Summary: Researchers turned to people who identify as psychics—those who report hearing voices but do not have a psychiatric diagnosis—to gain insight into the auditory hallucinations experienced by people with psychosis.
Source: Yale
Yale researchers compared voice-hearing among self-described psychics, individuals with schizophrenia, and a control group to learn why some people hear voices without developing distressing psychosis.
People with psychosis often suffer from persistent and distressing internal voices. To better understand how auditory hallucinations differ across populations, a team at Yale studied an atypical group: clairaudient psychics who report daily auditory messages yet do not meet criteria for a psychiatric disorder. The findings, published Sept. 28 in the journal Schizophrenia Bulletin, show important similarities between the voice-hearing experiences of psychics and those of people with schizophrenia, along with key differences that may explain why some voice-hearers remain functional and free of clinical diagnosis.
“We have known for some time that people in the general population can have the experience of hearing voices—sometimes frequently—without the need for psychiatric intervention,” said Albert Powers, a psychiatry fellow and lead author of the study. The research team set out to identify features of voice-hearing that distinguish distressing psychosis from nonclinical experiences.
Prevalence estimates cited by the researchers note that as many as one in 25 people hear voices at any given time, and up to 40% of individuals may report hearing a voice at some point in their lives. Most of these voice-hearers do not meet diagnostic criteria for a mental illness, but recruiting and studying healthy voice-hearers has been challenging for researchers.
Powers, Philip Corlett (assistant professor of psychiatry), and neuroscience graduate student Megan Kelley focused on a group of clairaudient psychics who described receiving frequent auditory messages. To ensure the study examined genuine subjective experiences and not malingering, participants completed forensic psychiatry assessments designed to detect false claims of hearing voices. Both the psychics and the clinical patients produced similar scores on measures intended to identify feigned voice-hearing, indicating that the self-reports were comparable in credibility across groups.
Despite these similarities, important contrasts emerged. People with schizophrenia were far more likely to describe negative, frightening, or distressing experiences associated with the voices and to report adverse outcomes when discussing those voices with others. By contrast, the psychics in the study tended to experience their voices as positive or neutral, and they described a greater sense of control over when and how voices occurred.
“These individuals have a much higher degree of control over the voices. They also have a greater willingness to engage with and view the voices as positive or neutral to their lives,” Corlett said. The researchers suggest that how people interpret and relate to voices—whether they judge them as threatening or as meaningful—may play a central role in whether hallucinations become disabling.
By comparing the experiences of clairaudient psychics, people with schizophrenia, and healthy control subjects, the authors identified potential protective factors that allow some voice-hearers to function well without psychiatric care. Greater perceived control, a tendency to appraise voices as helpful or benign, and more adaptive social responses when discussing voices appear to be associated with less distress and better overall functioning.
The team acknowledges that studying psychics is an unconventional approach, but argues it is warranted given the limited progress in treating and understanding psychosis. “Our understanding of psychosis is limited, and we’ve made only incremental progress for the past 50 years,” Corlett said. “The research may be unusual, but big, intractable problems require creative and sometimes unorthodox solutions.”
The researchers emphasize that the study does not argue for or against the validity of psychic claims; rather, it treats reported auditory experiences as an informative phenomenon to study. Comparing clinical and nonclinical voice-hearing can illuminate cognitive, social, and neurobiological mechanisms that determine whether voices are experienced as threatening or manageable.
Clinical implications of this research include the potential to develop therapeutic strategies that shift appraisals of voices, enhance perceived control, and promote more adaptive engagement with auditory phenomena. If validated in larger and longitudinal studies, these insights could inform cognitive and behavioral interventions that reduce the distress associated with hallucinations in psychosis.
Funding: This research received primary funding from the Yale Department of Psychiatry and the Brain and Behavior Research Foundation.
Source: Bill Hathaway, Yale
Image credit: Melanie Ulizio
Original research: The study was published in Schizophrenia Bulletin on September 28, 2016.
Yale. “Psychics Help Psychiatrist Understand the Voices of Psychosis.” NeuroscienceNews, September 27, 2016.
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