Lancet psychiatry cover image

Hearing the Voice is delighted to announce that the results of our study “What is it like to Hear Voices?” are now available to read freely online in The Lancet Psychiatry. Regular readers of the blog may recall that this study – one of the largest and most detailed to date on the experience of voice-hearing – was conducted in 2013 in collaboration with the Lived Experience Research Network.

Completed by 153 people (including 26 who have no history of mental illness), our open-ended online questionnaire aimed to strip away assumptions about what we think voice-hearers are experiencing, and instead ask people to describe what it is like to hear voices in their own words. We would like to thank everyone who participated in the study for sharing their experiences with us in such rich detail. We are also extremely grateful to those who circulated the link to our questionnaire through their networks for helping us to recruit such a large and diverse community of voice-hearing participants.

Key findings

Public perception is that hearing voices is always a symptom of severe mental illness such as schizophrenia and psychosis, and that the voices people experience are loud, commanding and dangerous. Our study confirmed previous research that challenges these assumptions, finding that people hear many different kinds of voices (some with strong characterful qualities); and that despite associations with negative emotions such as fear, anxiety and depression, many people also hear positive and supportive voices.

Perhaps more importantly, though, the study’s findings call in to question the presumption that voice-hearing is always and exclusively an auditory experience. While many of the participants said that the voices they heard were similar to hearing somebody speaking in the same room, 10% of participants reported purely ‘thought-like’ voices with no acoustic properties, and a further 40% reported ‘mixed’ voices that had both thought-like and auditory characteristics. These findings challenge the view that hearing voices is necessarily a perceptual or auditory phenomenon, and may also have implications for future neuroscientic studies of what it is happening in the brain when people ‘hear’ voices.

Our study also found that changes in emotion and bodily sensations often accompany voice-hearing experiences. 66% of participants reported alterations in the way their body felt while hearing voices, such as feeling hot or tingling sensations in their hands and feet. Nearly 20% of participants experienced ‘multi-sensory’ voices, suggesting that their voices were ‘perceived’ simultaneously through more than one sensory modality. Interestingly, it was voices with effects on the body that were more likely to be abusive and violent; and in some cases, were linked to previous experiences of trauma, such as bullying, neglect, and physical and sexual abuse.

Our online questionnaire drew on expertise from a wide range of disciplines including philosophy, psychology, history of psychiatry, and medical humanities, as well as insights from people with lived experience of hearing voices and other unusual mental states. The deeper, more nuanced understanding of voice-hearing which we have achieved as a result shows the value of interdisciplinary approaches to the investigation of human experience, and we hope may have far-reaching implications for the therapeutic management of distressing voices as well as future studies of voice-hearing in clinical, phenomenological and neuroscientific contexts.

Further information

Anyone who would like more information about the study is welcome to download the full paper here: Angela Woods, Nev Jones, Ben Alderson-Day, Felicity Callard and Charles Fernyhough, ‘‘Experiences of hearing voices: analysis of a novel phenomenological survey’’, The Lancet Psychiatry, March 2015.

Angela and Ben have also written an article for The Conversation, “Hearing voices? Don’t assume that means schizophrenia

A commentary on the study, ‘Voices beyond Words’ by Flavie Waters, will be forthcoming in The Lancet Psychiatry.

More information about the research methods used in the study can be found in this blog post: ‘How do we research people’s inner experience?’

More information about hearing voices, as well as sources of support for people who find their voices distressing, can be found in our Frequently Asked Questions and Looking for Support pages.