Auditory hallucinations: do you ‘hear voices’?

Auditory hallucinations from iStock
Auditory hallucinations from iStock

A person suffering from auditory hallucinations perceives sound when there is no auditory stimulus. In simple terms it is when people hear sounds or voices that aren’t there.

Auditory hallucinations or phantom auditory phenomena are usually associated with mental illness (psychiatric) like schizophrenia or mania, but in many cases there is an actual physical cause (non-psychiatric).

Auditory hallucinations with a physical cause are mostly just sounds like popping and ringing and don’t involve “voices”. This may be caused by tinnitus, tumours or epilepsy.

Read: 10 tinnitus facts

Angelic choirs

Two examples of historical figures who reportedly heard voices that weren’t there, were Joan of Arc and the composer Robert Schumann:

- Joan of Arc, at the age of thirteen started hearing the voices of Saint Michael the Archangel, Saint Catherine of Alexandria and Saint Margaret. When she was seventeen, these voices guided her to liberate France from the English.

- Robert Schumann heard “angelic choirs” and composed music based on his auditory hallucinations. He believed that another composer, Franz Schubert, was dictating music to him.   

Health24 asked Durban speech therapist and audiologist Heidi Allan a number of questions about auditory hallucinations: 

Q: What are the causes of auditory hallucinations?

A: Auditory hallucinations (also called phantom auditory phenomena) are defined as “auditory perceptions in the absence of external stimulation”. Auditory hallucinations should be considered as part of a complex condition and may arise due to a number of different causes. They are generally attributed to “central brain dysfunction” or “abnormal brain activity”.

Q: Are there people who are predisposed to auditory hallucinations, and if so, who are they?

A: In its more complex form, auditory hallucinations are often associated with schizophrenia and/or other forms of mental illness.  If there is no evidence of a psychiatric illness, but there are signs of depression, anxiety or unrealistic thoughts and actions, then these should be discussed with the patient and further referral to a mental health professional should be made.

Read: Are the mentally ill a danger to society?

Tinnitus (or ringing/buzzing in the ears) is the simplest auditory hallucination and is associated with changes in hearing which in turn affects brain activity. Therefore, people with hearing changes may experience this form of auditory hallucination.

Q: What do auditory hallucinations sound like?

A: Auditory hallucinations have been described in many different ways.  People who experience tinnitus often describe a cricket-like or Christmas beetle-like sounds. They may also describe humming, buzzing or ringing. In more severe cases, people describe music, voices or entire conversations.

Q: Are there remedies for auditory hallucinations?

A: Patients with a history of mental health issues should be referred to a psychiatrist or psychologist to assist them. Patients who have not had a history of mental health issues and hear music, voices or tinnitus would benefit from an assessment with an audiologist and assistance through counselling and sound therapy programmes.

Q: Are auditory hallucinations a sign of something more serious?

A: They could be and should therefore be fully investigated by a team of medical professionals including, but not limited to, an audiologist, an ear, nose and throat (ENT) specialist, a neurologist and a psychiatrist. 

Read more:


Managing tinnitus using mindfulness

What is schizophrenia?

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