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Just accept it: The voices are real

August 9, 2012
by Jessica Arenella, PhD
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Instead of denying the "delusions" and "hallucinations" experienced by her patients, a clinical psychologist describes the transformative and healing power gained by accepting these voices as real.
Clinical psychologist and psychotherapist Jessica Arenella, PhD, practices in New York City.

Command hallucinations are one of the most dreaded and misunderstood phenomena in psychiatry. Overcoming this apprehension is one of the greatest barriers to working effectively with people who hear voices, whether they are diagnosed with psychotic, mood, or dissociative disorders. So, consider these four facts as an anxiolytic of sorts:

1. Voice-hearing is not necessarily a sign of psychiatric illness.1 Many people in the general population report hearing voices. However, if they aren’t in need of

Examples of command hallucinations:


“This voice kept telling me that I was the real terrorist and I would be assassinated.”
 “The voice told me that I had to get off of the train immediately or else I might die.”
“It sounds like an emcee on a microphone,   announcing my every move, before I even take it.”

psychiatric help and don’t mention such experiences in daily conversation (or at cocktail parties), then no one is the wiser.

2. Hearing voices is not in itself a significant risk factor for violence.2 Under most conditions, even command hallucinations do not predict violence. Generalized hostility and substance abuse are stronger predictors.3

3. People frequently hear voices telling them what to do and do not follow them.After all, you tell your patients to do all kinds of things and they ignore you too!

4. Voices may be positive and helpful.Sometimes, voices may be experienced in a very positive way—as a form of instinct, intuition, or guidance. For example, on the morning of September 11, 2001, a woman reported hearing a voice that said, “Get off this train now.” She decided to exit the subway one station before her usual one near the World Trade Center. Don’t you wish sometimes that you had a spirit guide to keep you from harm?

These are among the things I learned from a two-day workshop sponsored by the NYC Department of Health and Mental Hygiene, Office of Consumer Affairs, about facilitating Hearing Voices Groups. Daniel Hazen from Hearing Voices Network (HVN) USA and Ron Coleman from INTERVOICE (International Network for Training, Education and Research into Hearing Voices) spoke about the history of the Hearing Voices movement around the world over the past 25 years, sparked by psychiatrist Marius Romme’s experience with voice hearer Patsy Hage and subsequent research by Professor Romme and Sandra Escher. HVN groups are self-help groups, ideally run by voice-hearers, but also sometimes facilitated by family members or co-facilitated by professionals.

A radical departure from orthodoxy

There are two central tenets of the Hearing Voice Network approach:

1.      The voices are real.

2.      You can change your relationship with your voices.

Yes, the voices are real. This is a radical departure from what we usually tell our patients: “You are hallucinating (i.e., the voice is NOT real) and once you understand this you will take your medication and the voices will go away.” Then, we have to keep repeating this until the patient has “insight” and the patient tells you the voices are gone. This is an uphill battle and we’ve all seen patients on cocktails of psychotropics who still hear voices.

But, what if we try understanding the opposite idea, that the voices are real? What if we acknowledge that the person who reports hearing voices is in fact hearing a voice, or two, or two dozen? After all, the portions of the auditory cortex that light up when you talk to your patients, light up just the same when she or he is “hallucinating.”6 What if we consider that the voices are received and processed like other voices? How might we approach a patient who was being emotionally abused by a non-supportive family, an abusive partner, or bullied by peers and strangers?

Once you acknowledge the experience of voice-hearing as real, then the door opens for a constructive conversation about how to make sense of the experience, how to respond to it, and then, how to alter the experience. In HVN groups, as in 12-step programs, peers who have been through the intensity and stigma of the experience are considered an invaluable resource for recovery, because they have first-hand experience of the realness of the voices.

If professionals want to help voice hearers, then they must make a commitment to accepting the voices as real. If the professional remains afraid of the voice-hearer’s experience and tries to smother it as an irksome symptom, the door to recovery is slammed shut. The professional or other peers often need to help or support the voice hearer in accepting and listening to the voices, particularly when the messages are of a disturbing nature. 

Once voice-hearers, peers and professionals have acknowledged the reality of the hearer’s experience, change is possible. Change begins when, often with the help and support of a HVN group, a hearer acknowledges the existence of his or her voice(s)and takes steps to alter his or her relationship with the voice(s):




I have trouble understanding what it means to say that we should "accept that the voices are real". Certainly the experience is real, but surely there is an important distinction between experiences that are triggered by external stimuli and those that are not. I may "see" things when I dream, but I would never claim that my dreams are as "real" as the outside world.

Of course we should always strive to understand and accept people's experiences, and to treat them with compassion and respect. And it is probably more fruitful to work with people to change their relationship with their voices, than to argue with them.

You make an important point here about "reality."

Some reality can be objectively observed--like multiple people who agree that they're having a conversation with each other. Some other "reality"--like having dreams--cannot be validated (objectively) in the same way, but can be accepted as real, perhaps because we've all had dreams or because we love/trust/care for those who report the dreams to us--like when a loved one, young or older, has a nightmare.

Your last point is especially important, I think: That it is probably more fruitful to work with people to change their relationship with voices than to deny that the voices exist and question the person who claims them. Denying the reality of another is hardly the basis for a treatment relationship.


A person who hears voices should certainly be able to discuss that occurrence, but should be given a good physiologic description of why this might occur, as well as being offered an opportunity to cause this condition to cease. This is a physiological condition, and very real. If the person enjoys the voices and they cause no harm, then why not? But I suspect most people don't enjoy that condition any more than folks enjoy tinnitus.

To say that the voices are real is to grant legitimacy to the person's subjective experience. I hope this example clarifies what I mean:

When a patient goes to a doctor for knee pain, the doctor acknowledges that experience as real and makes inquiries about the type of pain, when it started, what makes it feel worse/better, etc. The doctor doesn't say, "The pain doesn't exist" or "I've examined your knee and I don't see any evidence of pain." Even if the doctor takes an MRI of the knee and there is no structural damage, the doctor would work with the patient to find another explanation for the pain before saying "The pain isn't real and the sooner you accept this the quicker you will get better."
Jessica Arenella

This is exactly the issue. Experiences of mental health distress are as real as the symptoms of any physical illness. As you rightly point out, acknowledging the reality of the voice experience is different than obeying a command that might be spoken.

Many people test their experience of reality every day, such as women going through menopause often ask, "Is it hot in here, or is it just me?" While this may be a slightly humourous example, it is in the same genre of being able to share an experience in safety and with acceptance.

I wonder if something like mindfulness has any beneficial effects for people who hear voices? I know there are programmes in mindfulness based stress reduction from Jon Kabat-Zinn, and another programme developed to help people suffering with depression, from Oxford University (working in conjuction with JKZ).

So much time, energy, and money have been spent denying that actual external stimuli carries the voices and visions of "hallucinations" that people seem to be unable to accept that it really truly is real. When pressure in the air creates a lightening bolt, we have no ability to track it's path after it is no longer visible. It continues to fork and split until it peacefully ends as a static charge. Most people have never thought about psychic phenomenon, subliminal messaging, brain entrainment, synchronization or even voice to skull communication studies much less the effect of the technology, not on the known targets, but others who are sensitive enough to "tune them in". In 1865 man started trying to prove that some experiences were externally created, whether they created a huge social, emotional, or other physical problem or not. The psychedelics of the 60s was in part sketched, sequenced and broadcast cartoons target at the functional frequencies of people on certain drugs. We have had many experiences in group that we agree are real, but are in fact visual or auditory hoaxes. You have never seen a magician saw a chick in half and you do not want to, but the illusion is a childhood staple. You are trying to understand, but nudge the idea of external stimuli even when you start to talk yourself into doing something you know you will regret.

Most people think that voices come from schizophrenia. In our trauma clinic we have treated many clients who hear voices directly linked to their trauma histories. Medications are not necessary in these cases. We help people deal with their voices (even those command hallucinations that urge suicide) by using an "externalized dialogue." This method helps diminish the mystery of the voices and promotes negotiation. We stress that the dialogue is a "tool for life" and that it can be used in a variety of situations.

Linda Gantt, PhD, ATR-BC
Executive Director
Intensive Trauma Therapy, Inc.
Morgantown, West Virginia

I had one of my client's come in and show me this article.

I have 20 years of mental health experience and work daily with this population and am disturbed at your conclusions and lack of insight.

Accepting the voices is part of the healing processs but accepting them as real can as I have seen be dangerous. Take a look at our recent violent acts nationally from those who suffer from this illness.

Again be careful what you are saying and how you come across as it apears that you are saying they are "real" and with that comes power of what "they" are saying. Many of the command voices are of destructive content and as I have seen 1st hand believing them and acting on them can be destructive.

Steve T.

Acknowledging that a person is really hearing a voice- albeit disembodied voice- is light years away from believing that the voice is speaking the truth and that one should engage in destructive behavior based on what this voice says. Believing in the client's experience is not the same as believing that the voices speaks the truth and that the client should follow and destructive commands. I am fully aware that there are people who succumb to destructive voices and commit great acts of violence; people who hear these types of voices are at risk of behaving violently. It sounds like these are many of the clients you work with.

Fortunately, this is not representative of voice hearers generally (e.g. some do not hear commands or violent content, some feel disgusted and alarmed at destructive voices and have no inclination to listen to them.) Stigmatizing people who hear voices - by identifying them with horrific mass murderers- contributes to feelings of shame, isolation and resentment that only worsen the situation. Just today a person in the Hearing Voices Group said that she didn't tell anyone about the abusive voice she had been hearing for 20 years because she didn't want people to be afraid of her and think she was one of those "mass murderers or schizophrenics".

(BTW, I am curious about why your client wanted you to see this article, but I understand that due to privacy concerns this is probably not something you can respond to.)

Jessica Arenella

I have 28 years experience as both working as a nurse, and last 15 years of being part of the HVN movement. Accepting that the voices are real is definitely fundamental to the healing process, as is understanding what the voices are about.

What we have found is that a high percentage of voice hearers are the victims of childhood trauma, which has left them full of guilt & shame, low self-esteem and self-confidence and little belief in themselves. Often, the voice they hear is that of their abuser, or themselves at the age of abuse.

When you look at all the inquiries into murder committed by "schizophrenics," many were also under the influence of drugs & drink and many of the murders involved people that they knew. Many of these people had been told just to ignore their voices which, by the way, is almost impossible. Or, they lied to mental health workers about their voices because the automatic response of the worker was to give them more medication.

What actually happens when you begin to talk about the voices is that the person gains more trust, they really open up about their experiences so that you can actually have a dialogue about their "command hallucinations." For example, if a person says that "God has told me to kill someone," you can have a conversation with them about the nature of God; that it is not God's nature to wish you to kill, but then, who could have that nature?

In that conversation, the person can easily come to the conclusion that the voice is a voice of the devil. Now if the person is a Christian, one can argue that the voice of the devil is there to tempt you, which you can refuse. Conversation like this can lead the person to become more in control.

With out the conversation though, the person is alone in his or her battle and may succumb to their relentless voices. Interestingly, though, when voices say to kill themselves, most voice hearers spend their lives trying to resist them.

There is actually no evidence base for the so called dangers of engaging with a person in their psychosis. However there is plenty of evidence around that if we workers don't engage in dialogue, people remain trapped within their misery on lethal cocktails of psychotropic medication or self-medication with alcohol & illegal substances. These people are left to spend their lives with inadequate services, with little hope of full citizenship and the joys of life we all expect and need.


I am no expert about the HVN movement, but your description and example offered some insight into how voice hearers might benefit from this type of dialogue--how it might help them go from a place of mistrust and fear into a greater sense of safety or control.

I'm glad you spoke up.


there is ample proof that voices are coming not from the brain but from technology, read "the origin of the influencing machine" dating back 100 years psychiatry has recorded and kept silent this fact, that voice hearers get more than voices, but pain inducement. Why in the world would a body turn on itself? It wouldn't. what needs to be done is tell voice hearers how to defear psychic technology. energy follows a path. And it can be accessed from both directions. Thats how my voices are not able to be loud at all. In fact right now they only resonate from my left ear and i can barely make out what they say, because i faced my fears, i faced the horde of scenarios they placed in my reality. i saw the most amazing and terrible things. And im here to talk about it. Stop creating dellusions upon dellusions. help people face this head on with proper mental enhancements and usage.

I guess the context in which the word "real," (i.e. "the voices are real") is used may present to be ambiguous and therefore generating this controversy. Of cource, the experience of hearing voices is real and hearers need to accept the fact that it's real they hear voices. This may be a symptom of mental illness and they need to seek help. I think healthcare professionals need to be cautious to suggest to a client that the voices are "real" and should be "listening to the voices," particularly command halluciantions and/or delusions. Questions: 1. In reference to the example of someone who hears voices that she/he is a terrorist, what if another voice/thought commands him, 'kill them before they kill you?" 2. What is the rate of success, if any, had been statistically reported using this approach?

Your comment about the context of "real" is very important. An individual, along with a treatment professional or even a group of people, can accept that he/she is hearing voices. That's a first step in treatment, it seems.

But accepting that voices are speaking or being heard does not equate to an endorsement of what the voices are saying. One may listen to or hear something without acting upon it.

This is where the filter of the group comes in--as a means of helping the hearer to reflect on and to understand the content of the voice and how to deal with it.

Of course, the HVN approach seems to build on the idea that most voices and voice hearers are not malevolent--that was the first thing said at the HVN introductory meeting (not a group session) that I attended. So, your questions 1 and 2 are good ones to ask.

In addition to asking the author (who is not linked to HVN) to address this, I'll also reach out to the HVN folks.


My wife has d.i.d. and as I have helped her healed, it has taught me to listen to the voices in my head and it actually seems to help me deal with the stresses from dealing with her disorder when I address the concerns of "the voices."

I validate each and every girl (voice) in my wife's system and treat her as real (but incomplete) and my wife's recovery has been phenomenal and she rarely struggles with the things that are very typical of other d.i.d. people: suicide, need for antidepressants, self injury, etc.


Thankyou for your insights, as a psychiatrist in private practice who treats many individuals diagnosed as 'schizophrenic,' I agree with your approach and have watched many people gain control over their lives, take their power back, and become leaders and healers in their own right via the guidelines outlined here. Where there is too much consensus, there is also a lot of malarchy, so I'll also say everyone is different, and all points of view are valid. It takes a skilled and compassionate clinician to know which point of view fits for whom.

A thoughtful and balanced comment, Dr. Burman. Thanks for sharing it.

I have succesfully gained full control over the voices. It took two years of suffering but ive won. I have the mental ability to push the voices out of my mind, my house and into a far distance so i barely hear them outside, and rarely inside. i used my imagination combined with remote viewing subtechniques and precision mental acuity. I have coached other voice hearers to try what i have, i have had momentary succes with 3/3 people ive talked to. which proves that over time and with a combination of techniques, it can work to make them so quiet people can rest at night and be on low doses of meds or even not at all. I think voices are both good and bad, and are manipulating our reality for some hidden purpose. I also believe a secret group of humans know how to induce voices to have the technology to cause people to suffer pain inducement, voices, and gangstalking. I plan to win.

I am hearing voices consistently throughout the day and night. IT IS NON-STOP. I know each of the voices as past friends or current relatives. They claim to be using technology to do this but will not tell me how and claim that they will act as if nothing is happening if I talk to them about it. They have given me signs to prove it is real and I need to find out what technology is responsible. This is URGENT! Please help if you can.

There is non-stop discussion and criticism of my every action. They have the ability to replay sounds exactly the same (recorded) and make them deafening loud. They can create a ringing in my ears that is pervasive and the affect overall is intrusive. When they are confident and mocking me they will say things about how they are doing it. One thing they refer to are sound amplifiers and that there are implants in my ears. This sounds crazy I know but it is happening to me and I don't know where to find answers. They will, at times, slip up or get mad enough that they let information slip that I do not and find later to be true or false. For example, a reference to a news article with the title exactly as it appears in a magazine I haven't read. A real example is that they have printed google maps on my printer in the middle of the night. There is not way this could occur without knowing my network password and the drivers necessary for my printer and which printer in the house to use.

They torture me through sound and claim to be conditioning me in better behavior. However, they also mock me and "assign points arbitrarily" for good and bad things that I do in their opinion. This leads to a certain level of torture through sound (sometimes deafening) depending on the groups moods and things of that sort. They claim to have 3 people on out of a group of 12 at a time and change their voices via a voice synthesizer and recordings that they replay in order to make it seem as though a larger number of people are "on" at a time. I do not know how this is happening

Please help! I'm begging.

Hello needanswers1987. I really hope you're okay. I've been in exactly your position in terms of dealing with voices. The state that you're in is like living in a separate reality. You are perceiving things in a way that no one else is perceiving. In other words, you are basically living in your own reality. It might seem very real to you, but what you think is happening is not really happening. It's a subjective experience that can be brought on by drug use, stress, or even genetics. If you're more spiritual, some might even consider you to be possessed by an evil spirit. You're living in a waking dream that has turned into a nightmare, and yes there are ways to wake up.

Personally, I have found the fastest way to get out of that state is to take anti psychotics from a psychiatrist. It isn't a cure, but it will give you relief and give you back your mind to a large degree. That way you can understand your situation a better from a more logical mindset and decide how to deal with it.

I had a similar experience happen and was scared out of my mind, and could not express what I was going through nearly as clearly as you did. After taking anti psychotics for awhile I was able to get off them, and now I am living a happy, successful life. With a little luck, you'll be okay.

I am seriously just trying to calm myself down right now. In reading your post, I was taken right back to the place I was in 2012 & it was THE most horrifying experience of my life. I know EXACTLY what you're talking about, with the voices telling you things that seem virtually impossible ....like one time, I was instructed to walk to a small, gated community & was "told" a gate code, got in, was "instructed" to go to a certain house & to "go on in" (gasp, I know) because the door would be open (as it was) & the people inside were expecting me. Of course, they weren't but I'm lucky they didn't react with panic & the situation was quickly diffused. I apologized & explained I was mistaken & left without incident. I still don't know how I got as far as I did, but of course the "voices" gave no explanation at that time & I was immediately trying to keep up with their incessant directions.

I want to tell you right now, that I am no longer hearing voices & can only credit God as this being His miracle. I'll give you a bit of background, though, hopefully to help you in any way possible. I had been taking Adderal & was not using it properly. The voices began & I quit taking everything. I had NO idea WHAT was happening to me but "they" were saying SO many things..& it varied from topic to topic & how many would be talking, all at the same time...HORRIBLE. I wouldn't wish that on my worst enemy. This went on for about 6 months & I finally couldn't take it anymore. My husband sought out therapy (for himself) & when he did that, I realized, "Either he's wrong, or I'm wrong. Something's got to give." I was totally convinced he'd poisoned my food, was trying to kill me & had a chip implanted in my brain. (I believed it was put in my medication, at the point when I was taking it, and was in my body, causing these voices to happen.) As I mentioned before, I was no longer taking anything & finally decided to go to the ER. Where it was only a matter of minutes before they put me on the schedule to go to the psych ward. I wasn't surprised, as soon as I spoke & they left the room, I said to myself, "Oh my God, I sound crazy?!" & that, I did.

To make a very long story short, I was put on Risperdal, monitored & allowed to leave 5 days (!) later, with instructions to see my psychiatrist. There were a few other places I had to check in & be evaluated, I suppose for the assurance of public safety. When asked if I still heard voices, throughout this entire process, I lied & said no, for fear they'd hold me longer. I just wanted to get out of there & get home. As scary as a psych ward was, the voices were far scarier. Still, I had to get away from the screams & chaos of the other people there. Really sad.

Upon telling my psychiatrist, she increased the dosage of the Risperdal. That's some kind of serious antipsychotic. It gave me serious side effects & I'm glad I didn't drive my psychiatrist crazy, what with all the times I had her call me in other prescriptions to help me adjust. Yes, the voices were gone but I was feeling very panicked, grinding my teeth, & felt so dizzy, it freaked me out. Thankfully, these other meds helped me tremendously & I hate to think of others who had to go through that transition without their assistance.

My psychiatrist sent me to a psychologist, where I was tested to see exactly what was wrong with me. I was 100% convinced that it was Schizophrenia, but after the results came in, she surprised me by telling me I was not Schizophrenic. She had to convince me but she said she's dealt with patients who were & I just didn't have the difficulty with my thought processes, like they did. I could feel, however, that I was having difficulty speaking but I knew it was due to the Risperdal. I mean, serious issues with coming up with simple conversation, which was so unlike me & I hated how the medication made me feel.

After about 6 months, I told my psychiatrist that I wanted to get off the medicine, Since she saw my test results, she agreed & we started the weening off process. THAT took about a year. I was terrified to hear the voices again but I had gained so much weight due to the Risperdal, I had to take that chance. Something was giving me the impression that I would be okay to get off the medicine. I credit that something as being God.

It's been 2 years & I've never been better. My ease with speaking to passerby & friends & family is something I use to take for granted but not anymore. After reading your post today, I couldn't help but be reminded of the horror I endured during that time, with the voices. I can't believe something worse didn't happen...what with them, telling me to do certain things that I, of course, did. It's really impossible to express the depth of everything they said...it was CONSTANT, & at times, like having 8 tv's on, all at the same time. "They" told me they were demons, Angels, my family, (they could sound JUST LIKE THEM) & with that came the most traumatizing scenarios possible...with "them", posing as family members, screaming, being tortured & in agonizing pain. I was instructed to go on rescue missions, to save children who were in no apparent danger. Only in my mind.

It's hard for people to understand why one would believe these voices but I do believe the constant drilling, as in a form of brainwashing....they're relentless & evil & no one can ever convince me that they weren't demons. They knew my fears & played on them. They knew I would never kill myself or someone else, so that was never an issue to even suggest. But my family? To make it seem like they were in trouble & only I could save them, but I had to complete endless tasks..? I seriously think, if they weren't SO CONTINUOUS, it wouldn't have been so effective to get me to finally act. & the things they said were so convincing, at times, making so much sense & actually bringing CLARITY to chaos. At one point, they said they were Aliens...I could go on & on. Hard to fathom just how much information is taken in, going at it 24 hours of the day, 7 days a week. NONSTOP.

I really feel for you & I hope you're okay. I hope you got the much needed help you were seeking & I really hope you post an update. I'm not a religious fanatic but I will say, upon hearing testimonies from people who've experienced going to hell & back, much of what they describe sounds exact, with what I experienced. How "they" would go to great lengths to convince me of a thing, how they would enjoy tricking me & seeing how distraught & perplexed I was. Even going so far as to act like one would be on my side, fighting the others in defense of me, only to switch back to tormenting me again. That's precisely what I would call "them", TORMENTORS. If that's not a thing straight from hell, I don't know what is.

I wish you all the best in your recovery. I pray you are set free from that miserable state.

Thank you for publishing this well written article. Living in London, I first heard about HVN about 15 years ago, and have since met people who have been helped by their approach. It is one of many that question the traditional approaches and ask mental health treatment professionals and consumers to turn their assumptions upside down.

I like the way Dr Arenella clarifies that hearing voices is not always an indication of a disorder. And it also clarifies how HVN helps people to manage their experience.

Real voices are sound waves created by another physical entity which our eardrums interpret.

So these voices are NOT real.

Are they hearing them? YES, but they are a creation of their mind.

They should accept that they ARE having this experience, but that the voices are a creation of their imagination and therefore CAN be controlled.

To the person that mentioned Christians, I should point out that the Bible has many passages where God clearly kills women and children. So to say that somehow people that believe in God would be hearing a benign voice is flawed. Just look at all the killings from mothers that hear God tell them to kill their children and then went ahead and did it.

My sister now hears Jesus making jokes to her. I wonder what would happen if Jesus told her a bad joke?

Any advice on how to talk to her so that she gets help? or should I just let it be?


reality is perception. I hear and see things many ppl don't. till I ran into some one that heard the same things I heard ( we could repeat the voices back to each other ) I thought they were real b4 that but now I KNOW they'r real. they have an agenda I don't understand. there are three separate "department" of the same organization, or so I interpret it. anyway it's a question of what can we learn. they are more advanced then us but we can glean some truths from them and usually when they are driving us nuts it cause we are off the path god has for us. if u ppl are "treating" others by having them block out the voices my question is why ? they can't go around us only threw us. it's the next step in human evolution. we lost the tail lol the body is ok, it the mind that needs the most work now. we got groups of ppl hearing the same voices. it's REAL, not just real to the ppl hearing them and its being pushed on us. all the kids on meds for "ADHD" "ADD" ect. that's opening up their minds. till we accept that truth we'r stuck in a rut.


This is an impressive argument. I think a great deal of energy in psychiatry and psychology...actually, most of the helping professions...is invested in learning a set of concepts and vocabulary that fixes the way we interpret what people who come to us for help actually experience. Some of those professional interpretations are unhelpful. They dismiss the reality of the human experience they were designed to explain. But professionals become so invested in what they "know" that it is very difficult for us to accept that the basic approach to the problem may be off the mark or not informed by the best physical evidence.

Yes, the central auditory system responds to what we term hallucinations in a manner similar to the way it responds to externally generated sounds and signals. So, at the neurophysiological level, the voices are real.

Another issue is that traditional psychiatry - that developed in the latter half of the 20th Century - is frozen by a classificatory system that is not readily adaptable to the newest developments in neurophysiology. The DSM's - in all their iterations - rely on classifying observable and/or reported behaviors that can be verified empirically. This is a gross level of observation from a neurophysiological perspective. We are only beginning to understand the complex pathways in the CNS that support the behaviors we observe clinically.

Thank you for your thoughtful observations.

The voices are real? The patient thinks they are real, so hey they are real...

WOW! Is that what you tell your schizophrenic patients that see dead people? Accept it, they are real!

Holly Molly!

I'd take your license for incompetence!

It's clear that Doriansward doesn't much like this, but the idea is that to the person who's hearing the voices, they are "real" in that they are heard, or are reportedly heard or perceived, by that individual.

Accepting another person's reality by allowing for the fact that they may indeed be perceiving something - even dead people - that other's can't see doesn't make them any more real. It's just a logical first step for a therapist to begin helping the other person work through it until they can either deal more successfully with it or see it for what it is--something that doesn't really exist.

I've never denied that the patient hears the voices! I've only stated that they are NOT real.

Those examples are erroneous. The only one there that is a command "hallucination" is “The voice told me that I had to get off of the train immediately or else I might die.” This one is commands someone to get off the train. The other ones do not command anyone to do anything. Of these one is a making comments one, and the last one is some kind of threatening one, but without commanding anything. A twelve year old could see that.

My somewhat sarcastic post was in regards to the box "Examples of command hallucinations:
“This voice kept telling me that I was the real terrorist and I would be assassinated.”
“The voice told me that I had to get off of the train immediately or else I might die.”
“It sounds like an emcee on a microphone, announcing my every move, before I even take it.”

Firstly what id like to say if you don't hear voices then you shouldn't be commenting on what's real or not I heard voices 2 years ago for months and let me tell you there very real I knew things before they happened and was very spot on with everything just because you cannot explain something doesn't mean it's not real doctors are not trained in this field at all and do more damage then good if we're different were all categorised as sychotic or (mental) well il have you know a lot of us are very level headed and highly intelligent !!!!!!!!

Some of you may or may not know that it is actually an entity putting these sounds and voices in peoples heads.

It has been doing it to me for 5 years already(i met the entity 6 years ago). Not only does it put loud sounds in my head non-stop but it literally tortures me physically. It attacks the brain and heart the most but it also has sent this electrocution feeling throughout my spine which was the worst ever.

The entity attacks me more then anybody else because i betrayed its trust. It told me not to tell people about it and what we were doing(i wont get into that). So, obviously i told everyone i could and immediately it started attacking me.

I've tried tons of medication but nothing works. I know nothing can stop it unless it decides on its own. You may think your medication worked but it was actually the entity backing off.

And they are as real as sound can get. They are not just real to the person whom its happening to. If you monitored the brain activity you would have evidence of it being real.

Before it put sounds in my head... when i heard of people hearing voices i honestly thought that they meant they heard a thought that popped in their head randomly not actually auditory sounds. But it works just as you would hear someone talking to you in your dreams....you know you don't hear those through your ears obviously.

I am pretty certain i have the worst case of noise inside the brain not to mention the torture going on. There are literally tons of people who know about this entity(lots of mental health workers are aware of it but are forced to keep it secret and do.... i am a witness to this as i had actually tricked a few doctors into believing that i was not going to tell people anymore and they openly talked about the entity without me acknowledging it not to mention the countless others that were in contact with it and tried to convince me not to tell. Some co workers, some friends and other randoms who the entity used to no avail) And no they weren't trying to stop me from just looking crazy, I promise you that they were doing and saying exactly what the entity told them to. The doctor even said out loud to my face that it would heal me, specifically my ear which had hearing damage. The entity had already previously healed some of my wounds and massaged them. The entity actually did a lot more then this... it gave me the best massages you could ever imagine... literally through out every molecule the best tingly sensation ever it feels like pure love. It also did sexual things. Looking back i wish i kept it secret because this suffering is not worth telling people who don't believe you anyways. They have purposely put a stigma on this whole type of situation to keep it from being believable.

I doubt there's anyone out there who can help me but if you think there is any chance something would help or convince this entity to stop then please contact me... my email is blacchaze@hotmail.com. I have no interest in talking to someone who thinks i am imagining this. This is 100% real and not just to me. I got A's and B's in school and i can tell the difference between my imagination and something real. I remember when i had an answer for everything...much like some of you reading. But honestly there's no way to gauge something like this without it happening to you.

It has been talked about in the media before. Famous people claiming to have had sex with ghosts and entities ect. But the main reason you don't hear about it is because everyone is literally scared to death of this entity. I was not. I regret it.

Take your ridiculous lies and shove them where the sun does't shine.

how would someone like that find their way to a page like this..... just some skeptical simpleton trying to make fun of something they have no idea about...

No, it's called skepticism, and it's what keeps people from believing everything they read on a web page. Are the voices real? YES they are, to the person hearing them, YES, they are, but those voices are coming from INSIDE their heads, NOT from another entity.

The voices are a product of THEIR minds.

Because you know everything right. How would you know if it was their own brain or something else like an entity...brains don't come up with millions of different voices old and young, boy and girl and have them argue inside itself lol.... that is soooo much harder to believe then what i know to be true.
Just because you have not been enlightened by this entity or attacked by it for that matter...doesnt mean u know exactly whats causing it. You're here to try and make jokes about people who are being attacked by the craziest thing ever... beat it.

/Because you know everything right. / Show me where I said that.

/How would you know if it was their own brain or something else like an entity.../ Because everything happens in your brain. Without your brain you can't have a single thought or feeling.

/brains don't come up with millions of different voices old and young, boy and girl and have them argue inside itself lol..../ Asylums are FULL of people who talk to themselves thinking it's someone else. They can hear them and see them. They brain CAN and DOES come up with all kinds of delusions.

/that is soooo much harder to believe then what i know to be true./ You KNOW? How do you KNOW?

/Just because you have not been enlightened by this entity or attacked by it for that matter.../

How about you take full responsibility for your actions or the things your brain is producing? How about you realize there is something wrong with you and go get HELP?

/doesnt mean u know exactly whats causing it./

No I don't, I'm sure it's a psychological disorder, not little green men.

Go get help.

You're here to try and make jokes about people who are being attacked by the craziest thing ever... beat it.

never said it was lil green men u simpleton.... i know 100 perent that its an entity because we communicate and it touches me physically(sex and massages to pain and torture when i started telling people about it which it told me not to). You can go on believing that its hallucinations.. doesnt bother me one bit.... but why the hell are you even on this page..... just looking to argue about other peoples voices lol your simpler than anyone who is being attacked by this entity.

/never said it was lil green men u simpleton.... i know 100 perent that its an entity because we communicate and it touches me physically(sex and massages to pain and torture when i started telling people about it which it told me not to)./

""IT" told me not to" What is it? male/female/bi/trans/robotic?

Go see "A beautiful mind". You need help.

/You can go on believing that its hallucinations.. doesnt bother me one bit..../

That's because you believe your hallucinations to the point where you think other people are crazy and not you.

/but why the hell are you even on this page..... just looking to argue about other peoples voices lol your simpler than anyone who is being attacked by this entity./

No, I believe that I was on a religious conversation, and someone brought this up because it relates to the hallucinations that religious people use as evidence of their god.

Problem is, every country has different gods, and they all claim their god is the right god because they can hear him.

So the question is, how can they all be right, when all their gods are the one and true god.

The fact is that they all can't be right, but they all CAN be wrong and they are.

Just like you, they are hallucinating.

Go get help.

Clearly this method is coming from someone who does not suffer from this illness. I appreciate the work and effort but as one of these unfortunate cases, I not only try/tried this, but find it made me worse than before. take extra care when considering how to affect other peoples' already damaged realities-its not something to toy with using such novel alternatives.