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Hearing of Voices

Delve into the various aspects of hearing voices from inner dialogues to multiple personalities, with insights on causes and religious influences. Learn about neurobiological factors and the impact of stress on vulnerability.

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Hearing of Voices

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  1. Hearing of Voices Dr. Samuel Pfeifer

  2. Four Aspects of Inner Voices 1. Inner Dialogue („I tell myself“,„as if a voice was telling me . . .“ Ego-syntonic 2. Dialogue with God („God tells me . . .“, „The Bible talks to my heart“, „The Holy Spirit has pointed out to me”) Ego-syntonic (religious style) 3. Dialogue with spirit beings (Angels, spiritual beings, ancestors) In sensitive persons sometimes with anxiety can lead to psychosis 4. Voices coming through a Medium (Spiritism, Shamanism) Trance-Induction

  3. Hallucinations – organic Organic: Delirium (e.g. alcohol withdrawal), Disorientation (e.g. functional brain disorder) Toxic Substances: e.g. LSD Severe Psychotic Depression: Example: “The devil is laughing at me”; “I hear the police siren, they are coming to bring me to jail, where I belong.” Context: Severe Depression, often in old age. Typical: When the causing substance or brain condition subsides, the “hearing of voices” disappears.

  4. Hallucinations – Schizophrenia 1. Quality: external, ego-dystonic, “thoughts becoming audible, loud”, often with anxious feelings Criteria of DSM-IV 2. Content: muffled sounds, murmuring, single words, sentences, laughing, commentaries, insults. Often unspectacular comments, orders . . . 3. Additional phenomena: thought insertion, expansion, incoherence, bizarre delusions; clearly impaired ability to cope 4. Religious aspects: often search for explanations, rarely complex prophetic content; not congruent with the surrounding culture or religious group

  5. Obsessional Ideation 1. Quality: “I know that my thoughts are unrealistic, but if I do not give in, I am developing unbearable stress and anxiety.” 2. Content: fear of contamination, inappropriate behavior etc.; sexual or religious content; controlling, washing, ordering etc. 3. Additional phenomena: exaggeration of “normal” concerns and rules; varying severity; causing marked distress 4. Religious aspects: intrusive thoughts of blasphemy, religious symbols (“666”); obsessional doubting; Religious content in obsessive-compulsive structure

  6. Multiple Personality (DID) Origin: Dissociation of partial personalities in extreme trauma during childhood (“Persons”: victims, “tormented” children, guides, protecting alters, persecutors, functioning facade etc.) Inner Dialogue among the “persons“: dealing with past and present trauma; discussions: “Can we trust this person?” - “How do we cope with this situation?” etc. Crying or stiff upper lip? Not multiple: when a person feels “torn” between two options; when there are two streams of consciousness at the same time; frequent emotional swings; projective identification (“I feel like my mother”) Real DID: Emphasis on the existential experience of “real” persons, not mood swings or different emotional states. Varying behaviors, amnesia for substantial amounts of time. -- Further Criteria of DSM-IV.

  7. The Brain Frontal Lobe Sensory Areas Limbic System Brain Stem

  8. POSSIBLE NEUROBIOLOGICAL CAUSES OF HEARING VOICES • Neurotransmitter Imbalance (Psychotic Disorders) • Toxic Influences • Sensory Deprivation • Stress • Strain • Trauma - Dissociation STRESS AND VULNERABILITY

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