There is a wealth of research and anecdotal materials, current and historical, relating to physiological conditions and experiences that are likely or at least possible factors in contributing to hearing voices and seeing visions.
Drugs and toxins:
These can include social drugs such as strong marijuana as well as psychedelics and amphetamine type substances. In some cases orthodox medical preparations are acknowledged as triggering symptoms that appear to be part of the "schizophrenia" cluster of symptoms.
Usually when the drug is stopped or changed the effects diminish. I have worked with older men whose steroid medication produced vivid voices and visions and strange behaviour, leading to a potential new diagnosis and consequent treatment plan, until I researched the medication on behalf of the client and brought it to the Doctors' attention. Medication withdrawn over a few weeks and presto, the symptoms vanished!
Many of todays drug compunds are based on naturally occuring substances found globally in psychoactive plants and their effects were learned about from observing the healing customs and traditional medical practices of anciently established cultures. Shamanic systems and established cultural usage of these herbs and plants illustrated their powers and efficacies.
Fasting and meditative states/ spiritual crisis.
It is well known that on the path to "Satori", or breakthrough into enlightenment, Zen monks often undergo a quite profound experience that can seem very odd and unsettling. They laugh, they may cry, they might shout out in answer to voices and see things that no one else can see or witness. This experience often settles down and they then acquire a deeper meditative state of being.
I have read and heard many accounts of individuals who, in deeper modes of meditation, heard voices, not .unlike Ghandi. In spiritual landscapes these voices are often interpreted as being of divine origin and act as a guide and moral compass for the individual.In fact, many of our major religious and spiritual traditions have been inspired and shaped to various degrees by individuals who had these types of experiences!
Plenty of available evidence indicating just how commonplace hearing the voices of departed loved ones really is.
The experience can be a very comforting one for those left behind and there may even be a reluctance to stopping the phenomena as it provides an ongoing link and connection with the person who has passed on.
I have spoken with nursing staff and family members who have confirmed for me the high prevalence of these experiences. It usually dimishes in intensity and regularity over time but not always. I met an elderly lady on a bus in Glasgow who told me she still talks with her husband and he passed away in 1993. She is entirely content for this to continue!
Meandering in a desert for days or weeks on end? Trapped up a real or even a metaphorical mountain? Lost touch with other people? Withdrawn into a private inner world that minimises social contact and connections with others? Again, there is a wealth of shared experiences that indicate how it is possible to become detached, isolated and in some cases physiologically and neurologically discombobulated.
The desert mystics were drawn to the arid and silent landscapes of the dunes precisely in order to disconnect from the world and reconnect with God and self, but if it isn't part of the actual desired objectives required by a person, isolation can also be a very challenging place to be.
It is quite understandable that, on hearing voices for the first time, folk can become preoccupied with their inner experience and tend to withdraw as they muse and try to figure out what is going on for them. Medically, we often percieve this as a symptom of a schizophrenic episode but, in reality, it is a quite understandable response to hearing voices in the intitial phase.
For creative types, of course, isolation can be a necessary prerequisite for creating an environment that allows space for thinking, painting, writing etc and is a natural part of the process of potentiality and of giving birth to new ideas and concepts.
Who am I?
What am i doing here?
What is it all about?
These questions appear at various junctures in our life stories as we pass through periods of psychological and personal development on the path to being fully formed beings!
Existential anxiety can be a very powerful and transformative experience although passing through it is hardly an easy ride.
Teenage years are a well known landscape for these experiences to be at their most prominent but they can occur at any point in our lives.,societal status, i.e losing a job, self esteem issues, relationship breakdowns and breakthroughs occur as current patterns and ways of being are disrupted and our "certainties" are shaken up and occasionally dissolved in a stew of confusion.
It is at times of stress and intensity like these that anyone may be subject to visions and voices. They may comment on current predicaments, advise or guide and even offer criticisms and abusive suggestions!
Sir Anthony Hopkins has spoken of the strange experience of reading prospective scripts whilst performing current acting roles. Utilising differing voices in an attempt to find the necessary "characterisation" for various upcoming projects, he was unable to sleep while these other voices continued to talk and voice sections of script he had been reading and sometimes more besides! .
I am told by another actor, residing in Edinburgh, Scotland, that once, he was awake at night and forced to listen whilst the character voices he had been working with casually discussed him, his acting abilities (or lack of) and all complete with criticisms and barbed insights as to his individual character.
He quickly realised that maybe, he had taken too much on and said "yes" to too many concurrent projects. Lesson learned. Pace yourself..
Unresolved Psychological traumas
A great deal of work has identified just how many folk who hear voices have passed through a painful trauma of one sort or another. Personal abuse at the hands of others, sexual safety, emotional intimidation and physical assaults on an ongoing basis can all become contributory factors in unresolved traumas and consequently may lead to the manifestation of visions or voices.
I worked, briefly, in the U.S midwest with some veterans of the Vietnam war back in a hospital setting in 2003 and in a support group they shared the details of some of the experiences they were subjected to at the time.
Now much older and despite the passing of the years, they still , at times, heard the voices of fallen comrades and had visual flashbacks which still resonated and distressed them.
Many were diagnosed as having Schizophrenia or a sub type of the condition as well as Post Traumatic Stress and all were reliant on medication to ameliorate their distressing symptoms.
They also carried emotional burdens of guilt , simply for surviving when others did not and in some cases their percived powerlessness in being unable to help their friends and comrades at the time invited feelings of helplessness which still resonated for them.
Unresolved and unbearable life pressures
Living with impossible pressures, whether a relationship that has become untenable or even potentially debilitating and dangerous to our health and safety, a job that becomes undoable for various reasons, trying to survive as a civilian in a conflict zone somewhere in our world, natural catastrophies that impact on us, refugees far from home and facing uncertain futures.
Being bullied , diminished and rendered powerless, by whoever and however, all impact on our ability to function in a balanced and self promoting way. And these issues and pressures can play out in our experience in various ways, each path to some degree unique to the individual undergoing the challenge but often sharing common general features.
I have spoken with female prisoners in a U.K prison wing who all gave accounts of some aspect of trying to live within impossible ontological, physical and psychological landscapes and not feeling they could affect change or access appropriate support.
They accessed self harming behaviours as coping mechanisms and were diagnosed as having psychiatric and personality disorders but, interestingly, once they explained the concepts and frameworks of reference for their thinking and actions, it all seemed to make so much sense, even though they agreed that it was a faulty coping strategy and they required something better!
About a third of the women heard ongoing voices and were happy to try some of the management strategies in a free handbook on cognitive responses to challenging voices. Also opportunities were identified for counselling support and trauma recovery as an indirect result of the interactions and sharings of lived experience.
The chemistry of the brain itself, the effect of altering the chemical production of certain naturally occuring chemicals such as Dopamine and Serotonin. Specific transmitter sites are targeted by medication in an effort to disrupt possible over or underproduction of chemicals relating to our mood.
Historically there have been conceptual battles between different camps of believers around the best method for tackling mental health "disorders" and currently the "Neuro Science" dialogue is the predominant and favoured route to treatment for many in the medical profession and generally the first response for all sorts of reasons.
On occasion, there has been evidence that even these drugs can sometimes exacerbate existing conditions and cause deterioration intially on the journey to stabilisation and many individuals also have to keep a watchful eye open for unwanted outcomes such as Tardive Diskenisia and Parkinsons, which in turn may require further treatments and extra medications.
One of the reasons individuals are sometimes reluctant to comply with treatment is fear of side effects and possible risk factors relating to long term dependency and issues connected to developing resistance over prolonged exposure to these drugs.
Drugs may have their uses but I would like to see a coalition of choice when it comes to responding to mental health issues. Cognitive and self empowering strategies should be shared more widely so that we can reduce long term dependancy on drugs for stabilisation and symptom management.
The brain is a complex, subtle and sensitive instrument and is impacted by chemical changes of all kinds and however they are produced. The effects of coffee and tobacco, food ingredients, the air we breathe, the combinatory effects of all these and more can produce alterations in neurochemical actions and consequences for brain functioning.
Listening to accounts of the effects of oxygen deprivation on pilots flying high altitude planes, they reported hearing voices, having conversations and "seeing" other people, either inside or even outside the plane on occasion!
Also, mountaineers at high altitude have reported similiar experiences and occasionally deep sea divers too. I met professionals in the UK who confirmed similar experiences in their own personal dive histories.
If you have had a family member experience distressing visions or voices, research from the 1960s and 70s seemed to indicate a heightened likelihood that you may have a similar experience or at least be more predisposed to the condition.
Currently, no single gene has been identified as causing or triggering "schizophrenic" conditions.
Temporal Lope Epilepsy
I have worked with several individuals who claimed to me that they had struggled to have this condition acknowledged, explored, recognised and treated and consequently had been given a diagnosis of schizophrenia.
Eventually, I believe the correct tests were carried out and they received the more appropriate diagnosis and treatment. They brought in to the hospital their own research findings and matched their symptoms accordingly but told me that at the time, no one seemed interested in listening to their claims.
They were in acute admission wards which by their nature are intense and very busy places. Nursing staff reported and wrote it up as an aspect of obsessive behaviour and all it did was confirm an apparent lack of insight" which was then fed back to the consultant at care meetings and ward rounds.
Naturally, he was concerned enough to feel a need to request compulsory powers over care and treatment. The client perceived as "non compliant."
Sometimes our inner "reality" does not match up with generally accepted definitions of normality held by others. We may be hyper sensitive to perceived signs and symbols that appear to make sense and contain some meaning for us but not to others.
It is sometimes possible that we have a super inflated sense of something remarkable that is happening and we may have an important part to play in the unfolding drama.
I have worked with many individuals over the years who worried intensively about issues such as covert surveillance, government conspiracies and secretive plots against them.
When the perceived signs and symbols appear to confirm their thoughts and ideas this can be a very powerful experience, underlining and strengthening what psychiatrists refer to as "delusional thought processes".
Naturally enough, when this is happening, a person is in a super sensitized state, neurologically and psychologically, passing through an intense personal experience that may be entirely confusing and surreal to others who are exposed to the conceptual framework which purports to explain and rationalise the lived experience and understanding of the individual.
In other words...it may make little sense to observers but is entirely believed in by the person undergoing the journey...
Breakdowns sometimes can be breakthroughs too though , and once lived through, can be triggers to positive personal change and individual growth.
Often it might be necessary in extreme circumstances for a person to achieve a kind of separation from their body in order to survive traumatic experiences during the event or events. Survivors of torture, sexual abuse and physical mis treatment often recall or report this experience as it may seem to form something of a coping strategy to get through an unbearable ontological crisis.
In research, it has been revealed that a high percentage of people who utilised this response continue to hear voices and often have flashbacks which can be triggered by stressful situations and being exposed to material, sounds and sights which remind them subconsciously of their previous experiences.
Psychological therapies may be useful in assisting the reintegration of these individuals once the underlying condition is recognised and accepted as requiring support and treatment. obviously, if hearing voices, drawing upon established cognitive strategies for better management of symptoms may be beneficial too!