Auditory verbal hallucinations: social yet singular

What causes auditory verbal hallucinations (hearing voices)? Vaughan Bell of King’s College London contends that verbal hallucinations are primarily social events, albeit ones that involve only a single person.

People who have auditory verbal hallucinations aren’t usually hearing random phrases from an anonymous source. Instead, they tend to hear the voices of particular individuals, either real people the hallucinator knows or imaginary but recurring characters. In addition, over 80% of people with these experiences can conduct interactive conversations with the voices in their head.

Electroencephalography (EEG) has shown that the same area of the brain that gives normal people the sensation that they are with another person is active during an auditory verbal hallucination. It’s no wonder the hallucinations feel like actual conversations to the sufferers. They really feel like someone else is there with them.

Bell proposes that the hallucinations originate in our normal ability to imagine conversations with real people. We are all able to rehearse social situations in our minds. For the hallucinator, the distinction between the internalized model behavior and actual interactions is lost. 



Bell V (2013). A community of one: social cognition and auditory verbal hallucinations. PLoS biology, 11 (12) PMID: 24311984.