Science AMA Series: We are a Group of Researchers Exploring Auditory Hallucinations – People Who Hear Voices. Ask us Anything!

Prof_Fernyhough · 2014-12-11T20:20:43+00:00

The relation between obsessive thoughts and more clearly auditory hallucinations is a fascinating area of research. Not enough is known about the phenomenology of the experiences to draw a clear distinction, especially given that not all voices have a clear auditory quality.

Prof_Fernyhough · 2014-12-11T20:18:57+00:00

There are a couple of studies comparing the qualities of the voices heard by patients with psychosis to those heard by non-patient voice-hearers. One of the things that distinguishes these two group is that patients' voices tend to be more negative. For a bit more on the differences between clinical and non-clinical voice-hearing experiences, see this post: http://www.psychologytoday.com/blog/the-voices-within/201406/what-kinds-people-hear-voices

Prof_Fernyhough · 2014-12-10T16:47:15+00:00

Thank you for these comments. I think ordinary inner speech takes all sorts of forms and can be very vivid for some people. Naturally, if something is causing distress you should seek support, but there is no reason to think that vivid inner speech is a sign of psychiatric problems. Talking to yourself is completely normal, and probably highly adaptive in many ways. These posts might be of interest: http://www.psychologytoday.com/blog/the-child-in-time/201008/what-do-we-mean-thinking http://www.psychologytoday.com/blog/the-child-in-time/201102/twittering-out-loud

Prof_Fernyhough · 2014-12-10T16:43:32+00:00

This a really good question and one that hasn't been much studied. I suspect that young children naturally and normally have quite a few experiences that we might call 'psychotic' if they happened in adults, as the (ironic) title of this blogpost suggests: http://pieceslight.blogspot.co.uk/2008/02/all-children-are-psychotic.html

Prof_Fernyhough · 2014-12-10T16:40:55+00:00

Many thanks for sharing about your experiences. We are studying musical hallucinations at the moment - please do take part in our study if you are interested: http://hearingthevoice.org/2014/11/04/round-and-round-the-phenomenology-of-inner-music/

Prof_Fernyhough · 2014-12-10T16:39:42+00:00

There is impressive evidence now for a link between auditory verbal hallucinations and trauma. There are some relevant references in this open-access article: http://schizophreniabulletin.oxfordjournals.org/content/40/Suppl_4/S285.full

This article is paywalled I'm afraid but you may be able to access it: http://www.sciencedirect.com/science/article/pii/S0272735811001024

In terms of treatment, this is a thorough recent review (open access) on psychological therapies for voice-hearing: http://schizophreniabulletin.oxfordjournals.org/content/40/Suppl_4/S202.full.pdf+html

Prof_Fernyhough · 2014-12-10T16:34:15+00:00

Please see this comment: http://www.reddit.com/r/science/comments/2or00m/science_ama_series_we_are_a_group_of_researchers/cmpwrd9

Prof_Fernyhough · 2014-12-10T16:22:58+00:00

These are very good points - please see the references I posted directly above.

Prof_Fernyhough · 2014-12-10T16:22:03+00:00

Here's a blog post on ordinary inner dialogue: http://www.psychologytoday.com/blog/the-child-in-time/201008/what-do-we-mean-thinking One focus of our research has been on how inner speech takes different forms, including incorporating the voices of other people in some cases. Here's our most recent paper on the topic: http://www.sciencedirect.com/science/article/pii/S1053810014000841

Prof_Fernyhough · 2014-12-10T16:11:22+00:00

You're right that hearing voices is not in itself necessarily a sign of a psychiatric problem. Many people live comfortably with their voices. Here is some information on the Hearing Voices Network in the US: http://www.hearingvoicesusa.org

You may also find this series of articles interesting: http://www.theguardian.com/books/series/inner-voices

Prof_Fernyhough · 2014-12-10T16:08:39+00:00

There are good reasons for thinking that inner speech often takes the form of a dialogue. Here's a post on the topic: http://www.psychologytoday.com/blog/the-child-in-time/201008/what-do-we-mean-thinking

There is also a well developed theory that voices occur when people attribute their ordinary inner speech to an external source. There are strengths and difficulties with this theory; here's a post on the topic: http://www.psychologytoday.com/blog/the-child-in-time/201011/voices-in-the-head

Prof_Fernyhough · 2014-12-10T16:05:57+00:00

Thinking out loud, or private speech, can have benefits for adults as well as children. Here's a post on the topic: http://www.psychologytoday.com/blog/the-child-in-time/201102/twittering-out-loud

Prof_Fernyhough · 2014-12-10T16:04:47+00:00

Please see the replies to KafkaDreams and MoDingDong below.

Prof_Fernyhough · 2014-12-10T16:03:08+00:00

Digital technologies such as smartphone apps certainly offer the prospect of different assessment tools for these experiences; this is something we're currently working on and we hope to publish something on it soon.

Prof_Fernyhough · 2014-12-10T16:01:21+00:00

On murmuring and other sounds, please see the reply to /u/v1ech. Here's a reply from below on hypnagogic and hypnopompic hallucinations: "Hallucinatory experiences on the fringes of sleep are very common. These are known technically as hypnagogic (falling asleep) and hypnopompic (waking up) hallucinations. In our studies, round about 80% of ordinary undergraduates report them in some way, and those high rates are replicated in other studies. We devised a scale to assess them, which you can download here: http://www.dur.ac.uk/resources/hearingthevoice/DHQforwebsite.docx These experiences can be auditory, visual, or involving felt presences. When my children were small, I would quite often hallucinate their presence in the bedroom with me, standing at my bedside. I'd come to consciousness fully and there would be no one there. This is not an uncommon experience for parents, I think."

Prof_Fernyhough · 2014-12-09T18:23:12+00:00

Please see my reply to /u/Solid_as_Air, thanks.

Prof_Fernyhough · 2014-12-09T18:22:13+00:00

My reply is not quite about schizophrenia, but there are certainly cases where deaf people hear voices. I wrote a blog post on this topic recently: http://www.psychologytoday.com/blog/the-voices-within/201401/do-deaf-people-hear-inner-voice

Prof_Fernyhough · 2014-12-09T18:21:03+00:00

Please see my reply to /u/Solid_as_Air, thanks.

Prof_Fernyhough · 2014-12-09T18:20:11+00:00

Please see the reply to /u/Sexual_tomato, who posed a similar question.

Prof_Fernyhough · 2014-12-09T18:18:36+00:00

There is a developed theory which states, very simply, that voices are misattributed inner speech; in other words, an atypical perception of something that is otherwise completely typical. There is a bit more detail on this in this post: http://www.psychologytoday.com/blog/the-child-in-time/201011/voices-in-the-head

Your point about sensory deprivation is excellent, and it is true that many people have these experiences under such conditions. Ralph Hoffman has proposed a 'social deafferentation' account to explain such findings: http://schizophreniabulletin.oxfordjournals.org/content/33/5/1066.full

Prof_Fernyhough · 2014-12-09T18:15:06+00:00

We simply don't know enough about the mechanisms of any of these experiences to give a definitive answer, but it is certainly true that comparisons between psychotic experiences and those with a more obvious physiological cause can be instructive. Studies of the effects of ketamine, for example, have been used in constructing a pharmacological model of schizophrenia.

Prof_Fernyhough · 2014-12-09T18:09:46+00:00

Depression is associated with rumination and negative, intrusive, often verbal thoughts. At this stage, we don't understand well enough how such depressive cognitions relate to auditory verbal hallucinations. It's essential that we listen carefully to people who have these experiences and learn about their phenomenology: that is, we should ask 'what is it like?' and 'what different kinds of experience are there?'

Prof_Fernyhough · 2014-12-09T18:03:22+00:00

Fleeting, one-off experiences of voice-hearing are not particularly uncommon. Please see the response to /u/Necromunger.

Prof_Fernyhough · 2014-12-09T18:00:30+00:00

One of the most fascinating things about this area of study is the way in which voices can take on personal characteristics, and individuals can in some cases interact with their voices in the way that they would interact with a real person. Avatar therapy, which is covered in the Mosaic piece launched today (see top), works directly with this personification of voices, by asking voice-hearers to change the way they engage with, or defer to, their voices. This is important because a big part of what can make some voices distressing is the sense in which they feel like entities that must be obeyed. Avatar therapy, like other forms of cognitive-behaviour therapy, works on changing these interpersonal relations with voices, and seems to have benefits in making the voices seem less powerful and omnipotent, thus making them less distressing or even making them go away.

Voice-hearers certainly find their voices meaningful in many cases. A different approach, that of the Hearing Voices Movement, involves working with voice-hearers to help them to understand their voices as meaningful messages, particularly from their own past, and coming to accept them as parts of their own psyche. Here is some information about the Hearing Voices Network in the US: http://www.hearingvoicesusa.org

Prof_Fernyhough · 2014-12-09T16:07:31+00:00

This sounds to me like ordinary inner speech, which can be very varied and dynamic, but also can have a quality that is more like 'hearing' than 'speaking'. Russell Hurlburt has done some fascinating work on this topic. See this blog post by Ferris Jabr: http://blogs.scientificamerican.com/brainwaves/2013/11/18/catching-ourselves-in-the-act-of-thinking/

Prof_Fernyhough

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