Seeing Things That Are Not There: What it Means

This article is an excerpt from the Shortform summary of "Brain On Fire" by Susannah Cahalan. Shortform has the world's best summaries of books you should be reading.

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What does it mean when you are seeing things that are not there? What happened when Susannah Cahalan started having visual hallucinations in Brain on Fire?

Seeing things that are not there was a common experience for Susannah as she developed anti-NMDA-receptor encephalitis. She had a variety of visual and auditory hallucinations.

Read more about how and why Susannah experienced seeing things that are not there.

Susannah Starts Seeing Things That Are Not There

During the height of the Manhattan bedbug scare in 2009, Susannah finds two red dots on her arm. She’s convinced her apartment is infested, even though an exterminator says otherwise. At work the next day, Susannah feels the walls caving in. Posters on the wall pulsate. This is the beginning of her seeing things that are not there.

She has another hallucination in Times Square the next day. The garish colors on the Times Square billboards make the hairs on her neck stand up. A scrolling banner makes her want to vomit. She’s instantly hit by a migraine. 

Susannah asks another colleague for advice, and the woman gives her an excellent piece of counsel: Susannah should write down every symptom, no matter how small it is. Even the tiniest detail could turn out to be important. Susannah returns to her desk, writes down the word “insomnia” and shouts, “Everything’s going to be great!” 

Buoyantly happy for the moment, Susannah saunters over to Paul’s desk and invites him downstairs for a smoke. As she talks a mile a minute, Paul becomes increasingly concerned, convinced she’s on the verge of a breakdown. Excusing himself, he goes upstairs and tells Angela to call Susannah’s mom, partly because Susannah is seeing things that are not there.

Susannah’s now by herself on the street. She feels wobbly. She floats above the crowd, seeing the top of her own head. The Wiccan librarian walks by and tells Susannah she’s just experiencing astral travel.

Hearing Things Never Said

At her dad’s place, Susannah has a number of hallucinations. She hears her stepmom saying, “You’re a spoiled brat,” even though her lips don’t move. She is also seeing things that are not there. A painting comes alive. Her childhood dollhouse is haunted. Her father is beating her stepmom.

Convinced her father is going to kill her, Susannah runs to the front door of the brownstone and bangs her fists against the door, screaming, “Let me out!” When she hears her father coming, she locks herself in the bathroom. 

That night Susannah’s parents agree that she must be admitted to a hospital, but refuse to let her go to a psych ward. 

Even fully recovered, Susannah can remember only the hallucinations she experienced during her illness; she can’t recall its day-to-day reality. This strange discrepancy makes her wonder whether she can rely on her own mind. Why does she continue to favor hallucinations over reality? Why do those particular hallucinations persist? How did they materialize in the first place? 

 Hallucinations: Seeing Things

Hallucinations occur when the brain perceives a sensation that has no external source. In other words, you’re seeing things that are not there. Because hallucinations are self-generated, they are believable and remembered in vivid detail, a process termed the generation effect.

Mental illness is not the sole source of hallucinations. A 2010 study at Cambridge University found that injecting healthy student volunteers with the drug ketamine broke down their sense of reality. Ketamine blocks NMDA receptors in the brain, much like the autoantibodies in Susannah’s illness. 

Seeing Things That Are Not There: What it Means

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Like what you just read? Read the rest of the world's best summary of Susannah Cahalan's "Brain On Fire" at Shortform.

Here's what you'll find in our full Brain On Fire summary:

  • How a high-functioning reporter became virtually disabled within a matter of weeks
  • How the author Cahalan recovered through a lengthy process and pieced together what happened to her
  • How Cahalan's sickness reveals the many failures of the US healthcare system

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