Christmas is here, the nativity plays are over until next year. Teachers and parents have explained how the Angel Gabriel appeared to Mary and told her about the birth of Jesus; how shepherds heard about a baby in swaddling clothes lying in a manger. Yet if someone turned up at work and spoke about meeting an angel or hearing the voice of God there would be anxious looks. Hearing voices that no one else can is supposedly a sign of madness.
Yet new research says that it is a relatively common experience, albeit one that many people prefer to keep to themselves. Estimates suggest that more than half the “normal” population have auditory hallucinations at some time, while about 4 per cent hear voices regularly. Not all are attributed to supernatural beings — some are named and some remain incognito — but the majority of hearers cope with their voices, integrate them into their lives and have no contact with psych- iatric services.
Some voices are rewarding, amusing and offer constructive advice to hearers; others are depressing, critical and problematic. They can be experienced inside or outside the head (or even in the body) and can be one voice or many, around all the time or intermittent. Historical voice hearers include Socrates, Jesus, Joan of Arc and Winston Churchill. Lone sailors often report the phenomenon and the mountain climber Joe Simpson, on whom the film Touching the Void was based, was urged on to safety by a voice that was not his own.
Given the right situation, anybody can hear voices, says Philip Thomas, a consultant psychiatrist for more than 20 years in the NHS, and a writer and academic based at Bradford University. Isolated occurrences of voice hearing are common in the twilight state between sleep and consciousness, but traumas, such as physical or sexual abuse, can cause more long-lasting, disturbing and insistent voices. Bereavement is also a common trigger. Dr Thomas says: “If you have spent 40-odd years with somebody, then that person is removed, it has a powerful effect in upsetting your emotional balance. Our minds have a need to create a sense of wholeness.”
Psychiatrists typically, however, avoid the search for wholeness and the question of spirituality, says Dr Thomas. Instead they take a blinkered approach to voice hearing, focus solely on brain chemistry and reject the meaning of the voices in the context of the hearers’ lives. He adds: “That is a profoundly disturbing thing to do to somebody and one reason why many people who use mental-health services find that approach distressing. What is important is not the firing of the neurones; it’s how that is translated in terms of experience. For instance, let’s say you don’t like what is happening with Deirdre Barlow in Coronation Street. You’ll have more luck trying to change Deirdre’s behaviour by talking to the writers rather than taking a screwdriver to the inside of your television set.”
Dr Rufus May, a clinical psychologist and colleague of Dr Thomas, has seen mental illness from the perspective of both patient and health professional and agrees that helping voice hearers means listening to their stories rather than tinkering with their brains. At the age of 18 he had paranoid schizophrenia diagnosed and was put on anti-psychotic drugs, he was told, for the rest of his life, which left him feeling emotionally blunted. But eventually he escaped psychiatric supervision and 18 years later is also still medication-free. He has trained as a psychologist and now works with the Hearing Voices (self-help) Network to help others take back control of their lives. Research indicates that the hearer’s relationship with the voice is crucial in learning to cope and Dr May enables them to be more assertive with their voices, using techniques similar to those used in counselling couples.
He says: “You can theorise that the voices are sub-personalities talking to the person from the subconscious, like dream beings almost, and are there for an emotional reason — perhaps they haven’t worked through some experience — so we try to find that reason and help them to make peace with the voice. People can hear voices and get on with their lives. It’s not necessarily a sign of illness; it’s how they cope with it that defines whether they are disabled by it. Just medicating people is suppressing the problem and it will come back with a vengeance.”
Neil has heard voices since his early teens and has been receiving psychiatric care since the age of 17. In the beginning he was on high levels of neuroleptic, anti-psychotic drugs with side-effects that left him dribbling, shaking and impotent. Now in his fifties, he has learnt to cope with the support of psychotherapy, a self-help group, and medication that minimises side-effects.
Neil hears up to five voices when he is very ill. But the main one is the constantly abusive voice he attributes to his dead brother who drowned, at the age of 19, ten months before Neil’s birth. He says: “I don’t believe it’s his ghost but through counselling I recognise there was a lot of trauma at the time for my mum. I’m the youngest in a large family and I was born into a situation where there was a lot of anger and grief around the loss of my brother. It’s taken me a long time to realise how that may have had an impact on me.” Thanks to help from an understanding psychiatrist, Neil was able to go through college and take his exams. He is now a senior manager in a mental health trust.
Sara Maitland, an author and journalist, hears voices regularly and has incorporated them into her life without psychiatric help, although they are quiet at the moment and she rather misses them. She is “seriously religious” and frustrated by the attitude of most psychiatrists who regard voices as necessarily a symptom of mental illness, possibly schizophrenia, and in need of treatment with heavyduty drugs.
“There’s an absolute assumption that if people think they’re hearing the voice of God they must be mad,” she says. “I believe that some people do directly hear the voice of God and there isn’t any modern way of distinguishing that from psychotic voice hearing.”
Maitland’s fiction style is magical realism and she feels that her voices nurture her creativity. She says hers are flamboyant, articulate and never boring. “I have a little girl who is locked in the cellar and I have a dwarf who wears steel boots, quite fairy-storyish, although not necessarily in what they say,” she says. She believes that her voices are closely related to prayer and speculates that development of a “much more internalised kind of prayer” recently has “absorbed” and quieted some of them.
Dr Mark Hayward, a clinical psychologist and academic at Surrey University, is studying the experience of voice hearers and is especially keen to research people who hear voices yet go about their day-to-day lives. He says: “Otherwise much of our understanding is biased towards people who are distressed and we have to guess about the characteristics of positive relationships with voices. We don’t want to guess, we want to know.”
Dr Mark Hayward can be contacted by e-mail on m.hayward@surrey.ac.uk
Why do people hear voices?
If the inner voice is abusive, the person may separate it from their “self” as a form of protection. Information from Dr Mark Hayward, clinical psychologist
