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Auditory hallucinations are reported in many different psychological disorders, especially schizophrenia. In the following lesson, you will find out what causes people to ‘hear voices,’ what the voices commonly say, and how to make the voices stop.

What Are Auditory Hallucinations?

Auditory hallucinations are false perceptions of hearing sounds, like voices, music, etc.,without any real sensory stimuli. Auditory hallucinations have been reported in those suffering from epilepsy, brain tumors, migraines, dementia, Alzheimer’s disease, Lewy body dementia, bipolar disorder, post-traumatic stress disorder, and Parkinson’s disease.

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These hallucinations have also been known to be induced by drugs, such as cocaine and amphetamines.Perhaps most surprisingly, auditory hallucinations have been reported in approximately 15% of people with no mental or physical health problems whatsoever. The most common condition associated with auditory hallucinations, however, is schizophrenia, with a reported 70% of schizophrenic patients experiencing them.

Causes of Auditory Hallucinations

At the biological level, auditory hallucinations, and hallucinations of the other senses, are strongly linked to an imbalance of chemicals in the brain.

Specifically, a chemical called dopamine has been documented in excessive amounts not only in schizophrenics, but in people experiencing drug-induced hallucinations. When dopamine is reduced to normal levels through medication, this often causes a significant reduction in hallucinations or at least a decrease in their intensity.Another brain abnormality linked to auditory hallucinations is abnormal activity of the thalamus, which is a structure in the brain that is responsible for organizing information received from the senses and sending it toward more complex brain regions. Basically, the thalamus sends information from the ears to the auditory cortex in the brain, which interprets what sounds are being heard.

In the case of auditory hallucinations, the thalamus becomes very active despite a lack of external sound waves that would normally reach the ears and then cause such activity. In schizophrenics, the thalamus is not only overactive but reduced in size.In addition to the abnormal activity of the thalamus and auditory cortex, abnormal activity in the right side of the brain, or right hemisphere, has also been associated with auditory hallucinations. In the normal brain, much of the brain activity involved with language is specialized in the left hemisphere.

The right hemisphere is normally inhibited in regard to language. In patients suffering from auditory hallucinations, it has been found that there is no such specialization between brain hemispheres, and the right can be just as active as the left for activities involved in language.

Types of Auditory Hallucinations

The classification system of auditory hallucinations is not well defined, but different features have been identified, typically in patients with schizophrenia. The most common type of auditory hallucination is hearing voices, and in acute schizophrenic episodes, the voices almost always involve negative content.These voices can either be perceived as coming from inside the patient’s head or from an external source, often inanimate objects.

They can come in the form of only one voice talking directly to the patient or many voices talking amongst each other, usually about the patient, but no matter how they are manifested, they are believed to be real by the person experiencing them.As mentioned earlier, the content said by these imagined voices is often negative. More specifically, they can take the form of insults or threats directed toward the person experiencing them or can give the person experiencing them demands to do terrible things, such as kill someone.

Another type of auditory hallucination is a voice that repeats the same phrase. In some cases, entire memories, usually of a traumatic nature, are lived out again and again, as if they are actually happening. The realistic replay of memories seems to be more common in those suffering from post-traumatic stress disorder, unlike the other types described which are usually associated with schizophrenia.

When acute episodes of schizophrenia have passed and a patient is in remission, the content of imaginary voices can become more positive. The voices tend to turn from insulting to supportive and are directed at the encouragement of social interaction with real people rather than the imaginary voices.Lastly, another type of auditory hallucination that is typically not of a negative nature and is also the rarest form is musical hallucinations. These can manifest themselves in entire songs being played or just a repeating piece of a song.

Musical hallucinations are also the most likely to occur in healthy individuals who do not suffer from any type of psychological disorder.

Treatments for Auditory Hallucinations

The most common and effective form of treatment for auditory hallucinations is antipsychotic medications, which are primarily administered to schizophrenics. These medications work to correct the imbalance of chemicals in the brain, specifically to lower the excessive amount of dopamine associated with auditory hallucinations. Examples of such medications include Thorazine and Zyprexa.

The recommended instructions for use of antipsychotic medications involve taking the medication for a minimum of six weeks to produce the full effect, but usually patients take the medication for one year to reduce the risk of relapse of symptoms.Although in the past patients have taken antipsychotics consistently for several years, it was discovered to cause a disturbing side effect called tardive dyskinesia, or uncontrollable muscle jerks and tremors similar to Parkinson’s disease. This side effect further shows the relationship between dopamine, schizophrenia, and Parkinson’s disease. Those with Parkinson’s disease have too little dopamine in their brain, and those taking medication for Parkinson’s disease on a long-term basis can have auditory hallucinations as a side effect.Although antipsychotic medication has proven to produce the most significant improvement, some studies suggest that psychotherapy in conjunction with medication can improve patients’ ability to cope with auditory hallucinations.

This is focused on changing the way the patient thinks about their hallucinations by teaching them to realize that they are in control of the voices they hear and they do not come from an outside source, which makes attempts to ignore them easier. In some cases, patients were successfully able to tell the voices to ‘come back later.’

Lesson Summary

Let’s review. Auditory hallucinations are the perception of sounds without any actual stimuli to cause such a perception.

The most common type of auditory hallucinations are hearing voices, usually of an insulting or threatening nature. Auditory hallucinations occur in individuals suffering from a variety of disorders but are most common in those suffering from schizophrenia.The causes of this specific symptom include an excess of the chemical dopamine in the brain, as well as abnormal activity in the following brain areas: thalamus, auditory cortex, and right brain hemisphere. The most common way to treat auditory hallucinations is through antipsychotic medications, which aim to reduce the amount of excessive dopamine in the brains of individuals suffering from auditory hallucinations, although they can produce Parkinson’s disease-like symptoms when taken over long periods of time.

Learning Outcomes

After watching or reading the lesson, you should feel prepared to:

  • Define auditory hallucinations
  • Discuss some of the causes of auditory hallucinations
  • Differentiate between the different types of auditory hallucinations
  • Consider some of the treatment options for auditory hallucinations

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