. These two types of hallucinations are often referred to as varieties of pseudohallucinations. Among this variety of hallucinations, the following types of pathological representations are observed: visual (most often), verbal, tactile and combined. These disorders are not yet a symptom of psychosis; they often indicate a prepsychotic state or occur during an exacerbation of severe somatic diseases. In some cases, they require correction if they are the cause of sleep disturbance.

Additionally, according to the features of occurrence, the following types of hallucinations are distinguished.

functional hallucinations always auditory, appear only with a real sound stimulus. But unlike illusions, a real stimulus does not merge (is not replaced) with a pathological image, but coexists with it.

reflex hallucinations lie in the fact that correctly perceived real images are immediately accompanied by the appearance of a hallucinatory image similar to them. For example, the patient hears a real phrase - and immediately a similar phrase begins to sound in his head.

Apperceptive hallucinations appear after the volitional effort of the patient. For example, patients with schizophrenia often "cause" their voices.

Hallucinations of Charles Bonnet are observed when the peripheral part of the analyzer is damaged (blindness, deafness), as well as in conditions of sensory deprivation. Hallucinations always occur in the field of the affected or informatively limited analyzer.

Psychogenic hallucinations arise under the influence of psychic trauma or suggestion. Their content reflects the psycho-traumatic situation or the essence of suggestion.

Psychosensory disorders- violation of the perception of the size, shape, relative position of objects in space and (or) the size, weight of one's own body (disorders of the body scheme).

micropsia- reduction in the size of visible objects.

macropsia- an increase in the size of visible objects.

Metamorphopsia- violation of the perception of space, shape and size of objects.

Poropsia- violation of the perception of space in perspective (elongated or compressed).

Polyopsia- with the formal preservation of the organ of vision, instead of one object, several are seen.

Optical allesthesia- It seems to the patient that the objects are allegedly in the wrong place.

Dysmegalopsia- changes in the perception of objects, in which the latter seem to be twisted around their axis.

Autometamorphopsia- a distorted perception of the shape and size of one's own body. Disorders occur in the absence of visual control.

Violation of the perception of the passage of time(tachychronia - subjective sensation of time acceleration, bradychronia - slowdown). It is often observed in depression and manic states.

Violation of the perception of the sequence of temporal events.

This includes the phenomena of "already seen" - deja vu, "already heard" - deja entendu, "already tested" - deja vecu and "never seen" - jamais vu, "not heard" - jamais entendu, "previously untested" - jamais vecu. In the first case, patients in a new, unfamiliar environment have the feeling that this environment is already familiar to them. In the second, a well-known setting seems to be seen for the first time.

Psychosensory disorders rarely occur individually. Usually, individual symptoms of psychosensory disorders are considered within the framework of two main syndromes: derealization syndrome and depersonalization syndrome.

These disorders are most often found in exogenous organic psychoses, withdrawal states, epilepsy, and neurorheumatism.

Perceptual Disorder Syndromes

Hallucinosis – psychopathological syndrome, the leading disorder of which are hallucinations. Hallucinations, as a rule, occur in one analyzer, less often in several. Emerging affective disorders, delusions, psychomotor agitation are secondary and reflect the content of hallucinatory experiences. Hallucinosis occurs against the background of clear consciousness.

Disorders can proceed acutely, while bright hallucinatory symptoms are characteristic, hallucinatory arousal, an affective component of psychosis is expressed, delirium is possible, psychotically narrowed consciousness can be noted.

In the chronic course of hallucinosis, the affective component fades away, hallucinations become a monosymptom habitual for the patient, and a critical attitude towards disorders often appears.

Acute auditory (verbal) hallucinosis. The leading symptom is auditory (verbal) hallucinations. The prodromal period is characterized by elementary auditory hallucinations (acoasma, phonemes), hyperacusis. At the height of psychosis, true hallucinations are characteristic (sounds come from outside - from behind the wall, from another room, from behind). Patients talk about what they hear in great detail, and it seems as if they are seeing it (scene-like hallucinosis).

There is always an affective component - fear, anxiety, anger, depression. Often there is a hallucinatory variant of psychomotor agitation, in which the patient's behavior reflects the content of hallucinations (patients talk with imaginary interlocutors, plug their ears, make suicidal attempts, refuse to eat). Perhaps the formation of secondary delusions (hallucinatory delusions), delusional ideas reflect the content of hallucinations and affective experiences.

There is no criticism of what is happening. Consciousness is formally clear, psychotically narrowed, patients are focused on their experiences.

Chronic verbal hallucinosis- the manifestation is usually limited to hallucinatory symptoms.

It can be observed as an unfavorable outcome of acute verbal hallucinosis. At the same time, the intensity of the affect first decreases, then the behavior is ordered, delirium disappears. There is a critique of experiences. Hallucinations lose their brightness, their content becomes monotonous, indifferent to the patient (encapsulation).

Chronic verbal hallucinosis without an acute psychotic stage begins with rare hallucinatory episodes that become more frequent and intensify. Sometimes it is possible to form an irrelevant interpretive delusion.

Occurs in infectious, intoxication, traumatic and vascular lesions brain. May be initial sign schizophrenia, while it becomes more complicated and transforms into the Kandinsky-Clerambault syndrome.

Peduncular visual hallucinosis (Lermitte hallucinosis)

occurs when the legs of the brain are damaged (tumors, injuries, toxoplasmosis, vascular disorders). The leading symptom is visual hallucinations with extra projection at a small distance from the eyes, often on the side. As a rule, hallucinations are mobile, silent, emotionally neutral. Attitude to experiences is critical.

Visual hallucinosis of Charles Bonnet occurs with complete or partial blindness. Initially, there are separate incomplete visual hallucinations. Further, their number grows, they become voluminous, scene-like. At the height of experiences, criticism of hallucinations may disappear.

Van Bogart hallucinosis characterized by constant true visual hallucinations. More often these are zoooptic hallucinations in the form of beautiful butterflies, small animals, flowers. At first, hallucinations occur against an emotionally neutral background, but over time, the following appear in the structure of the syndrome: affective tension, psychomotor agitation, delirium. Hallucinosis is replaced by delirium. It is characteristic that this hallucinosis is preceded by a stage of somnolence and narcoleptic seizures.

Kandinsky-Clerambault Syndrome is a kind of syndrome of the first rank in the diagnosis of schizophrenia. The structure of the syndrome includes auditory pseudohallucinations, mental automatisms.

At hallucinatory form syndrome is dominated by auditory pseudohallucinations.

At delusional version the clinical picture is dominated by delusions of influence (telepathic, hypnotic, physical). Usually there are all kinds of automatisms.

Mental automatism- alienation to the patient of their own mental processes and motor acts - their own thoughts, feelings, movements are felt inspired, violent, subject to extraneous influences.

There are several types of mental automatism.

1. Ideatory (associative) is manifested by the presence of a feeling of embedding other people's thoughts, the phenomena of openness of thoughts are noted (the feeling that one's own thoughts become known to others, sound, a feeling of theft of thoughts).

2. Sensory (sensory) mental automatism consists in the emergence of sensations, feelings, as if under the influence of external ones. Alienation of one's own emotions is characteristic, the patient has a feeling that emotions arise under the influence of an outside force.

3. Motor (kinesthetic, motor) mental automatism is characterized by the patient's feeling that any movements are carried out under the influence of external influences.

The presence of this syndrome in the clinical picture of the disease indicates the severity of the psychotic process and requires massive complex therapy.

The syndrome is characteristic of schizophrenia, however, some authors rarely describe intoxication, trauma, vascular disorders.

It is also possible to develop the so-called inverted variant of the Kandinsky-Clerambault syndrome, in which the patient himself supposedly has the ability to influence others. These phenomena are usually associated with crazy ideas greatness, greatness.

Derealization syndrome. The leading symptom is an alienated and distorted perception of the surrounding world as a whole. At the same time, there may be violations of the perception of the pace of time (time flows faster or slower), colors (everything is in gray tones or vice versa bright), distorted perception of the surrounding space. Deja vu symptoms may also be observed.

When depressed, the world may seem gray, time drags on slowly. The predominance of bright colors in the surrounding world is noted by patients with the use of certain psychoactive drugs.

The perception of the environment in red and yellow tones is typical for twilight epileptic states.

A change in the perception of the shape and size of the surrounding space is characteristic of intoxication with psychoactive substances and organic brain lesions.

Depersonalization Syndrome It is expressed in a violation of self-consciousness, a distorted perception of one's own personality and the alienation of individual physiological or mental manifestations. In contrast to mental automatism, in these disorders there are no sensations of external influence. There are several options for depersonalization.

Allopsychic depersonalization. Feeling of a change in one's own "I", duality, the appearance of an alien personality, reacting differently to the environment.

Anesthetic depersonalization. Loss of higher emotions, the ability to feel, experience. Complaints of excruciating insensitivity are characteristic. Patients lose the ability to feel pleasure or displeasure, joy, love, hate or sadness.

neurotic depersonalization. Typically, patients complain of inhibition of all mental processes, changes in emotional response. Patients are focused on their experiences, an abundance of complaints about difficulty in mental activity, difficulty in concentrating attention is revealed. Characterized by obsessive "self-digging", introspection.

Somato-physical depersonalization. Changes in the perception of internal organs, alienation of the perception of individual processes with the loss of their sensual brightness are characteristic. Lack of satisfaction from urination, defecation, eating, sexual intercourse.

Violation of the scheme and dimensions of the body and its individual parts. Feelings of disproportion of the body and limbs, "wrong position" of the arms or legs. Under visual control, phenomena disappear. For example, the patient constantly has a feeling of the immensity of the fingers, but when looking at the hands, these sensations disappear.

Dysmorphophobia. The belief in the existence of a non-existent shortcoming in oneself proceeds without severe disorders of mental activity. It manifests itself mainly in adolescents as a transient age-related phenomenon.

Senesto-hypochondriac syndrome. The basis of the syndrome is senestopathies, which occur first. Subsequently, overvalued ideas of hypochondriacal content are added. Patients turn to doctors, the mental nature of the disease is rejected, so they constantly insist on a more in-depth examination and treatment. Subsequently, hypochondriacal delirium may develop, which is accompanied by its own interpretation of disorders, often of anti-scientific content, there is no trust in health workers at this stage (reaches the level of open confrontation).

Smirnova Olga Leonidovna

Neurologist, education: First Moscow State medical University named after I.M. Sechenov. Work experience 20 years.

Articles written

Disorders of perception are accompanied by a violation of the process of cognition of the surrounding world. The main variants of pathology are illusions and malfunctions of psychogenic synthesis. The patient can not do without the qualified help of a psychiatrist. In most cases, such phenomena indicate the development mental disorders. They bring a lot of problems to the patient and his relatives and require treatment.

Perception is characterized by a mental process that contributes to the formation of images of objects and phenomena of the external world.

Without the presence of primary sensations, perception of the surrounding world is impossible. A person draws conclusions on the basis of knowledge, desires, his own imagination, mood.

There are many types of perceptions. Each person perceives the world differently. If something seems obvious, it does not mean that the other person also thinks. Therefore, in order to avoid disputes, all the nuances should be discussed.

Perception has a direct relationship with emotional response. It determines emotions, and at the same time, emotions determine perception. Congenital features play an important role in its development. Since childhood, a person receives a lot of information about the world. But what will be the perception in the future depends on the level of activity of the baby. Therefore, the development of children should be promoted in every possible way.

How do receptors and sense organs affect

The sense organs help a person to compose a picture of the environment, taking into account all its diversity and versatility.

The world is known through sensations. With their help, you can find out individual signs of an object or their combination, using vegetative reactions for these purposes.

Feelings are objective, because they reflect external stimuli. The subjectivity of sensations depends on the state of the nervous system.

Feelings allow you to send information about the human body and environment into the brain.

Present in the human body sensory system, under the influence of which sensations arise. The analyzer analyzes and synthesizes external and internal stimuli, which includes:

1. A receptor responsible for converting an external stimulus into an external signal.
2. Conducting nerve pathways. Through them, signals are sent to the brain, and from it to the overlying sections, and then again to the brain and low-lying sections.
3. Cortical projection zones. This think tank, located in the region.

Individual receptors have the ability to receive certain manipulations. Different sensations arise with a distinctive speed. A person feels the impact, and then perceives it, depending on the threshold of sensitivity.

Types of disorders

Perceptual disorders in psychiatry exist different types. They have a distinctive clinical picture, duration and treatment methods. At the first manifestations, you need to consult a doctor, since the problem will not be solved on its own.

Illusions

In this case, a person sees in a distorted form an object that really exists. The patient may misperceive the shape, color, size, consistency, and other characteristics. In the presence of illusions, the visual image is distorted. For example, there is a coat hanging in the closet, and he was taken for a real person due to similar outlines. With auditory illusions, the perception of existing sounds is disturbed. For example, when someone shouts on the street, and it seems to the person that his name is. There are even taste illusions. At the same time, the taste or smell familiar to the dish is modified. There are cases of tactile illusions. Their formation is influenced by real sensations. Illusions develop under the influence of physiological and psychological characteristics.

A disorder of perception, which is called an illusion, manifests itself in the fact that a person perceives reality incorrectly, distortedly. He mistakenly recognizes objects, instead of one he sees a completely different one.

Illusory perception is often indistinguishable from sensory perception. Therefore, there is no criticism of illusory deception. A person is completely sure of what he saw or heard, even if it is something unusual, implausible, fantastic.

Illusions can also be optical, physiological and others. For example, if you lower a stick into water, it will seem that it is broken in half. While traveling in a train, it seems that the landscape also moves along with the vehicle.

In psychiatry, illusions are most often referred to as pathological conditions which arise not under the influence of physiological and optical laws.

Most often, the appearance of auditory, visual and affective illusions is observed. Deception of smell and touch is rare.

The most common are affective illusions. They appear if a person suffers from stress, anxiety, fear or prolonged depression.

There are illusions of the pareidolic type. They are distinguished by the complexity of images, fantastic paintings. For example, when a patient examines a drawing on a carpet, he sees people, animals, various scenes from their lives there. Sometimes illusions can follow each other like a movie.

In some cases, patients are completely sure that the images are real. If they are short-term, fuzzy or vague, then the person understands that this is not a real picture.

Illusions are considered a psychotic or subpsychotic symptom. With abundant visual illusions conclude that there is a change in consciousness.

A similar deception of hearing and vision often occurs if a person is in anxiety, is experiencing fear, suffers from stress, is in a room in which there is not enough light or noise, suffers from pathologies of the senses, is characterized by excessive impressionability and daydreaming, a penchant for fantasies, is too tired or sleeps little.

hallucinations

Major perceptual disturbances include hallucinations.

They are characterized by the perception of objects that do not exist in reality, but at the same time the person is completely sure of the existence of the object at the moment.

This is the most striking manifestation of a perceptual disorder, which has a serious impact on a person, his behavior and can induce action.

The occurrence of hallucinations does not depend on whether the object exists or not. Patients are fully convinced of the reality visible images. Hallucinations may be true. At the same time, a person indicates exactly where the image is located, which he perceives as real.

It is important to remember that a perceptual disorder, when the patient sees something that is not there, is called a hallucination. Such problems require treatment.

eidetism

This is a special kind of memory that allows you to retain and later reproduce a visual image. People with this feature quickly remember what they see and can return to memories at any time. Man is capable of long time save the image and scroll through it with the smallest details.

Senestopathy

This is a mental disorder that is accompanied by unusual sensations. A person suffers from vague, painful, unpleasant, obsessive, difficult to localize sensations.

Deviation is associated with hysteria, manic psychosis, schizophrenia, general neurosis, neurasthenia, chronic poisoning.

At the same time, it seems to the patient that he is sipping, tingling or burning in a certain place. But these sensations are not associated with organ pathologies and their nature and localization are changing rapidly.

A person constantly focuses his attention on these sensations. They interfere with his normal life.

Agnosia

Translated into Greek, "gnosis" means "knowledge". This nervous function allows a person to recognize objects, phenomena, own body.

Agnosia is a complex concept that combines violations of gnostic functions.

The pathological condition is usually observed in degenerative processes in the Central nervous system, after injuries, infections and.

Clinical agnosia is usually diagnosed in children at a younger age, since they have not yet completed the process of formation of nervous activity. The problem is often identified in children as young as seven years of age.

The problem is manifested by a lack of understanding of speech, the inability to determine the object by touch. Inability to consider the subject, to paint it.

One type of such a perceptual disorder is somatognosia, in which a person does not recognize parts of his own body.

Derealization disorders

Such a disorder of perception is a psychogenic disorder that manifests itself in the form of:

1. macropsia. At the same time, it seems to the person that the surrounding objects are decreasing in size. It is characterized by an increase in the size of surrounding objects.
2. Dysmegalopsia. In this case, the surrounding objects lengthen, expand, bevel, pervert around the axis.
3. Porropsia. The person has the impression that the object is moving away from him.

Such disorders of sensation and perception are characterized by an incorrect attitude towards one's personality, individual qualities or parts of the body.

A good example of a problem is the Alice in Wonderland syndrome. This disease is rare. With it, patients feel that their body is too big or small, time slows down or speeds up, space is distorted.

With such a disorder, a person has the impression that his limbs are lengthening, shortening, tearing off.

Temporal Perception Disorders

In this case, it feels like:

1. Time stopped. In this case, dullness and flatness of objects are observed. It seems to the patient that he has no connection with the outside world and loved ones.
2. The timer is stretched. The patient thinks that time is longer than usual. He relaxes and is in a euphoric state. The impression of a plane and three-dimensionality of objects, their mobility is created.
3. Lost sense of time. Man thinks that he is completely freed from time. At the same time, the perception of the world always changes. Increases the contrast of objects and people.
4. Time has slowed down. People move at a calm pace with grim expressions.
5. The timer has sped up. The world and your own body seem fleeting, and people are fussy. Feeling of your body worsens. It is difficult to determine the time of day and the duration of events.
6. Time flows backwards. If the event happened a few minutes ago, then it seems that it happened a very long time ago.

Temporal perception disorder occurs when right hemisphere the brain was damaged.

Perception in children

The process of its development depends on specific features. From birth, children own certain information. How its development will proceed in the future depends on how active the child is.

The process of formation of perception should be under the control of parents. It continues from birth and as the child develops. AT infancy a person learns to recognize people, to distinguish objects, to control his body. The completion of this process falls on the primary school age.

During this period, it is important to be screened for possible perceptual disturbances. The problem can arise in diseases of the brain that break the connection with the sense organs and centers of the brain. Trauma contributes to the development of disorders and morphological changes in the body.

Young children perceive the world vaguely and indistinctly. If, for example, mother changes into fancy dress, then it will be difficult for the baby to recognize her.

The development of the perception of the world is an important process, how the child perceives the world, reality, and adapts to environmental conditions depends on how successful it is.