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Article   |    
Max Levin
Am J Psychiatry 1932;88:1119-1152.
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Harrisburg State Hospital, Harrisburg, Pa.

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1. Four cases are presented of boys who had true auditory hallucinations. The boys were "non-psychotic," in the sense that they showed no acute psychotic disturbances, differing in this respect from the vast majority of the cases already recorded—cases which concern children who develop unmistakably psychotic states with hallucinations, usually at puberty. Altogether 24 episodes were reported by these boys. The episodes are recorded in detail, attention being given to setting, content, etc.2. Two of the boys showed what probably are early symptoms of a schizophrenic reaction, although at the time of this study the evidence was not conclusive. The other two boys, while maladjusted, showed nothing suggestive of schizophrenia or any other psychosis. All four boys were below the average in intelligence, two of them conspicuously so.3. The hallucinatory episodes are studied with regard to the quality of the hallucinatory perception, the localization, the presence of accessory sensations, the content, and the apparent "functions" that are involved.4. The hallucinations seem to have participated in the fulfillment of the following functions: (a) Defense. (b) Enhancement of self-esteem. (c) Satisfaction of instinctive cravings and of a desire for pleasure. (d) Repression of unwelcome instinctive cravings. (e) Self-punishment, in expiation of a sense of guilt.It is emphasized that while certain functions are fulfilled, these probably constitute only one link in the chain of factors which really ,causes the hallucinations to occur.5. In one case there is evidence of mixed deafness in one ear. In another case the evidence is suggestive of the possibility of an organic auditory disturbance.6. The significance of the findings for the general problem of projection, and their relationship to recent work on eidetics are discussed.

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