Because I work as a Psychiatrist, some people think that a trip to see me is not complete without the archetypal question, “Do you hear voices?” However, though I do usually cover this area at some point, that question itself is next to useless.
Some people will run a mile – especially if they actually suffer from something like OCD and just FEAR they are going mad. Others will have voices which for them are quite normal – about 1% of the UK population chronically hear voices and are not ill at all. And the group who you might think I am interested in (those with Schizophrenia) do not all hear voices and I am interested in far more than just hearing a voice.
Causes for Voice Hearing
Normality: Hearing voices or complex noises can be a normal experience and people live otherwise healthy lives. If it gets bad, the Hearing Voices Network have a helpful website with links to books and self-help groups all around the country. This resource can also be useful for some of the people who hear voices for the reasons listed below.
Split-Mind: The literal meaning of the word schizophrenia is ‘split brain’ but this is a misnomer – this is not what is happening in schizophrenia. But there are people whose mind is ‘split’ who hear voices. This may have occurred as a result of awful trauma when they were young such as sexual abuse – and our natural defence mechanism is to split off that awful memory into a hidden part of the brain. This is what can happen in Dissociation or Dissociative Identify Disorder. However, humans don’t do well with hiding things away, and the hidden bit tries to get out – some times as flashbacks, but sometimes as a voice saying nasty things like “You are dirty/horrible/useless.”
Low self-esteem: When our mood is chronically lowered, not typically due to depression which is episodic, but due to low self-worth; we can begin to hear a voice that resonates with our mood. This is less of a voice and more like an audible conscious stream of negative and critical comments: “You are useless. You are fat. I can see why no-one wants to be your friend…”.
Substance Misuse: If you use alcohol heavily, or other street drugs like amphetamines that stimulate dopamine, you will be likely to hear voices. In chronic alcohol use, the voice is similar to in low self-esteem above. In amphetamine intoxication it can be anything from hearing vague sounds to full-blown psychosis where all manner of things are believed.
Severe mental illness: People with schizophrenia will experience all kinds of voices. General voice hearing is common, but psychiatrists are particularly interested in three types of voice: two or more people talking about you, a voice commentating on your actions, or hearing your own thoughts read out aloud. These voices are strongly suggesting of schizophrenia rather than other causes. Voices are also sometimes heard in other severe mental illnesses such as bipolar affective disorder, advanced dementia or very severe depression.
A word about schizophrenia
It is worth emphasising that most people with schizophrenia can receive effective treatment and support - but this only occurs if they are enabled to see help and not driven away by stigma. Sadly, people have a negative image of schizophrenia – largely thanks to films like ‘One Flew Over the Cuckoo’s Nest’ and ‘Me, Myself and Irene’. The first is woefully out of date and even then inaccurate, the second is about multiple personality disorder and psychopathy – things completely unrelated to schizophrenia. Also, Christians can need reminding that Schizophrenia is NOT demon possession – most of the cases of demon possession in the Bible are completely unlike Schizophrenia and even the ‘Gerasene Demoniac’ in Mark 5 is pretty far off the mark.
Schizophrenia affects 1% of the population at some point in their lives and treatment can last for several years. This means that there are lots of people on treatment and you would never know – anymore that you could tell a person with diabetes was on insulin. People with Schizophrenia (and please lets call them this, not ‘schizophrenics’ or ‘nutters’) are more likely to get hit themselves rather than hit you – they are not typically violent, especially when well. In fact, in my experience, I have typically found them to be amazing and resourceful people who have to live with a severe illness that affects something very close to their core. Perhaps you or I would do well to meditate on this before we jump to any conclusions.
