Are people who hear voices mentally ill?

Auditory hallucinations are a very popular device in horror films when someone is possessed by an evil force, but the reality is that many sane people can hear voices where there are none.

Some people hear voices where there are none. This special form of acoustic hallucination seems so fascinating to many that it has found its way into pop culture. However, since most of us only know about hearing voices from books and movies, a number of myths have arisen about it. At the beginning there is the question of who is actually talking to the person in question. In the past, supernatural beings such as demons or angels were blamed for this and it was believed that those affected were possessed or enlightened.

Today we know that when we hear voices, areas of the brain that are responsible for understanding and speaking are activated. A very similar neural activity can also be observed when we listen to our inner voice, i.e. silently forming sentences in our thoughts. So it’s an internal monologue, but some people perceive it as if it came from outside. Then it sounds like someone is standing in the room. It’s not entirely clear what specific changes in brain function cause people to perceive their own thoughts as coming from outside.

Perhaps the biggest myth, however, is the assumption that anyone who hears voices is mentally ill. It’s true that hearing voices can be a symptom of a psychotic disorder. It occurs in approximately 70% of schizophrenia cases. People with post-traumatic stress disorder or obsessive-compulsive disorder as well as one in three people with borderline personality disorder are often affected.

However, there are also mentally healthy people who occasionally hear voices. They lead a normal life and do not need psychiatric or therapeutic help. Not all people who hear voices suffer from it. Studies suggest that between three and eight percent of adults have had vocal hallucinations while awake. It happens much more often at a young age: one in ten children has imagined voices. This is usually not a cause for concern; They usually go away on their own over time.

Half of psychotic disorders are accompanied by friendly voices that offer advice or comfort

Another myth is that voices are always evil. It’s true that the words people with a psychotic disorder hear are often critical, offensive, or even threatening. However, around half of psychotic disorders are at least occasionally accompanied by friendly voices that offer advice or comfort. Fantasy monologues, friendly or harsh, can last for hours, but often only one sentence is spoken.

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So how can you distinguish a harmless voice from an alarming one? First of all, it depends on the tension that this creates. In healthy people, the voices are usually short and neutral or positive. However, the episodes of a mental disorder usually last longer and are characterized by negative content. Those affected often find voices overwhelming and uncontrollable. The result is usually a withdrawal from social relationships. On the other hand, those who perceive the voices in their head as non-threatening and insistent tend to react to them more calmly and are able to ignore them more easily.

Dealing constructively with hearing voices is therefore one of the goals of psychotherapeutic approaches. The goal is not to get rid of the voices, but to disempower them. For example, you can learn to listen to voices without immediately believing everything they say. This is how you can live well with voices in your head.

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