Hearing Voices

Hearing voices is a common symptom of a mental illness. But not everyone that hears voices is unwell. This page looks at what it can be like to hear voices, why you might hear voices and how to cope with them.

 

Overview

  • Around 1 in 10 of us hear voices that other people don’t hear.
  • Another term for hearing voices is ‘auditory hallucinations.’
  • The voices can say positive or negative things
  • The negative voices can be hard to cope with and upsetting.
  • Hearing voices is not always a sign of mental illness.
  • Treatments for hearing voices can include medication, talking
    therapies and peer support.

About

What does the term ‘hearing voices’ mean?

Mental health professionals may call hearing voices an ‘auditory
hallucination’. A hallucination is where you might see, hear, taste, smell or
feel something that exists only in your mind.

There are different types of auditory hallucinations. You may experience
the following things.

• People talking to you
• People talking about you
• Hearing music
• Hearing animal noises
• Hearing background noises, like people chatting

What is it like to hear voices?

Hearing voices can be different for everyone. The voice might:

• be familiar to you or one you’ve never heard,
• be male or female,
• speaking a different language or have a different accent to the one you’re familiar with,
• whisper or shout,
• be a child or adult,
• talk to you often. Or only say occasional words or phrases, and
• talk at the same time as other voices. They may talk between themselves, or comment on what you are doing.

Hearing voices can be positive. You might find that the voices help you to
understand more about your emotions. The voices may be encouraging
and comforting. Or they may be helpful such as remind you to do things
that you need to do.

You may hear voices that are negative and upsetting. They can threaten
you and tell you to hurt yourself or someone else. They can say hurtful or
cruel things about you or someone you know. This can be frightening.
You may find that your voices change at different times. They may
become more upsetting during difficult or stressful times.

Stevie’s story

I’ve heard voices since I was young. They get worse if I’m worried about
something or if something bad happens. I usually hear the same voice but
sometimes random voices shout things. It makes it difficult to sleep or
concentrate. I find that listening to music or watching TV sometimes helps.
I didn’t tell anyone about the voices for a long time. As time went on I  decided to speak to people about the voices. This helped me to accept
what was happening.

Is hearing voices the same as intrusive thoughts?

No. But both can be upsetting and difficult to ignore.

If you hear voices, you will hear a sound. It will sound as though other
people can hear it. But you will be the only one who can hear it.

An intrusive thought is an unwelcome thought or image that enters your
mind and is mostly out of your control. It won’t sound as though others can
hear it. It may be a disturbing thought such as harming people that you
love.

Causes & treatment

Do I have a mental illness if I hear voices?

Up to 1 in 10 people hear voices. Hearing voices is not as rare as we used
to think.

Hearing voices may be a symptom of a mental illness. A doctor may
diagnose you with a condition such as ‘psychosis’ or ‘bi-polar’. But you can
hear voices without having a mental illness. Research shows that many
people hear voices or have other hallucinations. It is not always a sign of
being unwell.

You may find it helpful to have a diagnosis. But you may not identify with a
diagnosis. You may find it more helpful to think of the voices as part of
your personality. The same as someone may be ‘shy’ or ‘outgoing.’

You may have your own explanation for your voices. Some people have
spiritual reasons or other beliefs to explain the voices they hear. For
example, someone from a religious group may believe in demons. It
maybe their belief that the voices mean that they are possessed. 

You can find more information about:

• Spirituality, religion and mental illness
• Psychosis
• Schizophrenia
• Schizoaffective disorder
• Bipolar disorder
• Personality disorder
• Dissociation and dissociative disorders
• Depression

at www.rethink.org. Or call our General Enquires team on 0121 522 7007
and ask them to send you a copy of our factsheet.

How do I get help if I am hearing voices?

You may decide to get help if you don’t like hearing voices or you are
concerned about them. You can get help from:

• The NHS
• Adult social services
• Charities
• Self help

How can the NHS help me?

You can speak to your GP about your concerns. They will be able to talk
to you about treatment options and coping strategies. You don’t have to do
what your GP thinks that you should do. But you should listen to them.
Make sure that you understand the pros and cons of your treatment
options before you make a decision.

Your GP should not give you antipsychotic medication without first talking
to a psychiatrist. Your GP should refer you to a secondary mental health team if this is the first time that you have heard voices and asked for help.

You should be assessed quickly. A secondary mental health team will usually be called the:

• early intervention team (EIT)
• community mental health team (CMHT), or
• crisis team.

In some areas of the country you can refer yourself to secondary mental
health teams. They are NHS teams who help people that hear voices.
EIT’s specialise in helping people who hear voices for the first time. But
they aren’t available in all areas of England. To find your local secondary
mental health team you can try the following.

• You can ask your GP for their details.
• You can call NHS 111.
• Use an internet search engine. Use a term like ‘‘community mental
health team in Cheshire’ or ‘early intervention in psychosis
Camden’.

How can social services help me?

Your local authority is responsible for your social care and support. The
social services team are part of the local authority.

If you need help and support to look after yourself then you can have an
assessment by social services. For example, you may need support so
that you can:

• get out of the house,
• keep in touch with friends and family,
• get a job or take part in education,
• clean your house,
• prepare meals or go shopping,
• keep safe,
• manage your money,
• take part in leisure activities, or
• contribute to society (e.g. volunteering, being in a club or group).

What other help is available?

Charities

In some areas, charities will support people who hear voice In some
areas, charities will support people who hear voices. This may be through
support groups where you can talk to other people who have mental
health issues. Or there may be a different service available, such as
employment or isolation support.

Some of the main national mental health charities are:

• Rethink Mental Illness,
• Mind,
• Richmond Fellowship,
• Together, and
• Turning Point.

You can look on their websites to see what support they offer in your area.
If you would like us to look for you please contact our advice line on 0300
5000 927 and let us know what sort of support you are looking for.

Self-help

There are things that you can do to help manage your mental health. This
is called ‘self-help.’ 

You can find more information about:

• Community mental health team
• Early intervention team
• Crisis team
• Social care assessment - under the Care Act 2014

What causes someone to hear voices?

Nobody knows exactly what causes people to hear voices. And it is not
understood why some people hear voices and others don’t. It is thought
that many people hear voices, either partly or completely because of life
experiences. Which are largely out of our control.

Life experiences

You may hear voices as a way to cope with difficult experiences. In
particular abuse or other traumatic experiences.

Other life experiences can make you hear voices or make your voices
worse. These include:

• stress, anger or anxiety,
• drugs and alcohol,
• homelessness,
• delirium. This is a state of mental confusion which may follow a
serious physical illness or an operation,
• grief, divorce or separation,
• tiredness.

Genetics

Research does suggest that mental illness can run in families. But at the
moment it isn’t possible to separate genetics and life experiences to work
out the cause of mental illness.

Research suggests that changes to your brain chemistry can cause you to
hear voices.

What treatment should the NHS offer me?

The National Institute for Health and Care Excellence (NICE) recommend
that you should be offered antipsychotic medication and talking therapy if
you hear voices. If you decide not to take medication you should still be
offered talking therapy.

NICE produce guidelines for how health professionals should treat certain
conditions. You can download these from their website at www.nice.org.uk.

Your GP may refer you to a specialist mental health team such as the
early intervention team (EIT), community mental health team (CMHT), or
crisis team.

Medication

Antipsychotic medication can help with hearing voices. Medication may
not make symptoms go away but it can make voices seem distant or less
noticeable. Try not to be too upset if the first antipsychotic that you try
doesn’t help. There are lots of different antipsychotics to try because
people respond to different medications. You might need to try more than
one before you find one that helps. The main negative with medication is
that it can have bad side effects. A common side effect is weight gain.

Talking therapies

There are different types of talking therapies recommended for people
who hear voices.

Cognitive behavioural therapy (CBT)

CBT can help you to manage your voices and to notice any patterns.
This can help you learn what is your trigger for the voices. And how to
cope with them. For example, for some people stress can trigger voices.
CBT can help you find ways to deal with your stress.

Voices may say things that you think about yourself. CBT can help you be
more positive about yourself which can help reduce your negative voices.

What is CBT?

CBT is a talking treatment.

It is there to try and help you to:

• understand links between your thoughts, feeling and actions,
• understand your symptoms and how they affect your day to day life,
• look at your perceptions, beliefs and reasoning.

CBT aims to:

• help you to be aware of signs that your thoughts, feelings or behaviours are changing,
• give you a way of coping with your symptoms
• reduce stress, and
• improve your functioning.

Family intervention

Family intervention is where you and your family work with mental health
professionals to help you to manage your relationships. This should be
offered to people who you live with or who you are in close contact with.
The support that you and your family are given will depend on what
problems there are and what preferences you all have. This could be
group family sessions or individual sessions. Your family should get
support for 3 months to 1 year and should have at least 10 planned
sessions.

Family intervention can be used to:

• learn more about your symptoms,
• improve communication among family members.

Family intervention could help you and your family to:

• learn more about your symptoms,
• understand what is happening to you,
• improve communication with each other,
• know how to support each other,
• think positively,
• become more independent,
• be able to solve problems with each other,
• know how to manage a crisis, and improve mental wellbeing.

Art therapy

You may get art therapy if your voices keep coming back. Art therapy may
be more useful if you have depressive symptoms, such as withdrawing
from people or losing interest in things that you used to enjoy.29
You will have arts therapy with a therapist. It will usually be in a group. It is
there to mix different communication techniques with creativity. Art therapy
aims to help you to:

• learn new ways of relating to other people,
• show how you are feeling,
• accept your feelings, and
• understand your feelings.

Therapy for trauma

If you have experienced trauma, your voices may be part of your way of
dealing with this. This is something which can be treated with counselling
or psychotherapy. The therapist will help you to understand the root
causes of your voices. They will explore ways to over-come and control
difficult voices.

The NHS do not usually offer counselling or psychotherapy to people who
are hearing voices. But they should listen to you if you ask for it. Especially
if other therapies like CBT, family intervention and arts therapies, are not
available locally.

Fiona’s story

Therapy helped me to understand that the negative male voice was part of
me. It’s taken a long time, but the voice no longer holds any power over
me.

I listen to the voice now because I understand that, because the voice is a
part of me, I’m actually listening to myself. I now show respect to the voice
and he is now more likely to show me respect. What this means is that I
am being more caring and forgiving towards myself.

Risks and complications

What risks and complications can voices cause?

It can be common to hear negative, critical voices or unkind voices. This can have an impact on your sense of self worth and motivation. Voices can interrupt the thought process making concentration difficult. They can be overwhelming and intrusive, which can make it difficult to communicate or focus on activities. This can lead to social isolation. Intrusive voices can interrupt sleep leading to insomnia and additional health problems.

Sometimes voices can be demanding instructing you to do things you don’t want to. These are known as ‘command’ voices. In extreme cases voices can instruct people to harm themselves or others. The stress, isolation and associated with hearing voices can also increase the risk of suicide.

If you experience any of these problems, speak to your GP, call 999 or attend a local Accident and Emergency.

Problems with treatment

What if I am not happy with my care or treatment?

If you are not happy with your treatment you can:

• talk to your doctor about your treatment options,
• ask for a second opinion,
• get an advocate to help you speak to your doctor,
• contact Patient Advice and Liaison Service (PALS) and see whether they can help,
• make a complaint.

There is more information about these options below.

Treatment options

You should first speak to your doctor about your treatment. Explain why
you are not happy with it. You could ask what other treatments you could
try.

Tell your doctor if there is a type of treatment that you would like to try.
Doctors should listen to your preference. If you are not given this
treatment, ask your doctor to explain why it is not suitable for you.

Second opinion

A second opinion means that you would like a different doctor to give their
opinion about what treatment you should have. You can also ask for a
second opinion if you disagree with your diagnosis.

You don’t have a right to a second opinion. But your doctor should listen to
your reason for wanting a second opinion.32

Advocacy

An advocate is independent from the mental health service. They are free
to use. They can be useful if you find it difficult to get your views heard.

There are different types of advocates available. Community advocates
can support you to get a health professional to listen to your concerns.
And help you to get the treatment that you would like.

You can search online to search for a local advocacy service. If you can’t
find a service you can contact the Rethink Mental Illness Advice Service
on 0300 500 927, we will look for you. But this type of service doesn’t exist
in all areas.

The Patient Advice and Liaison Service (PALS)

PALS is part of the NHS. They give information and support to patients.

You can find your local PALS’ details through this website link:

www.nhs.uk/Service-Search/Patient-advice-and-liaison-services-
(PALS)/LocationSearch/363.

Complaints

If you can’t sort your problem, you can make a complaint. Your concerns
investigated in more detail.

You can ask an advocate to help you make a complaint. Advocates that
do this are called Independent Health Complaints Advocates. They are
free to use and don’t work for the NHS.

What can I do to manage the voices?

People deal with voices in different ways. You might need to try different
things before finding something that works.

Support groups

You could join a support group. A support group is where people come
together to share information, experiences and give each other support.
Hearing about the experiences of others can help you feel understood.
This may help you feel less alone and boost your self-confidence.
You might be able to find a local group by searching online. The charity
Hearing Voices Network have face to face support groups in some areas
of the country. Their contact details are in the ‘useful contacts’ at the end
of this page.

Rethink Mental Illness have support groups in some areas. You can find
out what is available in your area, or get help to set up your own support
group if you follow this link:

www.rethink.org/about-us/our-support-groups.

Or you can call the Rethink Mental Illness Advice Service on 0300 5000
927 for more information.

Recovery College

Recovery colleges are part of the NHS. They offer free courses about
mental health to help you manage your symptoms. They can help you to
take control of your life and become an expert in your own wellbeing and
recovery. You can usually self-refer to a recovery college. But the college
may tell your care team.

Unfortunately, recovery colleges are not available in all areas. To see if
there is a recovery college in your area you can use a search engine such
as Google. Or contact Rethink Mental Illness Advice Service on 0300
5000 927.

Taking control of the voices

When you hear voices, you could:

• Talk back to them
• Distract yourself
• Keep a diary
• Use a mobile app

Talk back to them

You may find that talking back to your voices helps you take control.
You could set a time each day to listen to and answer the voices.
Remember that the voices are a part of you, so it may be helpful to
respond to them in a way that you would like to be spoken to. For
example, if your voice is stressed you could try speaking to it in a calming
voice. Some people find it helpful to visualise the voices.

If you are worried about talking back to your voices in public you could
pretend you are speaking to someone on the phone.

If you start to talk back to the voices, you may find that they don’t like the
change. Standing up to voices that frighten or bully you can be tough. You
may find it helpful to have talking therapy to help you to take the power
away from the negative voices.

Distract yourself

Listening to music, the radio or an audiobook may help you focus on
something else.

Concentrating on a task such as a household chore or hobby can help to
distract you from your voices.

Keep a diary

You could keep a diary of your voices. You may want to keep a record of
the following.

• How many voices you have?
• How often they talk to you, or each other?
• What are they saying?
• How they make you feel?
• What you do to cope with each voice?

Keeping a diary may help you to notice patterns and if anything you are
doing is making them worse. This may help you to find new ways to cope
with them.

A diary may also help you to talk about your voices with your therapist.

Use a mobile app

The Hearing Voices mobile app offers support and promotes understanding of the challenges faced by people who hear voices. It was developed in partnership with the Hearing Voices Network England. The app is free to download. You can find more information at:

https://hearingvoicescymru.org/hearing-voices-app-a-guide-tounderstanding-helping-and-empowering-individuals/

Peer support through the NHS

Your doctor may offer you peer support. Peer support is when you work
with someone who has lived experience of hearing voices. And who are
now in recovery.

They should be able to offer advice and support with:

• side effects,
• recognising and coping with symptoms,
• what to do in a crisis,
• meeting other people who can support you, and recovery.

Self-management techniques

Managing your condition on your own is called self-help. Health
professionals may offer you help to manage your condition on your own.

They may call this a self-management programme.
You can try some of the suggestions below to manage or cope with
upsetting or negative voices:

• Speak to a supportive, friend, family member or someone else who hears voices.
• Try relaxation techniques, mindfulness and breathing exercises.
• Do things that you find relaxing such as having a bath
• Try a complementary therapy such as meditation, massage, reflexology or aromatherapy.
• Stick to a sleep pattern, eat well and look after yourself.
• Set small goals such as going out for a small amount of time everyday. Reward yourself when you achieve a goal.
• Do regular exercise such as walking, swimming, yoga or cycling.

What risks and complications can hearing voices cause?

Negative voices

It can be common to hear negative, critical voices or unkind voices.
Sometimes voices can bully you and tell you to do things you don’t want
to. In extreme cases voices can instruct people to harm themselves or
others.

This can have an impact on your sense of self-worth and motivation.
Thought processes

Voices can interrupt the thought process and make it difficult to
concentrate. They can be overwhelming and intrusive, which can make it
difficult to communicate or focus on things you are trying to do.
Look at section 4 of the factsheet, ‘How do I get help if I am hearing
voices?’ if you would like support.

Relationships

Hearing voices can have a negative effect on relationships. There’s lots of
different reasons that this could happen. Support such as family
intervention and support groups can help your friends and relatives to
understand you and how to best support you.

Sleep

Voices can interrupt your sleep. This can cause problems with getting
enough sleep. Not getting enough sleep can make you feel more
emotional. For example, you may feel more irritable or angry. Lack of
sleep can cause other health problems.

The Mental Health Foundation have made a guide called, ‘how to Sleep
better.’ Look at the ‘further reading’ section at the end of this factsheet for
more information.

Increased risk of suicide

People who hear voices are a higher risk of suicide. If you feel that you want to harm yourself or other people, you should get help right away. You can do this by:

• contacting your local mental health team or local crisis team,
• ask to see your GP urgently,
• call the NHS 111 service,
• go to your local accident and emergency department at hospital, or
• call 999 and ask for an ambulance

Information for family, carers, friends and friends.

If you are a carer, friend or relative of someone who hears voices, you can
get support.

How can I get support?

You can do the following.

• Speak to your GP about medication and talking therapies for
yourself.
• Speak to your relative’s care team about family intervention. 

What treatment should the NHS offer me?

• Speak to your relative’s care team about a carer’s assessment.
• Ask for a carers assessment.
• Join a carers service. They are free and available in most areas.
• Join a carers support group for emotional and practical support. Or
set up your own.

What is a carers assessment?

NICE guidelines state that you should be given your own assessment
through the community mental health team (CMHT) to work out what
effect your caring role is having on your health. And what support you
need. Such as practical support and emergency support.36

The CMHT should tell you about your right to have a carers assessment
through your local authority. To get a carer’s assessment you need to
contact your local authority.

How do I get support from my peers?

You can get peer support through carer support services or carers groups.
You can search for local groups in your area by using a search engine
such as Google. Or you can contact the Rethink Mental Illness Advice
Service and we will search for you.

How can I support the person I care for?

You can do the following.

• Read information about hearing voices or psychosis.
• Ask the person you support to tell you what their symptoms are and if they have any self-management techniques that you could help them with.
• Encourage them to see a GP if you are worried about their mental health.
• Ask to see a copy of their care plan. They should have a care plan if they are supported by a care coordinator.
• Help them to manage their finances.

Remember that not everyone who hears voices will have a mental illness.
They may also not feel the need to get treatment for their voices. The
person you care for may only choose to get help for their voices if they
don’t like them or if they are concerning them.

What is a care plan?

The care plan is a written document that says what care your relative or
friend will get and who is responsible for it.

A care plan should always include a crisis plan. A crisis plan will have
information about who to contact if they become unwell. You should be
given information about what to do in a crisis. 37 You can use this
information to support and encourage them to stay well and get help if
needed.

Can I be involved in care planning?

As a carer you should be involved in decisions about care planning. But
you don’t have a legal right to this. The healthcare team should encourage
the person that you care for to allow information to be shared with you.38

Eleanor Longden – The voices in my head

This video tells Eleanor’s story about the voices she hears. She talks
about her journey back to better mental health. And she makes the case
that by learning to listen to her voices she was able to survive.

Website: www.ted.com/talks/eleanor_longden_the_voices_in_my_head

The BBC – Why do people hear voices in their heads?

This BBC radio programme looks at what causes people to hear voices.
You can listen to it online or download it.

Website: www.bbc.co.uk/programmes/w3csvtc3

Northumberland, Tyne and Wear NHS Foundation Trust

This NHS trust has a lot of self-help materials on different areas. They
have a leaflet called, Hearing voices and disturbing beliefs.’

Website: www.ntw.nhs.uk/pic/selfhelp

Mental Health Foundation: How to sleep better.

Website: https://www.mentalhealth.org.uk/publications/how-sleep-better

Avatar Therapy

Researchers have been looking into how computer-based treatment may
help with hearing voices. This treatment is known as avatar therapy.
Avatar therapy is not available at the moment.

In this therapy you create a computer-generated face with a voice which is
like a voice you hear. This is called an ‘avatar’. You work with a therapist
to talk to the avatar and gain more control over the voice you hear.
Results show that this therapy is helpful for some people. But there is
more research taking place. You can read about the study by following the
link below.

Avatar Therapy UCL webpage: www.phon.ucl.ac.uk/project/avtherapy/

The Hearing Voices Network (HVN)

HVN give information, support and understanding to people who hear
voices and those who support them. They also support people who have
visual hallucinations and people who have tactile sensations. It gives
information and support through its website and self-help groups across
the country.

Address: National Hearing Voices Network (HVN), 86-90 Paul Street,
London, EC2A 4NE

Email: info@hearing-voices.org

Website: www.hearing-voices.org

Intervoice

Intervoice are a charity. They encourage people all over the world to share
ideas through their online community. You can also find information about
hearing voices through their articles and resources.

Address: c/o: Mind in Camden, Barnes House, 9-15 Camden Road,
London, NW1 9LQ, UK

Email: info@intervoiceonline.org

Website: www.intervoiceonline.org

Voices network

This is a UK wide, London based project supporting children and young
people who experience voices. They also offer advice and support for
carers, family members and professionals.

Telephone: 020 7911 0822

Email: info@voicecollective.co.uk

Website: www.voicecollective.co.uk

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