Voice hearing and its relationship with shame and guilt: What research tells us
Switchboard Operators, Seattle Municiple Archive, 1958
Voice hearing is a more common human experience than many people realize. While often discussed primarily in psychiatric contexts, research shows that auditory verbal hallucinations (AVHs) - or hearing voices - occur across a spectrum that includes many different types of experiences and relationships with those voices.
A systematic review published in BMC Psychiatry in 2022 explored the relationship between voice hearing, shame, and guilt.
The commonality of voice hearing
The research by Volpato and colleagues highlights that voice hearing affects approximately 10-15% of the general population. This challenges the notion that hearing voices is inherently problematic. Many people who hear voices consider these experiences meaningful, and some find them helpful or positive aspects of their lives.
The role of shame and guilt
The review found interesting connections between emotions like shame and guilt and the experience of hearing voices:
Shame was positively correlated with more negative features of verbal hallucinations. People experiencing shame might hear voices that mirror feelings of inferiority or unworthiness.
Guilt in voice hearing can sometimes act as an "internal reminder" of past mistakes, potentially serving as a moral compass that helps guide behavior.
For some voice hearers, these emotions might influence the relationship they develop with their voices, regardless of whether they seek support or not.
Social support helps
One of the most important findings was how social discrimination impacts those who hear voices. Many voice hearers hesitate to share their experiences because they fear judgment or misunderstanding from others. This secrecy can contribute to feelings of shame.
The research suggests that voice hearing embedded in a supportive social environment becomes more manageable for everyone. When people have social networks that provide validation and understanding, the experience is less likely to cause distress - whether or not they also seek professional support.
Different relationships with voices
People develop various relationships with their voices. Some live alongside them without seeking support, while others may find their voices distressing enough to seek help through peer support groups like Hearing Voice Network, counseling, or psychiatry. Some may be forced into treatment by others, which although might seem helpful, could create a context where voice hearers learns to feel shameful about their voices. Each person's experience is valid, and their choice about seeking assistance deserves respect.
The research highlights that in any context - whether in therapy, peer support groups, or independently - developing a constructive dialogue with voices associated with shame or guilt can be beneficial. This approach acknowledges the voices as meaningful rather than merely symptoms to be eliminated.
A holistic understanding
This research contributes to a more holistic understanding of voice hearing that moves beyond binary categories of "clinical" and "non-clinical." It recognizes that people may move between needing support and not needing it at different times, and that distress is influenced by many factors including social and systemic context, personal history, and emotional responses.
By understanding voice hearing as a human experience with many dimensions, we can foster greater acceptance and reduce the discrimination that often causes suffering, regardless of whether someone seeks professional support or not.
Reference: Volpato, E., Cavalera, C., Castelnuovo, G., Molinari, E., & Pagnini, F. (2022). The "common" experience of voice-hearing and its relationship with shame and guilt: a systematic review. BMC Psychiatry, 22, 281. https://doi.org/10.1186/s12888-022-03902-6