Beyond Trauma: A Multiple Pathways Approach to Auditory Hallucinations in Clinical and Nonclinical Populations

Abstract

That trauma can play a significant role in the onset and maintenance of voice-hearing is one of the most striking and important developments in the recent study of psychosis. Yet the finding that trauma increases the risk for hallucination and for psychosis is quite different from the claim that trauma is necessary for either to occur. Trauma is often but not always associated with voice-hearing in populations with psychosis; voice-hearing is sometimes associated with willful training and cultivation in nonclinical populations. This article uses ethnographic data among other data to explore the possibility of multiple pathways to voice-hearing for clinical and nonclinical individuals whose voices are not due to known etiological factors such as drugs, sensory deprivation, epilepsy, and so forth. We suggest that trauma sometimes plays a major role in hallucinations, sometimes a minor role, and sometimes no role at all. Our work also finds seemingly distinct phenomenological patterns for voice-hearing, which may reflect the different salience of trauma for those who hear voices.

Social interaction skills and depressive symptoms in people diagnosed with schizophrenia: The mediating role of auditory hallucinations

“…We inferred that the improvement of auditory hallucination severity can decrease the mood disturbances evoked by obstacles to social interaction; furthermore, because of the negative impact of the severity of auditory hallucinations on the severity of depressive symptoms (Chiang et al 2018;Connor & Birchwood 2013), improvement in the severity of auditory hallucinations can result in positive changes in this relationship. Previous studies confirm that social interaction can lead to depression in people diagnosed with schizophrenia (Luhrmann et al 2019). However, few studies have investigated the influence of psychotic symptoms in this process.…”

“…The overall profile of more masculine, dominant, powerful, and negatively personified voices in people diagnosed with schizophrenia clearly evokes higher levels of distress (Badcock & Chhabra ). Luhrmann et al () employed ethnographic method to explore different phenomenological patterns for voice‐hearing, which may reflect the different trauma experience for those who hear voices. The auditory hallucinatory experience might play a console function in the context of trauma.…”

“…These factors may be associated with other issues, such as cognitive impairment (Green 2016), misinterpretation of the information provided during interactions (Brune & Schaub 2012), interpersonal stress (Thomas, Hayward, et al 2014), and a lack of motivation to establish social belonging (Kring & Elis 2013). When people lack social interaction skills, they can become withdrawn and isolated, experience more negative emotions and lack positive proactive vitality, leading to increased severity of depression and increasing the possibility of suicidal ideation (Luhrmann et al 2019). Compared to people with schizophrenia without depression, those with depressive symptoms experience greater interpersonal stress (Abramowitz et al 2014), which leads to more limited social interactions and less opportunity to develop social interaction skills.…”

Encultured minds, not error reduction minds

“…This is a complex story. Biological affordance, genetic predisposition, life experience, and cultural invitation all seem to interact to shape the experience of hallucination-like events (Luhrmann et al 2019).…”

Anomalous experiences are more prevalent among highly suggestible individuals who are also highly dissociative

“…Accumulating evidence suggests that dissociation accounts for some of the heterogeneity in high hypnotic suggestibility (Dell, 2009;Terhune & Cardeña, 2015). Indeed, high dissociative highly suggestible (HDHS) individuals are more responsive to hypnotic suggestions for hallucinations than low dissociative highly suggestible (LDHS) individuals and are also characterized by an elevated propensity for dissociative states and previous exposure to stressful life events (Terhune, Cardeña, & Lindgren, 2011), both of which reliably covary with hallucination-proneness in clinical and nonclinical samples (Bailey et al, 2018;Fassler et al, 2006;Irwin, Schofield, & Baker, 2014;Luhrmann et al, 2019;Pilton, Varese, Berry, & Bucci, 2015). Previous research has found an interaction between hypnotic suggestibility and dissociation in the reporting of anomalous experiences, with both variables related to anomalous experiences, including hallucinations, particularly when in conjunction (Pekala, Kumar, & Marcano, 1995).…”