Is it normal to hear voices? Auditory hallucinations

Sometimes this type of hallucination is due to disorders, although in others they are normal.

The human being is a social being who communicates with his environment and with his peers, using oral language to a great extent for this purpose. We speak to communicate and express more or less abstract ideas and concepts, and we hear and listen to those of others.

However, some people report hearing voices that do not hear voices that do not correspond to a real stimulus.. In this context... What is happening with these people, is it normal to hear voices? In this article we are going to specify some cases in which the auditory perception of a voice appears.

Hearing voices: auditory hallucinations

The perception of elements in the absence of stimuli that provoke them is what we know as hallucination. is what we know as hallucination. In them, the sufferer perceives as true a stimulus that does not exist in reality, this being his own elaboration. Hallucinations can appear in any sensory modality, including hearing.

Hearing voices, if they do not come from a real stimulus, is therefore a hallucinatory phenomenon. In fact, it is the type of hallucination that can occur in any sensory modality, including hearing. it is the most common type of hallucination, especially in certain mental disorders.especially in certain mental disorders. The voices in question can externally reflect the contents of one's own thoughts, give orders, criticize the sufferer in the second person or make comments in the third person. It is even possible to perceive more than one voice and for them to establish conversations with each other, although this is not common.

The first thing most people think of when someone says they hear voices is the word schizophrenia, or that they are having a psychotic break. Linking schizophrenia to hearing voices is because the presence of hallucinations (especially auditory) is one of the predominant symptoms, especially of the paranoid subtype.

In schizophrenia the voices can be manipulative and frightening and order to do things that the subject does not want to do. It is frequent that in this disorder the content of the voices is threatening or critical and that they speak of the subject himself or of the environment, as well as they can provoke the interpretation of reality in a different way. cause the interpretation of reality in a different way than usual, generating delusions (for example, a person who constantly hears that they are being persecuted or that they want to see them dead may end up interpreting situations according to this idea).

Psychotic disorders are not the only ones in which the hearing of voices generated by one's own mind may appear. In some types of depression as the atypical one, in maniac episodes, anxiety crises or during epileptic crises voices can be heard. Also during dissociative states.

Also, some diseases and medical alterations can provoke this perception. For example, in the presence of high fever it is possible that hallucinations and delusions appear, as well as a great number of alterations that course with alterations of conscience.

Various conditions, such as withdrawal syndrome to certain substances, or neurological disorders such as dementias are prone to generate the perception of hearing voices.

We are not always in front of a disorder

As we have seen, when it is mentioned that a person hears voices, this fact is generally linked to the existence of schizophrenia or a psychotic disorder. This is because the presence of auditory hallucinations, especially in the form of voices, is one of the most characteristic symptoms of paranoid schizophrenia.

However, this disorder is not present in all cases: it is possible to hear voices for multiple reasons and not all of them are pathological.

1. Substance use

The consumption of certain substances, especially those of psychodysleptic type (such as hallucinogens) or psychoanaleptic, can also provoke the perception of voices or sounds by causing alterations in perception and/or level of consciousness. In addition, some substances can even provoke a psychotic break per se, which can also lead to hearing voices.

And not only during their consumption, they can also occur in intoxications by these substances or even in the case of abrupt cessation of consumption in cases of dependence, i.e. withdrawal syndrome.

2. Hypnagogic and hypnopompic hallucinations

An example of this can be found in hypnagogic and hypnopompic hallucinations, also called physiological hallucinations: this is a form of pseudoperception in the form of hallucinations which from wakefulness to sleep and vice versa, i.e., in a state in whichThey are a form of pseudoperception in the form of hallucinations that arise during the transition from wakefulness to sleep and vice versa, that is, in a state in which an alteration of consciousness is taking place.

Although it is frequent that they are of visual type, it is not rare that sonorous elements also appear, being able to hear voices, conversations or shouts. being able to hear voices, conversations or screams. They do not necessarily indicate the presence of a pathology, but it is not uncommon for them to appear in the non-clinical population.

3. Reaction to an intense stress or a traumatic event

Losing a loved one, having suffered some type of abuse or being subjected to considerable stress can cause those who have suffered from it to experience hearing voices at specific moments. For example, it is not uncommon when we lose a loved one to seem to hear the voice of the deceased, usually in the early stages of the grieving process.

Hearing voices can also be a consequence of a state of extreme excitement and nervousness. extreme excitement and nervousnessThis phenomenon appears as nervous paroxysm. In fact, the perception of these voices can further increase the state of tension of the subject and accentuate the perceptions.

4. Pareidolia

Pareidolia is understood as the phenomenon by which the human brain tends to cause us to perceive patterns in ambiguous stimuli, as occurs when we see shapes in clouds.

Although pareidolia in itself designates the endowment of sense and meaning to images that do not have it, similar phenomena can also occur in other senses. For example, in hearing. It is possible that certain environmental elements, such as the wind, produce noise that we can interpret as a human voice, even in the form of phrases.even in the form of sentences.

What are they really?

The origin of the perception of voices without anything to trigger the perception may depend on the type of phenomenon that originates them. Usually it is either an interpretation of an external noise or the perception as exogenous of a self-generated content (i.e. something that the person himself has thought of is perceived as external).

In the latter case, there are multiple hypotheses as to why this occurs. It has been perceived that the existence of an excess of dopamine in the mesolimbic pathway can generate hallucinations and delusions, as well as the possibility of prefrontal lesions has also been proposed. It has also been observed that many patients with temporal lobe asymmetries develop positive symptoms such as hallucinations. Another explanation may be a disconnection between the speech and prefrontal brain regions, which may lead to a dissociation between the prefrontal and speech brain regions.This may lead to a dissociation between self-awareness and the generation of verbal content.

How are they treated?

Hearing voices requires treatment if they are due to the existence of a mental disease and/or they suppose a significant damage, discomfort or limitation for the person who perceives them or his environment.

If the voices are perceived during a mourning process or after a traumatic experience, it may be necessary to work on the phenomenon that has generated it and its significance for the patient. The type of strategy to be used will depend on the case.

In cases of psychotic disorders, neuroleptic or antipsychotic drugs are usually used to reduce hallucinations. Both typical and atypical antipsychotics are very successful in this regard, although the former may cause significant side effects and in both cases may cause sedation. In other disorders, the corresponding cause must be treated.

At the psychological level and specifically on auditory hallucinations, focalization therapy has been used.. In this therapy elaborated by Slade, Haddock and Bentall, the patient is tried to focus gradually on different aspects of the voices. We start with the form and characteristics of the voice in question, to later analyze the content (i.e. what they say) and finally work on the beliefs that the subject has about them. The aim is to gradually get the subject to re-attribute the voices to his or her own mental contents.

In any case, when treating a person who claims to hear voices it is necessary to make him/her see a fundamental aspect: independently of what they say, the voices cannot harm him/her.