Mrs. Reena (name changed) is a 94 years old woman who is wheelchair-bound and has started hallucinating a lot after she broke her pelvis in a fall last year. Thus she constantly talks with her long dead relatives and her childhood acquaintances and imagines all sorts of weird things. She says she sees her dead relations with eyes open. The hallucinations were already happening intermittently, but after the fall the frequency of the episodes has increased rapidly. They also occur more often when she is sleep-deprived. These episodes have also coincided with her diminished desire to live as if the ego is simply fading away! 

During the dreaming process the ego is nearly absent and thus we have strange dreams. The memories still exist, but during dreaming their sequence in time is gone. The dreams are basically an outcome of thoughts produced by neural pathways which are randomly excited since ego is absent to structure them. Thus we may have dreams of people long dead interacting with us in weird ways and in very different places etc. They are almost like hallucinations.

Similarly hallucinations also happen after consumption of mind-altering drugs like LSD, heroin, ecstasy, etc. The chemicals play havoc with the ego which is reduced drastically and with its reduction the whole world becomes dream-like with no sequence to the events. An   absence of sequence also gives the images and experiences a surreal quality.  

Thus hallucinations are an outcome of the brain when the ego is absent or diminished drastically.  

As the Indian population is aging, anecdotal evidence suggests that a very large number of people are suffering from dementia, Alzheimer’s and Parkinson’s disease and other brain- related illnesses. All of these lead to episodes of hallucination.      

In old people the ego starts reducing because the brain’s processing power is reduced. Hence ego is unable to create proper neural pathways and sequencing, resulting in production of hallucination episodes. This is also called mellowing with age ! Ego or director of thoughts is nothing else but the sum and substance of our desires, memories and experiences.  It resides in frontal portion of the brain called fronto-insular cortex (FIC).  

Sequencing happens because there is a strong memory of events and objects. The directed neural pathways are like a thread connecting memories to produce sequencing. This experience is further reinforced when the sequencing is tallied with actual events. The brain actively compares its internal working with the actual events and produces a sense of reality. When the neural pathways are triggered randomly the sequencing is gone and hallucinations result.       

How can we ensure that hallucinations do not occur.  One of the ways to do it is to cultivate the habit of concentration or focus on a single thought for a long time, also called Sanyam in Patanjali Yoga darshan. This helps in increasing the power of the director or the ego. This process has to be cultivated from childhood and with strong memories the chances of hallucinations become less.  

There are many episodes where prisoners, who were put in solitary confinement for long periods of time, maintained their sanity by repeating the memorized mathematical tables. This repeated rote learning helped in concentration and increasing the power of the ego or the director.

The present generation with a focus on smart phones and internet suffers from attention deficit disorder. They cannot focus on any idea for a long time and continuously get random thoughts with no control over them. As the mind gets used to having these unfocussed random thoughts there are good chances that in old age this may lead to hallucinations and other mental illnesses.