Hearing voices is actually quite a common experience: around one in ten of us will experience it at some point in our lives. Sometimes hearing voices can be upsetting or distressing. They may say hurtful or frightening things. However, for some people the voices may be neutral or more positive. You may feel differently about your voices at different times in your life.
They will usually check for any physical reasons you could be hearing voices before diagnosing you with a mental health condition or referring you to a psychiatrist. You may also be offered family intervention where support is provided to both you and your family , art or creative therapy, or therapy for experiences of trauma. Rethink has more information about the treatment you may be offered. Sometimes, voices are a problem because of your relationship with them. Changing your relationship can make you feel differently about them.
This could include keeping a diary of your voices. You could note what they say, how they make you feel and how you manage them. This may help you to notice patterns of what makes you feel bad, what makes you feel good, or what triggers your voices. Some people find that standing up to the voices, choosing when to pay attention to them and when to ignore them, and focusing on voices that are more positive can help them feel more in control.
Talking therapy can help you with this, as it can be difficult on your own. Keeping busy can distract you from the voices, help you express yourself and feel more relaxed and allow you to meet new people.
Studies that have examined auditory hallucinations in real-life situations using experience sampling methods show that negative emotional states contribute to the modulation of hallucination intensity.
In a study by Delespaul and colleagues, 18 participants with schizophrenia were asked to report experiences of hallucinations as well as negative mood states throughout the day for 1 week. In that study, self-reported anxiety levels were associated with, and often predicted, increased intensity of hallucinations. These findings suggest a causal association between levels of anxiety and hallucinatory experiences.
Auditory hallucinations, in turn, cause high levels of stress. The content and the experience of intrusive and personal voices can cause distress. Patients may feel that they are unable to escape from the experience, and this feeling is persistent and beyond voluntary control. The exact processes that underlie auditory hallucinations remain largely unknown. There are 2 principal avenues of research: one focuses on neuroanatomical networks using techniques such as positron emission tomography and functional MRI.
The other focuses on cognitive and psychological processes and the exploration of mental events involved in auditory hallucinations. A common formulation suggests that auditory verbal hallucinations represent an impairment in language processing and, particularly, inner speech processes, whereby the internal and silent dialogue that healthy people engage in is no longer interpreted as coming from the self but instead as having an external alien origin.
There is support for this language hypothesis of auditory hallucinations from neuroimaging studies. These show that the experience of auditory hallucinations engages brain regions, such as the primary auditory cortex and Broca area Figure , that are associated with language comprehension and production.
This suggests that hallucinatory experiences are associated with listening to external speech in the absence of external sounds.
An explanation of why these experiences are not perceived as self-generated posits that audi-tory hallucinations arise because persons who have the hallucinations fail to distinguish between internal and external events. This abnormality also applies to inner speech processes and leads to the misclassification of internal events as external and misattribution to an external agent.
By contrast, Bentall and Slade 26 have proposed that individuals with hallucinations use a different set of judgment criteria from healthy people when deciding whether an event is real, and they are more willing to accept that a perceptual experience is true. This bias essentially involves a greater willingness to believe that an event is real on the basis of less evidence. According to the context memory hypothesis of auditory hallucinations, the failure to identify events as self-generated arises because of specific deficits in episodic memory for remembering the details associated with particular past memory events.
These specific deficits in memory cause confusion about the origins of the experience. The lack of voluntary control over the experience is a key feature of auditory hallucinations, which might explain why self-generated inner speech is classified as external in origin. Because deficits in cognitive processes, such as inhibitory control, are thought to render people more susceptible to intrusive and recurrent unwanted thoughts, studies have linked auditory hallucinations with deficits in cognitive inhibition.
From a neuroanatomical point of view, deficits in the prefrontal cortex of patients with auditory hallucinations are consistent with the hypothesis of cognitive inhibitory deficits. Recent advances in the neurosciences provide clues to why patients report an auditory experience in the absence of any perceptual input. Spontaneous activity in the early sensory cortices may in fact form the basis for the original signal.
Early neuronal computation systems are known to interpret this activity and engage in decision-making processes to determine whether a percept has been detected. Ford and colleagues 36 recently suggested that patients with auditory hallucinations may have excessive attentional focus toward internally generated events-the brains of persons who have auditory hallucinations may therefore be overinterpreting spontaneous sensory activity that is largely ignored in healthy brains.
Cognitive impairments are not the only factors responsible for auditory hallucinations. Psychological factors such as metacognitive biases, beliefs, and attributions concerning the origins and intent of voices also play a critical modulatory role in shaping the experience of hallucinations. These factors do not explain how hallucinations occur in the first place, but they have strong explanatory power when accounting for individual differences in how the voices are experienced.
The presence of hallucinations does not necessarily imply a need for medical treatment if the experience is not intrusive and does not interfere with everyday activities.
When treatment is required, antipsychotic medication is usually the treatment of choice in organic and psychiatric conditions. In view of such adverse effects, clinicians need to monitor the physical health of patients regularly. Few studies have compared the efficacy of different neuroleptic treatments, and hallucinations often persist despite intensive and prolonged psychopharmacological treatment.
Used as an adjunct to antipsychotic medication, studies show that rTMS can reduce the frequency and severity of auditory hallucinations in treatment-resistant cases.
Many psychological treatments target the idiosyncratic ways that individuals respond to an abnormal perceptual experience, based on the understanding that this influences their coping strategies and emotional response.
Anxiety reduction strategies are particularly effective in reducing the impact of voices. Self-help groups often encourage patients to take responsibility for their hallucinatory experience, to accept the voices, and to cope with them.
A series of investigations showed that accepting hallucinations as an aspect of the normal human condition is one of the most difficult steps to take, but that the acceptance process and lack of resistance lead to successful adaptation to hearing voices and a change in the relationship with the voices.
Because cognitive dysfunctions have been shown to underlie auditory hallucinations, cognitive deficits are becoming targets of treatment with cognitive remediation strategies, although these interventions are at a very early stage of development. By focusing on deficits found to be linked to auditory hallucinations, recent trials have focused on the convergence between theory and practice. Auditory hallucinations are much more than false perceptions. The combination of personalized contents and interpretational processes contributes to a dynamic and emotionally charged experience that can be better described as a belief system rooted in a perceptual experience.
Auditory hallucinations are most likely to arise because of an interaction between perceptual, cognitive, and biological vulnerability as well as affective factors and contextual influences. In addition, the interpretation of these experiences combined with delusional elaboration makes auditory hallucinations a complex and truly individualized phenomenon. Understanding their complexity can lead to useful insights for therapy. Portions of it may have since been updated.
Arch Gen Psychiatry. Auditory hallucinations in those populations that do not suffer from schizophrenia. Curr Psychiatry Rep. Tien AY. Distributions of hallucinations in the population. Soc Psychiatry Psychiatr Epidemiol. Ohayon MM. Prevalence of hallucinations and their pathological associations in the general population. Psychiatry Res. Psychotic disorder caused by a general medical condition, with delusions. Psychiatr Clin North Am.
Verdoux H, van Os J. Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophr Res. Auditory hallucinations: a comparison between patients and nonpatients. J Nerv Ment Dis. Lowe GR. The phenomenology of hallucinations as an aid to differential diagnosis. Br J Psychiatry. Hallucinatory experiences and onset of psychotic disorder: evidence that the risk is mediated by delusion formation.
Search this site Search all sites Search. Go to whole of WA Government Search. Open search bar Open navigation Submit search. Health conditions. Facebook Youtube Twitter. Home Health conditions Hallucinations and hearing voices. Hallucinations and hearing voices Hallucinations refer to the experience of hearing, seeing or smelling things that are not there.
Hearing voices speaking when there is no-one there is known as an auditory hallucination. Voices can talk about very personal matters, which can be quite frightening. Often, other sounds like music, animal calls and the telephone ringing can be heard.
The noise volume varies from very quiet to very loud. The experience is different for different people. Seeing images when there is nothing in the environment to account for it is a visual hallucination. Simple visual hallucinations may include flashes or geometric shapes. Other types of hallucinations include feelings on the skin, smelling or tasting things that cannot be explained. Causes of hallucinations Intense negative emotions such as stress or grief can make people particularly vulnerable to hallucinations, as can conditions such as hearing or vision loss, and drugs or alcohol.
Auditory hallucinations are typically more common in psychiatric disease, and visual hallucinations in disorders of old age, People who experience hallucinations do not necessarily suffer from a mental illness. Signs and symptoms It is possible to lead a productive and meaningful life with hallucinations.
Treatment of hallucinations There are different treatment options depending on the cause of hallucinations. Living with hallucinations Everyday strategies are very helpful for coping with hallucinations.
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