Types of auditory hallucinations – hearing voices.


By David Joel Miller.

How many types of auditory hallucinations are there?

Street art - confusing

Hearing Voices – sensory confusion.
Photo courtesy of Pixabay.com

Hearing voices or sounds that no one else hears occurs in people both with and without a diagnosable mental illness. Originally this question came in from a reader who asked about types of voices. What that reader was asking about was voices that speak in first, second or third person, a very different discussion from what we are talking about here. Their question got me thinking that all those things that get referred to as “auditory hallucinations” can be quite different experiences.

Since these auditory events can vary so much it may be useful to consider some types of auditory hallucinations, “hearing voices” as the auditory hallucinations are often referred to, and we can see just how different these auditory hallucinations might be. Some of these events are easily explained and other sound events are reasons to suspect a long-term mental illness is present.

Some “voices” are misinterpreted sounds.

Hearing voices or other sounds and then finding out that others did not hear what you heard happens more often than most people realize. At several times in the human lifespan this is so common that it appears normal. In children and adolescents and then again among the elderly these auditory hallucination type “hearing voices” are common enough that we are inclined to think this is a normal developmental event.

Mistaking one sound for another is a type of auditory hallucination.

Say you are sitting at a table eating lunch and then you think you hear someone calling your name. You look around and no one is there. Leaving out religious or supernatural interpretations here, you have just had an “auditory hallucination.”  If you hear an indistinct sound, your brain is likely to interpret this sound as something familiar, like your own name.

We have limited information on what these auditory hallucinations are like.

Auditory hallucinations are very individual experiences. Since part of the definition of auditory hallucinations is that they are heard by one person and not others we have only two sources of information most of the time. We, as in counselors, can rely on the reports of those who hear them or we can have observers who see people they believe are having auditory hallucinations describe how this is affecting the person who presumably is hearing voices. More information’s is coming in from brain scans but it will be some times before this begins to be widely used for diagnosis.

This more “objective” evidence of auditory hallucinations based on professional’s observations is subjective and involves a lot of guess-work and inferences. Clinicians may refer to a client as “internally preoccupied” and the presumption is that the client is listening to voices but they may also be lost in thought or because of concussions or dementia be unable to think coherently.

The experience of having an auditory hallucination has many personal features. The voice can vary in frequency from one time only to constant running commentary that never stops. Voices or other sounds can vary in intensity. Some voices are louder than others. Those hearing voices report varying degrees of ability to control the voices.

A person hearing voices may develop unique or special relationships with the voices for good or bad. Young children, especially those who have been under stress or traumatized, can begin to hear voices.

Here are some of the possible auditory hallucinations that have been reported by both clinical and non-clinical populations. Auditory hallucinations have been described in many ways and this list is far from inclusive.

Hearing hums or rhythmic sounds.

People who later develop distinct voices sometimes have told me that the “voices” began as indistinct humming or tapping sounds. For some people this progresses and for others it does not. Hearing issues, tinnitus and hearing loss have similar symptoms.

Non word sounds are more commonly heard by seniors, which does not automatically mean they are developing a psychotic condition. One research study I read recently reported that an imbalance in hearing between the two ears increases the risk that sounds will be miss attributed. This is more pronounced if the left ear has less hearing ability than the right.

For this reason and a bunch of others, seniors are getting prescribed a lot of sedating anti-psychotic medication.

Mumbling, whispers or indistinct conversations or laughter.

Clients whose auditory hallucinations went on to become distinct voices have told me that in the early stages this was more like whispering or several people talking at once. Over time the voices are likely to get more distinct and clearer.

Positive voice or voices.

This kind of voice may be a departed relative or friend, guardian angel or other spiritual force offering you encouragement. Clients have reported that they hear their grandfather, grandmother or other relative telling them they can do something.

This coincides with research that reports hearing voices does not appear to make you mentally ill or worsen an existing mental illness if you take the voices to be positive things. Your beliefs about hearing voices determine how much it will bother you when you do hear those voices (Hill, et. al., 2012)

A recognizable person known to the client.

Young children especially those who have been under stress or traumatized can begin to hear voices. These voices are often someone who has been negative, criticizing or even abusive. These kinds of voices may well be more a matter of memory failure, not being able to remember who said this to you in the past, than a current auditory hallucination.

A single unknown voice.

These voices do not appear to be anyone the person recognizes having heard in the past. This voice may be good, bad or may vary over time. What this voice says and how the person hearing it interprets this experience is important in how it will affect them.

Male only or female only voices.

May be a part of a single voice as above or multiple voices described next. Sometimes this connects to a specific life experience and sometimes not. Freudian psychoanalysts can have a field day with these kind of voices.

Multiple voices speaking at the same time or taking turns.

These voices may be talking to each other or they may be talking to the hearer. What they are taking about is sometimes significant. With this one and most of the ones to follow medication is highly indicated if it has not been tried yet.

A malevolent threatening voice.

This is a bad sign. Especially if the person hearing this voice has lost the ability to shut the voice up.

God or religious figure can talk to you.

Some people find this comforting others think the devil is in their head and freak out.

Voice from inside the head.

It has been suggested this is the result of an “attribution” error. If you lose track of when you are having internal thoughts and your own thoughts begin to sound like voices this is a problem.

Voice from outside the head.

More problematic, less likely the person hearing these voices will accept that these are their own thoughts or misinterpretations of sounds.

Voices that are only heard in certain situations.

Some people only hear voices when they are very depressed or when they are very anxious. These can be their own depression and anxiety taking on the role of speaking to them or we might interpret this as a problems with the brain as a result of a deficit in a neurotransmitter. Treat the depression and these kind of voices usually go away.

Voices giving commands – command hallucinations.

This is very worrisome to me. How can the person who hears the voices all the time resist these commands? Anyone having command hallucinations even potentially good commands, needs treatment. If the voices never stop, people will act on the voices, sometimes giving in and sometimes self-harming just to get the voices to shut up.

Voice is part of re-experiencing a past event.

Sometimes voices are the result of re-experiencing the past. An abuser said bad things about you and you remember their voice calling you names. But then again I tell my students that when they take licensing exams I hope they will remember my voice telling them the answers. A good teacher hopes their student will take their voice with them. Bad teachers find the student can’t get that critical voice out of their head.

Hearing voices is not always a bad thing.

I should also mention that not everyone agrees that hearing voices is a bad nor an abnormal event. Take a look at some of the things that the Hearing Voices Movement has to say about their perspective on hearing voices.

If you have experienced voices or have talked with someone who does feel free to comment. I will get to the comments as quickly as I can and this time of year that may take a while but rest assured eventually I will respond to your comments.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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19 thoughts on “Types of auditory hallucinations – hearing voices.

  1. This is a great article, thank you. I experience auditory and some visual hallucinations and I found that this post strikes very true to my experiences. This is probably the most detailed guide on auditory hallucinations that I’ve seen so far.

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  2. If kids have imaginary friends that they communicate with in an everyday basis and no one ever thinks anything other than that they are just playing or being cute….then what’s the difference when we become older, teens-adults? What really happens? Do kids outgrow it? Are they shamed by others to make it stop? Does it just recess til later in life? How about a damaged eardrum? That in itself could be one hell of a culprit. A psych Dr. does NOT check for any kind of damage at all. Wouldn’t it be a rational decision to do so in people who are considered schizophrenic? And parasites that enter the brain-like plasma gondhii? Those Damn Egyptian used cats for exactly that purpose didn’t they? Cats carry it and it’s very contagious. That’s why an obstetrician will immediately treat a pregnant woman so as to not spread it to the baby.. huge lawsuit. Parasites are like the main cause of most every disease known to man.

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    • Kids generally know that their imaginary friends are imaginary. No problem if adults keep that imagination alive. Big problem if we adults lose the difference between real and imaginary. I think kids get older and start living a real life. They trade imaginary friends for real ones. Hearing impairment is a significant issue, especially in older adults. Any mental health professional is taught to rule out medical issues before thinking the problem is psychological. Psych doctors (Psychiatrists) are also medical doctors and most run lab tests to rule out other things first. Not sure about parasites being the cause of most every illness, not unless you are including politicians in your definition of parasites. Remember there are viruses, bacteria and injuries among other things. Most illness that doctors and mental health people treat today are not acute illnesses. They are chronic ones like diabetes and depression. Thanks for reading and for the comments.

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      • I absolutely can not thank you enough for your genuine response! I believe that your answer is going to help my son better than anything so far. His psychiatrist refuses to check his hearing even tho he had tubes in his ears for 4 years as a child. Why this psych doctor is being so stubborn is anyone’s guess. And I appreciate your sense of humor…politicians indeed! Now, off to show that I actually have another person’s opinion that is exactly the same as mine. Thanks again,
        Molly

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      • Glad if this will help you. If it were my child I would not both arguing with the psychiatrist. You might see if you can get can appointment with an ear nose and throat doctor. They have specialized equipment that can look farther down in the ear and see what is going on.

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  3. My twelve has been noted to have full blown conversation by himself.denies strongly that he does not see or hear anyone,only does it when he is by himself and is not aware he is doing it.He has history of seizure and asthma,and also overweight.HELP

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    • Hi Loretta. Thanks for commenting. This does not sound like a serious issue. Talking out loud is a common behavior in young children. It is actually a suggested treatment for some disorders where the client has difficulty following detailed instructions or expressing themselves. We want young kids to practice skills that will be useful later in life. So we teach them how to play golf, tennis or work with their hands. Remember that pastors, priests, politicians and school teachers all earn their living by talking out loud. Some famous pastors used to spend their days in the woods preaching out loud to the animals. When this talking out loud becomes a problem is when someone talks out loud in front of others and is not aware that others are listening. I did a quick literature search of the research on self-talk. Came up with a number of reasons to encourage people to do self-talk both out loud and with their mouths closed so that others don’t hear them. Working on a post on those reasons, hope to get it done soon.

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  4. David, I ran across your blog this morning as I was looking for some answers to a situation I am in. I have been experiencing some visual and auditory episodes that I thought perhaps you could have some insight on. It mainly occurs right after lying down to sleep but I am still awake. It is like a quick flash of a picture. Some with a voice, some without. Most are self explanatory. Some are people I know and others I do not know. Some are people I do not know but have a connection to someone I do know. There is a message being conveyed in the “picture” whether a voice is heard or not. Some of these seem to be of little importance such as , some one didn’t pay their car insurance and they had their license suspended. However alot seem more focused on illness (Cancer in particular). It may be a one time occurrence or come in a series over a few months with names of Drs. and dates. Now I realize how all of this sounds and I would have to say that I would probably dismiss someone who conveyed these things to me…that’s the hard part. Not wanting to sound ridiculous when it sounds so ridiculous. Is there anything in the medical field to make sense of this?

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    • There are explanations, scientific and spiritual, that may fit this situation. Not unusual for people to have visons “hallucinations” when the brain is going to sleep or waking up. I think of this as mixing up dream states and awake states. Some people are very perceptive and other people are not. Think of a traffic accident and witnesses can agree on what happens. So if you are very perceptive you may notice or overhear conversations of people who are sick while you go through your day. If you don’t make a conscious note of it, you may not remember it till it pops up in a dream. There are people who believe that some people have visions of things they have never experienced. This could be a spiritual or religious experience. The problem is to separate things that you are “seeing” that are real from things your brain is creating or imagining. You may want to talk with these experiences with a mental health professional and with a spiritual advisor. Thanks for reading the blog and for writing. David

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  5. Pingback: What are the six kinds of hallucinations? | counselorssoapbox

  6. I really need some info and help. I’m not sure if what I hear is real or not. I used to use meth and I am positive that most of what I heard was not real. However I am clean now and still “hearing” things. It sounds like people I know and some I don’t know talking about me, my husband, and my life. It sounds like it comes from the apt beneath me or maybe a neighbor’s house..And when I were headphones and play music it is blocked out.

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    • When you hear something, or see something while under the influence of the drug but know that it is being caused by drug we would call that a pseudo-hallucination. Unfortunately, drug-induced hallucinations can continue long after you stopped doing the drug. Medication might be helpful. I would suggest you see a medical doctor.
      Thanks for contacting me. I’ve had the blog set to auto pilot, publishing prescheduled posts while I’m away, so it’s taken me a while to get back responding to some comments and questions.

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  7. Hi…..So I posted a comment earlier but had an errand to run and so was interrupted. What I hear are people I know and do them know having conversations about my life. Much thanks for this was while I was high on meth and I have discounted it as such. But now I’m clean and sober and it still happens periodically. It sounds like it comes from the downstairs apt or maybe a neighbor. And that is exactly how the sound is heard…So it’s not totally discernable….But it is plausible due to how it comes across. It only happens while I’m home. And mostly at night but it can and has happened at daytime hours too. Many coincidences have occured….And I have begun to fear that a recording or maybe even some gaslighting has been happening….Very scared! When I wear headphones, it is drowned out. IDK if what I’m hearing is caused from anxiety or something else but I’m worried and scared. The gaslighting is possible for reasons I will not go into but I am not the only person who has thought this a possibility. Please respond or email me….I’m trying to become a better person and move on with my life in a positive way and this is ruining my life….It scares my son, and I have doubted my husband and what he may or may not be doing cuz of this. Please help….Thanks so much!

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    • Thanks for contacting me. I’ve had the blog set to auto pilot, publishing prescheduled posts while I’m away, so it’s taken me a while to get back responding to some comments and questions.
      I would suggest that you see a professional therapist to explore all the issues involved. It might also help to see a psychiatrist try taking some medication to see if this eliminates the voices. When were under stress, it is dark or there are unfamiliar sounds the brain is at increased risk to make things up. You could really benefit from some professional help in sorting this out.

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  8. For years I have heard my kids crying at night and I run to check them – they are fine! I hear neighbours fighting and take over biscuits the next day to subtly check on them – they have not fought. When I was a child I had a “friend” who talked to me and made everything alright but my Mum said she was a ghost and made her go away. I’m really concerned at the moment as my ears hurt so much when all the kids talk at once. I need to be able to listen to them. I don’t have a voice in my head other than my own but the outside noise hurts. Any advice?

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    • First place to start would be seeing a medical doctor. You may also want to have your hearing checked. Not sure of your age but in older people hearing loss can complicate things. If those things check out okay I would suggest seeing a psychiatrist for possible medication and at the same time you should see a counselor or therapist to help you cope with this situation.

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