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Muses, Madmen, and Prophets: Hearing Voices and the Borders of Sanity

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I have long been intrigued by the ideas put forth in the late Julian Jaynes's "The Origin of Consciousness In the Breakdown of the Bicameral Mind". Jaynes's theorized that humans did not achieve actual consciousness until comparatively recent times (it varied from culture to culture but in the Near- and Middle-East, according to Jaynes it would have been several centuries or a millennium or so BC). And he believed that the pre-conscious state was characterized by auditory hallucinations that were generally interpreted as the voices of the gods.

Jaynes's central theory about the origin of consciousness is probably beyond proof (exactly what is consciousness is a slippery concept, but Jaynes does NOT equate it self-awareness), but he does supply a great deal of evidence about how ancient humans did believe they regularly "heard" the voices of gods, and that at some point (again, it was not the same for all cultures), that ability went away, often with devastating consequences for a culture suddenly left without seeming divine guidance.

Daniel B. Smith's "Muses, Madmen, and Prophets: Rethinking the History, Science, and Meaning of Auditory Hallucination" addresses the survival of the phenomenon of "hearing voices" generated unconsciously by one's own mind. Popularly, hearing such voices is viewed as evidence of mental illness (indeed, schizophrenia has become in recent decades almost defined by the phenomenon), but Smith's book demonstrates that auditory hallucination is fairly common in people who are otherwise viewed as mentally normal. Surveys have supplied varying figures for the phenomenon (understandably, many people are reluctant to admit to a circumstance which might earn them a careless label of "crazy"; I suspect that the frequency of positive responses to the survey questions depend a great deal upon just how the questions were phrased), but it appears that at least a few percent up to maybe the majority of people at some time in their lives experience auditory hallucination, perhaps only a single time, although in some cases the phenomenon can be almost continual (Smith's own father and grandfather "heard voices" much of their lives). The condition is sometimes connected with stress (participants in combat and victims of rape appear to especially prone to it) and it sometimes is associated with bursts of great creativity. Smith discusses quite a number of famous people who regularly experienced what in today's rational world would be termed auditory hallucination: Socrates, Joan of Arc, and William Blake included.

Smith's book is not a dense, statistic-laden study, but rather a fast-flowing, somewhat ancecdotal introduction to a fascinating phenomenon which at one time may have played a decisive role in human culture and continues even today to shape some people's lives.

This is a fascinating and important book about a common experience that has at different times led to inspiration, fear and sadly also misery and misunderstanding. It is estimated that at any given time about three percent of the population of the United States experiences auditory hallucinations, and over a lifetime the figure is much higher, particularly after a major stressor, such as bereavement. I say "United States" quite deliberately: there is evidence that in rural Africa and rural India visual hallucinations are more common than auditory.

As Daniel Smith says in his preface,
"It (hearing voices) occurs in cultures in al regions of the Earth and is an appropriate topic of study for an array of disciplines, including psychiatry, psychology, neurology, philosophy, anthropology, theology and linguistics."
To his list we could herbalism, pharmacology and parapsychology: there are hallucinogens that produce not only visual experiences, but also auditory and cross-modal hallucinations. And records of hearing discarnate entities have exercised parapsychologists for a century or more.

As Daniel says, he chose to be selective in his choice of material about unusual auditory experiences, and to try and tell a story. And what a story it is, running from ancient prophets to modern brain science. There are twelve chapters and the titles give you a good idea of his approach:
1. Prelude: The Pathological Assumption
2. The House of Mirrors
3. Noble Automatons
4. Interlude: Listening
5. The Tyranny of Meaning
6. The Soft-Spoken God
7. Enigmatical Dictation
8. Interlude: Floating
9. Personal Deity: Socrates Versus the State
10. Digna Vox: Joan of Arc Versus the Church
11. Morbid Offspring: Daniel Paul Schreber Versus Psychiatry
12. Postlude: Hearing Voices

Followed by Notes, quite a good Bibliography and Index.

Though he is not a specialist in the art and science of auditory hallucinations, Daniel has read widely, thought deeply and enlisted the help of some of the foremost experts in the field. He has the advantage of not only being able to think outside the box, but of throwing the box out of the window!

I sometimes sound like a broken record, insisting that hearing voices is NOT diagnostic of mental illness. Daniel makes the same point in this book, and it needs to be repeated until everyone "gets it." I have just had a discussion with some young and rather inexperienced psychiatrists who told me that if they met someone who was hearing voices, they would immediately prescribe antipsychotic medicines. There is not a shred of evidence that they should do anything of the sort unless someone is suffering or causing suffering. And even then, the "voices" should not be the focus of treatment.

Several reviewers have mentioned the work of Julian Jaynes, who postulated that auditory hallucinations were generated in the right, or non-dominant hemisphere of the brain. This book presents one of the best brief overviews of Jaynes' work that I have seen. There is an amusing little sidebar here. It is not widely known that Jaynes, like many creative innovators, had a hard time being taken seriously by other academics. He was ridiculed in some publications from the late 1970s, he was sometimes treated unkindly and people even tried to perpetrate hoaxes on him.

There is a region of the brain called the planum temporale that is the most highly lateralized part of the brain and is involved in the genesis of language and thought. Healthy right-handed volunteers usually have a large planum in the left hemisphere of the brain. In 1993 a team of people at Johns Hopkins first showed that people with schizophrenia do indeed have an equally large planum in the right hemisphere, suggesting that Jaynes was correct all along. When people hear voices, they really do: it is not something "made up." When Jaynes was called at his office at Princeton to be told about the research, he was initially suspicious that this was another hoax. Years of bad experiences had taught him to be cautious. He was thrilled when he was shown the data and that this was not some prank. The research was published in the American Journal of Psychiatry in 1995, and has since been confirmed many times.

This tale is important for another reason: Daniel does not make the common mistake of trying to reduce the hearing of voices to a some aberrant wiring in the brain. Sometimes it may be, but usually it is not. Instead he examines not just the phenomenon, but also the experience, from multiple perspectives: historical, cultural, anthropological, artistic and more besides.

The is a rich, very well written and wise book that should be an easy read for a generalist with an interest in psychology, history and spirituality.

Highly recommended.

Daniel B. Smith' Muses, Madmen and Prophets is a son's labor of love for his father. Smith's father, an attorney, heard voices throughout his life, a fact that shamed and terrified him. Smith's grandfather also heard voices, but in his case, he listened to the voices without distress.
Smith makes a good argument that voice hearing was accepted as a phenomenon in human experience until the rise of modern psychiatry in the first half of the nineteenth century. Socrates heard voices. Abraham, Moses and all eighteen prophets of the Old Testament reported hearing the voice of God, as did Joan of Arc. But as modern psychiatry developed, and because hearing voices is such a key symptom of schizophrenia, public opinion shifted to believe that all voice hearing was indicative of severe mental illness.
In the 1980's a Dutch psychiatrist went on a talk show with his voice hearing patient, and asked that anyone in the audience who had experienced voice hearing please telephone him. He received 450 calls, from which developed the Hearing Voices Network, an association of people who hear voices, many of whom lead normal lives and are not mentally ill. This break-through allowed a distinction to be made between voice hearing individuals who are schizophrenic and voice hearing individuals who are not. Thus ended more than 100 years of automatic classification as insane for people who hear voices.
Smith advances an interesting idea that at the time of the ancient Greeks, at the time of Moses, human beings experienced inspiration as coming from the outside, but as the human brain changed over thousands of years, inspiration came to be experienced as thought. Though he didn't mention it, there is a phenomenon called synesthesia in which people hear music when they look at certain sights and see colors and shapes when they hear particular musical notes. One explanation for synesthesia is that as the human senses have evolved, they have separated one from another, but in some cases, the senses remain bundled. Could human senses have been bundled at the time of the Muses and Oracles, at the time of Moses, or when Mohammed heard the Archangel Gabriel tell him to recite? Who knows?
Smith's book is scholarly and intriguing without being pedantic. His thought moves in great sweeps and his prose is luminous and fluid.
Underlying it all is the tragic loss of Smith's father. Had he known what his son discovered, this man might still be alive.

Daniel B. Smith comes to his interest in voices in an unusual manner. He doesn't hear voices (of people who are not present), and he has no medical or scientific training on the topic. Rather, he is intrigued because his father secretly heard voices yet was not schizophrenic.

By approaching voice-hearing through a historical lens, Smith is able to show how our current concept of voices is the product of the modern era's overthrow of religion by science and medicine (and specifically psychiatry). To make his point, he focuses on three of the most well-known voice hearers in history - Socrates, Joan of Arc, and Daniel Schreber, a 19th-century judge whose madness was analyzed by Freud and Jung. All eras, he explains, subject the hearing of voices to a test. In Socrates' time, the test was political: "Are the voices subversive or corrupting to the state?" In the Middle Ages, the test was theological: "Are the voices those of God or of the Devil?" It is only in the modern era that the test has become a psychiatric one. He makes an interesting argument about the use of the term "hallucinations," saying that it was the adoption of that term that made the ultimate pathologization of voice-hearers inevitable.

Smith frames voice-hearing in the modern era as a human rights issue. Voice-hearers must struggle against the psychiatric establishment for self-determination - the right to keep their voices, and to decide for themselves about the meaning of those voices.

Although Smith's style is a bit meandering at times, his effort to normalize the hearing of voices is refreshing in the current psychiatrically dominated climate of pathology. And his accounts of the three historical figures are quite interesting in their own right. I recommend the book to anyone interested in an offbeat, alternate history and interpretation of the widespread, multi-determined phenomenon of voice-hearing.

"Muses, Madmen, and Prophets" is a sketchy discussion of auditory hallucinations, which the author (and others) refer to as 'voice-hearing'.

In particular, the book addresses the issue of whether or not such hallucinations should even be regarded as symptoms of psychopathologies.

Unfortunately, the book only seems to skim the science, psychology and sociology of the subject, before embarking on various lengthy tangents, including long-winded descriptions of the life and times Socrates, Joan of Arc, etc.

For example, an entire chapter is devoted to whether Socrates was executed for the stated reason of 'corrupting the minds of the youth of Athens' or whether he was instead executed merely for claiming he heard voices. Personally, I'm much more interested in why (and how) he heard voices. I'm considerably less interested in the details of the Athenian legal system.

Although some readers might enjoy the author's "buffet-style" treatment of various far-ranging subjects, I'd have preferred a more thorough and rigorous discussion of the voice-hearing phenomenon itself, with less conjecture about historical figures.

Moreover, there is little discussion of topics that would seem to be pertinent, such as dreams. After all, aren't we all 'voice-hearers' while we're dreaming? And what does the science of evolutionary psychology have to say about auditory hallucinations (which would appear to be strongly disfavored from a survival standpoint)?

Also, there is little discussion of the contemporary science on schizophrenia, as it relates to auditory hallucinations. [For an interesting book on schizophrenia, see "Schizophrenia Revealed" by Green.]

Finally, note that the author is a journalist whose father and grandfather were both 'voice-hearers'. The book includes many of the author's musings about his father, which may be of minimal interest to most readers.

So, although the book is generally intriguing -- and helpful in re-calibrating our notions of whether auditory hallucinations are truly psychopathologic -- I cannot truly recommend the text.

P.S. Regarding the term 'voice-hearing', I understand the desire to avoid using the term 'hallucination', as it can be stigmatizing. But I'm not sure that 'voice-hearing' is helpful. As the author explains, many auditory hallucinations do not involve voices, but merely sounds or music. Also, of course, we *all* hear voices (other than those who are deaf.) So, we are all voice-hearers. As such, the term 'voice-hearing' doesn't seem to properly capture the phenomena.]

Join Daniel B. Smith on a fascinating and confronting journey based on the simple premise that, to those that hear them, the voices are real. It's a journey inspired by the author's desire to understand his own father's life-long battle with voices and to understand something he, despite some misguided but valiant efforts, has not been able to experience himself.

We start with an insightful account of the phenomenon of speaking in and hearing a "real" voice and the author's assertion that the precise nature of this most basic of human interactions remains elusive. We then meet some interesting theorists (including the always contentious Julian Jaynes), academics, neurologists, psychiatrists and other likely suspects, none of whom seem to have any definitive understanding of this apparently all-too-common human experience. We conclude with a good look at some historically famous voice hearers such as Socrates, Joan of Arc, and Freudian favourite Daniel Paul Schreber.

Smith writes in a witty, engaging, and authoritative style that makes for a great read. He calls us to re-think deeply ingrained cultural prejudices that would have us reductively interpret, stigmatise, pathologise, and fear voice hearing rather than asking what is being said, by whom, and why. Listen, enjoy, and be challenged, as I have been.

If you are interested in reading about the subject of those who "hear voices", you will like this book. It discusses those throughout history, who have famously been "guided by voices" who are considered to be geniuses, and not mentally unstable. It makes a case for considering all the circumstances around this phenomenon, and not just jumping to the conclusion that the person is "insane".

"Those who hear voices and what they hear in their hallucinations is examined thoroughly and almost explained in this penetrating study."

Very weak analysis. Weak book in it's entirety. Author does not know how to reach a conclusion. Don't waste your money.