Auditory Hallucinations Surprisingly Varied, Complex and Physical

Dr. Angela Interview with:
Dr Angela Woods

Associate Editor, BMJ Medical Humanities Journal
Senior Lecturer in Medical Humanities
Deputy Director, Centre for Medical Humanities
Durham University

Medical Research: What is the background for this study? What are the main findings?

Dr. Woods: We’ve known for a long time that hearing voices, or auditory hallucinations, is reported by people with a wide range of psychiatric diagnoses as well as by those who have no diagnosis. 5–15 per cent of adults will hear voices at some point during their lives – in circumstances that may be related to spiritual experiences, bereavement, trauma, sensory deprivation or impairment, as well as mental and emotional distress. However, what we know about voices clinically and empirically comes from a small handful of studies, typically conducted in mental health settings with patients with a diagnosis of schizophrenia using quantitative scales and measures. Our study asked people to describe, in their own words, what it is like to hear voices. We designed an open-ended online questionnaire which was completed by 153 people with a range of diagnoses, including 26 who had never had a psychiatric diagnosis.

Our study found that a large majority of participants described hearing multiple voices (81%) with characterful qualities (70%). While fear, anxiety, depression and stress were often associated with voices, 31% of participants reported positive and 32% neutral emotions. To our surprise less than half the participants reported hearing literally auditory voices; 45% reported either thought-like or mixed experiences. Perhaps the most startling finding concerned the physicality of voices. Bodily sensations while hearing voices were reported by 66% of participants – these included feelings of tingling, numbness, burning, pressure, and a sense of being distanced or disconnected from the body.

Medical Research: What should clinicians and patients take away from your report?

Dr. Woods: The significance of our research lies in its commitment to understanding the experience of voice-hearers. Auditory hallucinations are much more complex and varied that is frequently recognised. It’s important not to make assumptions about voice-hearing, especially not ones based on diagnostic status; instead, we need to ask people about their experiences and the ways they understand and make sense of them. A large majority of people hear multiple voices, and many also hear positive and neutral voices, so our understanding of hearing voices will be limited if we focus only on dominant or negative voices.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Woods: We hope that future research into the experience of voice-hearing will also be open to mixed-methods approaches and to working with voice-hearers in the design and conduct of research. More work needs to be done to explore the experience of hearing voices systematically and in cross-diagnostic and non-clinical groups.  A greater understanding of the complexity and variety of that experience could lead to the identification of sub-types of auditory hallucination, and this has implications for the therapeutic management of distressing voices and for the design of future clinical, phenomenological and neuroscientific studies of voice-hearing.


Experiences of hearing voices: analysis of a novel phenomenological survey

Angela Woods, Nev Jones, Ben Alderson-Day, Felicity Callard, Charles Fernyhoug
Lancet Psychiatry 2015 Published Online March 11, 2015 Interview with: Dr Angela Woods (2015). Auditory Hallucinations Surprising Varied, Complex and Physical

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