Regardless of whether it is a question of thinking or of perception, hearing voices is approached as a phenomenon of the mind and so we tend not to ask if it is also felt in the body. The legacy of Cartesian dualism – where mind and body are separate entities – runs deep in the psychological disciplines. Should some voice-hearing experiences be understood not as “problems” of perception or of auditory processing, but as more closely related to the complex ways in which we think? Bodily voices Interestingly, there was no clear link between people’s reported diagnosis and the quality of the voices they heard, which brings into question the idea that loud, external voices are “typical” of schizophrenia. It’s hard to describe how I could ‘hear’ a voice that wasn’t auditory but the words the voices used and the emotions they contained (hatred and disgust) were completely clear, distinct, and unmistakable, maybe even more so than if I had heard them aurally. They were much more intimate than that, and inescapable. Just under half of the participants in our study said that the voices they heard were indistinguishable from hearing somebody in the room, but a similar number reported thought-like voices or a mixture of the two. Is hearing voices always auditory?Īlthough the terms “true” and “pseudo” hallucination are no longer regarded as clinically useful, the idea persists that voices perceived as loud and as coming from outside the head are somehow a more serious symptom or disturbance. What we didn’t expect to find was how people’s responses to this survey would challenge our own understanding of the very nature and definition of an auditory hallucination. The findings, reported in The Lancet Psychiatry, reinforce some of what we already know about auditory hallucinations – people hear lots of different kinds of voices, some with strong characterful qualities, and despite strong associations with negative emotions such as fear, anxiety and depression, some people also hear positive and supportive voices. We designed an open-ended online questionnaire which was completed by 153 people with a range of diagnoses, including 26 who had never had a psychiatric diagnosis. Our research team at Durham and Stanford Universities decided to go back to first principles and ask people to describe, in their own words, what it is like to hear voices. The question arises: is there something we’re missing about this experience, just because we’re not looking for it? Questioning our assumptions Most of the scales and measures used in research, and for clinical and diagnostic purposes, start by asking people to report on things like the loudness, frequency and emotional content. This is not surprising when you consider that most of the research into auditory hallucinations is done in a clinical setting with people diagnosed as suffering from psychosis. Indeed, 5-13% of adults will hear voices at some point during their lives – in circumstances that may be related to spiritual experiences, bereavement, trauma, sensory deprivation or impairment, as well as mental and emotional distress.ĭespite this, many people, including health-care professionals, still regard hearing voices as a “first-rank” symptom of schizophrenia and assume that these voices are experienced as negative, commanding, loud, frequent and coming from outside the head. We’ve known for a long time that hearing voices, or auditory hallucination, is reported by people with a wide range of psychiatric diagnoses as well as by those who have none. For many people hearing voices is synonymous with schizophrenia and severe mental illness.
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