The feeling, embodiment and emotion of hallucinations in first episode psychosis: A prospective phenomenological visual-ecological study using novel multimodal unusual sensory experience (MUSE) maps

Background: Research and practice typically focus upon unimodal hallucinations, especially auditory verbal hallucinations. Contemporary research has however indicated that voice-hearing may co-occur within a broader milieu of feelings, and multimodal hallucinations may be more common than previously thought. Methods: An observational design asked participants to prospectively document the feeling and modality of hallucinations for one week prior to an interview. Novel visual diary methods involving drawing, writing and body-mapping generated 42 MUSE maps (multimodal unusual sensory experience), analysed with a par-ticipatory qualitative method. Twelve people took part: all experiencing hallucinations daily, accessing early intervention in psychosis services, given psychotic-spectrum diagnoses, and living in the community. The study took place during a seven-month period in 2018 at Leicestershire and Rutland's Psychosis Intervention and Early Recovery service (UK). Findings: All documented hallucinations co-occurred with bodily feelings. Feelings were localised to specific body areas, generalised across the body and extended beyond the body into peripersonal space. Co-occurring emotional feelings most commonly related to confusion, fear and frustration. Interpretation: Hallucinations were characterised by numerous feelings arising at once, often including multi -modal, emotional, and embodied features. Within this study, the immediate feeling of hallucination experi-ences were readily communicated through prospective, visual, and ecological information gathering methods and particularly those which offer multiple modes of communication (e.g. body-map, visual, writ-ten, oral). Uptake of visual, ecological and prospective methods may enhance understandings of lived experi-ences of hallucinations. Funding: University of Leicester. (c) 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

Automated summary

The study reveals that multimodal hallucinations often co-occur with emotional feelings, bodily sensations, and extend beyond the body into peripersonal space. Participants effectively documented hallucination experiences through visual diary methods, demonstrating the diversity of hallucinations.