Human beings are social beings who communicate with their environment and with their fellow human beings, to a large extent using oral language for this. We speak to communicate and express more or less abstract ideas and concepts, and we feel and listen to those of others.
However, some people say hearing voices that do not correspond to a real stimulus. In this context … What happens to these people? Is it normal to hear voices? In this article, we will clarify some cases in which the auditory perception of a voice appears.
Hearing voices: auditory hallucinations
The perception of the elements in the absence of stimuli that provoke them this is what we call hallucination. In them, the patient perceives as a real stimulus which does not exist in reality, of this own elaboration. Hallucinations can appear in any sensory modality, including hearing.
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 may outwardly reflect the content of one’s own thinking, give orders, criticize those who experience 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 this is usually not the case.
It should be noted 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 other hand, it causes great suffering to others. be critical, ridiculous and threatening voices which can even lead him to accomplish concrete acts.
Schizophrenia and other psychotic disorders
The first thing most people think of when someone says they hear voices is in the word schizophrenia, or they are suffering from a psychotic epidemic. The link between schizophrenia and hearing voices this 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 for the content of voices to be threatening or critical in this disorder and for them to speak about their own subject or environment, as well as differently provoke the interpretation of reality the usual generative delusions (for example, a person who constantly has the feeling of persecuting him or who wants to see him dead may end up interpreting situations according to this idea).
But not only voices are heard in schizophrenia. In fact, auditory hallucinations they are one of the main positive symptoms (Those which add elements to the normal functioning of the patient) both schizophrenia and other disorders of the psychotic type in which there is a partial or complete break with reality.
Other disorders in which voices may be heard
Psychotic disorders are not the only ones in which hearing self-generated voices can appear. In certain types of depression as atypical, during manic episodes, anxiety attacks or epileptic fits, voices can be heard. Also during dissociative states.
In addition, certain illnesses and medical conditions can cause this perception. For example, in the presence of a high fever hallucinations and delusions may appear, as well as a large number of alterations which are accompanied by alterations in consciousness.
Different conditions such as withdrawal syndrome to certain substances, or neurological disorders such as dementia are likely to generate the perception of hearing voices.
We are not always dealing with a disorder
As we have seen, when it is mentioned that a person hears voices, this fact is usually related to the existence of schizophrenia or a psychotic type disorder. Indeed, the presence of auditory hallucinations, especially in the form of voice, is one of the most characteristic symptoms of paranoid schizophrenia.
However, in all cases, we do not treat this disorder: it is possible to hear voices for several reasons and not all are pathological.
1. Substance use
The consumption of certain substances, especially those of the psychodysleptic type (Like hallucinogens) or psychoanaleptics, can also induce the perception of voices or sounds by causing alterations in perception and / or level of consciousness. On top of that, some substances can even cause a psychotic outbreak on their own, which can also make you hear voices.
And not only during consumption, they can also occur with poisoning by these substances or even in the face of abrupt cessation of consumption in the event of dependence, that is to say in the event of withdrawal syndrome.
2. Hypnagogic and hypnopomic hallucinations
An example is found in hypnagogic and hypnopomic hallucinations, also called physiological hallucinations: it is a form of pseudoperception in the form of hallucinations that they occur in the transition from wakefulness to sleep and vice versa, That is, in a state in which an alteration of consciousness takes place.
Although they are often visual, it is not uncommon for sound elements to appear as well. being able to hear voices, conversations or screams. They do not necessarily indicate the presence of pathology, but it is not uncommon for them to appear in the non-clinical population.
3. Reaction to severe stress or traumatic event
Losing a loved one, being subjected to some form of abuse, or being under considerable stress can cause those who have suffered to be heard at times. For example, it is not uncommon for when we lose a loved one we seem to hear the voice of the victim, usually early in the grieving process.
Hearing voices can also be a consequence of a state of extreme excitement and nervousness, Appearing this phenomenon as a nervous paroxysm. In fact, the perception of these voices can further increase the state of tension of the subject and accentuate the perceptions.
Pareidolia is understood as the phenomenon by which the human brain tends to cause us to perceive patterns of ambiguous stimulus elements, as occurs when we see shapes in clouds.
While pareidolia itself denotes the gift of meaning and significance to images that do not have it, also in other senses similar phenomena possible. For example at the hearing. It is possible that certain environmental elements, such as wind, produce noise that can be interpreted as a human voice, Even in the form of sentences.
What are they really?
The origin of the perception of voices without anything to trigger this perception may depend on the type of phenomenon that causes them. This is usually either an interpretation of external noise, or the perception as exogenous of self-generated content (that is, something that the same person has thought of is perceived as external. ).
In the second case, several hypotheses explain why this is so. 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 has also been proposed. It was also observed that many patients with asymmetries in the temporal lobe develop positive symptoms such as hallucinations. Another explanation may be the disconnection between speech and the prefrontal brain regions., Which can lead to 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 cause significant harm, discomfort or limitation to those who perceive them or to their environment.
If voices are perceived during a grieving process or after a traumatic experience, it may be necessary to work on the phenomenon that engendered it and its significance for the patient. The type of strategy to use will depend on the case.
In case of psychotic disorders, neuroleptics or antipsychotics are generally used to reduce hallucinations. In this aspect, both the typical and the atypical are very successful, although the former can cause significant side effects and in both cases can generate sedation. In other disorders, you will need to treat the corresponding cause.
At the psychological level and in particular on auditory hallucinations, targeting therapy was used. In this therapy developed by Slade, Haddock and Bentall, we try to get the patient to focus little by little on different aspects of the voice. It starts with the shape and characteristics of the voice in question, then analyzes the content (i.e. what they are saying) and finally works on the beliefs that the subject has about them. It is about getting the subject to gradually reassign the voices to his own mental content.
In any case, when it comes to a person who claims to hear voices, there is one fundamental aspect to be shown: no matter what they say, voices can’t hurt him.