People tell me they hear voices and my habitual response is that is fine, so does my dog.
The phrase ‘hearing voices’ is often used to refer to an auditory hallucination that is associated with psychosis, though it need not present itself either as madness or mental illness. Most psychiatrists know this intuitively though the journalistic depictions of hearing voices inside the head of a madman is still the image that enters into the public.
A Banal Yet Remarkable Hallucination
One day, my son had left a radio on in a room. After a moment, I thought the voice coming out of the next room was uniquely addressing me. I even answered it back on several occasions only to discover later that the person I believed to be addressing me was a radio. This coming in and out of a hallucination is not something obscene or mysterious, but a banal yet remarkable event. Hearing voices only becomes indicative of madness when the voice is commanding you uniquely, and there is no way to turn it off. But notice even this situation is not that mysterious as many people involved in social media find themselves speaking to and being spoken of by others in an inertia of messages, tweets, and memes that begin to have a life all their own.
This article argues why hearing voices today is neither fearful nor a sign of madness, but an altogether banal yet remarkable event of everyday life.
What Is A Hallucination?
A hallucination occurs when the perceptum — what is heard, seen, felt, etc. — has a percipien — a meaning — but in the lack of any actual referent. In the case of hearing voices, there is an auditory hallucination when there is a perception though there is nobody actually there speaking. If there were someone, the perception would be called an auditory sensation and not a hallucination. In the modern-day world, especially in the advent of machine technology, the fine line between sensation and hallucination is becoming blurred.
Everyday Symptoms
There is no reason to be afraid of hearing voices, and it is not difficult to describe what it is like to hear voices once an auditory hallucination is no longer confused with a mysterious voice inside your head or from the dark corridors of a Hollywood movie scene.
Hearing voices occurs in everyday scenarios, most notably, in people’s interaction with machines. For example, when was the last time you got in an elevator, and it said, “Going up!” or stood in an airport and heard a computerized ‘off’ voice say, “Now arriving from Chicago” or ‘Now boarding all passengers with infant children.” In fact, if you cannot hear voices today, and if you do not allow them to tell you what to do, then you will have definite problems in everyday situations.
When I first refer to these banal yet remarkable events of hearing voices to someone who thinks hearing voices must be crazy or obscene, they often think it is a joke. As time goes on, they usually discover how serious it is.
For unlike a more naive time when ‘hearing voices’ was still a hot topic for Hollywood movies and psychiatric asylums, today, hearing voices is neither madness nor mental illness. Nor is there mental illness and madness when such voices begin to think for you and give you commands. Instead, it is when such voices are addressing ONLY you that the risk of madness occurs. For instance, imagine that anyone of the programmed messages in an airport is speaking only to you, then begins to think for you and tell you what to do. At which point, you will have an insight into a mad use of hearing a voice.
What Is A Psychosis?
Take a glance at the article on Medium entitled ‘A New Device Can Hear Your Thoughts’ and you will have an introduction to a new twist in hearing voices today: not only can normal people hear voices that tell them what to do , but machines can hear your ‘thoughts’ and listen to what you tell them to do. The device, Alter Ego, described in the article, can not only hear 100 thought-words that are not spoken but in your ‘mind’, but hear numbers 1 through 9. Further still, it is in the planning stage that Alter-Ego will be tested in the military defense industry. However, the inventor Arnav Kapur, himself admits, “It’s really very scary that our thoughts are no longer private ” and “Technology like this can be used by the real-life Thought Police.”
Though the author is not aware of the clinical implications, these non-private thoughts that are produced and recognized by things or machines, are not new. They give the basis for a definition of psychosis:
Psychosis = a thing (chosis) + mental (psych).
What is necessary not to do is confound this chosis-psy — or thing-psy — with madness or mental illness¹. On the contrary, this thing-psy has become so ordinary; it is not abnormal, but hyper-normal:
Hypernormal = highly functional, yet delicate, mode of behavior that can be exhibited by machines or humans.
Imagine someone who can not use a metaphor, but is highly employable because they can do rote tasks, and you already have a glimpse of how normal and beneficial a psychosis can be in the search for a salaried worker. That someone who has identified as autistic would perform certain tedious and automated tasks better than most has already been recognized by many tech companies.
Hearing Voices: from Autism to Paranoia
If you refer back to the article about the Alter-Ego device of Kapur, you will notice that such machines begin relatively simple in the field of A.I. To use a clinical language, such machines exhibit a kind of autism, a minimal use of a functional language that is not so adaptable to others, that will later develop into a full-blown paranoia once they have a market use. Notice already the name of the device ‘Alter-Ego’ and the fact that it will be used as a part of military ‘defense’ is indicative of this later stage of paranoia.
In the end, it will always be important to study how machines think, but how not to think and speak like a machine is an altogether different story.
Disentangling the Knot
In the common psychiatric writing — nosology — of the last century, someone who hears voices habitually is said to be psychotic, in the sense of either being a schizophrenic who exhibits multiple personalities and believes s/he is someone else; or a paranoiac who thinks they are being controlled and commanded by a voice from somewhere else. In the classifications of the last century, a psychosis is usually associated with madness, or in more modern times a mental illness or mental disorder.
But to get a handle on a more modern shift away from the psychiatric and obscene portrayals of psychosis, I reformulated the problem into a thing-psy common to modern-day life and centered it around four banalities:
- Today, hearing voices, like psychosis, is not abnormal but hyper-normal: it is part of an everyday functional relation to people, things, and machines.
- Hearing voices is not mad or a sign of mental illness, even if they begin to speak for you and give you commands.
- Psychosis is not necessarily a mental disorder just as it is not necessarily madness, but has the structure of a machine or thing = thing-psy.
- Hearing voices only becomes mad or a mental disorder, when such voices begin to speak ONLY to you, and there is no way to turn them off, but they start to think for you and tell you what to do.
What is remarkable about such a banal notion of hearing voices and the thing-psy, is that it makes room for a reform of the understanding of madness and mental disorders today.
A Reform of Understanding
Most modern psychiatric theories do away with the notion of madness, or only consider it of a secondary qualitative nature. What is most important, at least for the psychiatrist, is to define psychosis as an illness or psychopathology. Again for the psychiatrist madness is only a term from pre-scientific folklore. Indeed, the word madness does not occur once in the current psychiatric codebook DSM-5 (Diagnostic Statistics Manual). This is also why today there are no longer any Mental Asylums only Mental Health Centers.
On the other hand, a more humanist tradition of psychotherapy still tends to make a qualitative difference between madness and sanity, while conflating psychosis with madness.
In my work with others, I split the difference: like the humanist psychotherapist, I recognize madness is still with us today and does not reduce to a psychopathology or neurobiological illness, but I also agree with the scientific and psychiatric model that madness is not what is fundamental, but its underlying causality.
Without going too far into the history of the transformation of the theories and terminology here, it is crucial to recognize that unlike the humanist tradition, psychosis is not madness, but unlike the psychiatric and scientific tradition, a psychosis can very well become mad.
This article addresses these distinctions in fuller detail.
Winter 2018
Santa Monica, CA
Notes
[1] One of the first to recognize the introduction of the chosis-psy into modern society was the French sociologist Gabriel Tarde who wrote:
The monads, the children of Leibniz, have come a long way since their birth. By several independent paths, unremarked by scientists themselves, they slip in to the heart of contemporary science. […] The hypothesis implies, both the reduction of two entities, matter and mind, into a single one […]
G.Tarde, Monadology and Sociology, 1895, re.press, Eng. Trans., Lorenc, p.5
Tarde calls this unification of the Cartesian duality of mind and matter, not an anthropomorphism, but a psychomorphism [p.15].
