The Hallucination, Between Alteration and Pathology of Consciousness

A state of consciousness is said to be “altered” (ASC) when it appears qualitatively different from what the subject considers normal. However, this reference to normality is paradoxical, ASCs being frequently distinguished from pathological states of consciousness (PSC), themselves recognized as a deviation from the norm. Therefore, the study of ASCs faces a dilemma: to either arbitrarily reject PSCs from its field of study or extend a concept whose limits are already blurry. Our purpose will be to approach this problem through the study of hallucinations, which are regarded at the same time as a paradigmatic case of ASC and as a central object for psychopathology. We show that, in the case of hallucinations, not only the traditional criteria of “reversibility” and “insight” are insufficient to distinguish ASCs from PSCs, but even the idea of a difference between “altered” and “pathological” states must be questioned. Following the philosophy of Wittgenstein, we therefore try to prove that the description of a hallucination as “pathological” is linked to a “game-language” specific to psychiatry and, for this reason, is irrelevant regarding the study of ASCs.