PsychosisFor yourself50 min read

Hearing voices: understanding and coping

Hearing a voice that no one else can hear is more frequent than people think, and it does not automatically mean what one fears. This guide explains what research has established, why some people suffer a great deal from it and others very little, which strategies help day to day, and why medical advice is always the first step.

Reviewed on October 25, 2026
Dr Zayan Al-Falasi, psychiatrist

In short

This guide is for adults who hear voices — whether or not a diagnosis has been made — and for those close to them. It describes what research has shown: the phenomenon exists in the general population, in people with no disorder at all; its causes are multiple; and what determines the suffering is not so much the content of the voices as what one believes about them. It offers concrete coping strategies, says when to seek help urgently, and sets out an absolute rule: one never alters or stops a prescribed treatment on one's own.

Topic: Psychosis
Who it's for: For yourself
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The programme

This guide is psychoeducational content. It does not replace a consultation. Hearing voices always warrants medical advice: see sections 9 and 24. Seek help urgently if the voices order you to harm yourself or to harm someone else, if they are accompanied by confusion, fever or an abrupt change in general condition, or if you are thinking about dying: see section 20, and in case of immediate danger, call the emergency services. Never stop a treatment that has been prescribed for you on your own, and do not alter its doses: talk about it with the psychiatrist or doctor who is following you. Allow fifty minutes to read.

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1. Before you begin

It may have started with your first name, spoken once, in an empty room. Or with a comment, while you were doing the washing-up, about what you were doing. Since then, you check whether someone has spoken, you put music on to cover it, and you have told no one, because you know what people think of those who hear voices.

Three things, straight away.

You are not alone, far from it. Surveys carried out in the general population show that around one person in ten, depending on the study, has heard a voice at least once in their life, most often without ever seeking help and without it affecting their existence. Hearing a voice is a human phenomenon, not a rare anomaly.

Hearing a voice does not, on its own, tell you what is involved. It can accompany a psychotic disorder, that is, an illness in which contact with reality is partly lost, such as schizophrenia. It can also occur after a sleepless night, in grief, under the effect of a substance, during a fever, in the aftermath of a trauma, or in entirely harmless situations. That is why the first step is not to conclude, but to have things assessed.

What causes suffering can be worked on. This is the most useful result of research on this subject: the distress depends far less on the presence of the voices than on what one believes about them — their power, their intention, what ought to be done about them. Those beliefs can change, and life then becomes very different, even when the voices remain.

2. What hearing a voice is

One experience, several forms

The word 'voice' covers very different experiences from one person to another.

The number: a single voice, or several, sometimes speaking to each other.
The location: outside, as if someone were in the room or behind the door; or inside the head, while still remaining distinct from one's own thoughts.
The clarity: sometimes as clear as a conversation, sometimes an indistinct murmur or a hubbub.
The identity: unknown, or recognised — someone close who has died, a parent, someone from the past.
The content: comments on what one is doing, insults, reproaches, orders, conversations, sometimes neutral or even encouraging words.
The frequency: a few times a year or permanently.
The trigger: in quiet moments, in the evening, in noise, in public, under stress, at the moment of falling asleep.

What it is not

It is not the ordinary inner voice, the one with which everyone talks to themselves in silence. The difference that most of the people concerned describe is the feeling that the voice does not come from them: it cannot be commanded, it takes them by surprise, it says things they would not have thought.

It is not imagination in the sense that one would choose what one hears. The experience is genuinely perceived.

It is not necessarily madness, and that is the subject of the next section.

The other perceptions

Some people see, smell or feel things that others do not perceive. The same principles apply, and the same precautions: have things assessed, do not stay alone with it.

What it costs

The suffering rarely comes from the sound itself. It comes from the content when it is hostile, from the exhaustion of a permanent presence, from the difficulty in concentrating, from the fear of being found out, and from the isolation that secrecy imposes. Each of these difficulties can be worked on, separately.

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What the rest contains

3. More frequent than people think
4. What it means, and what it does not mean
5. The possible causes
6. Why some people suffer and others do not
7. What the research says
8. Taking stock
9. The medical assessment: the first step
10. Sleep
11. Substances
12. Day-to-day coping strategies
13. Orders: not obeying
14. Working on what you believe about the voices
15. The plan, week by week
16. Psychological treatments
17. Medication
18. When things resist
19. Particular situations
20. Emergencies
21. Family and friends
22. Other people's view, work and study
23. Preventing relapses
24. When to seek help, and what to ask for
25. Frequently asked questions
26. Key points
27. Sources and foundations

Frequently asked questions

Am I going mad? This is almost everyone's first question, and it deserves a clear answer: hearing a voice does not mean that. The phenomenon exists in the general population in people with no disorder at all, and it has very varied causes, some of them ordinary and transient. What matters is to have things assessed.

Do I necessarily have schizophrenia? No. It is one possible cause among others: lack of sleep, grief, substances, medical causes, trauma, severe depression, among others. Only an examination makes it possible to say.

Will the voices go away? In some people, yes, particularly when a reversible cause is found and treated. In others, they persist and become much less invasive. Both outcomes are improvements, and the work proposed here aims first at the distress and at daily life.

Should I answer the voices? You are never obliged to obey them. Some people find it useful to address a brief, firm sentence to them; others prefer not to enter into any exchange. What matters is not submitting and not being drawn into an endless argument.

What should I do if a voice tells me to harm myself? Do not obey it, do not stay alone, and seek help without delay: this is an emergency. Call the emergency services or go to the emergency department, as section 20 explains.

Can cannabis be involved? Yes. The relationship between cannabis and psychotic risk is established, particularly for frequent use of concentrated products. In a person who already hears voices, it generally makes the symptoms worse. Stopping is the most useful measure.

I am better, can I stop my treatment? No, not on your own. It is one of the most frequent causes of relapse, and the improvement is often the effect of the treatment itself. If you wish to reduce it or stop it, that is a discussion to have with the psychiatrist, and it is prepared for and monitored.

Will medicines turn me into a zombie? Side effects do exist, they vary according to the molecules and the people, and they are not to be endured in silence. Many can be reduced by an adjustment or a change. Say what they are, do not put up with them.

Do I have to tell my employer? Nothing obliges you to. You can ask for adjustments without going into detail. An occupational health doctor, where one exists, can help you. Speak freely to your clinicians, and choose for the rest.

Can I work and have a normal life? Yes. Many people work, study, live as couples, bring up children. Supported employment services markedly improve access to work, and work itself is often protective.

Someone close to me refuses to seek help. What can I do? Stay present, do not take on the content of the voices, express your worry by talking about what you observe, suggest an appointment with the family doctor rather than a psychiatrist if that is more acceptable, and ask for advice for yourself. In case of immediate danger, call the emergency services.

Why are the voices worse in the evening? Often because tiredness accumulates, activity decreases, silence settles in and attention is less occupied. It is a very frequent regularity, and it indicates directly what to do: plan activities and a background sound at the risky moments, and look after your sleep.

Are hearing voices groups worth it? Many people find considerable relief in them: talking without being judged, exchanging strategies, coming out of isolation. It is not a treatment and it does not replace medical follow-up, but it goes with it very well.

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