Did Paul Hallucinate on the Road to Damascus?--Part One

In I Corinthians 15, Paul says that the risen Jesus appeared to him just like he had appeared to Peter, James, the Twelve and the 500. When did this experience happen and what was it like? It took place on the road to Damascus as Paul was on his way to persecute Christians. He had already been involved in the persecution and execution of Christians in Jerusalem. His experience on the Damascus road is recounted three times in the book of Acts.

Meanwhile, Saul was still breathing out murderous threats against the Lord's disciples. He went to the high priest and asked him for letters to the synagogues in Damascus, so that if he found any there who belonged to the Way, whether men or women, he might take them as prisoners to Jerusalem. As he neared Damascus on his journey, suddenly a light from heaven flashed around him. He fell to the ground and heard a voice say to him, "Saul, Saul, why do you persecute me?" "Who are you, Lord?" Saul asked. "I am Jesus, whom you are persecuting," he replied. "Now get up and go into the city, and you will be told what you must do." The men traveling with Saul stood there speechless; they heard the sound but did not see anyone. Saul got up from the ground, but when he opened his eyes he could see nothing. So they led him by the hand into Damascus (Acts 9:1-8, NIV).

And I persecuted the followers of this Way to their death, arresting both men and women and throwing them into prison, as also the high priest and all the Council can testify. I even obtained letters from them to their brothers in Damascus, and went there to bring these people as prisoners to Jerusalem to be punished. "About noon as I came near Damascus, suddenly a bright light from heaven flashed around me. I fell to the ground and heard a voice say to me, 'Saul! Saul! Why do you persecute me?'" 'Who are you, Lord?' I asked." 'I am Jesus of Nazareth, whom you are persecuting,' he replied. My companions saw the light, but they did not understand the voice of him who was speaking to me. " 'What shall I do, Lord?' I asked. " 'Get up,' the Lord said, 'and go into Damascus. There you will be told all that you have been assigned to do.' My companions led me by the hand into Damascus, because the brilliance of the light had blinded me (Acts 22:4-11).

On the authority of the chief priests I put many of the saints in prison, and when they were put to death, I cast my vote against them. Many a time I went from one synagogue to another to have them punished, and I tried to force them to blaspheme. In my obsession against them, I even went to foreign cities to persecute them. On one of these journeys I was going to Damascus with the authority and commission of the chief priests. About noon, O king, as I was on the road, I saw a light from heaven, brighter than the sun, blazing around me and my companions. We all fell to the ground, and I heard a voice saying to me in Aramaic, 'Saul, Saul, why do you persecute me? It is hard for you to kick against the goads.' "Then I asked, 'Who are you, Lord?'" 'I am Jesus, whom you are persecuting,' the Lord replied. 'Now get up and stand on your feet. I have appeared to you to appoint you as a servant and as a witness of what you have seen of me and what I will show you. I will rescue you from your own people and from the Gentiles. I am sending you to them to open their eyes and turn them from darkness to light, and from the power of Satan to God, so that they may receive forgiveness of sins and a place among those who are sanctified by faith in me.' "So then, King Agrippa, I was not disobedient to the vision from heaven (Acts 26:10-19).

What happened to Paul? Did he hallucinate or did he really encounter the resurrected Jesus?

One of the most recent attempts to bring together all of the relevant research related to hallucinations is Hallucinations: The Science of Idiosyncratic Perception by Andre Aleman and Frank Laroi(American Psychological Association, 2008). They open their book by saying:

Hallucinations are an intriguing psychological phenomenon. A person perceives something: a sound, a voice, an image. However, there is no corresponding source in the outside world. . . . Hallucinations can occur in several medical conditions, including psychiatric disorders, but they can also arise because of the intake of a variety of substances, such as LSD or PCP. Further, hallucinations have also been reported in healthy people from the nonpatient population. The riddle of how hallucinations come about has puzzled clinicians, researchers, and laypeople alike (p. 3).

They provide a number of various definitions of hallucination from the literature including one by Campbell's Psychiatric Dictionary (2004): Hallucination is a false perception characterized by externalization and a continued belief that the experience is a perception of something outside the self rather than an internal thought or image (p. 312).

What is the difference between an illusion and an hallucination? An illusion is a misperception that is based on an existing stimulus, for example, misinterpreting a coat and hat on a coat rack for a man standing in the hall. In contrast, a hallucination is entirely based on internal representations with no corresponding stimulus coming through the senses (p. 18). On the surface, this seems a clear enough distinction. However, often the lines are blurred. The fact that in a large number of individuals hallucinations can be triggered by certain enviromental stimuli already makes this distinction problematic (p. 18). In other words, often some external stimuli will result in an hallucination. The stimuli is misinterpreted (an illusion) and then the brain creates images and sounds which are not really present in the external world (an hallucination).

Is this what happened to Paul on the road to Damascus? Did he see some phenomenon in the sky which he misinterpreted as the risen Jesus and then his brain created sounds that he understood as Jesus speaking to him? It is certainly possible. The latest research reveals the following points which may help us in evaluating Paul's experience.

1. "Normal" people have hallucinations.

Hallucinations occur in "normal" people. In other words, they are not just found in people with psychotic disorders or in substance abusers. They are much more common than one might think among the general population. In 1991, Tien sampled 18,572 people and found 10-15% reporting experiences which could be classified as an hallucination. In 2000, Ohayon studied 13,057 people from three different countries in Europe and found 38.7% reported having experienced an hallucination (pp. 62-63).

As Aleman and Laroi report,

Numerous studies have revealed that hallucinations may occur in a number of populations, including psychiatric patients, non-psychiatric patients, and even normal subjects. These findings question the diagnostic specificity of hallucinations and also challenge the idea that hallucinations are necessarily a sign of mental illness or pathology. Moreover, these findings provide evidence for the so-called "continuum hypothesis of hallucinations," that is, that both clinical and nonclinical hallucinations lie as points on a continuum and do not differ qualitatively from each other (p. 47).

Hallucinations experienced by "normal" people do not differ qualitatively from those induced by psychosis or drugs. Aleman and Laroi state:

Similarities in both clinical and nonclinical groups suggest that hallucinations may lie on a continuum with normal experiences. This line of reasoning, known as the "continuum hypothesis," argues that the main difference between pathological and normal groups is quantitative rather than qualitative (p. 80).

2. Auditory hallucinations are the most common form of hallucination.

Research shows that auditory hallucinations are more common than visual hallucinations. Often the percipient hears a voice commanding him to do something. Command hallucinations may be considered a particular subtype of auditory hallucinations in that the voice is experienced as commanding rather than commenting . . . . Studies have reported that they are relatively common in voice hearers, with between 33% and 74% reporting such activity (p. 37).

3. Emotional factors can lead to hallucinations.

Its not surprising that one's emotions can be a major factor in producing hallucinations. Studies have shown several key emotional issues present in people who experience hallucination.

a) Stress

A study by Gauntlett-Gilbert and Kuipers in 2003 revealed that stress was a major factor in the onset of an hallucination. 85% of their patients reported being under enormous stress prior to their experience. This study also showed that a majority (55%) interpreted their experience as a supernatural event. It also showed that at least with their patients, the hallucinations were not chronic or persistent. Often they stopped in two weeks or less but they nontheless had an impact on patients long after their offset. For example, more than half of the participants reported that visual hallucination affected their beliefs, and in 55% of the cases, the visual hallucination helped underpin a delusion (e.g., "It is Jesus telling me I must kill a man") (p. 39).

In addition, Johns, Hemsley, and Kuipers (2002) found that a majority of non-psychiatric participants had experienced stress when their hallucinations first started and that stress was the most important factor in triggering hallucinations (pp. 66-67).

b) Anxiety

Another major emotional factor that seems to be present in many people who experience an hallucination is anxiety. This has been seen especially in those with posttraumatic stress disorder (p. 50). A traumatic experience, particularly, observing a violent death can be the stressor that leads to an hallucination.

Morrison et al. (1995) argued that the need to attribute intrusive thoughts to an external force is due to motivational factors. The presence of certain intrusive thoughts may lead to negative affect in the subject in the form of anxiety (Bentall, 1990) or congnitive dissonance (Morrison, et al., 1995). According to cognitive dissonance theory (Festinger, 1957), dissonance occurs when two cognitions contradict each other, resulting in an uncomfortable state from which an individual is motivated to escape. Morrison et al. argued that to reduce levels of negative affect, the subject chooses to externalize the intrusive thought, resulting in hallucinations (p. 147).

c) Depression

Severe depression is another factor especially in auditory hallucinations. A psychotically depressed person may hear voices that are mocking and humiliating and that criticize him or her for various failures, shortcomings, and sins (which may be real or imagined). A depressed person may be accused of various wrongdoings and might be further ordered by the voices to "make up" for these by performing acts of self-mutiliation or even suicide (pp. 49-50).

A number of studies indicate that emotional disorders (especially depression and anxiety) are associated with hallucinatory experiences in nonclinical participants (p. 65).

4. Auditory hallucinations are externalizations of inner speech.

As Aleman and Laroi write:

There is a certain consensus in the literature that auditory hallucinations occur when the individual misattributes inner speech to a source that is external or alien to the self. The term "inner speech" refers to the internal dialogue one uses to regulate one's own behavior. This may include commenting to oneself about what is happening or issuing instructions to oneself about what to do (p. 110).

Finally, neuroimaging studies have also shown that auditory hallucinations coincide with the activation of those areas in the brain responsible for the production and perception of speech, which in most people is located in the left hemisphere. Thus, the obserations from behavioral, electrophysiological, and neuroimaging studies all provide strong evidence that inner speech may occur simultaneously with auditory hallucinations and, therefore, that hallucinations relfect the individual's mistaken judgments about the source or location of their inner speech (pp. 111-12).

5. Culture and beliefs influence how one interprets the hallucination.

People will interpret their experience based on their culture and religious beliefs. A study done by Mitchell and Vierkant in 1989 compared hallucinations in patients admitted in the 1930's with those admitted in the 1980's in the same East Texas hospital. They found that the primary sources of the hallucinations in the 1930's were religious in nature (God, the Holy Ghost, spirits), whereas the primary sources of the hallucinations in the 1980's included not only God, devils, and demons but also doctor, scanner, television, and radio (p. 30). In the 30's people typically thought the voices they were hearing were from the spirit world whereas in the 80's they though the voices were coming from the television, radio, or scanner (as well as the spirit world).

More current research has confirmed this conclusion.

Furthermore, a cross-cultural study (Wahass & Kent, 1997) found that whereas patients from the United Kingdom were more likely to use biological and psychological approaches to explain the apparition of their hallucinations, patients from Saudi Arabia were more likely to evoke religious and superstitious causes (p. 31).

The suggestion that source monitoring judgments are influenced by the inherent plausibility of perceived events helps to explain the role of culture in shaping hallucinatory experiences. Bentall (2000) went on to explain that an individual who grows up to adulthood in a society that recognizes the existence of ghosts or that values spiritual experiences is more likely to attribute reality to the image of a deceased relative compared with a person who reaches maturity in a materialistic, scientifically oriented society (p. 120).

In the next post, we will examine the evidence that we have from Paul's life to see if he might have been a good candidate for an hallucination.