Is it normal to hear voices? auditory hallucinations

The human being is a social being who communicates with his environment and with his peers, largely using oral language for this. 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 claim 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.

Hearing voices: auditory hallucinations

The perception of elements in the absence of stimuli that provoke them is what we know as hallucination. In them, whoever suffers from them perceives as true a stimulus that does not exist in reality, this being their own elaboration. Hallucinations can appear in any sensory modality, including hearing.

The fact of hearing voices, if these do not come from a real stimulus, is therefore a hallucinatory phenomenon. In fact It 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 thought, give orders, make criticisms of those who suffer them 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 it is not usual.

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 other people great suffering, being critical, ridiculing and threatening voices that can even lead him to do concrete acts.

• Related article: "The 15 types of hallucinations (and their possible causes)"

Schizophrenia and other psychotic disorders

The first thing most people think of when someone says they hear voices is the word schizophrenia, or that he is suffering from a Psychotic attack. 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, the voices can be manipulative and frightening and order to do things that the subject does not want to do. It is frequent that in this disorder the content of the voices is threatening or critical and that they speak of the subject himself or of the environment, as well as provoke the interpretation of reality differently to the usual generating delusions (for example, a person who constantly hears that they are being persecuted or they want to see them dead may end up interpreting situations according to said idea).

But not only voices are heard in schizophrenia. In fact, auditory hallucinations are one of the main positive symptoms (those that add elements to the normal functioning of the patient) both of schizophrenia as well as other psychotic-type disorders in which there is a partial or complete break with the reality.

• You may be interested in: "The 8 types of Psychotic Disorders"

Other disorders in which it is possible to hear voices

Psychotic disorders are not the only ones in which the hearing of voices generated by one's own mind can appear. In some types of depression as the atypical, in manic episodes, anxiety attacks or during epileptic seizures voices can be heard. Also during dissociative states.

Also, some diseases and medical conditions can cause this perception. For example, in the presence of high fever hallucinations and delusions, as well as a large number of alterations that occur with alterations of consciousness.

Different pictures such as withdrawal syndrome to certain substances, or neurological disorders such as dementias are prone to generate 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 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, not in all cases we are facing this disorder: 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 those of a psychodysleptic type (like 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 to this, some substances can cause a psychotic break per se, which can also cause hearing voices.

And not only during their consumption, they can also occur in poisoning by these substances or even before the abrupt cessation of its consumption in the cases that suffer from dependency, that is to say before the 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 taking place.

Although they are often 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 moments. For example, it is not uncommon that when we lose a loved one we seem to hear the voice of the deceased, usually in the early stages of life. grieving process.

Hearing voices can also be the consequence of a state of extreme excitement and nervousness, appearing this phenomenon as nervous paroxysm. In fact, the perception of these voices can further increase the state of tension of the subject and accentuate the perceptions.

4. pareidolia

Pareidolia is understood as the phenomenon by which the human brain tends to cause we perceive patterns in ambiguous stimuli, just as occurs 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 in audition. It is possible that certain environmental elements, such as the wind, produce noise that we can interpret as a human voice, even in the form of sentences.

What are they really?

The origin of the perception of voices with nothing that triggers said perception may depend on the type of phenomenon that originates them. In general it is either an interpretation of an external noise or perception as exogenous of a self-generated content (that is, that something that the person himself has thought is perceived as external).

In the second case, there are multiple hypotheses as to why this is the case. 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 prefrontal lesions. 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 disconnect between the speech brain regions and the prefrontal, 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 during 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 be used will depend on the case.

In cases of psychotic disorders, neuroleptics or antipsychotics are often used in order to reduce hallucinations. In this regard, both the typical and atypical ones are very successful, although the former can cause relevant side effects and in both cases they can generate sedation. In other disorders the corresponding cause should be treated.

At a psychological level and specifically on auditory hallucinations, Focusing therapy has been used. In this therapy elaborated by Slade, Haddock and Bentall, the patient is trying to gradually focus on different aspects of the voices. It begins with the shape 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 to them. It is about getting the subject little by little to re-attribute the voices to their own mental contents.

In any case, when treating a person who claims to hear voices, it is necessary to make them see a fundamental aspect: regardless of what they say the voices can't hurt you.