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Dreaming, Dementia and Hallucinations

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In dreams, our mind pulls information from a variety of sources - what someone said the other day, a segment from a TV show or movie, past experience, something we read and so forth. In our dream, this all seems to flow and make sense. Yet when we awaken, as real as the dream seemed at the time – we know it was only a dream.

How do we know what is real?

My mother had a stroke, and often when we hear or think about stokes, we think about the type which leaves the person paralyzed on one side. A stroke can affect any part of the brain and in my mom's case, it damaged a segment of her temporal lobe. Her ability to walk and speak were unaffected but she left the hospital with significant (vascular) dementia.

The aspect of the dementia that I'm going to talk about today is what has happened to her memory and her conscious thoughts and how similar they are to what we experience in dreams.
I don't know if this is a unique case or if this sort of thing happens in other cases of dementia or this angle has even been considered before.

Our memories tend to organized in a linear fashion. We have a pretty good grasp on whether an event happened recently or a long time ago. For some memories, we can remember a specific date of the incident. In my mom's case, it was as if someone had taken the filing cabinets that contained her memories, dumped them on the floor, mixed them up and put them back. Her history as we knew it and as she once knew it has been replaced with a different set of events, some that actually happened and others that have been created by fragments of "other" (thoughts, feelings, memory segments).

In our dreams, even the strangest connection of events seem normal or reasonable. In remembering out dreams, we find ourselves a little surprised about how some of the incidents in the dream fit together and that they did make sense to us at the time.

The veil between conscious reality and dream state has thinned and is even transparent in my mom's new world. Sometimes she sees images that are not really there. Sometimes she has conversations with memories of my father (making him and his memory two different people). Most of it doesn't happen in the moment, while we are there, but is told to me later as if it did happen (memory). What is real to her – is not necessarily real to us.

While writing this blog, I'm thinking about other circumstances where hallucination happens and we lose our ability to distinguish between reality and imagination. Hallucination is actually a common phenomena that we experience daily. We though we saw our keys on the table and they are not there or they are there and we don't see them. We mistake a branch in the distance for an animal and so forth. What differs our hallucinations from a diagnosis of dementia or schizophrenia is that our hallucinations are minor and usually have to do with perceptual mistakes and not abnormal reasoning about what we thought we saw, heard or felt. We don't think we see a dragon in the distance, we may think we see a bear. With mental illness, what is perceived is real and no other explanation is accepted.

I've read that with hallucinatory illnesses such as schizophrenia, too much dopamine in the system is responsible for the hallucinations. I don't know if anyone has ever tested dementia patients for dopamine levels? It would be interesting to know if there is a connection. I also wonder if our dopamine levels are higher while we dream or if they spike when we hallucinate or experience an ASC (altered state of consciousness)?

It would also be interesting to know the EEG readings on my mom when she is "remembering" something or while a schizophrenic is having an episode or … . I suspect Theta Delta being in appropriating dominant. I guess I'll have to look into this further.

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Updated 05-27-2011 at 11:09 AM by Marisa (didn't like font)

Human Interest , The Brain , Altered States


  1. neuroasis's Avatar
    I do not tend to think of memories being stored in a linear fashion however with the case of your mother (which is very trying and heart-wrenching I am sure, my grandmother had a stroke and we took care of her for 8 years as she progressively moved further into dementia) ... there is a unique opportunity to understand a bit more about the organization of our memories.

    I use a model of understanding memory stores as association chains. In this way memories are organized into clusters of relatedness. So if I think of a cat I trigger a whole chain of associations. To rebuild a particular story of a cat, I follow a particular link in the chain which leads to another link and so on.

    I also do know for a fact personally that memories or items in memory can be organized alphabetically or at least that is a serialized overlay pattern. I often know the first letter of something that I am trying to remember and observe myself following the chain to retrieve the remaining letters.

    This model of association clusters can go a long way in explaining dreams (where at one level clusters are built in free-form manner without the necessary formal rules of logic) and also may help shed some light on your mother's condition. In her present state, associational paths are acting as if they are cross wired. That way one bit of memory composites with another bit of memory along a seemingly haphazard path. However, as these memories are clustered together then they trigger one another and she is not quite able to retrace the exact path along the original chain. Just food for thought.

    Having said this, it probably now makes a little more sense what I was talking about in the kundalini thread with traumatic memories being an overriding cluster on which the whole associational structure is superimposed, acting as a strange attractor, with every memory ultimately reminding of and triggering some aspect of that trauma.

    Also, in the 'conversational hypnosis' thread brewmasher's observance that he goes into the kitchen and forgets why he is there could reveal that the act of going into the kitchen has triggered an association cluster that he has become immersed in for a moment and his original purpose for being there is diffused in the chain. So he begins retracing to find the trigger.

    Once again, this is all just speculation but I have put this model to great use myself.
    Updated 05-19-2011 at 05:00 PM by neuroasis
  2. Robert Austin's Avatar
    Fascinating post, Marisa! What a strange experience of the world your mother must be having. My mother's strokes were all in her right hemisphere, which has scrambled her visual memory. Though she's still pretty lucid and can sound like her pre-stroke self, she has reported that there was a dragon living under her bed, is convinced that my brother's son's wife just had two children despite being reminded that there was just one, and the like. When I ask her what she spends time thinking, she says "making lists" and "analyzing" which is pretty consistent with having a functioning left hemisphere.

    Regarding your Mom's EEG, you are almost certainly right - regions near the locus of a stroke tend to spend most of their time in low frequency land, and sometimes neurofeedback to specific areas (temporal in your mom's case) can improve things. I left my mother a Procyon programmed to ramp between 12 and 18 hz as she expressed interest in trying this, and hopefully the folks running the family home haven't taken it away since it was not prescribed by her doctor...
  3. Anji's Avatar
    Did you read the book "My Stroke of Insight"?
  4. Marisa's Avatar
    Sorry for the delay in responding. I just found that I had comments. Doh!

    Anji, Yes, I did read that book. It was incredible!

    Robert, That's very interesting how your mother and mine have hallucinations of a similar nature. While my mom isn't seeing dragons, she does think that this stuffed dog I gave her is sentient. Also, she thinks both me and my sister were adopted. She even has entire stories built around how this happened. The stories are not really logical but in her mind they make sense. This does remind me of how when we dream our minds can create stories and they make sense to us at the time.

    Neuroasis, I agree with you about how memories are linked with associations. The brain also does have a sense of temporal organization which allows us to know whether something happened in the recent or distant past (if not the date). That's a whole discussion on its own - temporal organization. I recently came across a good paper on the subject - in case you or anyone is interested in this subject -
  5. neuroasis's Avatar
    There is a beautiful documentary by Ram Dass (Richard Alpert) who was an associate of Timothy Leary and who is the author of the famous sixties book Be Here Now. It is about how he has coped with being 'stroked' (his words) and how it has changed his perspective. It is called Fierce Grace. It is also available for streaming on Netflix.