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26 December, 2011


The most common olfactory (smell) hallucination experienced by sexual abuse survivors is a foul smell in some area or room in the home.  The location is frequently associated with where abuse occurred in the past.  Oddly enough, sometimes there is a direct opposite that is reassuring; a sweet smell like flowers or perfume.  When asked about that, survivors will associate the smell with someone supportive and loving in the past (often someone who has passed away but whose mental image provides solace for the survivor, like a grandmother who had been kind and understanding).

That survivors can have olfactory hallucinations is, from a theoretical perspective, somewhat astounding.  The development of hallucinations in most psychiatric disturbances follows the phylogeny of the special senses (the order in which they were developed through evolution) in reverse order.  Hallucinations in more recently developed senses (vision, hearing) are common.  The sense of smell is the most primative and connected with the most primative parts of the brain.  Ordinarily, olfactory hallucinations are associated with neurological problems such as the olfactory hallucinations experienced by some seizure patients as an ‘aura’ preceeding the onset of a seizure. The phylogenetic depth to which survivors’ hallucinations penetrate is testimony to the depth of their trauma … dramatic proof of how deeply seated their PTSD can be.


Tactile (touch) hallucinations involve skin sensations and usually involve something like a brush on a shoulder from behind, hair being lightly stroked or a touch in the middle of the back.  These hallucinations, sometimes called “haptic” hallucinations,  can be more directly sexual and disconcerting, such as the sensation of breasts or genitals touched. (The difference between tactile and somatic hallucinations is that the former involve sensations just on the skin while somatic hallucinations involve sensations in deeper tissues such as muscle or fat – the difference between an arm lightly brushed versus being poked.)

For the light touch hallucinations, there is a sort of parallel with the hearing of one’s name or nickname being called out as this hallucination can occur in the midst of other people, and can feel like a joke tap on the shoulder.  However, asked what the feeling is that goes along with the touch, survivors will describe it as creepy or sneaky. There can be a ‘perfect storm’ of multiple kinds of hallucinations involving all or nearly all modalities.


Proprioception is the sense of body or body part position.  It’s the sense that allows one to touch one’s nose with one’s eyes closed.  For instance, one survivor described a very spooky incident in which her husband had gotten up to use the bathroom.  She felt him get into bed after he returned; the depression of the mattress, movement of the covers (actually having a tactile element), and him getting settled in bed including feeling the weight of him putting his arm around her.  She rolled over to put her arm around him, but he was not there. He had not yet returned to the bed. That sort of sensation is not uncommon among survivors who are alone at night; feelings of their mattress being depressed as if someone was getting into bed with them though they may be alone and, indeed, live alone.


I mention this particular hallucination separately due to it being so common among survivors. The sensation is that of an earthquake occurring while in bed. The bed is felt to shake and move, a combination of proprioceptive, tactile and somatic hallucinations. All of my work was done in California where that is not an unknown experience in reality but, curiously, it happens to survivors who do not live in earthquake-prone areas.

It bears noting that survivors tend to have phobias about living alone and that their settling for real turkeys as male partners is in part motivated by an understandable avoidance of solitude.  Most hallucinations associated with the night and with solitude are relieved by having someone else around.  The habit of survivors of taking very marginal men as partners led a brief attempt, early in the experience of working with survivors in groups, to do “turkeyectomies — to get survivors to dump what only served as alternative sources of misery in their lives.  The powerful need not to be alone, among other things, doomed the turkeyectomy efforts to failure.


Survivors having a particularly bad night of hallucinations and nightmares have described relief in going to a friend’s home to spend the night.  Oddly, sometimes simply reversing their sleeping position and sleeping with their heads at the foot of the bed sometimes helped as well.


Somatic hallucinations involve deep tissue sensations, body sensations such as a feeling of being penetrated or, in addition to the tactile sense, having breasts squeezed.  These hallucinations tend to occur in more severely abused survivors, often in combination with hallucinations in other sensory modalities.

  1. Julie O'Connell permalink

    I just found out today (after switching from private Psychiatrist who said these symptoms were side-effects of my meds) to the County Psychiatrist (on permanent SS Disability after years of hard work). Anyways, He named my condition of daily feeling of water drops on my legs (and I ALWAYS thing they are real and reach down to dry them, but they aren’t there) as above – said it was a Psychotic symptom; and I also have the smelling thing – this one not every day – and he told me what that was, even though he said it’s a Psychotic symptom. Interestingly, however, I had been raped at age 16 with a knife at my neck when I was a virgin, and again a few years later by someone I did know from school, but never would have done “that” as I didn’t want to do that (and now I am asexual) as I had further sexual exploitation from a Psychologist for 6 months while under erroneous diagnoses, given wrong and high doses of meds that left me completely vulnerable.

    So I have the OLFACTORY Hallucinations and the TACTILE Hallucinations per the Psychiatrist and I guess I might be psychotic here at age 55. I’ve never physically hurt anyone except when very little, just kid stuff (youngest of 5 – had to defend myself).

    Anyways, I REALLY appreciate this page in giving a more in-depth definition of these types of Hallucinations! I’ve been long-time diagnosed with PTSD, Major Depression, Anxiety Disorder and a plethora of back, knee, hip, ankle, neck, shoulder issues that really cause a lot of pain every single day almost.

    Thank you for having this page! I am with much gratefulness! ❤

    • Thank you for taking the time to comment, Julie.

      While the signs and symptoms associated with rape at age 16 vary from those of women who were abused at younger ages, having “psychotic” symptoms does indeed not necessarily mean one is psychotic. There is a reason why there is an axis III in any diagnosis (stressors related to the difficulties being experienced), and the psychiatrists appear to have ignored that. The Diagnostic and Statistical Manual III, (edited, by the way, by a social worker) introduced the five-axis diagnosis more than forty years ago but the medical model many psychiatrists cling to continues to exist.

      The fault is in their training, abetted by individual inabilities to apply a more scientific approach to disorders in spite of the fact that physicians would claim medicine is more scientific than psychology. My general experience is that psychiatrists make lousy diagnosticians. That’s all fine and good as long as patients don’t take their diagnoses too seriously. Their diagnoses are for the justification of using medications, which may in fact be helpful, not for the treatment of disorders. Psychiatrists tend to be expected by the general public to be well trained in psychology and psychotherapy but, sadly, they are not. A good professional social worker will know more about that and, in fact, clinical social workers provide the lion’s share of therapy throughout the various mental health systems.

      I can’t leave this without observing that being given multiple diagnoses like PTSD, anxiety disorder and depression simply mean the person doing the diagnosis has not followed the specific instructions in the DSM IIIx in making diagnoses. In addition to the description of the signs and symptoms of a diagnosis being considered, there is description of the factors that would rule them out. Again, psychiatrists are all about prescribing medications. Their diagnoses are to support the giving of those medications. If depression is present, they’ll want to prescribe for it. If anxiety is present, they’ll want to prescribe for it. Fine and dandy, but those symptoms in and of themselves don’t mean they’re the diagnosis – they’re just the signs and symptoms. Of what is the question they miss.

  2. Thank you for taking the time to alert people to this process. I must confess, I have a heavy bias: While I agree that drug treatment can do as much harm as good, in that it treats only the symptoms of PTSD and not the root causes, I am suspicious of ANYthing that claims fast cures – often for the same reason; the focus on symptoms. The PTSD symptoms in adult female survivors of childhood sexual abuse are the result of two powerful emotions – horror, and rage. Until, and unless, the source of those cataclysmic emotions is vented, blown off if you will, the symptoms will remain. As a Vietnam veteran myself with a brother, and many friends, struggling with PTSD, I have come to the conclusion that in most cases, there is no cure. That does not mean there is no hope. Symptoms can be greatly reduced, with attendant improvements in quality of life. That process takes tremendous, lengthy, and often very painful work. Drugs do have their place when used with discretion. One thing I noticed over a couple of decades is that improvements in anti-depressant medications, and their use, actually impeded progress and left the users stuck with living with a lifetime of drug suppression rather than victory over their suffering. However, there does come a time when one should consider whether the turmoil of suffering should be allowed to have full reign over a person’s life when drugs might offer some additional relief.

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