This month in voices: December 2012

Plenty more research at the end of 2012…

SomersetSomerset, England. Burbach and colleagues examine the links between imaginary childhood friends and auditory hallucinations.

Accessible summary: This study interviewed 6 people who heard voices, and who’d also had imaginary friends when they were younger. The study found that the imaginary friends had seemingly appeared in order to protect the children in a challenging childhood environment (e.g., in the context of childhood sexual abuse or loneliness). One participant said of her imaginary friend:

“She used to hold my hand when I was being beaten and when I were being sexually abused. She was there. She used to sit next to the bed and tell me not to worry, you know, she was there.”

All participants described others reacting negatively to their imaginary friends, or at least feeling that negative judgements would be made by others. The authors found the imaginary friends were described by the participants in a very different way to the voices they now heard.  Whereas the imginary friends “were seen as phenomena outside of the self, welcome, helpful in nature and often under some semblance of control, voices were described in opposite terms. All participants described their voices as an unwelcome force located inside themselves”. The authors conclude that imaginary friends may act as a risk factor for the later development of hearing voices in response to stress in later life.

Link to paper:


utrecht4Utrecht, Netherlands. Another paper from this great research group, in which Daalman and colleagues examine the relation between childhood trauma and hearing voices.

Accessible summary: This study examined rates  of childhood trauma in people with psychiatric disorders who heard voices, people without a psychiatric disorder who heard voices, and people from the general population who didn’t hear voices. Both groups of voice-hearers had experienced more sexual and emotional abuse than the non-voice-hearers in the general population. However, in the voice-hearers, there was no link between trauma and the specific properties of the voices (e.g., the voices’ frequency, duration, loudness, and whether they were nice or nasty voices). The authors conclude that sexual and emotional abuse in childhood make people more vulnerable to later developing hearing voices (of both the nice and nasty types).

Link to paper:




Sydney/Melbourne, Australia. This paper is from my good self and my colleagues in Melbourne.

Accessible summary: This paper looked at what voices were like in 199 people diagnosed with psychiatric disorders. There are a large number of findings in here, but to pick out a couple: First, there seemed to be a relation between memory and voice-hearing, with 39% of participants stating that their voices seemed in some way to be “replays” of memories of previous conversations they’d had.  Second, the voices were typically very repetitive, with 45% of participants stating that the general theme or content of what their voices said was always the same. Thirdly, auditory hallucinations could be split into four types; constant commenting and commanding voices, own thought voices (voices like one’s own thoughts), replay voices (voices identified as being identical to memories) and non-verbal voices (either sounds or verbal gibberish). It was also notable that over half of participants believed that the message/content of the voice was linked to someone who is (or was) influential in their lives. This suggests that examining links between the identity and content of the voice, and the life of the voice hearer, may be informative.

Link to paper:


Bondi1Sydney, Australia. Staying in Oz, Paulik and colleagues examine the effectiveness of Cognitive Behavioural Relating Therapy for people who hear voices.

Accessible summary: This paper presents a case-study of Cognitive Behavioural Relating Therapy for people who hear voices. This form of therapy aims to improve the relationship of the voice-hearer with both their voices and people in their social world, as well as to decrease the distress related to the voices. In this case, the client reported improvements in her
relationship with her voices (finding them less intrusive), reductions in voice-related distress, and was able to start attending a Hearing Voices Group.

Link to paper:


AdelaideAdelaide, Australia. More from Australia! Mertin and O’Brien examine voice-hearing in children.

Accessible summary: Children who hear voices have higher levels of anxiety, depression and re-experiencing than children who don’t hear voices. The authors conclude that voices may be memories or traumatic re-experiencing of past events.

Link to paper:


London1London, England. Brébion and colleagues examine the role of source monitoring in auditory hallucinations.

Accessible summary: Source-monitoring is the skill of being able to determine the source of an event. This includes being able to determine whether an event occurred externally in the real world or in one’s imagination/memory (reality monitoring) or whether it was you or someone else who performed an action (self-monitoring). Altered abilities in these skills have previously been linked to auditory hallucinations. In this study, Brebion and colleagues found that auditory hallucinations were associated with remembering words that had not actually been presented on a task, as well as associated with temporal context memory errors (confusing the time order in which words were presented). The authors conclude that their findings “are compatible with the view that verbal hallucinations arise from confusion between internal verbal thoughts and perceived speech”.

Link to paper:

Hong KongHong Kong. Ng and colleagues examine how people cope with hearing voices in the Chinese sociocultural context of Hong Kong.

Accessible summary: Initially people tried to cope by ignoring the voices (often in vain),  worshipping gods in a temple, or drinking amulet tea. These approaches failed for many, who either ended up in hospital, or sought out medical help. In hospital, in addition to medication, people also attempted other strategies to help cope with the voices, including entering into dialogues with the voices by listening to them selectively, and setting boundaries for the voices. Voice-hearers also tried to change the meaning of their voices, for example, considering the voices as a part of
themselves and of their lives and hence feeling more in control. Finally, the authors note that “psychiatric recovery in Hong Kong generally stress medical care, and there is no systematic individual and self-help group service for the voice hearers”.

Link to paper: (you can read the full-text of this paper for free)


AmsterdamAmsterdam, Netherlands. van Oosterhout and colleagues examine the role of metacognitive beliefs (how we think about thinking) in relation to voice-hearing.

Accessible summary: This study found that metacognitive beliefs predicted how depressed or anxious people who heard voices were. Specifically, voice-hearers who held negative beliefs about the controllability of thoughts and the corresponding danger (e.g., who believed that ‘Worrying is dangerous for me’ or ‘I cannot ignore my worrying thoughts’) had higher levels of depression and anxiety.

Link to paper:


Other papers potentially of interest

More next month! SMJ

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