Hallucinations are the most recognized—and most misunderstood—symptom of schizophrenia. Movies depict them as dramatic, terrifying commands or cinematic visions, but the lived reality is far more complex. In this episode we unravel what hallucinations actually are, why they happen, and how people learn to live with them.

This episode is a special feature from our sister show Inside Schizophrenia. Hosted by Rachel Star Withers (who lives with schizophrenia), with Gabe Howard as co-host. (Don’t worry, new Inside Mental Health episodes return in 2026.)

In this episode, Rachel shares her own experiences, from everyday “simple” hallucinations like sounds or shifting faces, to more intense, emotion-laden complex hallucinations. She challenges the assumption that hallucinations are always violent or dangerous—and breaks down the critical differences between hallucinations and sensory disturbances.

Expert guest Dr. Paul Fitzgerald joins the conversation to explain how the brain creates these perceptual misfires, why hallucinations in schizophrenia differ from those caused by grief, sleep deprivation, or drugs, and what current research reveals about how universal these experiences are across different cultures and countries.

Listener Takeaways

The difference between simple vs. complex hallucinations

Why hallucinations in schizophrenia feel different from drug- or grief-based ones

Why reducing—not eliminating—hallucinations is often the realistic recovery goal

How CBT and coping strategies help reduce fear and regain control

Whether you live with schizophrenia, love someone who does, or are simply curious about how the brain works, this episode offers clarity, compassion, and surprising insights you won’t forget.

Guest, Professor Paul Fitzgerald, completed his medical degree at Monash University and subsequently a Master of Psychological Medicine whilst completing psychiatric training. He then undertook a Clinical and Research Fellowship at the University of Toronto and The Clarke Institute of Psychiatry, Toronto, Ontario, Canada. On returning to Melbourne, he worked as a psychiatrist and completed a PhD in transcranial magnetic stimulation in schizophrenia. Since completing this PhD, he has developed a substantial research program including a team of over 25 psychiatrists, registrars, postdoctoral researchers, research assistants, research nurses, and students.

Professor Fitzgerald runs a research program across both MAPrc and Epworth Clinic using brain stimulation and neuroimaging techniques including transcranial magnetic stimulation, functional and structural MRI, EEG, and near infrared spectroscopy. The primary focus of this program is on the development of new brain stimulation-based treatments for psychiatric disorders.

Guest host, Rachel Star Withers, creates videos documenting her schizophrenia, ways to manage, and let others like her know they’re not alone and can still live an amazing life. She has written “Lil Broken Star: Understanding Schizophrenia for Kids” and a tool for schizophrenics, “To See in the Dark: Hallucination and Delusion Journal.” Learn more at RachelStarLive.com.

Our host, Gabe Howard, is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, "Mental Illness is an Asshole and other Observations," available from Amazon; signed copies are also available directly from the author. Gabe is also the host of the "Inside Bipolar" podcast with Dr. Nicole Washington.

Gabe makes his home in the suburbs of Columbus, Ohio. He lives with his supportive wife, Kendall, and a Miniature Schnauzer dog that he never wanted, but now can’t imagine life without. To book Gabe for your next event or learn more about him, please visit gabehoward.com.

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Inside Schizophrenia: What Hallucinations Really Feel Like