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Auditory Hallucinations May Vary Across Cultures


For people with schizophrenia, auditory hallucinations can be terrifying - voices that come out of nowhere to berate you or tell you to harm yourself. But the experience of those voices - what they say and how they say it - might be different across cultures. Dr. Tanya Luhrmann went through accounts of schizophrenics in the U.S., in Accra, Ghana and in Chennai, India.

TANYA LUHRMANN: The Americans I spoke to, they felt assaulted by horrible voices that told them that they were worthless and they should die. Those voices were full of violence. In Ghana, the Africans heard an audible God who told them not to ignore those evil voices. And in Chennai, people heard annoying relatives who told them to do chores and cleanup.

RATH: Dr. Luhrmann emphasizes these are findings across populations, not individuals. Having schizophrenia in the U.S. doesn't necessarily mean that you'll hear scarier voices, but the broader differences across cultures were unmistakable. Dr. Luhrmann is not a psychologist but a professor of anthropology, so I asked her about the cultural factors that could influence the nature of hallucinations.

LUHRMANN: So I think Americans think of their minds as a private fortress. And they have this model that when you hear an audible voice, it means that your mind is broken. And I think people find that terribly upsetting. I think they're different social invitations in Chennai and Accra. I think that there's a much more of a invitation to think about things supernatural, to think about the religious world, to interpret these experiences as the voice of a spirit. Particularly in Chennai, there's this invitation to a much more social world to interpret that auditory experience as if it's another person. Somehow, this kind of - this sense of private violation is so much more salient to the Americans than it was to people in these two other worlds.

RATH: Can you talk about the implications this might have for treatment? Could it be possible for people to learn how to perceive these voices differently?

LUHRMANN: I think there are reasons to think that that's true. Increasingly, we have research within psychiatry that suggests that when you train people to think about the meaning of their voices and to respond differently to their voices, voice hearing can change for them. One of the more fascinating studies was done by this guy Julian Leff who created a computer avatar for a voice. And then he had the patients talk to the voice, and he manipulated what the voice said in return. And as patients experienced their sense that the voice was changing in response to them, their voice hearing diminished.

RATH: For a very long time, there've been individuals advocating incorporating Eastern philosophy into Western psychology, and that goes all the way back to Jung. Is that kind of what you're talking about here?

LUHRMANN: Yes. I think that you can think about this practice as a different way of paying attention to your own thoughts. I actually think of it as sort of analogous to prayer - that you - when you pray, you are paying attention to your inner experience and you are trying to pay attention to some parts of your mental experience and not others. You're trying to look for positive thoughts, not negative thoughts. You're trying to quiet your anxious inner voices.

Thats kind of what these new interventions suggest. And what I saw in the difference between Accra and Chennai and the American patients was a different kind of approach to thinking about thought and thinking about mental experience.

RATH: Dr. Tanya Luhrmann is a professor of anthropology at Stanford. It's fascinating, Tanya. Thank you very much.

LUHRMANN: Thank you so much. Transcript provided by NPR, Copyright NPR.

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