6 Myths Surrounding Voice-Hearing

Hearing voices is often deeply misunderstood. As a therapist with a specialty in psychosis, it is common for me to hear ripples of shame and a sense of aloneness among voice-hearers. Yet, research shows that as many as one in five people may hear a voice at some point in their lifetime (Beavan et al, 2011). What follows are six myths about the experience of voice-hearing and six facts.

Myth 1: Everyone who hears voices has schizophrenia.

Fact: There are several reasons why someone might hear voices.

In Western culture, voice-hearing is most often associated with mental illnesses. Indeed, hearing voices is among the most frequently reported symptoms in those living with schizophrenia, a complex condition affecting multiple areas of one's life. Still, not everyone who hears voices lives with a mental health condition. Hearing voices can be caused by many things ranging from sleep deprivation to grief and neurological anomalies. Hypnogogic hallucinations, which could include hearing voices as one falls to sleep are common in healthy people. In addition, voice-hearing is a part of many spiritual practices and not always a cause for distress. Hearing voices can also be found in those living with many mental health conditions beyond schizophrenia such as severe depression, bipolar disorder, and post-traumatic stress disorder.

Myth 2: Voices are always heard outside one's head.

Fact: Voices can be heard both internally and externally.

Voice hearing is most commonly thought of as hearing a voice outside one's head. Most people have an internal monologue or thoughts that are experienced auditorily. Still, this is a continuum. When someone experiences voices inside their head that they do not identify as coming from the self, they could be hearing voices. It's important to differentiate these from other experiences such as intrusive thoughts. In people living with schizophrenia, internal voices are often cited as being more distressing and negative than those heard outside one's head (Docherty et al, 2015), however, those who identify their voices as internal often show greater insight into the nature of their experience.

Myth 3: If someone hears voices, they know they hear voices.

Fact: Many people who hear voices do not know they do.

Unfortunately, this myth runs rampant within the mental health community. When screening for voices, many therapists will simply ask "Do you hear voices?" That makes sense, right? The reality is that for many, especially those experiencing severe psychosis, the outward answer will be 'no' even if the person is hearing voices. This is because the person may carry beliefs about their voices such as that the voice is a neighbor, a demon, or something transmitted to their mind by an implanted chip. Some people also believe that their voices can also hear them and may be fearful of openly discussing their voices particularly if they see their voice as having real power (such as that of an angel or demon). Tools such as the Beliefs About Voices Questionnaire help mental health practitioners to better understand and explore these thoughts (Chadwick et al, 2000).

Myth 4: People who hear voices are dangerous.

Fact: People who hear voices are usually not dangerous.

No one knows you better than your voices and so the depth of unkindness some receive from voices can be incredibly distressing. Some react by yelling back at the voices, covering their ears, or acting in ways that others might find difficult to understand. It is rare for someone to act in violence toward another person during these experiences. Some who hear voices do experience 'command hallucinations' or voices that tell them to do something. This said, those who hear these kinds of voices may or may not feel a need to act on the command. When a person is hearing voices telling to harm themselves or others it is important for them to seek help right away. Still, even then the person is more likely to be a risk to themselves than anyone else. What's most needed when hearing distressing voices is compassion, not fear.

Myth 5: When someone hears voices, the voice is always talking to them.

Fact: There are many experiences of voice-hearing.

While some individuals experience voices that comment on their actions, tell them to do things, or otherwise talk to them, this is only one of many ways voice-hearing is experienced. Many people who hear voices find it difficult to make out the specific words being said. Some people hear two or more voices talking to each other. Others will hear more than 10 voices at a time. A common manifestation of voice-hearing is also what is called 'tape recorder' voices which repeat the same word or phrase over and over.

Myth 6: If you hear voices that bother you, there is nothing you can do about it.

Fact: Help is available to those who hear voices.

Several interventions exist to assist individuals who hear distressing voices ranging from peer support groups to medication. Psychotherapies such as compassion-focused therapy and cognitive behavioral therapy for Psychosis can also help. With support, many are able to cope with their voices and some find total relief.