Hostage hallucinations. Visual imagery induced by isolation and life-threatening stress

The literature on hallucinatory experiences of hostage victims is reviewed. The phenomenology is examined in 30 case studies involving 31 persons, including ex-prisoners of war and victims of rape, kidnapping, terrorism, robbery, and "UFO abductions." The victims were subjected to conditions of isolation, visual deprivation, restraint on physical movement, physical abuse, and the threat of death. For eight victims, these conditions were sufficient to produce a progression of visual hallucinations from simple geometric images to complex memory images coupled with dissociation. The other 23 victims, subjected to similar conditions but without isolation and life-threatening stress, resulting from the threat of death, did not experience hallucinations. The hostage hallucinations are compared to those resulting from sensory deprivation, near fatal accidents, and other states of isolation and stress. A common mechanism of action based on entoptic phenomena and CNS excitation and arousal is suggested.