If we close our eyes and concentrate on it, we may be able to hear our heartbeat, how air enters our lungs, or when our kidneys or liver are aching. This is because we are able to perceive sensations from inside our body, something that helps us adapt to situations and survive.

But these situations have a reason: our heart beats, we breathe, we are full or we have a urinary infection. However, sometimes some people can have perceptions of this kind, coming from inside the body, without there being anything that really causes them. These are cenesthetic hallucinations .

What is a hallucination?

As a preamble and in order to make the concept of coenesthetic hallucination more easily understood, it is useful first to review what a hallucination is and implies.

The concept of hallucination refers to the existence of a false perception or perception without an object , that is, the capture by a person’s senses of information or stimulation that does not come from any real and existing source. It is a type of perceptive deception in which something is perceived that does not exist and that is a product of the subject’s mind.

However, it should be noted that this is a perception: the subject actually sees, hears or notices some kind of sensation even though this does not prevent any stimulation from generating it.

This is one of the main symptoms of schizophrenia and psychotic disorders , although it can appear in a large number of situations that do not always have to be the result of a psychopathology (for example, poisoning or intoxication can generate hallucinations, or even prolonged experience of stress).

There are many different types and classifications of hallucinations, among which we can find visual, auditory, olfactory or taste, tactile, kinesthetic (movement perception) or those that give name to this article: cenesthetic hallucinations.

Cenesthetic hallucinations

Cenesthetic hallucinations (also called somatic or visceral hallucinations) are those in which the subject has a perception without object referring to the existence of sensations inside his own body , in which specific reference is made to elements such as the viscera , specific organs or elements of the organism regardless of whether or not these elements have sensitivity (for example blood).

This is a type of hallucination in which perception is carried out at a somatic level or body awareness: in the internal perception of the organism itself. The subject has the perception of some kind of alteration inside his body, which may be limited to specific parts or organs of the body or to the organism at a general level. It is common for this type of hallucination to occur together with different types of delusions that explain them, which are usually of a high level of extravagance and strangeness .

An example of this is given by those people with delusions of infestation, in which they often refer to the sensation that ants, insects or other small beings have infested the subject and are moving around inside the body, and there may even be the idea that they are devouring their organs.

Perceived sensations can be very variable and include among others the perception of mechanical pressure, displacement, vacuum, pain, itching or temperature changes. There can also be the sensation of changes in the composition of body parts (for example perceiving that one of your lungs has dissolved), sensations related to organ movements (such as perceiving that the brain has lowered to the position of the stomach) or variation in their number (as could occur in the case of having the sensation of having lost a leg without having done so).

Other possible sensations could be the perception of the presence of external elements inserted (for example the perception of the insertion of a microchip would enter into this type of hallucination) or extraction/loss of body parts (feeling that the heart has left their body).

Linked to other types of hallucinations

As can be imagined from this description, kinesthetic hallucinations are deeply linked to others such as tactile or haptic hallucinations or those related to movement perception or kinesthetic hallucinations.

In fact, it is often possible to find that both types of hallucinations occur together. Some authors even indicate that in reality cenesthetic hallucinations include tactile, kinesthetic and visceral hallucinations as subtypes, although cenesthetic is usually identified with visceral.

The main difference between these types is that in the case of coenesthetics we are talking about perceptions relative to the body itself and generally to its interior, without the idea of external contact or without the displacement occurring externally . Despite this, they often occur in an associated or joint manner.

Contexts of appearance

Cenesthetic hallucinations are less common than others such as auditory or visual hallucinations, although they can occur in multiple contexts and conditions.

On a psychiatric level, one of the best known is schizophrenia, along with other disorders on the psychotic spectrum such as chronic delusional disorder.

For example, in Ekbom’s syndrome or delirium of parasitosis , in which the subject sustains the belief of being infested by living beings, or in Cotard’s syndrome (delusional disorder in which there is a belief of being dead or that the organs are rotting, something that can be based on the interpretation of somatic hallucinations). However, it should be noted that such syndromes are based on the existence of delirium, without the need for hallucinations.

They can also occur in the context of some depressions , and it is possible for them to appear in some cases in manic-type episodes (such as in bipolar disorder).

Another context of appearance may be medical alterations. These include, for example, the appearance of kinesthetic hallucinations in situations such as intoxication by substances such as cocaine or in some cases of epilepsy, although this is less frequent.

Causes

Beyond the context in which they appear, the causes of cenesthetic hallucinations are not clear, although as with other hallucinations the limbic system and the diencephalon seem to be involved .

The involvement of the somatosensory cortex has also been observed, as well as the part of the cortex corresponding to the insula. Some theories stipulate the existence of a basic difficulty in integrating sensory information, something that can cause our nervous system to generate perceptions without a physical element triggering it.

Likewise, other theories (which do not exclude the previous one) indicate that the problem may stem from a difficulty in separating the mental content from the physical experience , in such a way that it is not possible to separate the imagined from the perceived.

Treatment

Cenesthetic hallucinations are not a disorder per se, but are a symptom of the existence of some kind of alteration . In this sense, treating these hallucinations will require an evaluation of the patient’s situation and an assessment of the origin or disorder of which they are a symptom. This will require the multidisciplinary work of various professionals from different areas of health.

Depending on the case, it is possible to employ different therapeutic strategies. At the pharmacological level the use of antipsychotics can contribute to curb this type of perceptions, as well as some antidepressants.

On a psychological level, treating these perceptions may require helping the subject to reattribute their perceptions so that they end up seeing them as a product of their own mind, with techniques such as cognitive restructuring and proposing behavioural experiments in which they can check whether their perceptions are real or not.

Bibliographic references:

  • Belloch, A., Baños, R. and Perpignan, C. (2008) Psychopathology of perception and imagination. In A. Belloch, B. Sandín and F. Ramos (Eds.) Manual de Psicopatología (2nd edition). Vol I. Madrid: McGraw Hill Interamericana.
  • Cruzado, L., Córdova, R. and Vizcarra, O. (2012). Visceral and cenestopathic hallucinations in the differential diagnosis of medically unexplained symptoms. Heredian Medical Journal. 23 (3). Peruvian University Cayetano Heredia. Alberto Hurtado School of Medicine. Peru.
  • Fernández-Díaz, A., Bobadilla-Pérez, E., Bello-Porto, J., Méndez-Iglesias, R. and Menéndez-Sánchez, B. (2013). Psychotic clinic or police crisis? Diagnostic considerations in clinical practice. Journal of the Galician Association of Psychology, 12.
  • Seva, A. (1979). Psychopathology of Perception. In: Psiquiatría Clínica. Ed. Spaxs. Barcelona, pp 173-180.
  • Slade, PD. & Bentall, R.P (1988). Sensory deception: A scientific analysis of hallucination. Baltimore: The Johns Hopkins University.