Hearing Voices

October 14th, 2024

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”.