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IF YOU ASK someone in the street about the phenomenon of people hearing voices, the Hollywood interpretation may be something that springs to mind.

In movies like Russell Crowe’s A Beautiful Mind, the voices heard by the protagonist are pernicious and misleading. They don’t have the character’s best interests at heart to put it mildly.

The reality of hearing voices is, as you might expect, far more complex, and far more subtle than anything seen on the big screen.

“In terms of hearing voices saying quite a few words or sentences whilst wide awake, my estimate is that around 2.5% of the population will experience this in their lifetime,” says Simon McCarthy-Jones, associate professor in clinical psychology at Trinity College Dublin’s department of psychiatry.

Let’s put that another way – taking Ireland’s 2013 Census population, you’re talking about nearly 115,000 people here who may have heard, or continue to hear, voices. Which means it’s a condition which may well have crossed our paths, whether we were aware of it or not.

Just under half of that figure will be untroubled by what they hear. For the other half, it can be a distressing affliction.

Childhood trauma

McCarthy-Jones’ new book, ‘Can’t You Hear Them? The Science and Significance of Hearing Voices’, explains new ways to look at what hearing voices really means, and describes individual’s stories together with much of the state-of-the-art work being done on the issue.

Some of the ideas explored in the book:

• Childhood trauma, such as abuse, is associated with hearing voices as strongly as lung cancer is with smoking
• Whether or not those hearing voices end up being treated by psychiatric services is influenced by how negative (critical, abusive, or humiliating say) the voices are
• People hear voices in lots of different ways, not least of which is the talking breast-pump phenomenon
• Voice hearing has the potential to be a creative phenomenon says the author, such as the individual being given the plots and storylines for books as well as answers in exams. And the theory goes that those who don’t hear voices could access that creative well also

That is far from an exaggeration by the way – watch psychologist Eleanor Longden describe how she overcame her diagnosis of schizophrenia and even used it to her advantage:

Another man, Peter Bullimore, whose story is detailed in the book, describes how his voice helped him write a novel.

38-year-old McCarthy-Jones, who hails from the UK and has been based at Trinity for nearly two years, doesn’t fudge how difficult hearing voices can really be however.

“The experience should not be romanticised,” he tells TheJournal.ie.

For many people it is hellish. However, hearing voices may be helpful to the hearer. It may help people access information they may not have been able to on their own.

He has spent eight years doing voice-hearing research (including four years in Australia) since gaining his PhD at Durham University.

Hearing voices isn’t just associated with schizophrenia – it can be found in people with a range of psychiatric diagnoses – bipolar disorder, eating disorders, or post-traumatic stress disorder (PTSD) to name just three. It can also be caused by neurological conditions like epilepsy or Alzheimer’s Disease.

Avatar therapy

And medication is far from the only option for someone who is upset by hearing voices.

McCarthy-Jones agrees that popular culture, and particularly the news, do not help from the point of view that the phenomenon can be demonised.

“A recent study found 47% of news stories on voice-hearing associated it with violence towards others,” he says. “This grossly over-represents the small proportion of instances in which voice-hearing and violence are entangled.”

There are myriad innovative ways of coping with the hearing of voices it seems. Some people seek to quieten their voices down, perhaps by agreeing to speak with them at a later time. Other look to understand their voices in order to live with them better.

Scientifically, approaches include the Maastricht Interview which presumes that hearing voices is a personal reaction to life’s stresses. This sees the hearer seek to understand who, or what problems, their voices represent. Avatar therapy, meanwhile, sees the voice given a virtual reality avatar, which the hearer then converses with (their therapist filling the voice’s role).

Finally, there is neurofeedback, a technique which McCarthy-Jones has just received a two-year grant to trial. The idea here is to reduce the activity in the parts of a person’s brain associated with voice-hearing to see if it can quieten the experience, making the voices easier to live with.

But, for someone who has never experienced life as a ‘hearer’, what is life-like for those who may live that reality every day?

“Imagine trying to do something, like a job interview, with someone constantly talking to you. It can be very distracting,” says McCarthy-Jones.

Some people’s voices will say that other people are out to get them, and can make the hearer very scared and paranoid. This could result from the person feeling vulnerable, with the voice just in essence being worried about them and trying to protect them in its own way.

Still others are afraid to talk about their experiences, due to society stigmatising the hearing of voices. Hearing Voices Groups can be helpful here, where people can go and talk with others who have the same experience.

Around the world, voice hearers have vastly different experiences. “Voice hearers in the US typically hate their voices, according to a recent study, a feeling that is apparently mutual,” says McCarthy-Jones.

Whereas voice hearers from India or Ghana have much better experiences. The authors (of the study) proposed that the Western sense of self as private and bounded caused Americans to experience their voices as an intrusion into their private world. People from India were more likely to experience their voices as relationships, rather than as signs of a violated mind.

But part of the solution to the hearing of voices may include its normalisation.

“Some voice-hearers have argued that their goal is a world in which people can walk down the street talking to their voices without being stigmatised or deemed mad for it,” says McCarthy-Jones.

‘Can’t You Hear Them? The Science and Significance of Hearing Voices’ is available now

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