Alpha claims to see insane human-horse things when he's taking Psycho. Often, they help him shoot at the ghouls whom's skulls he is ever so kindly and delightfully filling with lead. This leads him to not really shoot at them (that much). When the Psycho wears off, he often makes puns about having gone Psycho and runs from these equine beings, whom are, for some apparent reason, not drug-encased hallucinations.
There ya goe