“On being an auditory hallucination”: A reflection on theory, practice, existential philosophy, and hearing voices.

As a mental health practitioner, I tried to engage with a person who suffered from auditory hallucinations. That person reported that they heard my voice when I was not there. There are contrasting theoretical accounts of voice hearing which provide different ways to frame this experience. The voice which neither of us owned can be understood as either a meaningless symptom of mental illness, or as a form of communication which others need to hear so that relationships can be improved. In the first of these understandings, rationalized objective explanations ignore the intersubjective aspects of the phenomena, casting our being into separate conscious spaces within each of us, where different first-person views might never meet. In an example of the second understanding, the “open dialogue” approach, practitioners work instead with that intersubjective form of communication. However, there is another “disowned voice” expressed in professional practice. This is the third-person voice, a “voice from nowhere,” which everyone speaks but no one owns. This is the rational and impartial voice of instrumental rationality, which has the quality of an auditory hallucination. It is only through a second-person voice that shared understandings can develop through which voices can be adequately placed and owned. (PsycINFO Database Record (c) 2018 APA, all rights reserved)