Is It Normal To Hear Voices? Auditory Hallucinations
The human being is a social being who communicates with his environment and with his fellow human beings, largely using oral language to do so. We speak to communicate and express more or less abstract ideas and concepts, and we hear and listen to those of others.
However, some people say hearing voices that do not correspond to a real stimulus. In this context… What is happening with these people? Is it normal to hear voices? In this article we are going to specify some cases in which the auditory perception of a voice appears.
The perception of elements in the absence of stimuli that cause them It is what we know as hallucination. In them, those who suffer from them perceive as true a stimulus that does not exist in reality, this being their own creation. Hallucinations can appear in any sensory modality, including hearing.
The fact of hearing voices, if they do not come from a real stimulus, is therefore a hallucinatory phenomenon. In fact This is the most common type of hallucination, especially in certain mental disorders. The voices in question can externally reflect the contents of one’s own thoughts, give orders, criticize the sufferer in the second person or make comments in the third person. It is even possible to perceive more than one and for them to establish conversations with each other, although this is not usually common.
It must be taken into account that the perception of voices can be experienced in different ways. For some people it can be a rewarding, positive and even mystical experience, especially when its content is not aversive. On the contrary, it causes great suffering for other people, being critical, ridiculing and threatening voices that can even lead you to do specific acts.
Schizophrenia and other psychotic disorders
The first thing most people think of when someone says they hear voices is the word schizophrenia, or that they are suffering a psychotic break. The link between schizophrenia and hearing voices It is because the presence of hallucinations (especially auditory) is one of the predominant symptoms, especially of the paranoid subtype.
In schizophrenia, voices can be manipulative and terrifying and order things to be done that the subject does not want to do. It is common that in this disorder the content of the voices is threatening or critical and that they talk about the subject themselves or the environment, just as they can provoke the interpretation of reality in a different way to the usual one, generating delusions (for example, a person who constantly hears that they are being chased or that they want to see them dead may end up interpreting situations according to said idea).
But voices are not only heard in schizophrenia. In fact, auditory hallucinations are one of the main positive symptoms (those that add elements to the patient’s usual functioning) of both schizophrenia and other psychotic disorders in which there is a partial or complete break with reality.
Other disorders in which it is possible to hear voices
Psychotic disorders are not the only ones in which hearing voices generated by the mind itself can appear. In some types of depression Like the atypical one, voices can be heard in manic episodes, anxiety attacks or during epileptic seizures. Also during dissociative states.
Likewise, some diseases and medical disorders can cause this perception. For example, in the presence of high fever Hallucinations and delusions may appear, as well as a large number of alterations that occur with alterations in consciousness.
Different symptoms such as withdrawal syndrome certain substances, or neurological disorders such as dementia, are prone to generating the perception of hearing voices.
We are not always facing a disorder
As we have seen, when it is mentioned that a person hears voices, this fact is generally linked to the existence of schizophrenia or a psychotic-type disorder. This is because the presence of auditory hallucinations, especially in the form of voices, is one of the most characteristic symptoms of paranoid schizophrenia.
However, we are not faced with this disorder in all cases: It is possible to hear voices for multiple reasons and not all of them are pathological.
1. Substance use
The consumption of certain substances, especially the psychodysleptic type (such as hallucinogens) or psychoanaleptic, it can also cause the perception of voices or sounds by causing alterations in perception and/or level of consciousness. In addition, some substances can cause a psychotic break per se, which can also cause hearing voices.
And not only during consumption, poisoning from these substances can also occur. or even in the event of abrupt cessation of consumption in cases that suffer from dependence, that is, in the face of withdrawal syndrome.
2. Hypnagogic and hypnopompic hallucinations
An example of this is found in hypnagogic and hypnopompic hallucinations, also called physiological hallucinations: this is a form of pseudoperception in the form of hallucinations that arise in the transition from wakefulness to sleep and vice versa that is, in a state in which an alteration of consciousness is occurring.
Although it is common for them to be visual, it is not uncommon for sound elements to also appear. being able to hear voices, conversations or screams. They do not necessarily indicate the presence of a pathology, but it is not uncommon for them to appear in the non-clinical population.
3. Reaction to intense stress or traumatic event
Losing a loved one, having suffered some type of abuse or being subjected to considerable stress can cause those who have suffered it to experience hearing voices at specific times. For example, it is not unusual that when we lose a loved one we seem to hear the voice of the deceased, usually in the early stages of the grieving process.
Hearing voices can also be a consequence of a state of extreme excitement and nervousness, this phenomenon appearing as a nervous paroxysm. In fact, the perception of these voices can further increase the subject’s state of tension and accentuate the perceptions.
4. Pareidolia
Pareidolia is understood as the phenomenon through which the human brain tends to cause us to perceive patterns in ambiguous stimulus elements, just as happens when we see shapes in clouds.
Although pareidolia itself designates the endowment of meaning and meaning to images that do not have it, similar phenomena can also occur in other senses. For example at audition. It is possible that certain environmental elements, such as wind, produce noise that we can interpret as a human voice even in the form of sentences.
What are they actually?
The origin of the perception of voices without anything that triggers said perception may depend on the type of phenomenon that causes them. Generally it is either an interpretation of an external noise or the perception of self-generated content as exogenous (that is, something that the person himself has thought about is perceived as external).
In the second case, there are multiple hypotheses as to why this happens. It has been perceived that the existence of an excess of dopamine in the mesolimbic pathway can generate hallucinations and delusions, as well as the possibility of lesions in the prefrontal. It has also been observed that many patients with asymmetries in the temporal lobe develop positive symptoms such as hallucinations. Another explanation may be the disconnection between the speech and prefrontal brain regions which can cause a dissociation between self-awareness and the generation of verbal content.
How are they treated?
Hearing Voices Requires Treatment if these are due to the existence of a mental illness and/or represent significant harm, discomfort or limitation for the person who perceives them or their environment.
If the voices are perceived throughout a grieving process or after a traumatic experience, it may be necessary to work on the phenomenon that generated it and its significance for the patient. The type of strategy to use will depend on the case.
In cases of psychotic disorders, Neuroleptics or antipsychotics are usually used in order to reduce hallucinations. In this aspect, both typical and atypical are very successful, although the former can cause relevant side effects and in both cases can generate sedation. In other disorders, the corresponding cause must be treated.
On a psychological level and specifically on auditory hallucinations, targeting therapy has been used. In this therapy developed by Slade, Haddock and Bentall, the patient tries to focus little by little on different aspects of the voices. He begins with the form and characteristics of the voice in question, to later analyze the content (that is, what they say) and finally work on the beliefs that the subject has regarding them. It is about getting the subject little by little to reattribute the voices to their own mental contents.
In any case, when treating a person who says they hear voices, it is necessary to make them see a fundamental aspect: regardless of what they say, the voices can’t hurt you.
