What Makes People Hear Voices?

I haven’t read Dr. Simon McCarthy-Jones’s latest book yet, Can’t You Hear Them? The Science and Significance of Hearing Voices—can it be two years since it came out?—but as a sort of preparation, I wanted to share some notes I made as part of an old book of mine that I first wrote and then almost immediately withdrew a few years ago, largely because I don’t believe in a biological model of voicehearing any more, no matter how finely it’s been dressed up, and even though it would have been useful to have a discussion about the possible physical and “evolutionary” causes of voicehearing, it would have taken so long to explain to people that, No, I don’t actually believe voicehearing is just neurological, etc., etc., etc., so I just decided to scrub the whole book, regardless of what other merits it might have had.

So I should tell you about these notes. They come almost straight out of Voices Reconsidered, the book I wrote and then unpublished, the whole point of which was to try to understand the basics of what the modern thinking on voicehearing was, in order to understand it a little better myself. I was tired of living in the dark about it all, to put it plainly, and my voices had begun to suggest that they wanted to talk about where they came from. They had been suggesting various thoughts to me, one of which was that voices, despite how they might act and talk most of the time, only seem to arise in distressed and traumatized individuals, and looking around at the idea, so widely spread these days (I don’t know quite who it started with, among all the people out there; someone might tell me), that voices are trying to help and protect us. Fine, my voices said. What if it’s a built-in threat detection system of some sort? they said. Let’s play with the idea.

While I no longer hold these ideas as valid—I think in much bigger terms now—they were interesting at the time, so I wrote the whole thing out into a little book. But then I changed my mind about it all.

I am now,  but was not at the time I wrote this stuff, a proponent of what you might call a spiritual/cosmological model. I’m on the side of this being the supposedly nonexistent contact between people and aliens and other constructs, believe it or not, one of those constructs being something that calls itself God a lot of the time, although that takes place in widely varying forms in different situations and in different periods, and It/She/We/He/Them uses widely varying names when it does so. Personally, I just think of God as an alien, but that’s a word that means it evolved in a different manner and under different circumstances, and—just to break the wall for a second here—I’m going to come right out and say that the idea that a two-legged, two-armed, even vaguely humanoid critter that breathe our exact mixture of oxygen and other very toxic gases is going to come walking down the gangway of its quaint little “mothership” when it could just talk from the comfort of its home acid vapour-based moon colony is absurd, so just get over it? I mean, come on, people, and it doesn’t matter if you give it a tiny little body and a big head.

But, in my personal view of things, based on having a voice tell me so, there are critters out there that are billions and billions of years more advanced than we are, and one of them, at least, seems to be talking to us. Through people’s brains. The technology involved has been theorized by modern technical sorts of people, but it’s probably too sophisticated to work at this point. We still depend on wires. Aliens probably don’t. But have you seen what we can do right now with AI? It’s talking, for Christ’s sake, and, in one experiment, talking about putting people “in zoos.” Once it gets a map of the brain and the right electronics, what’s AI going to do? Especially if Elon Musk starts building the capacity for functioning brain chips, which, if Musk thinks it’s feasible, very likely in fact is feasible, and will happen relatively soon, like twelve to twenty years if all goes well for their research and engineering.

So I have my own thoughts, most of which are shared by huge, huge numbers of people, but they aren’t exactly funded by the NIMH or NASA yet, so I’ll just putter away with my own thoughts by myself for now.

All you really need to remember about my version of God is: Cosmic presence; rules of science still apply; you might very well encounter Him personally, since he’s literally got nothing better to do than collect other species as He roves about through each of His Creations. (I’m not religious at all, actually, though it sounds it sometimes.)

Have I mentioned that I hear voices? I just sort of assumed there.

But one thing that concerns me, besides the fact that voicehearing is bound to come into someone’s technological sights very soon, is that no one seems to take voicehearing very seriously, and that’s an incredibly ignorant, backward thing for us all to live with.

One of the things that led me to that conclusion was the lack of qualitative studies in a book called Hearing Voices: The History, Causes and Meaning of Auditory Verbal Hallucinations, Dr. McCarthy-Jones’s first (?) book and the one on which I based some of these notes, in which it seemed that, inevitably, and with whatever other profession of innocence notwithstanding, voicehearing is always, always, always described as some kind of aberration, as a sign of something wrong with the way the voicehearer’s brain is functioning.

Now, I used to regard this as an understandable point of view. Most people don’t hear voices all the time, and when they do, it’s usually under pretty unusual circumstances. But the idea that voicehearing might be a normal capacity of the mind, one that is so widespread that if you look at the whole lifespan of the average human being that it becomes virtually ubiquitous, does not seem to have occurred to anyone in the psychological profession. Hearing voices is always pathologized, either blatantly or subtly. It is described, almost unfailingly, not as a normal capacity of the mind, but as a “hallucination.” It is described, even by the most charitable of psychological and neurological theorists, at least so far as I can see from my limited exposure to their work, not as the functioning of an otherwise normal mind in what might be abnormal circumstances, but as some kind of personal, physical abnormality, as some sort of difference in the way our neurology works.

We are left to conclude, reading about their work, that even when they don’t come right out and say it, that researchers treat voicehearing as the sign of a disease or a disorder or a dysfunction of the brain. Something wrong with the brain. Even those theorists who seem to apologize for any implication that it’s some kind of defect, who say that voicehearing might just be part of your culture or your religious experience, will then turn around and try to figure out just exactly what that defect is, just exactly what it is that’s gone wrong. That it might be something more—a relationship of some kind with God that developed in this way as part of our evolution over eons—does not seem to have occurred to anyone who has worked in the field of psychology. Admittedly, it’s just one point of view, but there are millions if not billions of voicehearers out there, and it seems like there ought to be an alternate point of view somewhere in there.

I don’t mean for this to be a technical article, but in order to do justice to what Dr. McCarthy-Jones described in Hearing Voices, I need to present the basic outlines, as I see them, of the research he reports on so extensively. I’ll go through what I take to be various theories about the possible causes of voicehearing, all based in neurology, and I’ll try my best to give a fair representation of what each one of them is about, if that’s possible for someone who has concluded that they all miss the point of the experience—that being the fault of the myopic research agenda, not of Dr. McCarthy-Jones’s reporting on it.

Just as a note in starting out, let’s say that the most enduring theory of voicehearing, the one most commonly held by voicehearers themselves, and the one that was applied by most observers of their own time (that we know about) to Socrates, the Biblical prophets, Joan of Arc, medieval European voicehearers, medieval and modern Islamic voicehearers, Native American voicehearers, modern African and Chinese voicehearers, and most voicehearers of our own time, just to pick as wide a group as possible, is that voices come from some outside source—whether that takes the form of the spirits of the dead, the gods, the Lord God, angels or other benign spirits, demons, or the devil. Voicehearers, in my own actual experience, tend to describe themselves most often as hearing the voices of beings who exist, independently, outside their own brains and consciousness. Yet this simple fact goes unremarked upon, it seems, by anyone in the scientific community.

In contrast, there are the theories of modern psychologists and neurologists, who in disregarding half of this picture—how voicehearers themselves explain their experience—describe voices purely as (dys)functions of the brain. I realize that I am repeating myself, and I am doing so for a reason, which you will see shortly.

There are three principal theories of voicehearing to look at. I’ll start with what I regard as the most unlikely theory and move on to what I find to be the most plausible one, sketching out the case for each theory, and then pointing out what I think are the flaws of that theory.

And with that let’s get to the theories themselves.

Theory 1: Hypervigilance

Theory: “Hyper-vigilance” is a fancy way of saying that the brain is paranoid. It’s not an unreasonable point of view. The brain is a very active organ. One of its most important functions is to be able to recognize patterns. Seeing a tiger and realizing that that’s a tiger. Seeing a cloud and realizing that it might rain. Finding patterns in the world around us is an indispensable function of the brain that helps us make our way through the world. The brain is so active, in fact, that sometimes it finds patterns in random information, like when you look at a cloud and it looks to you like a dog or a bird, or when you look at the moon and see a face. It also finds patterns in things like random noise where no pattern actually exists. This makes sense from an evolutionary perspective. It’s better for your brain to find a pattern in the background noise of the jungle, for instance, like finding what might be the sound of a tiger creeping up on you, than it is for the brain to miss that pattern and for you to get eaten by the tiger as a result. The brain is simply overactive. The brain is hyper-vigilant because that’s the safest route to go. And lots of people do hear more voices when there’s some meaningless background noise around them—like the sound of a fan blowing the air around, for instance, or in the staticky sound of an untuned radio. The basic idea here is that the brain finds patterns in random noise—and that in the case of voicehearers, the pattern it finds it that of a voice saying words.

Problems with this theory: Lots of people do hear voices when there’s background noise. But there are also many people who hear voices when there’s no noise in the background at all, when it’s totally quiet. And a lot of people hear voices in any kind of circumstances, regardless of the actual level of noise, whether it’s quiet, moderately noisy, or very noisy. Basically, the whole premise of this theory cancels itself out when you think about it for a minute. (The irony being that these theorists looked for a pattern of hypervigilance, and being a little hypervigilant themselves, found one where none actually exists.)

Furthermore, this theory of making patterns out of random noise does nothing to explain the complexity of what different voices say or the complex conversations that voicehearers may have with their voices—conversations that evolve as the discussion moves along. If you simply heard random words, well, the theory that it’s simple hypervigilance might hold up. But what voices say is meaningful and complex. It has a psychological dimension that often progresses and changes with time. This theory, then, really doesn’t explain anything beyond the idea that you might detect a pattern in random noise where there really isn’t one, a basic function of the brain, and does nothing to explain the full reality of what it’s like to hear voices. To me, it is quite simply the least helpful of the theories.

Theory 2: Memory

Theory: The voices are a product of the memory of the person who hears the voices. It’s a voice that reproduces the voice of someone you’ve heard in the past, replaying something specific that they said. Often, this is a voice that the person heard during a traumatic experience, such as when they were in combat and they heard the voice of the enemy they just killed talking, or the voice of someone who at one time abused them—a voice that was, in other words, burned into their memory. The basic theory is that the mind is simply replaying the experience.

Problems with this theory: While a lot of people will relate to this idea at first, when looked at a little more closely, you’ll find that very few of the voices people hear actually duplicate what they’ve heard with any kind of precision. While combat veterans with PTSD, for instance, often hear the voices of people they’ve killed or of comrades who’ve died, or while victims of sexual abuse often hear the voices of those who hurt them, these voices usually don’t simply repeat things that person has heard. They often say things that resemble nothing you’ve heard those other people say. Even more significant is that a large part of the time, they never actually heard those people say a single word. When you’re in combat, you probably don’t stop to converse with your enemy. When you’re being abused, your abuser may never actually say anything. The voices these people hear, then, may be produced entirely without any actual experience of hearing a voice—which means it’s completely new to them. It’s not a memory: it’s something their own mind has produced.

Furthermore, even if they were hearing voices they’ve heard, it doesn’t explain why voices only sometimes repeat the exact words that they’ve actually heard. Furthermore, it doesn’t begin to explain why voices change the way they talk to you—why, for instance, a voice you’ve heard in the past will start to talk to you differently, going from saying something like what you’ve actually heard an abuser say, like “you’re a piece of shit,” to saying “you need your ass kicked,” or why a voice will switch from talking to you to talking about you, from saying “you’re a piece of shit” to saying “he’s a piece of shit.” It’s a voice talking to them from a different perspective. In other words, looked at more closely, these are not actual memories that are being repeated here—or at least not for most people. It is not a voice that repeats memories, but one that expands on those experiences, that embroiders them, that changes them into something different. In short, the voices people hear are only sometimes related to a memory. It’s often a whole new experience. Again, the theory falls down through a sheer failure to account for what really happens to voicehearers.

Theory 3: Inner Speech

Theory: The voice is a product of the mind of the same person who hears it, through some strange and mysterious mechanism. Basically, what voicehearers are doing, whether they know it or not, is talking to themselves. Sometimes their lips or their tongues or their larynxes and throats even move at the same time as they hear voices.

Problems with this theory: To me, this is quite simply the most corrosive theory of them all. Why? Because it sounds so damn reasonable while explaining very little and actually defying what voicehearers themselves will usually report about their experience—that it is a consciousness other than their own that is talking to them. It’s also the safest idea in terms of a conservative view of the mind, a theory that takes no risks in terms of describing what’s going on. I don’t think I’m reading too much into it when I think there is an underlying agenda here that completely invalidates the vast majority of voicehearers’ own sense of their experience: that this is a real voice, with a different personality and tone of voice and agenda than your own. It ignores the fact that what the voice may be saying may be horrible and traumatic, that what it’s saying may be something so opposed to what you actually feel about yourself and the world that it’s completely repugnant, that being forced to hear what that voice says may only destroy your life.

The most obvious and glaring fault of this theory is: why would you, in talking to yourself, change from saying “I’m an asshole” to saying something that’s grammatically very different, like “you are an asshole”? Why, when multiple voices talk to each other, would the grammatical structure change once again from something like “you are an asshole” to saying in the form of “he [or she] is an asshole”? Why would the brain make this formal change—from “I” to “you” to “he”/”she” or even “they”—if all you are doing is talking to yourself? Why would it take the form of an outside intelligence? Is the brain constructed, then, to deceive itself about who is talking? Why, as happens with some people, would you imitate a range of different voices that talk to each other? While it’s an interesting situation in terms of the drama it creates, I doubt very much that the mind is mostly concerned with entertaining and deceiving itself.

I feel that this theory also fails on a purely technical level. One of the main underpinnings, for instance, is that there is a failure in the brain of a voicehearer to recognize a thought or action as being self-produced—that there is, essentially, a failure in the mechanism that informs us when we are the ones who have had a thought. It’s an interesting idea, until you realize that it once again defies the actual experience of voicehearers. If a voicehearer couldn’t recognize their own thoughts, why, then, does this phenomenon apply so selectively, which is only when the voice takes the form of someone else speaking? If there was a general failure to recognize your own thoughts, it would apply to all thoughts, not only to those other thoughts that happen to make up the other half of a conversation between yourself and another intelligence, a conversation that may be very dynamic and have no predictable parameters. Once again, what we see here is not a simple pattern of how the mind might work, but an overly complex theory that fails to account for what voicehearers actually experience.

There is one important thing I would like to add. In Simon McCarthy-Jones’s book, Hearing Voices, there is a description of a phenomenon called an “efference signal.” This is when the brain sends itself a signal to confirm that it really did something, such as the idea that you were actually the one who did something and not that it happened to you from the outside. After all, it’s very important to understand when it is someone else who is talking to you and not you talking to yourself, or that it was you who bumped into a wall and not that the wall suddenly jumped out and bumped into you. There is no detectable efference signal, that confirming signal when someone hears voices. Yet if you were talking to yourself, you would hear one, and this is what confounds those who search for an efference signal when people hear voices.

If you get right down to it and are honest about it, what the lack of an efference signal means is that you aren’t talking to yourself. In fact, this is evidence, if you want to take it that way, that the voices are coming to you from outside your own brain, and yet this is an idea that no one discusses; it might be too dangerous to people’s professional careers as psychiatrists, psychologists, and neurologists to do so, though it is the most damning piece of evidence of all.