Invisible companions of mountaineers in crisis: the third man phenomenon and isolated altitude-induced psychosis under extreme stress

Imagine you are alone on a storm-tossed glacier, exhausted to the limits of your physical endurance – and suddenly you sense a calm, friendly presence at your side.

You see no one. But someone is there. Someone who gives you hope and shows you the way.

What sounds like a scene from a novel describes a real, scientifically studied phenomenon: the third man phenomenon.

It tells of the surprising ability of our consciousness to mobilise new forces in the face of existential threat – sometimes in the form of an invisible companion.

In this article, we shed light on the psychological background, medical findings and cultural interpretations of this extraordinary experience.

The third man phenomenon: more than a hallucination?

The third man phenomenon describes the perception of an invisible, emotionally supportive presence in extreme situations.

It became known through reports by polar explorer Ernest Shackleton, whose crew felt guided during a life-threatening return from Antarctica – by an ‘extra’ person who did not actually exist.

Modern hikers and mountaineers also report similar experiences on expeditions in the Himalayas or on Mount Everest. I experienced it myself during the ascent to the Larkya La Pass. In moments of deepest exhaustion, an inner voice emerged, providing guidance, comfort and courage. ‘Everything will be alright...’ it sang in time with my steps, allowing me to keep moving forward without gasping for air.

From a psychological point of view, this phenomenon indicates that our consciousness does not collapse under extreme stress, but finds creative ways to maintain survival and the ability to act.

Sometimes the greatest resource we have left is the one our mind creates.

Clinical picture of psychosis and hallucinations: when inner voices become a warning sign

As empowering as the third man phenomenon may be, similar experiences can also be signs of a serious mental illness, which has been investigated in more detail in a study.

Psychosis describes a severe disturbance in the perception of reality, accompanied by hallucinations, distorted thinking and disorientation.

Hikers, especially at extreme altitudes, increasingly experience symptoms of so-called isolated altitude-related psychosis: psychotic episodes that occur independently of physical damage.

Here, the boundaries between inner salvation and loss of reality gradually become blurred.

Early recognition of these symptoms is crucial – because sometimes the ‘invisible companion’ does not save you, but heralds a dangerous alienation from your own self.

Causes: oxygen, stress and the fragile balance of the mind

Why do such extreme experiences occur in the first place?

The answer lies in a combination of biological and psychological causes, which are being analysed in current studies.

At altitudes of around 7,000 metres or higher, altitude sickness often leads to serious health risks that need to be investigated. Oxygen deprivation can cause massive impairment of sensitive areas of the brain – those that control self-perception and spatial orientation. Fluid loss, infections and the psychological burden of extreme isolation further exacerbate the effects.

Interestingly, medical research now clearly distinguishes between organically caused symptoms – such as high altitude cerebral oedema – and primarily psychologically induced experiences, which have been analysed in a recent study.

Not everyone who perceives an invisible presence suffers from physical damage. Often, it is consciousness itself that ultimately develops creative protective strategies to overcome the risks of altitude sickness.

Symptoms: when isolated altitude-related psychosis sets in

Isolated altitude-related psychosis was only described relatively late as a distinct clinical condition.

Typical symptoms include:

• Sudden perception of an invisible person,

• Hearing voices without an external source,

• Dissociation, the feeling of being outside one's own body.

Noteworthy:

Motor skills often remain intact for a long time. Those affected, such as extreme mountaineers, can continue to climb or move – even though they are already losing touch with reality.

This silent shift in perception makes isolated altitude-related psychosis particularly difficult to recognise – and therefore dangerous.

The Innsbruck research: extreme experiences under the microscope

In 2008, a team from the University of Innsbruck, renowned for its studies on altitude sickness, is an important research location. Together with the doctor, we analyse the symptoms that occur in mountaineers at extreme altitudes. Institute for Alpine Emergency Medicine systematically analysed reports of psychotic episodes from extreme hikers for the first time.

Katharina Hüfner and Hermann Brugger identified clear patterns:

• The episodes often occur during critical phases of descent.

• Many of those affected have only fragmentary memories afterwards.

• In numerous cases, symptoms remain unrecognised or are misinterpreted.

This research has significantly expanded our understanding of psychiatric reactions to extreme environmental conditions – and opens up new approaches to prevention and treatment.

The Third Man Factor: Hope as a survival strategy

The so-called Third Man Factor Theory considers the third man phenomenon to be a psychological emergency mechanism.

In moments of extreme threat, the consciousness activates an inner figure that restores strength, comfort and the ability to act.

What was once dismissed as a ‘pure hallucination’ now appears to be a highly sophisticated survival strategy:

a creative, instinctive response of the mind to existential danger.

The Third Man phenomenon is less a sign of weakness than a silent testament to our amazing psychological resilience, as documented in studies of extreme mountaineers.

Prevention and self-care on expeditions

If you are planning expeditions to high altitudes, you should also consciously prepare yourself for psychological challenges.

Recommended measures:

• Careful acclimatisation to high altitudes,

• continuous fluid intake,

• attention to subtle changes in your own perception,

• consistent descent at the first signs of hallucinations or loss of reality.

In particular, inner voices or the experience of an invisible presence should be taken seriously and clarified medically.

Conclusion: When hope takes shape

The third man phenomenon reveals that even in moments of greatest loneliness, our consciousness does not give up.

It creates what is missing on the outside: comfort, direction and the will to survive.

In a world that often puts rationality above everything else, these experiences remind us that mental resilience can have many faces – and that sometimes our invisible companion is our strongest ally.

FAQ: Frequently asked questions about the third man phenomenon

What is the third man syndrome?

Third man syndrome describes the perception of an invisible, supportive presence in extreme situations. It is understood as a natural psychological defence mechanism.

What is third man syndrome in Christianity?

In Christianity, third man syndrome is often interpreted as the intervention of a guardian angel – a spiritual presence that offers comfort and salvation in times of need.

What is the Third Man Syndrome of 11 September?

Several survivors of the attacks of 11 September 2001 reported an invisible companion who guided them through the rubble – a remarkable example of the Third Man phenomenon.

What was the name of the third man in the film and novel of the same name?

In the famous film and novel ‘The Third Man’ by Graham Greene and Carol Reed, the mysterious character is named Harry Lime, who can be seen as a fascinating figure in the study of the human psyche. The story itself has no connection to the psychological phenomenon.

Films that explore the phenomenon of the third man factor

Some films take up similar experiences, such as:

• Touching the Void (2003),

• Gravity (2013), in which a study was conducted on altitude sickness and psychological reactions in extreme mountaineers.

• The Revenant (2015).

These works impressively demonstrate how psychological defence mechanisms can shape our survival.