Hearing Voices

By P. Casey Arrillaga, LCSW, LCDC

Hearing voices is one of the most stigmatized mental health symptoms, yet it is it surprisingly common. It is sometimes the result of alcohol and other drug use, but is more often a symptom of other mental health conditions that can put a person at risk of serious problems. There is an increasing movement within the mental health field to reduce the stigma and instead focus on how a person can function well in their life when hearing voices. This post will look at what is known about hearing voices and how to best help those for whom it is a problem.

What We Know So Far

Hearing voices is a condition that involves hearing talking that others do not. This may involve any number of experiences, such as hearing singe words, narration of the hearer’s actions, complete sentences, or a running commentary. It is the most common form of audio hallucination. Most people have had some experience of hearing voices, usually while falling asleep, but this is not considered a problem. What we are discussing in this post is the experience of hearing voices on a regular basis while wide awake.

Hearing voices often popularly associated with negative messages, such as harsh criticism or commands to do things destructive to the individual or those around them. This is not always the case, however. Some people hear neutral or helpful and kind voices. Some individuals and whole cultures think of the voices as divine communication, so when approaching someone who experiences voices, it should not be assumed that it is a negative experience or that the person wants to change what is happening.

There is no real way to know exactly how many people experience hearing voices. Estimates range from 5% to 28% of the population. The wide range is largely because of the stigma attached to hearing voices. Those who experience voices as children quickly learn that it is not normal and is usually considered very serious. Some may be actively discouraged from talking about their experiences, be told that they are making it up, or may not be taken seriously. As a result, they may go years and even decades without letting anyone know about their experiences again.

For those who start hearing voices as teens and young adults, there may be a lot of fear attached to the experience. This is part because they are already likely to have preconceptions about hearing voices and also that they will get negative attention when others find out. Once again, this can result in hiding what they are experiencing.

Another reason why they might hide the voices, though is that a person’s late teens and early 20’s are the years in which some of the more serious mental health conditions associated with hearing voices develop. These include the schizotypal disorders, the most famous (and feared) of which is schizophrenia. Someone experiencing this disease may also be having other symptoms that interfere with telling people about voices, such as paranoia or decreased interest in social interaction.

There are other reasons for hearing voices and other audio hallucinations. One of the most common is the use of alcohol and other drugs. These can interfere with the listening and speech centers in the brain, but the voices are only likely to happen while that person is intoxicated. There is little data about how much overlap there is between chemical addiction and hearing voices, but some clinicians have observed that their clients are using drugs to silence their voices, making it an even more difficult choice to get and stay sober.

How Can We Use This Knowledge to Help People?

At Windmill, we understand that hearing voices is a more common occurrence than most realize. That’s why the first thing we do when someone is experiencing voices is to let them know how normal it can be and encourage them to let go of any stigma they may carry around it. Next, we assess the nature of the voices to see if they are helpful, neutral, destructive, or some combination of these things. We find out whether the nature and messages of the voices have changed over time. We help the client understand that there may be variety of reasons the voices are happening, and we help them see if there are any underlying conditions that may be causing the voices.

From there, we move into finding solutions. If the voices seem to be a symptom of other conditions, medication may be helpful in quieting destructive or overly-distracting voices. If the client is open to it, we can use techniques such as Internal Family Systems therapy to assist them understand the voices and even work with them to become allies. For those who might benefit from recovery fellowships centered around their experience, we can connect them with mutual support groups such as the Hearing Voices Network. Such social support, including online and in-person meetings, has been shown to help people feel better about themselves and give them both inspiration and tools to help manage how the voices fit into their lives rather than derail them.

The Bottom Line

Hearing voices scares many people, but it doesn’t have to be as terrible as they assume. Instead, healing and help can be offered by a variety of means. Greater understanding and healing techniques offer real relief for anyone who experiences voices that cause them problems. If you or a loved one has trouble with hearing voices, reach out to us or another source of professional help.

About The Author

P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.