Does religious belief enable positive interpretation of auditory hallucinations? A comparison of religious voice hearers with and without psychosis

Abstract

Introduction. Hearing voices occurs in people without psychosis. Why hearing voices is such a key pathological feature of psychosis whilst remaining a manageable experience in nonpsychotic people is yet to be understood. We hypothesised that religious voice hearers would interpret voices in accordance with their beliefs and therefore experience less distress. Methods. Three voice hearing groups, which comprised: 20 mentally healthy Christians, 15 Christian patients with psychosis, and 14 nonreligious patients with psychosis. All completed (1) questionnaires with rating scales measuring the perceptual and emotional aspects of hallucinated voices, and (2) a semistructured interview to explore whether religious belief is used to make sense of the voice hearing experience. Results. The three groups had perceptually similar experiences when hearing the voices. Mentally healthy Christians appeared to assimilate the experience with their religious beliefs (schematic processing) resulting in positive interpretations. Christian patients tended not to assimilate the experience with their religious beliefs, frequently reporting nonreligious interpretations that were predominantly negative. Nearly all participants experienced voices as powerful, but mentally healthy Christians reported the power of voices positively. Conclusion. Religious belief appeared to have a profound, beneficial influence on the mentally healthy Christians' interpretation of hearing voices, but had little or no influence in the case of Christian patients.

Hallucinations: A Systematic Review of Points of Similarity and Difference Across Diagnostic Classes

“…71 Such special significances are also reported in religious experiences, 49,50 although the interpretation is more positive than for those in schizophrenia.…”

“…4,8,89 Auditory “verbal” hallucinations, which are vivid, occur frequently, and are experienced as coming from outside of the head, are present in all 4 major groups considered here (nonclinical, substances, medical or neurological, and psychiatric). Examples include hallucinations linked to religious experiences, 49,50 dissociative identity disorder, 44,77 and temporal lobe epilepsy. 62,90 Of note, voices originating in external space occurred in half of nonclinical voice hearers, 44 one-third of individuals with tinnitus, 60 and 60%–83% of individuals with PTSD, 76,77 bipolar disorder, 69 and dissociative identity disorder.…”

“…62 In nonclinical groups (such as evangelical born-again Christians), it is common for voices to be interpreted as having religious meaning. 49,50 …”

“…Articles involving direct comparisons with schizophrenia included the following 4 major groups: (1) nonclinical groups (general population, 44–48 religious experiences 49,50 ; total 7 studies); (2) drug- or alcohol-related (substances) conditions 51–59 (9 studies); (3) medical and neurological conditions (tinnitus, 60 epilepsy, 61,62 narcolepsy, 35 other medical and neurological causes 53,63–66 ; total 9 studies); and (4) psychiatric disorders (affective disorders, 8,42,53,64,66–70 borderline personality disorder, 71–74 PTSD, 75,76 dissociative identity disorder, 44,77 anorexia 78 ; total 18 studies). There were a further 2 articles on attenuated psychosis (ultra high risk [UHR]), 79,80 which were classed in the psychiatric group.…”

Unusual perceptions at the end of life: limitations to the diagnosis of hallucinations in palliative medicine

“…Hallucinations may be associated with post-traumatic stress disorder,22 or not 59. Hallucinations can be prompted by religious adherence and belief, or enjoy ‘protection’ from that risk through religious belief and adherence 60 61…”