Auditory Hallucinations and ‘Voice Hearing’ for Audiologists

My first clinical encounter with auditory hallucinations occurred during an early 1980s tinnitus study while I was Director of Aural Rehabilitation at the University of Northern Colorado.  At the time, we were experimenting with biofeedback in the clinic to facilitate relaxation that, in some patients, seemed to reduced their tinnitus.  One of our patients was an 89-year-old woman who had recently lost her husband. No matter what we did with the biofeedback, she had auditory hallucinations of her husband calling her from a distance.  At the time, we referred her to her physician who, in turn, referred her to a neurologist.  We went on about our biofeedback study and simply thought of this subject as a bit mentally disturbed

What Are Auditory Hallucinations?

 Hallucinations–sensations that seem real but are created by your mind–can affect all five senses.  The most common type are Auditory hallucinations, sometimes also called “voice hearing.” A person experiencing an  auditory hallucination may hear someone speaking or telling them to do certain ahthings. The voice may be angry, neutral, or warm. Other examples of auditory hallucinations include hearing sounds, such as someone walking in the attic, or repeated clicking or tapping noises.  Badii and Krucik (2015) specifically present 19 causes of auditory hallucinations discussing everything from mental illness, to side effects of medications, or physical illnesses such as epilepsy or alcoholism. They further state that deafness and blindness and other vision issues can also cause these hallucinations.  Depending on the cause, patients will generally work with a psychiatrist, a neurologist, or a general practitioner, and their treatment may include taking medication to cure a physical or mental illness or adopting healthier behaviors like drinking less alcohol and getting more sleep.

New Research in Voice Hearing

In a multi-author, multi-nation study led by Durham University in the North East of England, studies demonstrate that the ah3voices in people’s heads are far more varied and complex than mere labeling of a disease.  The researchers, funded by the Wellcome Trust, collected answers to open- and close-ended questions through an online questionnaire focused on description of experiences from 153 respondents. The majority of respondents had been diagnosed with a psychiatric condition, but 26 had no history of mental illness. Participants were free to respond in their own words. Results demonstrated that most of the subjects  described hearing multiple voices (81%) with characterful qualities (70%).  Fewer than half the participants reported hearing purely auditory voices with 45% reporting either thought-like or “in-between’ah5” voices with some thought-like and some acoustic qualities. 

These data challenge the generally accepted opinion that hearing voices is always a perceptual or acoustic phenomenon, and the researchers feel that it may have implications for future neuroscientific studies of what is happening in the brain when people “hear” voices.  Two-thirds of the subjects (66%) felt body sensations while hearing voices, such as feeling hot or tingling sensations in their hands and feet.  Voices with effects on the body were more likely to be abusive or violent and, in some cases, were linked to experiences of trauma.  While fear, anxiety, depression and stress were often associated with voices, 31% of participants said they also felt positive emotions.

Discussing the results of one of the largest, most detailed studies to date on the experience of auditory hallucinationsDr. Angela Woods (2015) of Durham University said that both people with and without psychiatric diagnoses hear voices and that the

Dr. Angela Woods
Dr. Angela Woods

majority of them hear multiple voices with distinct character-like qualities and even experience physical effects on their bodies. She believes that their study has the potential to “overturn mainstream psychiatric assumptions about the nature of hearing voices and call into question the presumed auditory quality of hearing voices and show that there is an unrecognized complexity in the ‘character’ qualities of some voices.”  The study also asserted that “it is crucial to study mental health and human experiences such as voice-hearing from a variety of  perspectives to truly find out what people are experiencing, not just what we think they must be experiencing because they have a

Dr. Nev Jones
Dr. Nev Jones

particular diagnosis. We hope this approach can help inform the development of future clinical interventions.” 

Another of the authors of the study, Dr. Nev Jones from Stanford University, says, “Our findings regarding the prevalence and phenomenology of non-acoustic voices are particularly noteworthy. By and large, these voices were not experienced simply as intrusive or unwanted thoughts, but rather, like the auditory voices, as distinct ‘entities’ with their own personalities and content. This data also suggests that we need to think much more carefully about the distinction between imagined percepts, such as sound, and perception.”

ca3Audiologists should realize that according to this study that between 5% and 15% of adults will experience “voice hearing” during their lifetimes and expect to see this in their patient populations, especially since deafness is one of the causes.

 

 

References:

Badii, C., & Krucik, G., (2015).  What causes hallucinations – 19 possibly causes.  Symptom Checker.  Retrieved May 12, 2015:  http://www.healthline.com/symptom/hallucinations

Rivas, A., (2015).  What hearing voices sounds inside heads of mentally ill people.  Medical Daily  Retrieved May 27, 2015:  http://www.medicaldaily.com/pulse/what-hearing-voices-sounds-inside-heads-mentally-ill-people-316398

Thompson, C. (2015).  Durham University reveals the truth behind ‘hearing voices’ in your head.  Chronicle Live:  Northeast News  Retrieved May 27, 2015:  http://www.chroniclelive.co.uk/news/north-east-news/durham-university-study-reveals-truth-8852482

Woods, A. , Jones, N.,  Alderson-Day, B.,  Callard, F. &  Fernyhough, C.. (2015).   Experiences of hearing voices: analysis of a novel phenomenological survey. Lancet Psychiatry  Retrieved from Science Daily May 12, 2015:  http://www.sciencedaily.com/releases/2015/03/150310205707.htm

Images:

Opacity Sound (2013).  Auditory hallucinations.  You Tube  Retrieved May 27, 2015:  https://youtu.be/rTWifWp6GSY

Smith, L. (2015).  Did I just have an auditory hallucination:  how can I tell.  Healthtap.  Retrieved May 27, 2015:  https://www.healthtap.com/topics/did-i-just-have-an-auditory-hallucination-how-can-i-tell

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About Robert Traynor

Robert M. Traynor, Ed.D., MBA is the CEO and practicing audiologist at Audiology Associates, Inc., in Greeley, Colorado with particular emphasis in amplification and operative monitoring, offering all general audiological services to patients of all ages. Dr. Traynor holds degrees from the University of Northern Colorado (BA, 1972, MA 1973, Ed.D., 1975), the University of Phoenix (MBA, 2006) as well as Post Doctoral Study at Northwestern University (1984). He taught Audiology at the University of Northern Colorado (1973-1982), University of Arkansas for Medical Sciences (1976-77) and Colorado State University (1982-1993). Dr. Traynor is a retired Lt. Colonel from the US Army Reserve Medical Service Corps and currently serves as an Adjunct Professor of Audiology at the University of Florida, the University of Colorado, and the University of Northern Colorado. For 17 years he was Senior International Audiology Consultant to a major hearing instrument manufacturer traveling all over the world providing academic audiological and product orientation for distributors and staff. A clinician and practice manager for over 35 years, Dr. Traynor has lectured on most aspects of the field of Audiology in over 40 countries. Dr. Traynor is the current President of the Colorado Academy of Audiology and co-author of Strategic Practice Management a text used in most universities to train audiologists in practice management, now being updated to a 2nd edition.