Article Summary by Christopher C.H. Cook
When people hear a voice in the absence of any objectively present speaker, these voices are professionally understood as auditory verbal hallucinations (AVHs), but those who hear such voices do not see them in this way. We surveyed a predominantly Christian group of 58 people who reported hearing spiritually significant voices. Research has not typically seen the context, content or identity of voices as important in clinical practice, but the classification of AVHs that we have proposed, based on our research, takes into account frequency, context, emotional tone, and identity of the voice. It has 8 categories: Comforting, Calling, Confirming/Clarifying, Conversion, Communications, Crisis, Conversational, and Companions. For example, a comforting voice was heard to say, “Do not be afraid”. A voice amidst a crisis said, “Trust me!”. Most people in our survey began to hear voices in adult life and the voices were infrequent experiences. For example, almost 90% reported that the voice was God, and approximately one-third heard the voice in the context of prayer. The characteristics of these voices were different from those in previous studies of AVHs. Most comprised a single voice; half were heard “out loud”; and a quarter were more thought-like (the rest being a mixture). Only half were said to have a kind of character, like a real person, and one-third included commands or prompts to do things. The voices were experienced positively and as meaningful. The survey has implications for both clinical and pastoral work. Spiritually significant voices may be confused with the psychopathology that psychiatrists are taught to identify, thus potentially leading to misdiagnosis of normal religious experiences. The finding of meaning in content and context may be important in voice hearing more widely, and especially in coping with negative or distressing voices. Religious experience needs more attention in the medical humanities, so that we may better understand these experiences.
Christopher C.H. Cook is Emeritus Professor in the Institute for Medical Humanities at Durham University. He is Chair of the Spirituality & Psychiatry Special Interest Group at the Royal College of Psychiatrists and Honorary Chaplain for Tees, Esk & Wear Valleys NHS Foundation Trust. He was awarded the Canterbury Cross by the Archbishop of Canterbury in 2020 for his work on theology and psychiatry, and the Oskar Pfister Award by the American Psychiatric Association in 2021 for his work on religion and psychiatry. His books include Hearing Voices, Demonic and Divine (2018), and Christians Hearing Voices (2020).
Adam Powell is a Lecturer in Medical Humanities in the Institute for Medical Humanities and the Department of Theology & Religion at Durham University (UK). He is the author of Irenaeus, Joseph Smith, and God-Making Heresy (Fairleigh Dickinson University Press, 2015) and Hans Mol and the Sociology of Religion (Routledge, 2017) as well as many articles on anomalous spiritual experiences, social conflict, and minority religious communities. Powell is the founder and current chair of Religion, Health, and Humanities Researchers (RHHR), a global network for scholars of religion and spirituality working in medical and health humanities. His research into those who hear supernatural voices has been featured in Slate, Forbes, BBC Science Focus, and news outlets in over 30 countries.
Ben Alderson-Day is an Associate Professor in the Department of Psychology at Durham University and a specialist in interdisciplinary approaches to mental health and atypical development. From 2012-2022 he was a member of Hearing the Voice, becoming its Associate Director in 2020. His research spans psychology, psychiatry, philosophy, and neuroscience, and has included work on inner speech, imagination, autism, psychosis, and phobia.
Angela Woods is Professor of Medical Humanities and Director of Durham University’s Institute for Medical Humanities. From 2012-2022 she was Co-Director of Hearing the Voice, a large interdisciplinary study of voice-hearing funded by the Wellcome Trust. Her co-edited volume Voices in Psychosis: Interdisciplinary Perspectives will be published by Oxford University Press in 2022.