The Science and Significance of Hearing Voices (Book Review)

I initially became interested in the topic of voice-hearing while listening to a TED talk about someone who started hearing voices, which was then diagnosed with schizophrenia, hospitalized and drugged to infinity. Not only did it not help her, but it made it much worse. She eventually got into the Hearing Voices Movement (HVM), and with its help, distanced herself from the current psychiatry model, and recovered. I can’t quite pinpoint the specific talk, but unfortunately, it doesn’t even matter because this story and path are so incredibly common.

In this age, voice-hearing is a symptom of madness. It’s the result of a “broken brain”, a simple biology misfunction. Fitting with the overall biomedical model of mental illness that is so pervasive today.

Simon’s book has 2 major points, with are deeply connected. First is a critique of the current medical model of categorizing and interpreting voice-hearing. While I wouldn’t say it’s his intention, this ends up being a critique of psychiatry as a whole. Much like psychological explanations went too far in the 60s, we’re still too tied to biology, suffering from a trend of genetic and biological determinism from the 80s. Advances in neuroimaging techniques made this much worse, giving an impression that we’re able to track down pathologies to simple “malfunctions” of the brain, while often they’re just brain correlates, and might not be causal.

The second point, is that if we’re overemphasizing biology, what are we underemphasizing? He argues that much of voice hearing is connected to trauma. Child abuse alone contributes to around a 1/3 of psychosis. The voices aren’t random, and they’re clearly meaningful manifestations of one’s life. Despite this, this is never taken into account with modern psychiatry. The meaning of the voices are never explored, and everything is sucked into a framework of brain pathology. Not that a neuro and biochemical approach aren’t useful, and the author certainly doesn’t ignore it, having several chapters dedicated to them alone.

Can’t You Hear Them? The Science and Significance of Hearing Voices
By Simon McCarthy-Jones (2017)

While these are the two major theses, it does touch on a wide range of topics, from the interactions of genes and environment to epigenetics, the relationship with other “mental illnesses” like PTSD and depression, neurodevelopmental models of psychosis, the role of neurotransmitters, the side-effects of antipsychotics, and much more.

Most if not all the claims seemed quite reasonable. There aren’t sketchy psychoanalytical interpretations, and evidence is always taken into account. In some instances, to a painstaking degree.

I’ll admit that the book isn’t the most fun to read. If you don’t have a big interest in psychiatry, I’d guess this would be a hard book for most. However, its primary goal isn’t to be fun. While interesting, dealing with these topics can easily get tedious at times, but despite it, it’s nevertheless captivating as a whole, and the increased understanding one gain’s from it is incredibly valuable and fascinating. If you truly want a deep understanding of voice-hearing, I doubt there is a better book than this. Simon’s experience and knowledge are hard to match.

Simon is an Associate Professor in Clinical Psychology and Neuropsychology at Trinity College Dublin, Ireland. He has previously worked at Macquarie University (Sydney, Australia) and Durham University (Durham, UK). His research focuses on three topics: auditory verbal hallucinations (‘hearing voices’); child sexual abuse; and the right to freedom of thought.

Thanks for reading. If you like non-fiction book reviews, feel free to follow me on Medium.

I also have a philosophy podcast. If you want to check it out look for Anagoge Podcast.

Tiago V.F.




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Tiago V. Faleiro

Tiago V. Faleiro

BA Psychology & Philosophy ; Currently studying MSc Applied Neuroscience at KCL ; Host of Anagoge Podcast

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