Schizoaffective Disorder and Hearing Voices

Auditory hallucinations are a key sign of schizophrenia. Find out what it's like hearing voices and having a visual hallucination.

Yet it is in place to appeal to the fact that madness was accounted no shame nor disgrace by men of old who gave things their names; otherwise they would not have connected that greatest of arts, whereby the future is discerned, with this very word 'madness', and named it accordingly.
-- Plato Phaedrus

Auditory hallucinations are the key sign of schizophrenia. After the summer I was diagnosed, when I related my experience to a fellow UCSC student who studied psychology, he said that the fact that I heard voices by itself made some psychologists consider me schizophrenic.

Everyone has an inner voice that they talk to themselves with in their thoughts. Hearing voices is not like that. You can tell that your inner voice is your own thinking, that it's not something you're actually hearing someone saying. Auditory hallucinations sound like they're coming from "outside your head". Until you come to understand what they are, you cannot distinguish them from someone actually talking to you.

I haven't heard voices very much, but the few times I have is quite enough for me. While I was in the Intensive Care Unit at the Alhambra Community Psychiatric Center that summer of '85, I heard a woman shout my name - simply "Mike!" It was distant and echoey, so I thought she was shouting my name from down the hall, and I would go look for her and find no one.

Other people hear voices whose words express much more disturbing things. It is common for hallucinations to be harshly critical, to say that one is worthless or deserves to die. Sometimes their voices keep up a running commentary about what's going on. Sometimes the voices discuss the inner thoughts of the person who hears them, so they think everyone around can hear their private thoughts discussed aloud.

(One might or might not have a visual hallucination of someone actually doing the speaking - the voices are often disembodied, but for some reason that doesn't make them any less real to those who hear them. Usually, those who hear voices find some way to rationalize why the speech does not have a speaker, for example by believing that the sound is being projected to them over a distance via some kind of radio.)

The words I heard weren't disturbing in themselves. For the most part, all my voice ever said was "Mike!" But that was enough - it wasn't what the voice said, it was the intention that I knew to be behind it. I knew that the woman shouting my name was coming to kill me and I feared her like nothing I've ever feared.

When I was brought to Alhambra CPC, I was on a "72-hour hold". Basically, I was in for three days of observation, to allow myself to be studied by the staff to determine whether lengthier treatment was warranted. I had the understanding that if I just stayed cool for three days I would be out with no questions asked and so although I was profoundly manic, I stayed calm and behaved myself. Mostly I either watched TV with the other patients or tried to soothe myself by pacing up and down the hall.

But when my hold was up and I asked to leave, my psychiatrist came to tell me he wanted me to stay longer. When I protested that I'd met my obligation, he replied that if I didn't stay voluntarily he would commit me involuntarily. He said something was seriously wrong with me and we needed to deal with it.

He told me I'd been hallucinating. When I denied it, his response was to ask "Do you ever hear someone call your name, and you turn, and no one is there?" And yes, I realized he was right, and I didn't want that happening, so I agreed to stay voluntarily.

Hallucinations aren't always menacing. I understand some people find what they have to say familiar and comforting, even sweet. And, in fact, another voice I think I heard (I can't be sure) came when I was hanging out by the nurse's station in the ICU. I heard one of the nurses ask me an inconsequential question and I answered her only to be surprised to find her looking down at her desk, ignoring me. I think now she hadn't addressed me at all, that the question I heard was one of my voices speaking to me.

I became very determined that the voices were going to stop. They really bothered me. I worked hard to determine the difference between real people talking and my voices. After a while, I was able to find a difference, although a disturbing one - the voices were more convincing to me than what real people actually said. The concreteness of my hallucinations' apparent reality always struck me immediately, before I ever heard what they said.

Some of my other experiences are this way too: the conviction of their reality always strikes me before the actual experiences do. People have often told me I should just ignore them, but I haven't had that choice, by the time I can make the decision to ignore something I have already been frightened by it.

After a while, I decided I just wouldn't listen anymore. And after a short time, the voices stopped. It only took a few days. When I reported this to the hospital staff, they seemed quite surprised. They didn't seem to think I should be able to do that, to just make my hallucinations go away.

Still, the voices bothered me enough that for years afterwards, it startled me to hear anyone call my name when I didn't expect it, especially if someone I didn't know was calling someone else who happened to be named "Mike". For example, there was someone named Mike who worked on the night shift at the Safeway grocery store in Santa Cruz when I lived there, and it would frighten me when they would call his name on the public address system, asking him to come help at the cash register.

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