What happens during a hallucination?

How did you get your website to look like that? Mine's so basic.

Thanks. I just used Wix Harmony.

Sounds fancy. What's that?

It's Wix's AI website builder.

You can just tell it what you want and it builds you a whole site.

So it's like vibe coding a website?

Exactly, but even better.

Because you can still click and edit anything by hand.

You don't have to use prompts for everything.

Oh, that's neat.

Yeah, try it for free at wix.com slash harmony.

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If you'd like to get in touch with the show, you can email us science at news.com.

We get to all of those comments at the end of the podcast.

First, as always, it's time to look back at some of the more interesting stories

from the world of science this week,

rejoined by Dr. Ruth Freeman from Research Island and Dr. John Regan

Research Fellow in the Department of Theoretical Physics at Manuth University.

I warn you both, I've had a lot of coffee.

So with our first story,

has to do with breath tests.

And I'm really surprised this isn't something that's been around for a long time.

What I thought this would have been an obvious one.

You know, I had that same thought.

I kind of had to go and search.

Do we not already have something like this?

But I guess the sort of the story starts when you go into hospital in pain,

maybe with a fever and a lot of clinicians will look at you and say,

we better get you on an antibiotic just in case.

But then they take a sample and they send it away to a lab.

And really our goal standard testing for whether you have a bacterial infection

is to grow a bacteria in culture,

which really takes at least overnight if not a bit longer.

So they can't wait for that to make a clinical decision.

So they give you a broad spectrum antibiotic.

And we all know that giving out broad spectrum antibiotics

when you don't necessarily need them is in a great outcome for everybody.

So how do we get in with quicker tests?

And there are some quicker tests out there.

So if you remember during COVID,

the antigen tests, that kind of lateral flow tests,

there are some of them that have been sort of trialed and are close to market.

For bacteria.

For bacteria.

But they're quick.

But they're not necessarily as accurate

or they might be very specific to one type of bug.

And of course, bugs change.

So there are some issues with those.

So really these researchers in the University of California and St. Jude's Hospital

were trying to see, could you combine that really good specificity with speed?

And they were inspired by a test that's done for Helicobacter Pylori,

which is the bug that's associated with giving you stomach ulcers.

And in that test, they essentially give people a special drink,

which the substance is metabolized only by Helicobacter Pylori.

And it produces a metabolite, a type of carbon that then goes into your bloodstream

and they can pick it up in your breath.

And so that was what inspired them.

But what they did, they said,

can we pick up bacteria maybe in your bone marrow or embedded in anywhere in your body

by picking up metabolites from those bacteria?

So what they did was their idea was to give a sugar solution,

but not just regular sugar because all our gut bacteria would love to get their hands on that.

But Manital, which is a sugar that our own bacteria in our body don't eat.

And of course, they put it into the blood so it's isolated from our gut bacteria

so that they don't get their hands on it either.

Right.

And they modified the carbon in the Manital.

So instead of carbon 12, which is the normal carbon,

they put a heavier carbon, carbon 13, which doesn't do any harm.

But as it's metabolized, it can be picked up in the breath coming out.

And what they found was, and they can pick that up using a very simple

spectroscopy technique, a bench top, fairly cheap piece of kit that they can use.

And what they found was that within 10 minutes they could detect

a bacterial infection.

Injection 10 minutes later, they could metabolize

of carbon 13 in the breath from the Manital, being metabolized by the bacteria.

And they could do this for E. Colo.

They could do this for pseudomonas.

So they could do this for a wide range of different bacteria.

And they actually pushed it even further.

Because then if they administered an antibiotic,

they could see the level of carbon 13 in the breath going down.

Wow.

And so you could actually see straight away if you were using the right antibiotic.

So rather than again using a broad spectrum,

you could go into the more specific antibiotic,

give it 10, 20 minutes, half an hour, see if it looks like it's working,

and then go in with something else if you needed to.

So I mean, the researchers, if you read the quotes from them,

they're really excited about this because it is actually,

you know, when you read it first, you go,

this seems like something we should already have.

But actually, the more you read about what they've done

and kind of where the inspiration came from, it's very clever.

And you can really see the potential for this to move quite quickly into practice.

Because I mean, a Manitol drip, a glucose drip,

I mean, that exists in a hospital already,

you know, breathing tests using a spectroscopic,

you know, easy, it's there already.

So I mean, turn around times very quick,

because you don't need, you know,

you could do a battery of these things,

identify the exact bacteria, see it's working,

and then say that's used for solved,

you know, without having to wonder, you know, is it sepsis?

Is it something else?

And that's the big issue, you know,

avoiding sepsis without taking that really precautionary principle

of doling out loads of broad spectrum antibiotics,

which are leading to the global issue of antimicrobial resistance.

So yeah, it's a really...

Which isn't going to be any better either.

It's not going to be any better. So really great science.

Fantastic. I'm second story, John.

Yeah. It sounded like a big story to me,

but then I'm a layperson who doesn't know anything.

And what the headline said was,

scientists discover heavier version of proton

with an upgraded detector. This is soon.

Yep. So the big loopy thing underneath Switzerland,

that's right, like the atom smasher,

the Hadron smasher, at least.

Yeah. That's right.

So look, is it a heavy proton kind of?

Right. Just give us a, give us a, what is the proton?

I'm going to go into the proton now.

So the proton is a subatomic particle.

It's made up of two up quarks and a down quark.

So in like kind of like years and years ago,

with hot proton was really fundamental.

The smallest particle.

Lego bricky again. Exactly.

Itself and the electron were supposed to be the building blocks

of the universe, if you like.

But around the 1960s, we were starting to get our particle

accelerators up and running.

So that was where we were smashing atoms together,

or protons, or electrons, or whatever.

And we were getting a zoo of particles coming out.

And it soon became apparent that actually protons

were not the fundamental particle.

Within each proton are what are called quarks.

And this was actually theorized by a guy called

Murray Gelliman in the 1960s.

And he got the name quark, incidentally,

from one of James Joyce's novels.

Oh, really?

Yeah, a nice Irish connection there.

But so it found, and it was quarks

are really the constituents.

They're the basic building blocks of nature.

And like I said, a proton has two ups and one down.

What they found in CERN this week is a different subatomic

particles.

Like a heavy proton, that is true.

It's got two charm quarks and a down quark.

So it's a little bit different.

You know, you have to be careful here.

It's not going to revolutionize anything.

It has been predicted.

It's great that they found it.

So was it upgrade to the CERN facility?

It took one year to find it.

10 years of.

Is it a new particle?

As far as we know, we've never seen a new particle like this.

So why is that not a big deal?

Because you were very unimpressed by this story.

You were like, oh, it's predicted.

We expected to find it.

We'd already found its cousin,

which had two charm quarks and an up quark already.

So this is the two charm quarks and a down quark.

So it wasn't a big break to put it did show you

that once we got a more powerful accelerator,

we were able to form this particle.

But when we look at subatomic physics,

at least how it was taught in school,

my day, I don't imagine it's changed.

It's enormous, but definitely some things were changed.

But the protons, I'm not that old, John.

Look at the face of KB.

But the protons were sort of one type of thing.

We didn't realize there were different types of protons.

So surely that has some sort of significance

for how we understand the world.

Yeah, and it does.

It does allow us to understand the world better.

There's no doubt about this.

And it allows us to probe what's called a strong force.

It's really look how nuclei and how protons

really stick together.

That's true.

It's a huge breakthrough for that.

Now, we have to bear in mind that this heavy proton,

it lasts for like, femtoseconds.

That's a millionth of a billionth of a second.

So they're very short-lived.

A millionth of a billionth of a second.

Oh, no, no.

It's quicker than that.

You want to go for coffee, would you?

And then come back to when they're doing that?

Definitely not.

Nothing or walk around the garden.

Nothing like that, right?

But it is important.

It does allow us to really probe particle physics

and the strong force.

And that's important.

And test our theories.

One really quick question because it's just

printed in my head.

If it's that unstable, does it actually exist

in a way that's meaningful in our universe?

Do they?

Is it something that's, is there an artificial fabrication?

Because you can create things that don't really

have any relevance to how our universe works.

Yeah, is that what it is or no?

It is important.

And you don't think about it in terms of human time scales.

So like, the millionth of a billionth of a second is true.

But what does happen within that millionth of a billionth of a second

is that the little quark, the up quark,

does orbit around the charm quarks.

And that's important.

So it has this dynamical time within that particle.

So it is a real particle.

It does live for a certain amount of time.

Does decay very quickly?

And it's through that decay, we actually detect it.

That's how it's detected.

We detect it through its decay process,

not the actual particle itself.

The way you were talking about these different types of quarks,

that was imagining sort of a fairy tale.

It's like, you can actually totally write it a little.

It's a charm quark.

No idea.

Well, there's a charm, and a strange quark.

So there's six quarks up down charm, strange,

and top and bottom.

There you go.

It sounds like, you know, seven dwarves?

Yes, seven dwarves, part two.

Our third story has to do with a game that I used to love.

We had a network manager, and every time the network manager

we would switch screens, but most of the time

when we were supposed to be helping our staff

like get their computers working, we were playing Doom,

and it was the most fun ever for a 21-year-old.

I'm glad you've played Doom,

because I happened, and this story is all by Doom,

so maybe you can help fill in some of the blanks for me.

So you were sitting there playing Doom

when you should have been helping people.

So imagine that scene, but instead of you,

there's a petri dish filled with human neurons playing Doom.

So that's what happened in Australia this week,

and it's research that was done by cortical labs in Australia.

And people may have heard of them before,

because a few years ago, they hit the headlines

because they had a similar experiment

where they had a petri dish of neurons playing Pong,

which was a two-dimensional sort of paddle game

where people might have seen it on an old Atari

where you have to bounce a ball back and forward

and move a paddle left and right.

But Doom, as you say, is a much more complicated game.

It's kind of like, I call it duty, if I didn't have a seat.

It's kind of primitive 3D game.

You're going through corridors.

You have to shoot monsters, people come at you.

And you're in the first person character.

So what they did here was they had about 200,000 human neurons,

which they had growing on a special kind of electrical matrix,

which could send electrical signals into the neurons.

And they got quite a young computer programmer,

actually, who didn't have a huge amount of experience

in this area to use Python coding to turn the inputs

or the output signals from Doom,

so the position of the players where a monster is coming from

into code.

And then they converted that code back

into sort of positional information

on the grid for the neurons.

So the neurons were getting the input from the game.

And what they found is, over time,

the neurons started to play the game.

So the neurons are electrically active cells.

So they were able to produce charge responses

to the electrical inputs that they were getting.

And of course, their charge responses

could be converted back into an action in the game.

But usually, when you play a game,

or you perform an action that isn't completely random,

there's some sort of reward.

Exactly.

And there was a reward here.

So imagine, I suppose the neurons don't have eyes,

they don't have arms to play,

but imagine you're dropped into a dark room.

And as a biological system,

you're seeking kind of steady state or less chaos.

So you don't see anything, but you can walk forward

and you hear more noise and chaos,

or you can walk backwards and you get to kind of calm.

And I mean, that's essentially what these cells were doing.

So when they did something,

or they shot an electrical signal

that did something good in the game,

they were rewarded with a sort of steady states pulsing signal

that gave a sense that they, you know,

that was a state that they sort of wanted.

It wasn't a negative stimulus.

What wanted is a terrible word to use in this context.

But, you know, this idea that there was some sort of reward

for stimulus response, yeah.

That's obvious, we're not exactly.

So they're not very good at playing Doom,

but so they're worse than a novice player,

but they are better than random at playing Doom.

And of course, the reason why this research is so fascinating,

I mean, this is, you might say,

why would you even do this in a world of AI

where we have computers that can do all sorts of things

for us so quickly?

But I mean, the human brain only uses

about 20 kilowatts of energy.

It's about as much, you know, as we use to light a light bulb.

And it's not trained.

These neural systems don't have to be trained

on hundreds of thousands of scenarios

to be able to do this.

They just have this inherent capability to respond

and create this feedback, which enables learning.

So this idea of kind of biological,

electronic merge systems is of real interest

because they're potentially very low power

computer systems that could be built.

But all sorts of interesting ethical questions arise as well.

Exactly.

Our final story, John,

has to do with quantum batteries.

And this is a pretty big story.

Yeah, this was, this was really interesting, actually.

So first of all, let's think about a lithium-ion battery,

which is the one in your smartphone

or your EV car or whatever, your Walkman.

So the way that that works.

Are you going to attempt to explain electricity to me?

Oh, I've been in my room for 20 years.

It's good to look.

Like batteries.

And it Walkman.

Yeah, yeah, yeah, yeah, yeah.

I try and think it's something I put batteries into.

It's not that frequent anymore.

So with a lithium-ion battery,

so that's a chemical battery,

and what we do is we put electricity in,

we change the chemical state inside that battery,

move it to a higher electrical state,

and then we can just charge it

just basically whenever we want.

Well, it assumes it's within some time for it leaks away.

And that's how a chemical battery works.

And if we want more power,

we need more battery, essentially.

So like, for example, your EV car has a lot of batteries

in it versus your smartphone.

Yeah, also your EV car takes overnight to charge

approximately, and your mobile phone doesn't take so long,

at least, you know, given the same amount of power.

But with a quantum system, it's very, very different.

In that sense, it can actually take advantage

of some really weird quantum behavior

and operate collectively.

And by that, I mean that if we want to charge up

the quantum battery, it'll do so not incrementally,

but are not linearly, but super linearly.

So that like, it'll basically charge up almost instantly,

given a certain amount of power.

And it's not like if I want more power,

I need to add more battery.

It scales, it's super linearly.

So with more and more batteries,

I just get more and more power and I charge faster.

So much, much more power, what?

You charge faster with a larger battery.

Not more, a lot faster,

because it doesn't scale as it has basically

and the number of molecules.

It charges end to some power.

Right.

And it'd be one for a chemical battery,

but could be end to the 1.5 or something like that.

So it gives basically harnesses the collective power

of the quantum and really charges very, very quickly.

So we're talking about power.

And we had Valeria Nicolosi talking about

graphene 2D materials on this program.

She was saying she'd worked with her colleagues

and Trinity on developing the sort of material

that discharges and charges instantly.

We're seeing some of this technology,

whether it's not a 2D coming out of China,

I should don't know if you saw this week,

we saw cars that will charge in 10 minutes,

fully charged, incredible stuff.

But this is the first quantum battery.

This is slightly different.

Yeah.

But it will have the same effect,

like five minutes or two minutes to charge an entire car.

Potentially, right?

This is a very much a proof of concept.

So we're not there yet.

What they were able to show,

and this was the first time they were able to use

as an Australian group.

So they were able to charge it up,

they were able to store it,

and they were able to discharge it.

Nobody had ever done that before.

So this was the real breakthrough.

The full battery cycle, if you like.

People had charged them up before,

but not actually drained current.

Right, right, right.

So this one had gone through the full cycle.

Now again, unfortunately, we're back to the same,

like the protons were a timescale issue.

So they charged up in vento seconds,

stored for nanoseconds, and discharged for a bit.

They're okay.

So like, you know, we're not there yet.

If you sneeze, you've seen the entire thing, right?

Don't put likes.

You know, the pathway is good.

Okay, very interesting.

I think, you know, in 10 years' time,

looking back at how we fiddle around with adapters

like I drove to the north to let a Kenny last week

and finding a charger that worked.

It was just so everything was so frustrating.

And the idea that you could just recharge in 10 minutes,

like, you know, such amazing stuff, you know,

on the horizon.

The potential with this is that it charges faster

than you fill up your car with petrol.

So you just plug it in, charge up, and drive away.

That'll be it.

Like, it's really powerful.

It's the future, Dr. John Reagan

and Dr. Wuth Freeman, thank you very much.

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

What's the future?

Really looking forward to this piece,

because it's something that really fascinates me.

What happens when you hear a voice that isn't there?

Is it sort of a slant on imagination?

Is your biology and your brain misfiring?

Or is it something more complex going on?

Because we don't know a lot about hallucinations.

And when perception and reality start to blur

and people start hearing voices

that they then think are telling them to do things,

what's really going on there?

That's a question that's fascinated me for years.

Dr. Anna Georgiadas is a lecturer

in early intervention in psychosis

at the Institute of Psychology, Psychology and Neuroscience,

at King's College, London.

She is studying this very thing.

Great to have you on the program.

Anna, how are you?

I'm good. Thank you very much for having me.

You're very welcome.

We are, we're going to be talking about hallucinations

and these command hallucinations.

So tell us what exactly that is as far as we know.

Absolutely.

So individuals who experience psychosis,

they can have kind of strange and unusual experiences.

One of them being maybe hearing voices

or maybe feeling suspicious.

But the people that hear voices about half of them

experience something what we call command hallucinations.

So voices that give them instructions

or commands to do things.

Now, this could be as simple as stand-ups sit down

or it could be more more scary, you know, harm someone else.

And this is why it's so important clinically

and as a clinical psychologist,

that I do see this a lot in the clinic.

So I really wanted to focus on this in my research

to understand it a bit more.

I mean, even for those of us who aren't suffering

from psychosis, the idea that you have a voice

in your brain that you sometimes talk to,

that the idea that you can have a dialogue

with yourself in your brain is kind of crazy to me.

Like, you know, I often find myself telling me,

come on, get up, you need to get up.

And then I actually get up.

But I then think, who was that telling me to get up?

It's me.

I'm telling myself to get up.

It's all very strange.

But when it comes to psychosis, obviously,

this can be very upsetting and it can be quite scary.

When someone is having an auditory hallucination,

do we see the auditory cortex,

the part of the brain that is associated with hearing?

Does that fire up?

Do they actually hear or do they think they hear a voice?

This is a really good question and a great distinction.

So whenever we're assessing someone

who's not maybe entirely sure what they're going through,

we want to understand, is it a voice

that they're talking like an internal thought?

Like, oh, I've got to pick this up from the shops

and I've got to do this today.

Or is it something distinct and separate from themselves?

So usually the people that I see in the clinic

are on the severe side

and it's something that's causing them distress

and they're actually hearing it

like how you're talking to me and hearing me right now.

It's like a separate person,

but they might be hearing it in their head.

They might be even hearing it outside of themselves.

Like in the room.

Okay, so their brain is actually perceiving this voice

as very much not being them.

Yes, absolutely.

It could be a male voice, a female voice,

it could be muffles, it could be clear.

And I think the important distinction is

it feels separate from them.

It doesn't feel like a thought,

oh, I'm going to,

this is my plan for today.

This is what I'm going to do.

It actually feels very separate

and that's why it can be feels so distressing.

Do the people who suffer from these hallucinations

do they associate the voice

with a specific person?

Like would they think,

oh, this is Satan or this is God

or this is a ghost or something?

Or is it just our voice?

That is an excellent question

and this is kind of what the psychologist loves

to find out and listen to for in the session.

How the client interprets it is critical.

Now they can interpret it as someone from their past,

say a bully from school.

They can interpret it as the voice of God

or devil, angels or demons.

It could absolutely be,

it could be a government agent.

It could absolutely be anything.

And part of trying to understand

what's causing them distress

is trying to identify what's their interpretation of who it is.

Right, because I guess if they're hearing things

that they perceive to be as bad ideas,

they might say, you know, this is Satan,

or this is the devil telling me to do this.

And there have been cases

for people who claim that in serious criminal cases,

but it's in the States, right?

Yeah, absolutely.

And what we've found from the literature

is that when people believe it's more on the malevolence side,

like bad or Satan or demons,

they're more likely actually to resist the command.

If they believe it's actually something of good intention

like God or angels,

they're actually more likely to comply.

So part of the assessment is trying to understand

how are they interpreting it?

Are they willing to listen to the instruction?

Because that's quite, that increases risk.

For sure.

And I suppose the voice could be saying the same thing,

but if it's perceived as from God versus Satan,

then the outcome for that person

could be completely different.

They both might be saying, you know,

attack that person on the street.

But the motivation will change dramatically,

depending on how they perceive that voice in their head.

That is exactly, that's exactly a great point

because if they think, oh, it's the voice of God.

So surely it must be a good thing to do.

Even if it's a terrible instruction

someone on the nose,

they might be more willing to kind of comply with that command.

But if they perceive it to be a demon or the devil,

they'll be like, oh my God, this is scary.

Surely it can't be a good thing.

And there's more of that ability to resist.

But again, it's not guaranteed.

We can't just assume it's just those two outcomes.

It really is individual for every single person.

That's why sort of in a way, the devil's in the detail,

we have to get their perspective on who they think it is.

And are they willing to comply?

And what are their worries if they don't comply?

And that's where another important feature

that came up in the paper was

this concept of appeasement.

Oh, shall I partially comply?

Do something a little bit to please the voice

just to get them off my back.

And that is just as important clinically.

And I think it's kind of under-explored in the literature.

And that's what I wanted to emphasize it in my paper.

Just when I pause for a second and just ask you

because I think it's the case that,

you know, only a very small number of people

who have hallucinations are actually danger to themselves

or others.

I always worry when we talk about,

you know, the edges of mental health that,

that, you know, it's really important to emphasize

that hallucinations are quite normal.

And lots of people have them.

I would imagine, you know, command hallucinations

probably a little less normal.

But the percentage of the people who are dangerous

or, you know, how they're often portrayed in the media

is the very one percent of the one percent.

Would that be correct?

Yeah, absolutely.

So look, we have to put this into perspective.

About 5% of the general population

will have the odd voice or the odd,

unusual experience or sensation,

but it doesn't warrant clinical attention.

They will never end up in my clinic.

They might hear the doorbell ring upon awakening

or they might hear the door knock upon sleeping.

This is what we call a hypnopompic

or a hypnagogic hallucination.

Absolutely normal, absolutely common, nothing to worry about.

Now, the people that I tend to see,

that's usually the 1% of the population

that they've experienced just way too much stress.

They might be a bit of a family history

of mental health difficulties.

And through no fault of their own,

maybe just sometimes too much stress,

brings about the psychosis,

which is maybe hearing voices.

It could be command hallucinations.

But again, not everyone is violent,

but people that we have to assess for risk.

And if there is a worry that they could harm themselves

or others, that's why services get involved

to try and protect them and the public.

Psychosis, obviously, being completely separate

from, you know, psychosis and psychopaths

have the same stem of the world.

They're very different things, of course.

And a lot of these patients do get better.

But what is it like dealing with people

who are probably the worst mental state they can be at?

What does it like doing that day to day?

Working with individuals with psychosis.

Is that the question?

Yeah, absolutely.

Look, I think that they're normal people

that have just had really experienced just way too much stress

of failing an exam.

They witnessed a mugging, they saw a car accident.

They're usually lovely people

that have just experienced way too much stress.

And then this is the brain overfiring

with maybe chemicals like dopamine

and other neurotransmitters.

Maybe the way they're perceiving the event

if they keep them thinking psychologically,

the world is absolutely dangerous all the time.

And then their anxiety level is way too high.

That kind of concoction and cocktail

then tips them over into maybe experiencing

these more unusual experiences

that are out of character for them.

So really, there is hope, there is, you know,

people do live rich and fulfilling lives.

They could have had one incident, they have their medication,

they stabilize, they have psychology, it helps them.

And they may never experience psychosis again.

But when you're speaking with them,

surely having realized that there is a voice

inside their head that none of anyone else can hear,

surely that is distressing for most of them

or do some people welcome the voice.

It's a mixed bag.

Usually the people I see in the clinic

are usually distressed by the voice,

which led them to come to our service in the first place.

But there are a small subset of people that actually say,

I'm hearing the voice of angels telling me I'm beautiful

and that's a wonderful thing.

I don't want it to stop or me feel I'm not alone.

So there's a kind of protective function

is what we would call it.

That there's something actually really positive about it.

Now, regardless of whether they see it as positive

or negative, it's what they do about it that counts.

Even if they say, oh, they say I'm beautiful,

but I'm still going to go and I don't know,

punch people in the street, that's problematic.

And we have to work with the behavior

regardless of their interpretation.

So we don't.

Yeah, I mean, apart from, you use CBT

and sometimes drug to treat psychosis is that right?

Or is there a, is there a tried and tested path

to treat someone who has a psychotic episode like this?

So absolutely.

So working in an early intervention service,

we try and what we work with people

that have had their first ever episode.

Right.

So there's three treatment pathways.

There's medication, which is incredibly important

and really encourage people to take their medication

as prescribed.

And they usually need to take it for one to two years

following from that first episode.

Wow.

Just one episode means that you're recommended

to have a two year, up to two years of medication.

Yes.

As we stabilize, we want to stabilize those chemicals

in the brain that could have gone one key

in response to heightened stress.

But medication isn't the only thing

where I come in is the psychology aspect.

They might think they might, you know,

in response to stress, you know,

that they've got the chronic anxiety.

Their perceived world is completely dangerous all the time.

So we need to balance that thinking and improve coping.

And also, you know, involving families and carers

to keep doing the great job that they're doing

to support their loved ones.

If there's less stress in the house,

there's less stress for the clients and works both ways.

So yeah, if there's families, medication,

psych, individual psychology is usually the treatment pathway.

Is there a case over the years that you worked on

that has really stuck with you?

Oh, I think they're all memorable in a certain way.

You know, thankfully, you know,

I see improvement in the people that we work with,

the young people that we work with as a team,

to get better.

And then they're like, oh, I understand now that

it was this stress that caused this.

And then all of these bits of intervention helped.

So I can't say there's one,

one absolute particular one that stands out.

They all stand out in their own way.

Yeah.

As I said, like they're all incredible people

that have just experienced just a bit too much stress.

There are certain conditions and other things

that can trigger psychotic episodes, right?

Like diseases and even infections sometimes.

Now, so you're talking more about the organic stuff.

So if someone has maybe like a brain tumor,

they could have maybe some visual hallucinations

or if someone's starting to experience

some signs of dementia with great old age,

they could maybe start maybe hearing sounds or noises.

This is different from what we see in the clinic

because we would say that's kind of secondary

to something organic going on.

Right.

We wouldn't call that like a true first episode psychosis.

Right, but the hallucinations that people might have

with Alzheimer's, is that a very different thing

to a psychotic episode that someone might have

after a traumatic experience or drug use, right?

Drug use can trigger psychotic episodes?

Oh, yeah.

So older age, it's different.

Drug use, if they're only experiencing voices

when they're high on a specific substance,

we still wouldn't even call that a true psychosis.

If they take the substance, the voice starts,

but then the substance is out of their system

and they keep hearing the voice,

then they end up coming to us.

I see.

If it's persistent, we'd say that's a drug-induced psychosis

and maybe this is continuing

and it's becoming a proper psychosis.

And in terms of what determines a psychotic episode,

because obviously you would have hallucinations sometimes,

you might have delusions and so on,

you might have disturbed thoughts.

Are there other things that would say to you,

this is different, this is a psychotic episode

that aren't the obvious stuff?

So in terms of anything other than voices?

Other than voices, yeah, or dangerous commands.

Are there other things if you hear that you think,

this might require a little bit of more thought?

Yeah, so what we also see very commonly in the clinic

is people with suspiciousness.

So they worry that they're being monitored, followed

or the government is after the...

Right.

And this is what we call a delusion.

But there are different types of delusions.

You could have a delusion that there's a chip in your brain

from aliens.

You could have a delusion that you're the king of England

and you believe that everyone should bow down to you

in the street and that's what we call a grandiose delusion.

There's one person in England who has that delusion.

Yeah, delusion, reality.

We'll let the Bucky and Palace decide that.

Yeah, yeah, yeah.

It's really interesting speaking with you.

Thank you so much for joining us.

Just before we let you go, if someone is listening

and if they are concerned about themselves or another person,

what is the best thing they should do

if they feel like they may be having a psychotic episode?

Absolutely.

So if you're worried that you're starting to have experiences

that a bit unusual, a bit of out-character for yourself,

do talk to your GP.

Do you maybe mention an early intervention service?

If it's the first time you've ever experienced this

because they can refer you on.

So GP, think about early intervention

and just don't worry.

There is hope out there.

This is the most important thing.

There is medication, there's psychology.

People do get better and this is absolutely normal

response to too much stress.

Dr. Anna Georgiardis from King's College London.

Thanks for your time.

Thank you very much for having me.

Okay, time to look back at some of your comments from last week.

And we were talking about dogs changing their pitch

when they listen to music and why they might do that.

Sir, she says, I always admire how a tuned dog

seemed to be to the tone of your voice.

I wonder if that's connected to their ability

to understand sound.

I don't know.

I had this conversation with my son recently.

He was like, I don't think Roxy knows her own voice.

He's 11.

He's a smart little kid.

He said, I don't think Roxy knows the name of her voice.

Like, if I just say Roxy, La La La,

she won't pay attention.

Will she do that?

And so we tested that and sure enough, Roxy didn't.

But when, as soon as she said, Roxy,

the dog flipped its head up and turned around.

And it was the tone of the voice

that Cohen had picked up.

The dog was understanding.

So I think the tone is a lot.

And Holly says,

do dogs actually perceive music as music

or simply as sound patterns?

That was part of what that researcher

last week was trying to figure out.

And because the idea, at least,

and there's a bit of evo psych,

so evolutionary psychology,

which, you know, if you're having a lot of evidence,

it can be a bit of a guessing game.

But you're just trying to connect

why would something be a certain way

but you need evidence to be able to make something

solid, but the thoughts where that,

these dogs would change their pitch

to appear as a bigger pack.

And so that's why dogs might

how that music or whatever.

One person says,

could species-specific music,

like if it was designed around dogs,

hearing ranges and natural vocalizations?

Could that produce stronger effects

in terms of the data?

What I get is,

I mean, if you're talking about species-specific music,

you're not just talking about dogs-making vocalizations,

and then it's not really music, is it?

So I don't know.

I think, although our dog does,

I don't know if you remember,

there was a dog song on Spotify.

It was pretty big one year.

They made a song for dogs,

and it was lots of barking.

And then someone's saying,

good girl.

And the dog, the dogs apparently went nuts for it.

Our dog was like,

meh, about the whole thing.

It's not really first about walks, to be honest.

But I don't know.

I think if you're actually making dog music,

then it's just howling, isn't it?

Well, maybe I'm just,

maybe I'm disposing an entire potential genre

of actual dogs singing.

But look, if you want to go down that road,

that's the time I have to use.

That's what we're gonna do in this show.

That's it from us on this episode.

Thanks to Marisa Sullivan,

producing Rory Gavanan podcast.

You could see over Scott Hansen.

Thank you for listening.

We'll be back with more future proof

in your podcast feed on Tuesday in the meantime.

That was pretty fast, isn't it?

Stay curious.

Future proof with Jonathan McCray.

Proudly supported by Research Ireland.

Sunday from midday.

News talk, conversation that counts.