Don't believe everything you hear

It's difficult to imagine that Pythagoras, St Augustine, Galileo, and Joan of Arc could possible have had anything in common. But although they lived at different times and in markedly different cultures, they all shared an affliction. They were, according to new research, all voice-hearers.

It's difficult to imagine that Pythagoras, St Augustine, Galileo, and Joan of Arc could possible have had anything in common. But although they lived at different times and in markedly different cultures, they all shared an affliction. They were, according to new research, all voice-hearers.

Hearing voices may have now been demonised and forever associated with the small proportion of mentally ill people who are violent, but 2,000 years ago it was a sign of wisdom, knowledge, and of a superior intellect and great virtue.

But despite becoming acutely unfashionable, voice-hearing has not gone away. New research being published this week suggests that around one in 20, or some two million people in Britain, hear voices on a regular basis, perhaps once a month or more, and that as many as one in five are occasional voice-hearers. Many get therapy, but some may not need it. Many people also keep their talking voice a secret, worried they will be seen as being mentally ill. But a new book published this week argues that hearing voices is not necessarily a health problem at all.

"Our argument is that hearing voices itself does not necessarily indicate mental illness anymore than do thinking, remembering or any other ordinary psychological function. Some people who have a mental illness have deluded thinking, but that does not mean that all deluded thinking is a sign of insanity,'' says Dr Ivan Leudar, reader in psychology at Manchester University and co-author with consultant psychiatrist Philip Thomas, of Voices of Reason, Voices of insanity.

Hearing voices, or verbal hallucinations, has been documented for at least 2,000 years. Voices were implicated in the religious conversions of St Augustine and Hildegard, while Achilles had a whole repertoire of voices, and Galileo heard the voice of his dead daughter. Hearing the voice of a dead relative, especially someone close, is not unusual. In some cases the voice makes comments that person would have made if they were alive.

"Experiences are often described as being very positive and sometimes practical. An academic who took part in our study has a voice that calls her name whenever she goes into a strange area. It sounds like her absent father and says, 'What are you doing here?' The voice is giving her the kind of advice her father would have done,'' says Dr Leudar.

"It is also common in people who have lost loved ones, especially older people. There is research showing that widows two to three months after bereavement hear the voices of their loved ones. There is no indication that these people are depressed or suffer from schizophrenia.''

As part of their study, the researchers interviewed a number of people who had heard voices for more than four years. Most could not pinpoint when the voices began, and some thought that they had always been there.

One of the voice hearers interviewed by the researchers describes how she associated the voice with her dead husband. She says it has the same mannerisms and anger. "There were some occasions when I wasn't sleeping very well and I would start missing him and thinking of him and remembering occasions when we were happy together and looking for comfort from him. I would almost feel that kind of comfort and almost feel him there, almost feel him breathing on my face,'' she says. "But he would come and he would say, 'you're being stupid, it never was like that', or 'you're neglecting things', or 'you're a mess'. It would be very derogatory to me.''

Another woman described how she heard a voice that sounded like her mother and which typically criticised her: "I don't know if it is my mother, I just know it sounds like her. It's very much putting down what I've done, or criticising me or saying that what I am doing is for the wrong reasons,'' she said.

A young man told researchers that his voice was the opposite of critical and kept on flattering him: "The voices just tell me that I'm orgasmic, that I'm really good looking, and that all girls will fall at my feet. I hate that feeling because it's not the real me. The real me is me."

It's thought that the phenomenon of hearing voices involves the same areas of the brain that are active when people talk to themselves. Researchers have found when people talk to themselves internally there is an increased electric activity in the lips and larynx, even though they are not speaking, suggesting that the pathways to the brain involved in normal speech are open. And when people who were hearing voices had their brains scanned, it was discovered that the same areas of the brain were active that were also working when people talk to themselves. One theory is that the two are part of some inner speech phenomenon When the brains of voice hearers were examined it was found there was reduced activity in the area of the cortex that is thought to be involved in the generation and monitoring of inner speech.

"The society we live in pathologises the hearing of voices. We think they are deluded, but I have yet to meet anyone who hears voices who thinks other people hear them as well. Most voice hearers are puzzled by it rather than anything else,'' says Dr Leudar. "People will need therapy if there is an underlying problem, but the truth is that much of what these voices say is extremely mundane and boring. One person, for example, has a voice which every time they go to open a door tells them to use their other hand.''

Voice hearers without a disease problem can go into therapy to learn how to deal with it, especially how to avoid a compulsion to do everything the voice says.

Dr Leudar says that those without an underlying disease should be reassured, but one of the problems is that because of social stigma, they never feel able to talk about it. Many of these people, he says, would benefit from knowing that hearing voices doesn't necessarily mean they are mentally ill.

But the reality, says the book, is that the majority of people who admit to hearing voices are under psychiatric care and on neuroleptic medication: "Their experiences have been interpreted within a medical framework which regard voices as a symptom of serious mental illness.''

'Voices of Reason, Voices of Insanity', by Ivan Leudar and Philip Thomas is published by Routledge, £15.99.

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