Psychotic hallucinations, whether they are visual or vocal, they address you. They accuse you. They seduce you. They humiliate you. They jeer at you. You interact with them.

Sacks is underscoring a phenomenological difference between many neurological “misperceptions” (which can be oddly neutral or impersonal) and psychotic hallucinations, which often feel socially charged and directed at the self. By listing verbs of interpersonal engagement—accuse, seduce, humiliate, jeer—he emphasizes their second-person quality: they seem to have intention, attitude, and agency. The final sentence (“You interact with them”) highlights how such experiences can pull a person into dialogue, argument, compliance, or resistance, shaping behavior and identity. The quote also reflects Sacks’s clinical-humanistic aim: to describe symptoms not as abstractions but as lived encounters that can be emotionally coercive and relational.