Should I be afraid of auditory hallucinations?

how the subjects deceived the psychiatrists

In 1973, an article was published in the journal Science that made a splash. It was called “How does a healthy person feel in a psychiatric hospital.” It described how healthy in all respects people who did not have a history of any mental disorders, for the sake of experiment, turned to doctors with complaints that they heard voices.

They said that for the most part they couldn’t make out what the voices were saying, but sometimes they could make out words like “void,” “hollow,” or “thump.” Apart from this complaint, people behaved absolutely adequately, they could remember the real events that had happened in their lives.

Nevertheless, all of them were diagnosed with schizophrenia (with the exception of one “patient”, who escaped with manic-depressive psychosis). All these “patients” were hospitalized for up to two months. All were prescribed medications (although they did not take them).

The result of this experiment, designed by Stanford psychologist David Rosenhan (who himself was one of the pseudosicks), shows, among other things, that a single symptom – “voices” – may be sufficient for a peremptory diagnosis of “schizophrenia” even in the absence of other symptoms and abnormalities in behavior.

“voices” are not necessarily a sign of insanity

Psychiatrists, like the rest of society, have fallen prey to the common misconception that “voices” are always a sign of insanity, that they only appear in the context of severe mental disorders. And this is a big mistake, since most people who hear “voices” do not suffer from schizophrenia. All human existence is permeated with conversations of man with himself.

The great Russian psychologist Lev Vygotsky believed that “inner speech” is an indispensable prerequisite for any conscious activity. “For example, I talk to myself most of the day: scolding (“Fool, where did you put your glasses this time?”), Encouraging (“You can do it!”), Complaining (“Why is someone else’s car in my place? ”) and, less often, congratulate myself on success (“You managed to do it!”).

These voices do not come from outside. I will never confuse them with the voice of, for example, God. But when I once found myself in great danger, trying to go down a mountain with a badly injured leg, I heard an inner voice that was not like my usual inner mumbling. Then it cost me incredible effort to cross a wide stream with a tightly bandaged sprained knee. I hesitantly stopped in front of an obstacle, just numb, I realized that I could not overcome this water barrier.

I experienced a strange weakness, a tempting thought came to me: what if I had a rest? Sleep a little, gain strength. But then an authoritative, commanding, unanswerable voice sounded in my ears: “You have no right to stop – neither here nor anywhere else! You must go. Get up, find the right pace, and go.” This kind voice, the voice of Life, strengthened my resolve, gave me strength. I stopped trembling and continued on my way without hesitation.”

“voices” that help

Such voices people hear quite often when they find themselves in a situation that threatens mortal danger. For example, Joe Simpson, who was climbing in the Andes, fell off an icy ledge and fell into a crevice, breaking his leg in the process. He began to fight for his life. It was the voice he heard that helped him then overcome all the difficulties and get out of the distress. He wrote about this in his book Touching the Void.

Freud, in his book On Aphasia, writes about two cases when he heard voices: “In my whole life I have twice found myself in situations that threatened my life, and both times the realization of the danger came suddenly, like some kind of insight. Both times I felt that this was the end. An inner voice babbled something incoherent, and I moved my lips, making inarticulate sounds. But in view of the extreme danger, both times I heard a voice from outside, which loudly shouted distinct commands into my ear. I not only heard these words, I saw them written on a piece of paper that hung in the air in front of me.

The threat to life can also come from within, and although we do not know how often the voices prevented suicide attempts, I think that this happened and does not happen so rarely.

One of my acquaintances named Liz felt completely crushed and oppressed after a failed love affair. She was about to take a decisive step when she suddenly heard someone’s voice sternly say to her: “No, you must not do this,” and then added: “Remember, it will not be long before you will no longer feel as miserable as now.”

A male voice came from outside, and Liz didn’t know who it belonged to. She quietly asked, “Who said that?” There was no answer, but on the chair in front of her suddenly appeared the “grainy” figure of a young man dressed in an XNUMXth century costume. The luminous figure sat on the chair for a few seconds, and then disappeared, dissolving into thin air. Liz experienced a feeling of incredible relief, a wave of quiet joy swept over her.

She knew the voice was most likely coming from some part of her own brain, but she still playfully talks about that young man as her guardian angel.

what causes auditory hallucinations

Many hypotheses have been proposed to explain why people hear voices. It is most likely that the accusatory and threatening voices heard by psychotic patients are different in nature from the voices that sometimes – in an empty house – call a person by name; and these voices, in turn, are different from the voices that help us in moments of extreme danger.

Auditory hallucinations may be due to abnormal activation of the primary auditory cortex. This violation requires investigation not only in patients with psychosis, but also among mentally healthy people. Until now, most of the research in this area has been carried out on patients with schizophrenia.

Some scientists suggest that auditory hallucinations result from the loss of the ability to recognize internal speech production as one’s own. (Alternatively, as internal speech is generated, areas of the auditory cortex are simultaneously activated, and what we normally perceive as an internal monologue acquires a “real” voice.) This question can be reformulated and asked this way: why do most of us not hear any votes?

One thing is clear, “hearing voices” and “auditory hallucinations” are terms behind which phenomena of different origin are hidden. Auditory hallucinations in many cases are meaningful – a person hears a voice that says something meaningful, even if sometimes trivial and pompous, but in the vast majority of cases, the content of auditory hallucinations turns out to be strange inarticulate sounds.

Probably the most common auditory hallucination is a phenomenon that is almost always diagnosed as “tinnitus”. This almost incessant sound – buzzing or ringing – occurs with hearing loss and sometimes becomes simply unbearable for the patient.

Along with voices and other imaginary noises, people often hear fragments of music or even entire songs. Musical hallucinations can occur after strokes, with brain tumors, aneurysms, and also with severe infectious diseases. They usually disappear after the improvement of the general condition of the patient.