When mentally ill people “hear voices”, how do they mainfest themselves? Are they just disembodied voices in their heads (in addition to the “voice” of their own regular thougths)? Or are they actual auditory hallucinations, as if someone invisible in the room was speaking? If the latter, is this why so many severely mentally ill people believe that God or The Devil or The Beatles or their dog are speaking to them? Why does “hearing voices” happen?
Based on the comments of a some-time poster who has suffered from them, they would appear to be auditory hallucinations.
During one episode, the poster asked about ways to inflict deafness on oneself because the poster was so exhausted by “hearing” the incessant “instructions” of the voices. Given that the perception was that the poster was physically hearing actual spoken sentences, it would seem to be some aspect of brain wiring that interferes with the aural system of the brain, turning “spoken thoughts” into perceived sounds.
We never got into the “where” of the voices, although it appeared that they seemed to emanate from within the head to be “heard” by the ear.
(Said poster did not, fortunately, damage their ears as a result.)
Im deaf, I hear voices, must not be an auditory thing. Best voices I have heard in my life, perfectly clear too. No accents.
There was discussion here about hearing voices & it being perfectly fine.
I’ve done a fair amount of crisis intervention in the past, frequently with people who are suffering from schizophrenia or delusional mania. The source of the voices can vary from person to person; I’ve heard some people say the voices are indeed localized in the person’s head. Other people have indicated that the voices are coming from other areas around them.
I don’t have any cites, but I think the main reason people tend to hear God, the Devil, whomever, is that they are attempting to put structure upon an event that they cannot readily explain otherwise; I have no idea what the Devil’s voice sounds like, but I know that I wouldn’t really want to think that my brain is telling me to harm myself or my loved ones. The voices apparently sound quite real. Besides that point, most people I’ve dealt with weren’t hearing God or the Devil - they were hearing unidentified voices.
I’ve been told that medications don’t necessarily make the voices go away, but aid the patient in disregarding the voices. If anyone else has more experience with the various antipsychotic medications they are welcome to correct me.
The ‘why’ of people hearing voices is, unsurprisingly, not entirely clear. Most antipsychotics decrease dopamine transmission; that’s why some of them produce Parkinson’s like symptoms (Parkinson’s results from dopamine deficiencies). Fortunately, there are a newer generation of more selective antipsychotic medications that are less likely to produce the dyskinesia-type symptoms.
FunkDaddy. Awwyeah.
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Sometimes when I’m laying in bed and cannot sleep, I make myself hear voices. Really! I try to recreate voices from the Radio, TV, ect, and make them sound as if they are real. Works sometimes, My eardrums don’t vibrate i’m sure, but I seem to successfully stimulate the hearing part of the brain. (Audio cortex?) I don’t know if this classifies me as mentally Ill, as I tell my voices what to tell me.
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Most of the schizophrenics I’ve worked with are aware that the voices are coming from inside their head. Most either can’t quite make out what the voices are saying or else they’re making sort of a running commentary on their actions. They’re usually very negative–in the words of one patient I had, they told him he “was a no good sonofabitch and ought to die.”
Dr. J
On first onset of voices, they are usually described as being external- coming from the environment. If someone on first presentation says that the voices are ‘in my head’ it is reason to consider non-psychotic causation- tinnnitus, drugs etc., or the hearing of one’s own internal dialog. In time, people may come to perceive that the psychotic voices are internal.
Often, psychotic voices are recognized as particular voices with particular personalities- maybe even the voice of someone known to them.
Given your User Name, felix penfold, I wonder if you are aware of The Ordeal of Gilbert Pinfold by Evelyn Waugh which has an excellent literary description of auditory hallucinations.
Hearing voices doesn’t make someone schizoid. Nor does it make them insane. What defines that is whether they tune into those channels for a living.
The voices are typically auditory hallucinations, meaning that they subjectively seem to be external.
It’s interesting to note that when undergoing normal internal dialog, the Broca’s (roughly language production) and Wernicke’s (roughly language comprehension) areas of the brain are active, but the sound perception areas typically are not. In auditory hallucinations the sound processing areas of the brain (in the temporal gyrus) are active as well.
Though I have serious doubts about Jaynes’ hypothesis that this article claims to support, it does mention some interesting experimental observations of a hallucinating mind.
Hey, Handy! Mind if I use this as a sig???
Be my guest dobbinaire 
Mental illness is very individualized, but a very common theme to auditory hallucinations, according to my Psych nursing instructor, is a religious/authority figure. If God or the Devil or an angel speaks, it lends creedance to the words spoken. The voices usually don’t have positive things to say. Patients have related that the voices are as clear as mine, but much more familiar.
I’m able to do this too, most effectively with music I’ve already heard - once it gets going properly in this way, perhaps because of the rhythm, it seems to continue of its own bat. That’s what scared me about it, actually, and why I don’t do it any more. I wouldn’t like for them to get out of control and it seems to me that the more used my brain becomes to such activity, the more likely it is to become as regularly uncontrollable as, say, sexual fantasies, etc.
BAD THEORY
Some guy wrote a book called “The Origin of Consciousness in the Breakdown of the Bicameral Mind”, which I read voraciously as a pseudo-intellectual adolescent. It posits that in hallucination one half of the brain is communicating with the other, and that all ancient peoples actually used to hear voices as part of their everyday life - the idea is that when a dog learns to obey instructions, then learns to perform the command even without instruction, he’s actually hallucinating the command back to himself involuntarily because his brain’s become so used to it. This book suggests that human consciousness developed that way, originating with inscriptions on the obelisk of the local deity, for example, which wouldn’t just be read but actually hallucinated by those who read them. We then evolved into people with more dynamically co-operative brain-halves.
Somebody is buying this book because it had reached its third edition by the time I read it, but it is universally considered to be a load of dingo’s kidneys. With which I agree.
GOOD THEORY
As I understand it the primary way auditory hallucination manifests is by taking a genuine outside sound (say a car going past) and interpreting it as something else. Think about how easily a creaking floorboard can sound like a voice when you’re in a spooky mood, for example, and you’re on the right track. This just goes out of control in some individuals, and very distressing and disabling it is too.
MY THEORY
Don’t screw around with it. Like Hannibal Lecter, you don’t want this stuff in your head.
I have heard my named being called out (Get your minds out of the gutter, you dirty beasts! ) and it definitely camed from “outside my head” - usually from another room or fairly far away. Now, my name is three syllables so it’s not like I’m mistaking a random sound for my name. It sounds so real that I actaully answer it, but it only seems to happens when no one else is home. This has only happened 3 or 4 times in my life but I have to admit that it makes me question my sanity a bit.
There is never anything else, just my name. Am I going mad or does anyone have any thoughts on what this might be? Has anyone else ever had this experience?
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No, bad terminology! A misperception of a sound is classed as an illusion, not a hallucination. Auditory hallucinations (to be defined as such) must depend on now external stimuli and the person concerned must be absolutely certain that it is a voice or sound that is occurring outside of his/her head; if he/she believes it to be an internally sourced voice/sound (my thoughts, just my brain working) then by definition it is not a psychotic auditory hallucination.
Similar structures are used to separate Paranoia from normative suspiciousness, or delusions from normative unusual ideas.
And by the way, Miss Gretchen, hearing your voice shouted out alone is by definition excluded from a full psychotic auditory hallucinatory state. The content of the voice need to be more complex than just a single word or small group of words.
Fair enough. I should have said that it’s how it often starts - I’m certainly not an expert but I’ve heard it on fairly good psychiatric authority. However I still don’t understand about how complete or “absolutely certain” psychosis itself is necessary for hallucination to be a proper term. Say a long-term sufferer of severe psychotic illness battles daily against the voices while maintaining a relatively balanced “care in the community” lifestyle, CPNs, drugs, etc. He is aware of his condition and highly intelligent - he knows the truth about the voices and yet still hears them, as his brain continues to misfire. Surely this at the centre of the painful paradox that schizophrenia produces - “they’re not real, I know they’re not real, I can prove they’re not real, I believe they’re not real, but dammit the howling murderous legions still echo in my head!”
Are they illusions when he is well (it’d sure be a comforting way for him to think of it) and only hallucinations if he begins to lose his grip and become again a slave to his condition? So any reference to hallucinatory drugs like acid is only proper if they induce a complete psychotic episode?
You’re probably right, of course - I just don’t understand!
Fair enough. I should have said that it’s how it often starts - I’m certainly not an expert but I’ve heard it on fairly good psychiatric authority. However I still don’t understand about how complete or “absolutely certain” psychosis itself is necessary for hallucination to be a proper term. Say a long-term sufferer of severe psychotic illness battles daily against the voices while maintaining a relatively balanced “care in the community” lifestyle, CPNs, drugs, etc. He is aware of his condition and highly intelligent - he knows the truth about the voices and yet still hears them, as his brain continues to misfire. Surely this at the centre of the painful paradox that schizophrenia produces - “they’re not real, I know they’re not real, I can prove they’re not real, I believe they’re not real, but dammit the howling murderous legions still echo in my head!”
Are they illusions when he is well (it’d sure be a comforting way for him to think of it) and only hallucinations if he begins to lose his grip and become again a slave to his condition? So any reference to “hallucinatory” drugs like acid is only proper if they induce a complete psychotic episode?
You’re probably right, of course - I just don’t understand!
ooops. Sorry. 
Voices in your head make you double post Ross? 
Reply to Ross:
A lot of this is psychiatric terminology, but it does affect how we describe such events. It is important that, if we are to discuss such events then we must have a common terminology.
Technically, the situation that you describe (awareness of the cause and effect of auditory hallucinations by a long term sufferer) would be called ‘encapsulation’, where the experiencer is able to ‘re-frame’ the experience and react differently to the experiences. Although they still experience the voices, they no longer have to react to them at a gut level. Two similar models are
1/ control of pain by opioids- where you retain the cognitive (thoughtful awareness) experience of pain without the affective (emotional) response or the need to react in an uncontrolled manner to the experience and
2/ Cognitive re-framing of an experience (pain, loss, other psychological impairment) where there is a forced separation between the experience and knowledge of it on the one hand, and the emotional reaction to it.
I would argue that true psychosis- for instance auditory hallucination- is of different import to encapsulated or re-framed experience of voices.