Auditory verbal hallucinations (AVH) often become personified, but little is known about how this happens. In interviews with 40 early psychosis service users, 40% reported complex personification of their voices. Personified voices were more likely to be experienced as conversational and companionable, but not as commanding or trauma-related. The duration of voice-hearing or age at onset did not predict personification. The findings suggest that personification is linked to the social affordances of voices—their capacity for conversation and companionship—rather than their threatening or commanding qualities.
Voice-hearing in people with psychosis and in nonclinical spiritualist communities shows important similarities and differences. Nonclinical voice-hearers report less distress and more control over their voices, consistent with prior findings. They also often integrate multiple sensory modalities into a single entity, experience high levels of associated visual imagery, and perceive voices in locations that differ in relation to perceptual boundaries. Most nonclinical voice-hearers reported hearing voices before encountering spiritualism, indicating that onset was not solely due to deliberate practice. The study suggests that understanding how spiritual voice-hearers cultivate and control voices after onset may inform interventions for distressing voices in psychosis.
Felt presence—the sensation that someone else is nearby despite no sensory evidence—has been recognized in psychosis for over a century but has been difficult to study. Recently it has been identified across multiple diagnoses and emphasized by people with psychosis as a clinical priority. This work describes how felt presence appears in a first-episode psychosis sample and reports initial links to affect, gender, and psychopathology.