Voice-hearing: how common are auditory hallucinations in the general population?

© Danabeth555 | Stock Free Images & Dreamstime Stock Photos
© Danabeth555 | Stock Free Images & Dreamstime Stock Photos

Introduction

Voice-hearing refers to the experience in which a person hears one or more voices that other people cannot hear. The medical term for this phenomenon is auditory hallucination, a symptom that traditional psychiatric services view as having diagnostic significance in serious mental disorders such as schizophrenia. But how common is voice-hearing in the general population?

Surveys of voice-hearing

Surveys that have asked large numbers of people as to whether they have heard voices that others present cannot hear have produced widely differing results. Questionnaire surveys, where the respondent is asked to tick boxes, tend to lead to higher reported prevalence rates than when face-to-face interviews are employed.

The earliest study was undertaken in the late 19th century with a community sample of 17,000 people (1). The authors found that 12% of women and 8% of men claimed to have had at least one hallucination (auditory or visual) during their lifetime. Comparable outcomes emerged over 100 years later in a sample of American adults where over 8% of the participants endorsed hearing voices (2).

A survey suggesting a much higher incidence of voice-hearing was conducted with 375 university students, none of whom had any history of contact with psychiatric services (3). Over 71% of the students reported that they had heard voices at some point in their lives. Items endorsed included: hearing one’s thought spoken aloud (39%), hearing the voice of God (11%) and conducting conversations with voices (5%). The finding of such a high level of voice-hearing in this college population suggests a greater incidence in younger people, an assertion supported by a number of other studies.

At the other end of the spectrum, some studies have provided much smaller (although far from rare) estimates of voice-hearing in the public at large. The Eastern Baltimore Mental Health Survey (4) found that 4% of people “heard things that others could not hear.” Similarly, an Australian census revealed that 3.4% of the sample claimed to have had at least one voice-hearing experience (5).

A recent review article provided the most convincing estimate of voice-hearing (6). Considering 17 surveys across nine countries, the authors calculated a typical incidence in the general population of around 13%.

The importance of personal meaning

When attending an event organised by the Hearing Voices Network one is struck by the wide variety of people who participate; people from professional and managerial occupational groups stand alongside manual labourers and the unemployed. In addition to occupational status, voice-hearers differ hugely in relation to the amount of distress they experience. At one end of the spectrum is the person suffering a psychotic episode, tormented by the voices he hears. In stark contrast there will be people who are untroubled by their voices, or who may even find them comforting.

A key determinant of the degree of distress associated with voice-hearing is the meaning that the person attaches to the experience. By way of illustration, consider two people (person A and person B) who hear exactly the same voice repeatedly saying, “take care.” Person A may interpret the voice as being that of the devil making threats to his personal safety and, as a consequence of this interpretation, he will feel scared and vulnerable. In contrast, person B might make sense of the same voice as emanating from his guardian angel and therefore feel safe and secure.

Marius Romme (MD PhD) in conversation with Pete Sanders

You're never far away from a voice-hearer

If you are not one of the 13% of the world’s population who experience auditory hallucinations, no matter where you are or what you’re doing, you will never be far away from someone who does.

The United Kingdom hosts somewhere in the region of eight million voice-hearers. In the USA the number can be estimated to be around 41 million. If you happen to be a spectator at an average NFL game there will be about 8,500 voice-hearers in the stadium. The large majority of these people will not have had any contact with psychiatric services, nor would they seek or require such contact. Some will have experienced auditory hallucinations in the context of illicit drug use. For others, voice-hearing may have emerged in the aftermath of the death of a loved one, or as a consequence of a trauma or a prolonged period of sleep deprivation.

In recognition of the high prevalence of voice hearing experiences in the general population, a service-user run organisation called the Hearing Voices Network has emerged. The first branch of the network was established in the United Kingdom in 1988, as a result of the pioneering work of Dutch psychiatrist Marius Romme. Hearing Voices Networks have now been established throughout Europe and in Japan, Australia, New Zealand, Israel and the USA. The main aims of the Hearing Voices Network are to raise awareness about voice-hearing, promote peer support and to deliver training sessions on the topic of voice-hearing to mental health professionals and the general public.

References

  1. Sidgewick et al. (1894). Report of the census of hallucinations. Proc. Soc Psyche Res 26, 585 – 586.
  2. Shevlin et al. (2007). The distribution of positive psychosis-like symptoms in the population: a latent class analysis of the National Comorbidity Survey. Schizophrenia Research, 89, 101 – 109.
  3. Posey, T. and Losch, M.E. (1983). Auditory hallucinations of hearing voices in 375 normal subjects. Imagination, Cognition & Personality, 3(2), 99 – 113.
  4. Eaton et al. (1991). Screening for psychosis in the general population with a self-report interview. Journal of Nervous & Mental Disorders, 179, 689 – 693.
  5. Scott et al. (2008). Demographic correlates of psychotic experiences in young Australian adults. Acta Psychiatrica Scandinavica, 118(3), 230 – 237.
  6. Beavan et al. (2011). The prevalence of voice-hearers in the general population: a literature review. Journal of Mental Health, 20(3), 281 – 292.

Voice hearing poll

How often have you heard voices that other people cannot hear?

  • Never
  • Rarely (no more than 3 times in my life)
  • Sometimes (more than 3 times but less than once per year)
  • Regularly (at least once per year but less than once per week)
  • Continuously (at least once per week)
See results without voting

If you have heard voices, how distressing was the experience?

  • Not distressing at all
  • Moderately distressing
  • Very distressing
See results without voting

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Comments 13 comments

kristyleann profile image

kristyleann 4 years ago from Oceana, WV

This is interesting. I don't know if this really counts as hearing voices but once when I was a kid I was in the living room by myself (mom was at the neighbor's house talking on their porch) and my dad was gone (don't remember where he went that day but he was going to be gone a while). I was sitting there playing with legos and I suddenly heard his voice say "Kristy!" like he often did when he got home. It was as plain as day. I ran outside and he wasn't there and I ran over to mom and asked her where he went and she said he was still gone. I don't know if I just imagined it or what but it was really weird.


A K Turner profile image

A K Turner 4 years ago from West Yorkshire

I here voices, and I see dead people! No just kidding I don't see dead people, but I do definitely here weird stuff, like knocking sounds and stuff, I have always attributed to demonic ( I am a Jesus loving Christian), but this article makes me feel better-thankfully I am just crazy!


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

kristyleann - Thank you for dropping by and sharing your interesting story from childhood.

I think your experience would qualify as voice-hearing, albeit at the lowest (probably once in a lifetime) end of the frequency spectrum. Children and females are more likely to hear voices, so I suspect your weird experience is commonplace.

Thanks again for taking the time to comment.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

AK Turner - I appreciate your interest in the topic.

I'm glad you feel better for no longer attributing your knocking sounds to demons. I assume your comment about concluding your "just crazy" is a light-hearted one; voice-hearing is so widespread that it can no longer be referred to as a rare (or crazy) experience.


Denise Handlon profile image

Denise Handlon 4 years ago from North Carolina

Very interesting. I have never heard of the 'Hearing Voices Network' so this has been a learning experience for me. Thanks for including that piece of the information here.

I was just having a conversation about this with my voices...no, just kidding...seriously, I was just discussing this phenomenon with a friend of mine in the mental health field. I told her that one of the things I noticed with some of the patients I work with is their inability to distinguish from voices that are disturbing, such as in psychosis, and other events of hearing voices-like in thinking 'loudly' to oneself.

This opens up a new area for me to investigate. Thanks.


Mom Kat profile image

Mom Kat 4 years ago from USA

I worked as a DSP for adult with mental illness for a few years. This was a very common occurrence with our clients. I noticed that when the client was under stress or ill the voices would get worse. I also noticed that when the client was feeling they were not getting the attention they craved from actual people, their voices increased.

For those who suffered from depression in the combination of diagnosis when they had a more difficult or "down" day, the negative voices were also more strong and negative.

I truly believe that this is a coping mechanism that is developed in some people's minds to help them deal with traumatic experiences at an early age.... sort of like an imaginary friend gone wrong.

The ability to distinguish real from make believe is skewed or distorted to such a degree that they become dependent upon these voices in order to gain a sense of importance or to not feel alone.

As with a child, any attention is better than no attention, so even a negative voice is better than no voice. If you hear voices then you are never alone, plus it gets the attention of others around you ~ they will want to take care of you, talk with you to help you work it out. It's a manipulative behavior that is derived from the avoidance of the true issue they are trying to avoid or run away from.

Similar to a split personality, only they don't "turn into" or become someone else as a defense mechanism; they simply hear the other personalities.

I am not a therapist or doctor, my opinions are simply my opinions based upon personal observation and independent study. My intentions are not to offend anyone who suffers from this or who knows someone suffering from this.

Very well written, great job!


meloncauli profile image

meloncauli 4 years ago from UK

Very interesting article which will hopefully spread more awareness.

I have talked to people who experience both aggressive type voices and comforting voices. Some of these people have told me of their problems before the voices started. It would appear to me that conscience has something to do with the voices.

One man I knew who heard voices was riddled with guilt about his mother, and letting her down before the voices started. His voices were venomous and reflected this guilt he felt. Whilst I was listening to him tell me what the voices said to him, I couldn't help but think that the core problem was this man's guilty conscience. I wondered why this wasn't being addressed!

Many people who hear voices are quick to be tagged by the psychiatric profession and then left to a lifetime of them and taking medication for them. It is a shame that at diagnosis point, a more thorough personal history isn't analyzed and an appropriate therapy given in the first instance, even if it is alongside medication.

Four years ago I had to write an essay on "hearing voices" and I found out that a large majority of people who hear voices are diagnosed as schizophrenic on the strength of about four or five questions! Apart from being asked "do the voices scare you", little was discussed about their personal meaning.

My thinking is that hearing voices could be another way of the brain coping with overwhelming personal problems and, as you say, it is the interpretation of the voices that is telling of how severe the problem becomes.

Isn't it strange how this can typically start happening during young adulthood? This is a time when a bad childhood can start having a profound negative effect and a person is trying to make their way in the world, possibly with the added stress of work or studying.

Voted up, useful and shared.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Denise - Thank you for taking the time to drop by and leave a comment. The "Hearing Voices" networks developed in Europe but I'm sure I read that there are groups now in the USA (although can't remember where).

There are various theories about the causes of voice-hearing, including the loss of the ability to distinguish between self-generated speech and sounds that have an external origin - which sort of fits with your own ideas.

Thanks again for your interest.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Thank you Mom-Kat for sharing some of your own thoughts about voice-hearing, and also for your generous comments.

It is certainly the case that for many voice-hearers their mood at the time would influence the frequency and content of the voices - for example, when low in mood the voices are likely to be self-critical and condemning, when stressed and anxious the voices are likely to threatening. Also the link between early trauma and voice-hearing/psychosis is well-established. And people do often find their voices comforting and a way of counteracting loneliness. Not sure about the attention-seeking/manipulation; any attention voice-hearing attracts is usually a negative type, such as ridicule.

I appreciate you dropping by.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Hi meloncauli

Thank you for taking the time to share your wisdom. As usual I can only echo everything you say. Your guilty conscience idea makes complete sense; voice-hearing is typically about hearing your own thoughts out loud, so if someone feels guilty the voices will tend to be critical.

As you say, in psychosis the content of voices is not meaningless as traditional psychiatry often assumes. Rather it can be imbibed with personal meaning.

Best wishes and hoping you are recuperating well.


Nicola Tweedie profile image

Nicola Tweedie 4 years ago from East Sussex, United Kingdom

SO helpful. Can we give this to teachers?


sparkster profile image

sparkster 4 years ago from United Kingdom

Very interesting article indeed. Auditory hallucinations is something which I have addressed in my article on parapsychology. Of course, I have explained the phenomena in terms of how the average person with no medical problems can mis-perceive clicks and popping sounds as speech (as speech is made up of a series of several clicks, noises and pops anyway) which often results in the person turning around and saying "did you say something?" only to be told "No!"

Of course, in terms of Schizophrenia and other medical disorders then the explanations could be very different.


gsidley profile image

gsidley 4 years ago from Lancashire, England Author

Nicola - So good to hear that you found the hub of interest. Feel free to use in any way you wish.

Sparkster, thank you for dropping in. It is currently a major point of contention in the mental health arena as to whether hallucinatory experiences within a psychotic episode are qualitatively the same as the voice-hearing experiences widespread in the general population.

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