![]() An example is Charles Bonnet Syndrome, where visual impairments in the elderly can produce visions of human figures. Indeed, sensory deprivation can produce hallucinations in the sense mode that is deprived. Often one of the first signs of schizophrenia-occurring well before manifestations such as hearing voices-is social isolation. The second idea is that deprivation of social interaction - namely human conversation-makes the brain more likely to produce hallucinated conversations. It is as if the string section of the orchestra suddenly decided to play its own music, disregarding everyone else. (See also Impact of Schizophrenia on the Brain.) As a result, certain groups of neurons, such as those responsible for producing and perceiving language, may begin to function autonomously, beyond the control or influence of other brain systems. The first is based on studies suggesting that schizophrenia patients suffer from reduced brain connectivity. What remains unaddressed is the root cause of abnormal brain activations. These results, although preliminary, suggest an alternative treatment if validated in larger-scale studies. So far, most patients appear to experience significant improvements from TMS directed to both brain regions, with improvements lasting from two months to over a year. To test this theory we are using trans-cranial magnetic stimulation (TMS) to reduce the excitability of portions of the temporal lobe and Broca's region. One theory is that voices arise because Broca's area "dumps" language outputs into parts of the brain that ordinarily receive speech inputs from the outside. Our research at Yale University, as well as studies conducted at the Institute of Psychiatry in London, also detected activation in an area of the brain known as Broca's region during production of "inner speech" or verbal thought. Without treatment, these experiences recur relentlessly.īrain imaging studies have found that parts of the temporal lobe activate during these hallucinations. Not so for the person with mental illness. How can we understand differences between an inspired voice, an isolated instance of hearing one's own name, and the voices of the mentally ill? One answer is that "non-pathological" voices occur rarely or perhaps only once. This experience prompted his writing the Duino Elegies. Rainer Maria Rilke heard the voice of a "terrible angel" amidst the sound of a crashing sea after living alone in a castle for two months. Joan of Arc described hearing the voices of saints telling her to free her country from the English. Hallucinated voices are also known to occur during states of religious or creative inspiration. Our brains are primed to register such events so on rare occasions, the brain makes a mistake and reconstructs unrelated sounds (such as people talking indistinctly) into a false perception of the spoken name. But hearing voices is not necessarily a sign of mental illness, so understanding the mechanics of auditory hallucinations is crucial to understanding schizophrenia and related disorders.įor example, your occasional illusionary perception of your name spoken in a crowd occurs because this utterance is uniquely important. One patient described the recurrence of voices as akin to being "in a constant state of mental rape." In the worst cases, voices command the listener to undertake destructive acts such as suicide or assault. Often certain actual external sounds, such as fans or running water, become transformed into perceived speech. The sound of the voice is sometimes that of a family member or someone from one's past, or is like that of no known person but has distinct and immediately recognizable features (say, a deep, growling voice). The compelling aura of reality about these experiences often produces distress and disrupts thought and behavior. For these individuals, instead of hearing just one's name, voices produce a stream of speech, often vulgar or derogatory ("You are a fat whore," "Go to hell") or a running commentary on one's most private thoughts. This foray into the uncanny is as close as most people come to experiencing auditory hallucinations or "hearing voices," a condition that affects 70% of patients with schizophrenia and 15% of patients with mood disorders such as mania or depression. It dawns on you that the voice you heard must have sprung from your own mind. ![]() You are in a crowd when you hear your name. Professor of Psychiatry at Yale University ![]() ![]() Hearing Voices: Hearing What Others Can't Hear ![]()
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