Call for Review: ‘Emily’s Voices’ by Emily Knoll

We are delighted to offer Emily’s Voices by Emily Knoll (2017) for review. Expressions of interest are welcome from voice-hearers and the friends, families and professionals who support them, as well as from academic researchers with an interest in hearing voices and other unusual experiences.

This memoir tells Emily’s story of her struggle with hearing voices and her journey through the mental health system. Emily’s voices are distressing, but her therapist and close friends help her to challenge the voices, and to confront some of the self-stigma which she feels about being a voice-hearer. Emily must find a way of accepting that she hears voices, or she can’t be in the world. It’s a confrontation that takes all of her new-found strength and resolve.

If you would like to review Emily’s Voices (no more than 1,000 words in length), then please email Victoria Patton with a short explanation of why you are well placed to review the book.

Reviewers will receive a free copy of Emily’s Voices.

Emily’s Voices is available to purchase on Amazon here.

‘The Strange World of Felt Presences’ by Ben Alderson-Day and David Smailes

In a recent piece for the Guardian’s Inner Voices series, our Postdoctoral Research Associates in Psychology Dr Ben Alderson-Day and Dr David Smailes write:


On 20 May 1916, Ernest Shackleton, Frank Worsley, and Tom Crean reached Stromness, a whaling station on the north coast of South Georgia. They had been walking for 36 hours, in life-threatening conditions, in an attempt to reach help for the rest of their party: three of their crew were stuck on the south side of the island, with the remainder stranded on Elephant Island. To reach the whaling station, the three men had to cross the island’s mountainous interior with just a rope and an axe, in a journey that few had attempted before or since. By reaching Stromness they managed to save all the men left from the ill-fated Imperial Transantarctic Expedition.

They did not talk about it at the time, but weeks later all three men reported an uncanny experience during their trek: a feeling that “often there were four, not three” men on their journey. The “fourth” that accompanied them had the silent presence of a real person, someone walking with them by their side, as far as the whaling station but no further. Shackleton was apparently deeply affected by the experience, but would say little about it in subsequent years, considering it something “which can never be spoken of”.

Encounters such as these are common in extreme survival situations: guardian angels, guides, or even Christ-like figures have often been reported. We know them now as “third man” experiences, following a line in TS Eliot’s poem, The Wasteland:

“Who is the third who walks always beside you? When I count, there are only you and I together. But when I look ahead up the white road, there is always another one walking beside you”

Eliot had heard of Shackleton’s encounter, but could not remember the precise details – meaning that the “fourth” man became the “third”.

In his book The Third Man Factor, John Geiger collects together a wide range of third man stories, including accounts from mountaineers, sailors, and survivors of terrorist attacks. They all involve a strong impression of a felt presence, sometimes with a voice or a shadow-like image, but often without a clear form. Extreme physical conditions, threat to life, and social isolation all seem to trigger the feeling of a presence, which will often feel as if it has a spiritual or guiding purpose.

In the case of the third man, it is tempting to think that strong feelings of presence act as some sort of hallucinatory defence mechanism – something that could happen to anyone, but only in very extreme scenarios. Such experiences are, however, also reported in much less dramatic circumstances. Following bereavement, for example, many people report sensing the presence of their deceased loved one; a feeling that someone is still in the house, just upstairs, or in their favourite chair.

Felt presences are common during the experience of sleep paralysis, when people have the feeling of being awake but not being able to move their body. Often this is accompanied by a sense of a presence in the room, along with physical sensations such as pressure on the chest and difficulty breathing. Feelings of presence also feature in particular neurological disorders – such as Parkinson’s disease – and cases of brain damage.

The different contexts in which felt presences occur give us some clues about what might be happening. For example, their association with bereavement suggests that emotional factors (eg, strong, persistent feelings of sadness), as well as strong expectations that another person ‘should’ be present, are important factors. In the case of Parkinson’s disease, they appear to occur most often in people who receive high doses of medication, suggesting that the neurotransmitter dopamine may well be involved in felt presence experiences.

Perhaps most revealingly, people with brain injuries who report felt presence experiences often have damage to an area called the temporoparietal junction (TPJ), and electrical stimulation of this area can induce the feeling of a nearby sensed presence. Among many other things, the TPJ appears to play an important role in maintaining an internal representation of our body image. So, one possibility is that feelings of a presence occur when our representation of our body is somehow duplicated or projected outside of us (something known as an “autoscopic” experience). Supporting this idea, often the person having a felt presence feels like they have some important bond or affinity with the figure they experience.

On the other hand, some feelings of presence are described as being very alien and often malevolent towards the perceiver: sleep paralysis, for example, is often accompanied by feelings of anxiety and dread in relation to the “entity” in the room. It has been argued that cases of sleep paralysis also involve old, evolutionary impulses to detect threat in our environment. This, coupled with muscle paralysis, could lead to an intense fear of the presence in the room.

Understanding more about how and why felt presences occur has the potential to tell us many things about ourselves: how we react under intense mental or physical stress, how we deal with danger and threat, and how we recognise the shape and position of our own body. But one thing it also may do is shed light on other unusual experiences that are hard to understand.

For example, in cases of hearing voices (sometimes called auditory verbal hallucinations), people sometimes struggle to describe the nature of the “voice” they hear. Because we tend to use the term ‘hearing voices’ to describe this experience, researchers and clinicians often focus on auditory characteristics (Did the voice sound like it was coming from inside your head, or outside of your head? How loud was the voice?). But sometimes, feelings of presence might accompany the voice-hearing experience, and some people who hear voices describe their “voice” being there even when it is not speaking; a voice that seems to have a presence of its own. In these cases, hearing a voice may be much more like sensing a person or being visited by an entity, rather than experiencing sound. Interestingly, there is also some evidence that the neural connectivity of the TPJ area is organised in a different way for people who hear regularly hear voices.

If voices and presences were to overlap in some way then it could have consequences both for research and treatment, when help is sought. For instance, researchers might need to look closer at social factors that seem to trigger voices, or study brain networks that support social cognition and body representation. Approaches that involve interacting with voices and treating them like people – something that voice-hearers themselves have often advocated – could prove to be useful for health professionals, and some psychologists are already having success with such techniques. In this way, the third man does not just tell us about our own minds or bodies; it offers us a way to help and understand others – just as he did for Shackleton.

This article was originally published here in the Guardian Psychology blog. If you like to know more about felt presences and hearing voices, or would like to take part in our research, you can contact us via email.

Call for Papers: ‘Voices and Thoughts in Psychosis’, Review of Philosophy & Psychology, Special Issue

What is like to hear a voice when no-one is speaking, and how is that different from having a thought? Could “inserted” thoughts (i.e. thoughts that somehow feel like they belong to another person) be the same kind of thing as hearing voices? Hearing the Voice is pleased to announce that  our postdoctoral researchers Sam Wilkinson & Ben Alderson-Day will be guest editing a Special Issue of the Review of Philosophy & Psychology on the topic of “Voices and Thoughts in Psychosis”. Submissions are welcome for theory and review papers on the relationship between hearing voices, inserted thoughts and inner speech, with a deadline of October 17th 2014.

Full details and submission guidelines are available via the official Call for Papers. If you have any queries, please contact either Ben or Sam directly.


Report on the 2nd Meeting of the International Consortium on Hallucinations Research

The second biannual meeting of the ICHR (International Consortium on Hallucinations Research) was held at Durham University in September 2013. A full report on the meeting by organisers Flavie Waters, Angela Woods and Charles Fernyhough has just been published in Schizophrenia Bulletin. The report, which can be accessed in full here, summarises the presentations of each of the twelve working groups and identifies ten ‘hot spots’ for future hallucinations research.

AbstractThis article presents a report on the 2nd meeting of the International Consortium on Hallucination Research, held on September 12th and 13th 2013 at Durham University, UK. Twelve working groups involving specialists in each area presented their findings and sought to summarize the available knowledge, inconsistencies in the field, and ways to progress. The 12 working groups reported on the following domains of investigation: cortical organisation of hallucinations, nonclinical hallucinations, interdisciplinary approaches to phenomenology, culture and hallucinations, subtypes of auditory verbal hallucinations, a Psychotic Symptoms Rating Scale multisite study, visual hallucinations in the psychosis spectrum, hallucinations in children and adolescents, Research Domain Criteria behavioral constructs and hallucinations, new methods of assessment, psychological therapies, and the Hearing Voices Movement approach to understanding and working with voices. This report presents a summary of this meeting and outlines 10 hot spots for hallucination research, which include the in-depth examination of (1) the social determinants of hallucinations, (2) translation of basic neuroscience into targeted therapies, (3) different modalities of hallucination, (4) domain convergence in cross-diagnostic studies, (5) improved methods for assessing hallucinations in nonclinical samples, (6) using humanities and social science methodologies to recontextualize hallucinatory experiences, (7) developmental approaches to better understand hallucinations, (8) changing the memory or meaning of past trauma to help recovery, (9) hallucinations in the context of sleep and sleep disorders, and (10) subtypes of hallucinations in a therapeutic context.

“Hallucination” A new collection of essays edited by Fiona Macpherson and Dimitris Platchias

Hallucination (edited collection)Charles Fernyhough and HtV team members Richard Bentall and Simon McCarthy-Jones have recently published articles in Hallucination, a new collection of essays by scientists and philosophers edited by Fiona Macpherson and Dimitris Platchias.

The volume is described on the MIT Press website as follows:

“Reflection on the nature of hallucination has relevance for many traditional philosophical debates concerning the nature of the mind, perception, and our knowledge of the world. In recent years, neuroimaging techniques and scientific findings on the nature of hallucination, combined with interest in new philosophical theories of perception such as disjunctivism, have brought the topic of hallucination once more to the forefront of philosophical thinking. Scientific evidence from psychology, neuroscience, and psychiatry sheds light on the functional role and physiology of actual hallucinations; some disjunctivist theories offer a radically new and different philosophical conception of hallucination. This volume offers interdisciplinary perspectives on the nature of hallucination, offering essays by both scientists and philosophers.

Contributors first consider topics from psychology and neuroscience, including neurobiological mechanisms of hallucination and the nature and phenomenology of auditory-verbal hallucinations. Philosophical discussions follow, with contributors first considering disjunctivism and then, more generally, the relation between hallucination and the nature of experience.”

Contributors: István Aranyosi, Richard P. Bentall, Paul Coates, Fabian Dorsch, Katalin Farkas, Charles Fernyhough, Dominic H. ffytche, Benj Hellie, Matthew Kennedy, Fiona Macpherson, Ksenija Maravic da Silva, Peter Naish, Simon McCarthy-Jones, Matthew Nudds, Costas Pagondiotis, Ian Phillips, Dimitris Platchias, Howard Robinson, Susanna Schellenberg, and Filippo Varese.

Hallucination is available to order here.