Our beliefs about the voices we hear and the way in which they present are a powerful influence on, and in, the hearing voices experience. How can we simplify our understanding of the wide variety of beliefs that we form about this phenomenon? How do our beliefs relate to the phenomenology presented?
Our beliefs often get in the way of sense-making. In part, this is because we form beliefs in spaces where we lack good evidence. In order to move forward, we select the evidence that we choose to act on, often dismissing contradictory evidence. This works because we can accept that contradictions exist and still navigate our way toward the belief we have adopted, in effect making it self-fulfilling in the world we live in. Our cognitive bias confirms our belief and we sometimes adopt the belief as a truth, without realizing that it is nothing more than a working truth — a functional idea rather than something that is also true for others or in other circumstances.
The hearing voices experience presents an unusual case because it presents evidence in extraordinary ways that leads us to particular themes of belief. We have a proliferation of beliefs and hypotheses (the only difference being the conviction with which we hold them) that clearly cannot all be true.
Our beliefs about voices are different because we have different evidence and different frameworks of explanation.
For starters, I hear them while most others do not. I explain them on the basis of how I experience the phenomenon and how voices behave. For those who do not hear them and cannot conceive of an unseen source, the reasonable assumption is that it must have something to do with me — my brain or events in my past.
Yet many of us locate the voices outside of ourselves (where we ordinarily experience voices that are ‘other’) because the stimuli go way beyond words or voices, with effects that I equate to body language — distance, clarity, direction, tempo and style deployed in tactics that display sentience and intent. This seems unbelievable to others and is readily dismissed, introducing conflict between hearer and non-hearer beliefs.
Let me illustrate by way of example, showing how my own beliefs developed as my experience progressed and I gathered more information. I will show how the phenomenology as presented led me to locate voices in particular ways that shaped my beliefs, narratives and sense of agency.
At first, I had no concept of what “hearing voices” meant, other than glimpses from occasional news articles which were clearly not good sources of knowledge of the phenomenon or experience, and I interpreted them as people in my everyday environment.
Located in My Everyday Environment
My experience began when I heard two people talking about what I was doing, when I was home alone. It was unexpected (the prompt that got my attention), so I needed a reasonable explanation (answers). I heard voices that were distinct and quiet — as if at a nearby distance speaking softly. It had to be people, and two comments led me to conclude that it had to be my upstairs neighbors and rationalize why it was them.
Voice 1, female sounding: “He seems to be OK.”
Voice 2, male sounding: “Hmmph,” somewhat disinterestedly.
Voice 1, “He eats better than we do.”
They could see what I was doing. The only place from which that was possible was from the external fire escape. The only people with access were my upstairs neighbors. The fact that my upstairs neighbors were a couple offered corroborating evidence.
This was rather unusual and I needed a rational answer for why they would be observing me through the window. I had hurt myself that afternoon and made a lot of noise. I inferred that my neighbors must have heard the commotion, that they were concerned enough to feel the need to check on me and did so from the fire escape because we did not know each other. Also, they seemed to display different levels of interest or intent with some tentativeness in their style.
No other plausible explanation presented itself. In other words, the phenomenology (content, distance, clarity, personalities), in context, led me to a very specific and reasonable ‘belief’ which located the voices as people nearby, which I identified as my neighbors by a logical process of exclusion of alternatives.
In my case I ran upstairs after I had eaten to let them know I was OK. There was no answer to my knocking and I left it at that, satisfied. My chain of evidence was intact — the process of reaching a conclusion or closing off questions was complete and stable.
Instead of describing this as delusional, how can we analyze it differently? I simply asked the obvious questions that the unusual stimuli provoked. Let us examine how the questions led to beliefs.
The stimuli prompted the basic what? question (two voices nearby, the evidence). This led to how? (from the fire escape, the means) and who? questions (the upstairs neighbors, a logical inference). The why/why me? question (I had hurt myself, the rationale) was actually based on an answer to when/where?. I now had a logical chain of answers that “made sense,” by which I mean one answer led to another question and answer in a logical series that was complete and coherent — there were no nagging questions remaining. If anyone else had challenged my reasoning that day, they would have accepted my explanation as entirely logical, not delusional.
This is the belief “system” I refer to — a logical series of basic questions to which we seek stable or coherent answers that make up our picture of an object in flux. In another context my answers might have been different, but the questions would have been the same, which gives us a different way to systematically examine our beliefs.
When I heard my neighbors’ voices the next day, instability crept in to my why? answer — they now seemed a little nosy. A few days later when I began to hear them in my bedroom and bathroom, there was no reasonable why? answer anymore, which closed off paths of action — approaching them would now simply yield a denial of their unacceptable behavior.
They now seemed to be spying on me and I spent some time exploring the how? question, assuming it had to be technological means (also based on the location context) — cameras on my own phone and PC, or hidden cameras. The only reasonable course of action open to me was to find evidence of their bad behavior to confront them with. Notice how a simple change in where I heard voices destabilized the chain of evidence and created a new experience — of being spied on — simply by opening up basic questions to new answers.
I now call this a soap opera narrative, where the villain is someone known or unknown in my life, based on the ‘proximity’ with which voices presented which located them in my personal world. With this location as the context, the only plausible answers to who? and how? questions were the neighbors and cameras. Variations on this how/who/why chain proliferate in the hearing voices community, with how answers derived from the way the phenomenology makes its presence known and who/what based on other behaviors of the phenomenology. Since we cannot fathom why, we tend to find an answer for why me to complete the evidence chain.
A Location That Tracks My Movement
The next change came about when I began to hear the voices outside of my apartment — this new presentation meant that my how answer no longer made sense and the whole evidence chain opened up.
First, I began to hear them just outside my front door, then on the staircase, then in front of the building and finally along the street. It did not seem reasonable that my neighbors could somehow be following me on the street. I needed a new answer to how? and who? and the only plausible answer was likely to be some organization, unknown and with unreasonable intent, such as the CIA — any organization that might also plausibly provide a how? answer, which must now account for the experience of being followed on the street.
I now located the voices in the world at large, with a belief that ‘they’ were acting with greater malice than, say, my neighbors, because their apparent technology was now inexplicable to me. I had no idea what powers they had and my questions shifted to what does this mean for me, or others? I was now assessing the implications based on a chain of evidence made unstable by a weird presence that could not be ignored. This is the basic mechanism underpinning paranoia — a bad actor, out of reach, assumed to have power based on the weirdness of the phenomenology experienced.
I call this a conspiracy narrative because voices later used this “following, knowing and anticipating” experience to claim I was caught up in some conspiracy.
Locating Voices in the Brain
A day or two later I went to see my doctor, who described what I was experiencing as ‘auditory hallucinations’. I had a new and apparently well-accepted answer to the what? question. I interpreted this to mean that my brain was somehow misfiring and I located the voices inside my brain, as the only plausible explanation.
I could not observe a source for the stimuli even though the experience of the voices was external and I was forced to confront the plausibility of the “mentally ill’ narrative. Nothing in my history supported the idea of mental illness or unusual distress or trauma. The term ‘hearing voices’ was and is an inadequate description of the stimuli presented, which were quite unlike anything experienced before. I could not fit the phenomenology to how I imagined hallucinations might be — they were too complex and behaved in sentient ways that I could not accept as me. Nor could I see how trauma could cause such traumatic stimuli. Mine have even composed songs for me with mellifluous music — even though I am not musical at all.
None of the clinical or psychosocial explanations made sense in that none offers a reasonable, or frankly even plausible, hypothesis of a mechanism by which the brain can create these complex stimuli. I lacked good how? and why? answers to what made these stimuli so provocative and bullying.
Locating Voices in an ‘Other’ Supernatural World
At about this time, I developed what is called a thought echo. The effect is to bring one’s own thoughts into focus in the same bandwidth as the voices I could hear — lending itself to ideas of telepathy or other supernatural how? answers.
There were now about ten voices with distinct personalities that responded tactically when I ‘thought’ back at them. I was in control of my thoughts — and voices were heard in parallel. My thoughts were suddenly experienced as having consequences in this interaction with every thought expressed and shared, beyond my control.
This interactive to-and-fro in the phenomenology made me firmly locate the voices as external to me once again. Now with only questions, no stable answers in the evidence chain because in an ‘other’ world, inexplicable, anything becomes plausible, even possible. The only evidence is what voices say and how they behave. And our cultural beliefs come into play.
Soon voices began to suggest and assert answers. They claimed to be people who had died, trying to connect with the fairly common belief in some sort of hereafter to locate themselves in specific cultural beliefs involving good and evil ‘spirit’ entities, as most do. Soon they claimed to have a hold over members of my own family, torturing me by placing my thinking in the middle of a battle between good and evil, wrapped in religious themes. Worse, I experienced it as downright evil.
Soon, one claimed to be God. Then, as I pushed back, the devil. Then an evil God — behaving as threateningly as they could and deploying special effects to try and back up those claims. Of course, each of these was designed to assert maximum power over me and lead me to beliefs that give them power.
Cultural beliefs accept only the good and are more likely to blame the hearer than accept a challenge to some cutesy belief from which they gain social acceptance. Broach this topic and you are branded as a heretic and threatened with the modern equivalent of being burned at the stake — it must be something the hearer has done, is the inference made.
This ‘other’ world location makes the most sense in the experience of the “supernatural “ (as in as-yet unexplained) phenomenological special effects. The lack of evidence or provenance means that voices can assert answers to what/who? and why? questions, with how? simply a fait accompli that can not be ignored. They presented themselves as supernatural beings with power. They engaged me in scary ways to encourage beliefs in their power and their evil intent — and made threats backed up by aggressive phenomenology.
Locating voices in another world supports spiritual and cosmic narratives — what I call cosmic opera. A space in which what/who and so what? answers can take on any characteristics — and here we see many ‘unusual’ belief systems. Including our cultural interpretations.
Note that even here we can analyze our belief system using the basic questions that the unusual stimuli provoke. Doing so helps show that voice claims can be rejected as without evidence.
We will find a how? answer based on our experience of the phenomenology, the what? evidence we observe and experience. It might be someone in the next room, telepathy, voice to skull technology or some supernatural means — made plausible in the way the phenomenology is experienced. The how? answer leads directly to where we locate voices.
The fact that we so often find a who? answer when asking where the stimuli come from shows that we experience the stimuli as sentient entities with intent, most often experienced as being harmful in the sum of their interaction, even if sometimes ‘pleasant’.
It is first the phenomenology that leads us to locate the who/what? in self, my world, the world or an ‘other’ world. Each location fuels themes of beliefs and shapes our emotional response to them as well as our sense of agency.
A my world location leads to soap opera type narratives, locating in the world leads to conspiracy narratives and locating in an ‘other’ world easily leads to spiritual themes and cosmic opera.
The exception is the location in the brain as brain malfunction or some psychosocial cause, which derive from accepting one or other clinical-based narrative which locate causality internally.
It is relatively straightforward from here to see how each defines a relationship with the phenomenon and how it interacts in our world, and how it affects our relationships with others, through conflicting beliefs and rationalizations of causality.
Start with the answer to how? and we can examine the logic of our so-called delusions. Doing so requires the suspension of beliefs and a focus on the phenomenology. That way we can find a path to using the same evidence to figure out what this phenomenon is all about.
Everything flows from the phenomenology.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.