Hearing Voices in Schizophrenia

First, there are no schizophrenics but rather people living with schizophrenia. It is important to make this distinction as talking about schizophrenics implies wrongly that schizophrenia changes the core of who people are. Schizophrenia is something that happens to people and not who they are.

While most people can relate to the experience of someone struggling with severe depression or severe anxiety it is not easy to understand the experience of someone who has schizophrenia. That is because most people have had the experience of feeling depressed and anxious. At the same time, most people do not have the experience of feeling even a little psychotic. Or do they?

Psychosis and Auditory Hallucinations

Psychosis, which is the core of the schizophrenia experience, is a combination of thoughts, feelings, and perceptions that feel utterly strange, out of this word, and at the same time as real as real can be.

You can hear a whole gamut of noises and voices, from repetitive, screeching sounds suggestive of rats to painfully loud, thumping music themes, to voices of people blasting mean orders or comments or talking about you as if you were not even present.

Many times the voices can start gradually. The first experience might be an impression of hearing your name called or people talking about you. The impression is vague: it is “as if someone just called my name” or “as if people were talking in the hallway”. It might be vague and fleeting: “I thought I heard something but then I am not sure”. It turns out that such vague, uncertain auditory perceptual illusions or hallucinations are not as uncommon as once thought and in fact up to 10% of the general population might have had the experience of hearing one’s name called, especially during the twilight times of falling asleep or waking up. There is even a name for this type of hallucinations: hypnopompic (at the time of falling asleep) or hypnagogic (at the time of waking up) hallucinations.

For some people with schizophrenia, the voices appear suddenly. In her “Living with the voices” article T. M. Luhrman, a professor of anthropology at Stanford, describes the experience of a young man who started hearing the sound of rats scratching behind his ears. His auditory hallucinations came into existence rather rapidly, soon after he destroyed a number of rats nests. Another young man started to suddenly hear the voice coming from outside his apartment that sounded like a woman screaming she was raped and begging her help.

Regardless of how they start the voices tend to grow stronger over time, meaning that they tend to get louder and also make themselves heard more and more often. Unfortunately, they also tend to grow meaner and can become so persuasive that the voice hearer might choose to give in and follow their orders. The orders the voices give vary. As Eleanor Longden, a research psychologist with a diagnosis of schizophrenia explains, the voices can order you to do completely nonsensical things, such as taking a glass of water and pouring over your head. Due to their repetitive, never stopping, annoying quality, the voices' hearer will be profoundly distracted and at times overwhelmed to the point of choosing to follow their orders. Voices giving orders to harm oneself or others need to be approached with great caution. Hearing such orders tends to be a frightening experience, especially when the voice hearer cannot understand why such loud orders are screamed non-stop. Alternatively, a voice hearer feeling threatened to death by a secret organization might experience such commands as sensible in the greater scheme of things.

While hearing such command auditory hallucinations does not automatically imply that violence will ensue, the risk for acting on the voices’ orders need to carefully considered, especially when such voices are compounded by how persuasive they are and how often they speak out.