It’s a Spectrum …

It is now recognised that voice-hearing exists on the end of a ‘spectrum’ or ‘continuum’ that includes ordinary verbal thinking, day-dreaming and intrusive thoughts.

We all have the capacity for hearing voices, it’s just that some of us are more likely than others to hear more intense voices or to hear them more often. 

Did you know?

%

Up to 1% of people have frequent voice-hearing experiences and no need for psychiatric care

%

A separate 1% will have a diagnosis of schizophrenia or psychosis

%

Around 75% of people with a diagnosis of psychosis will hear voices others don't

Researchers are only just beginning to understand the differences between voices in people with a diagnosis of psychosis and voices in people with no diagnosis.

Click through the tabs below to find out about some of the key points of similarity and difference.

  • Can be inside or outside the head
  • Can vary in volume
  • Will comment on things or take part in conversation
  • Are often difficult to control
  • First experienced aged 16–25 (on average)
  • Tend to occur many times a day
  • Can be outside or inside the head
  • Can vary in volume
  • Will comment on things or take part in conversation
  • Often easier to control
  • First experienced aged 5–15 (on average)
  • Tend to occur a few times a day at most.

Voices in people with no need for psychiatric care are also more likely to be positive and helpful than those in people with a diagnosis of psychosis. They tend to provide support and guidance and also often have an important spiritual aspect.

If voice-hearing is fairly common, why is it only distressing for some people?

1. Control and Content

People often struggle with controlling when the voices speak and the content of what they say

One thing people often struggle with is not being able to control when the voices speak – it’s often a surprise and it can go on for a long time. For others, it is not so much when the voices speak or how much, but what they say. That is, they find the content of the voices distressing – perhaps because it is derogatory, offensive, or expresses views, thoughts or intentions that are very different from the person’s own. 

2. Trauma

Individuals with a history of childhood adversity are approximately 3 times more likely to develop psychosis

Research indicates that, for some people, voice-hearing is a response to traumatic life events, particularly during childhood. 

Examples include bullying, neglect, physical, sexual and emotional abuse. 

Major life changes such as the end of a relationship, becoming homeless, or starting a new school or college have often been linked to the onset of hearing voices. 

2. Other triggers

Other things that can make distressing voices likely to occur include:

    • Lack of sleep
    • Extreme hunger
    • Drugs and alcohol
    • Danger and feeling under threat
    • Stress and pressure