The Voices
Locutions, the discernment of spirits, and hearing voices without illness.
In the Texts
The manuals know three kinds of voice: the demon’s, speaking through the possessed or in the ear of the tempted; the saint’s locution, which Teresa of Ávila describes with care; and the voice of the melancholic, which the physician must tell from the others. The discretio spirituum, the discernment of spirits, was a developed art with its tests: whether the voice urges humility or pride, whether its fruits are good, whether it agrees with the faith.
What Medicine Makes of It
Hearing a voice is not in itself a sign of illness: surveys put the lifetime rate in the general population at five to fifteen per cent. The anthropologist Tanya Luhrmann found American evangelicals learning to hear God through practice, and found the voices of psychotic patients in Chennai and Accra kinder and more familiar than those in California, the culture shaping even the symptom. Psychiatry now distinguishes the voices of schizophrenia, which are often commanding and abusive and come with other signs, from the voices of grief, trauma, and religious practice, and the Hearing Voices Movement has taught clinicians to ask what the voice says before asking what drug will silence it. The discernment of spirits was a version of that question.
The Evidence
- Luhrmann’s fieldwork among American evangelicals (2012) found that hearing God’s voice was learned by practice, in a minority of worshippers, and was experienced as external and benign; in interviews with voice-hearers in Chennai and Accra (2015) the voices were more often kin and spirits, and less often abusive, than in San Mateo.
- About 5 to 15 per cent of the general population hear voices at some time without illness (Beavan et al., 2011); the voice itself is not the disease.
- Joan of Arc’s voices have been diagnosed as temporal-lobe epilepsy, schizophrenia, and tuberculosis, and none of the diagnoses accounts for a girl who led armies; the retrospective diagnosis of saints is a game the evidence cannot settle (Ratnasuriya, 1986).
- The medieval discretio spirituum, the discernment of spirits, had its own tests: humility, orthodoxy, the fruits of the voice in conduct; Jean Gerson’s treatise (1401) reads like a clinical interview.
- The Hearing Voices Movement (Romme and Escher, 1989) treats voices as meaningful experiences to be understood rather than symptoms to be suppressed, and has moved psychiatric practice toward the older view.
Where They Part
The manuals asked whose voice it was; the clinic asks what it does to the hearer. The old test, by fruits, is nearer the modern one than the nineteenth century’s, which called every voice a symptom.
In the Materia Medica
Sources
- Luhrmann, T. M. (2012). When God Talks Back: Understanding the American Evangelical Relationship with God. Knopf.
- Luhrmann, T. M., et al. (2015). “Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana.” British Journal of Psychiatry 206.
- Beavan, V., Read, J., and Cartwright, C. (2011). “The prevalence of voice-hearers in the general population.” Journal of Mental Health 20.
- Gerson, J. (1401). De distinctione verarum visionum a falsis.
Historical and interpretive; not medical advice.