What are auditory hallucination, elementary hallucinations, quality of voices, commands, running commentary, effect on the person hearing voices

1. Auditory
Hallucinations
DR VIJAY BHATIA. PSYCHIATRIST

2. Auditory Hallucinations
 Auditory Hallucinations means hearing something without any stimulus.
 It can be hearing voices. These voices can be from people that you know or are from
strangers, one may recognise the voices. Can be one voice or more than one voice. Can
be commanding or demanding. Can be running commentary on actions or behaviour.
Can be in third person meaning two or more people discussing the patient. Can be male
or female, young or old or people you know from the past or even people who have
passed away.
 Can be derogatory or amusing.
 Hearing bells, music, band or songs.
 Hearing noises like distressing noises.
 People calling names
 Can be outside the head, near the ear or far away in distance or even in another town.
 Can hear only when something else is going on for example hearing voices only when
tap is turned on

3. Elementary auditory hallucinations
 Experienced as simple noises, bells, undifferentiated whispers or voices.
 Can occur in organic states.
 Noises or partly organised as music
 Or completely organised as hallucinatory voices in Schizophrenia.
 Voices are characteristic of schizophrenia.

4. Quality of Voices
 Vary in quality – ranging from that are quite, clear and can be ascribed to
specific individuals.
 Or vague and cannot be described with any clarity.
 Patients are often undisturbed by their inability to describe the direction
from which the voices come or the sex of the person speaking.
 The voices sometimes give instructions to the patient who may or may not
act upon them.
 These are termed as imperative hallucinations.

5. Voices
 May speak about the person in third person.
 May give running commentary on their actions.
 Auditory hallucinations may be abusive, neutral or even helpful in tone.
 At times they may speak incomprehensible nonsense or neologisms.

6. The effects on the person is variable
 A number of patients have continuous hallucinations that do not disturb or
trouble them.
 For others the persistence of the hallucinations cuts across all activities so
person is seen as to be listening and even replying to them at all times.

7. Gedankenlautwerden (German)
 One type of auditory hallucinations is hearing one’s own thoughts spoken
aloud
 It describes hearing one’s own thoughts spoken aloud just before or at the
same time as they are occurring.
 Echo del la Pensée (French) is the phenomenon of hearing them spoken
aloud after the thoughts have occurred.

8. Thought broadcasting and thought
diffusion
 Patients may complain that their thoughts are no longer private but are
accessible to others.

9. Origin of voices
 Patients may insist that origin of voices are the result of Witchcraft,
telepathy, radio, television and so on.
 Sometimes they claim that the voices come from within their bodies such
as their arms, legs, stomach etc.
 Some patients hallucinate speech movements and hear speech that comes
from their own throat but no connection with their thinking.
 One patient complained of her talky- talky tongue because she was
continuously auditory hallucinated and felt speech movements in her
tongue. Thus she had both auditory and possibly somatic hallucinations.

10. Functional Hallucinations
 This is the strange phenomenon in which an external stimulus is necessary
to provoke hallucinations, but the normal perception and the hallucination
in the same modality are experienced simultaneously.
 A patient heard hallucinator voices only when water was running through
the pipes of his ward.
 Another patient heard voices when the radio or television was switched on,
alongside the broadcast voices.

11. Reflex hallucinations
 A stimulus in one sensory modality producing an hallucination in another
is called a reflex hallucination.
 This is in fact, an hallucinatory form of synaesthesia.
 For example – the feeling of discomfort caused by seeing and hearing
somebody scratch a blackboard with their finger nails.
 Another example a women who experienced pain whenever certain words
were mentioned.
 As doctor was writing in his case notes during the interview of a female
patient, she said “I can feel you writing in my stomach.
 Reflex hallucinations do not have much significance.

12. Extra Campine Hallucination (Concrete
Awareness)
 I know someone is behind me all the time; he moves when I move.
 I keep on hearing then talking about my disease down in the post office.
 These hallucinations are experienced outside the limits of the sensory field;
outside the visual field or beyond the range of the audibility.

13. The End
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 More videos on perception
 Visual and other hallucinations.