Question

When you hear voices, is it like a literal sound you think you hear, or someone speaking silently in your mind, like a thought that isn't yours?

Answer 1

When a person experiences auditory hallucinations or "hearing voices" in the context of psychosis, it can vary significantly from individual to individual. Auditory hallucinations are perceptions of sound that occur without any external stimulus, meaning the person hears something that others around them do not hear.

The experience of hearing voices can manifest in different ways:

1. Literal sound: For some individuals, auditory hallucinations can be experienced as if they are hearing actual voices or sounds coming from the external environment. These voices may seem as real as any other external sound, like someone speaking aloud in the room.

2. Internal voice: Others may experience the voices as if they are coming from inside their head or mind. These voices can be perceived as thoughts that are not their own, like someone else speaking silently to them.

3. Mixed experience: Sometimes, the distinction between a literal external sound and an internal thought can become blurred. The voices might seem to originate from both internal and external sources simultaneously, making it challenging to differentiate between reality and hallucination.

4. Multiple voices: Auditory hallucinations can involve one or more voices, each with its own characteristics and often with unique personalities or roles.

It's important to note that auditory hallucinations are not exclusive to psychosis; they can also occur in other conditions like severe stress, substance use, and certain medical conditions. Additionally, not everyone who experiences auditory hallucinations has a mental illness. Some individuals with healthy minds may occasionally experience benign or non-distressing auditory phenomena.

For those with psychosis, hearing voices can be distressing and disruptive to their daily life. Treatment and support are essential for managing these symptoms effectively. Cognitive-behavioral therapy, medication, and other forms of psychotherapy can be helpful in addressing the underlying causes and reducing the impact of auditory hallucinations on the individual's well-being.