What It's Like to Hear Voices

My psychosis was relatively mild, but it was a constant interruption, and almost killed me. I can’t imagine what people who have severe hallucinations go through day to day.

There’s a man I see on the main street where I live. He spends his time sweeping the sidewalks and generally cleaning up. He is almost constantly talking to someone who isn’t there. Shopkeepers give him free coffee and food. He is diligent and does a good job.

What makes psychosis different from “imagination” is that it seems absolutely real. If you are reading this on your PC (I hate Macs – sorry), and someone is sitting nearby and talking at you, that’s what psychosis feels like. That talking is real – it isn’t in your head. You might even see that person, and they are real – just invisible to everyone else.

What I had were auditory hallucinations – that meant I heard voices (well, one voice, actually), but didn’t see things that weren’t there. When I first heard the voice I thought that someone was playing a trick on me, because I couldn’t see anyone. I came to realize it was coming from my own head, but that didn’t make it any better.

Hallucinations are compelling. Even though on some level I knew there was no Darth Vader around me, I listened as if there were, and responded to him when he asked.

I mentioned before how some philosophers have queried how we differ dreams from reality. The consensus seems to be by the intensity of what we experience. The real world is just more compelling than our imagined one, and so is separated by a wall from the dream world.

When you are experiencing psychosis, that wall begins to crumble. Your dreams (or nightmares) become just as intense and compelling as the reality, and you can’t tell them apart.

Psychosis can be a very dangerous state. That’s why it’s treated so seriously. The people on the street that you see who are talking to themselves may not be on medication, but will have been through the mental health system at some point, and are generally benign. They won’t hurt you – they are fragile and much more likely than the average person to be victims of crime than victimizers.

Antipsychotic medications are like the “contrast” control on a PC monitor. They sharpen the image up, so you can tell what is real and what isn’t. They worked well for me. First Darth Vader became quiet and an obvious delusion, and then the voice stopped. I cannot describe the relief that I felt.

I don’t know how to use the contrast control on a Mac. It’s not as easy as a PC, so I didn’t feel right using it in the analogy above.

Sorry, Mac users.