Trauma can contribute to voice-hearing but is not necessary for it. This article uses ethnographic and other data to show multiple pathways to voice-hearing in both clinical and nonclinical populations, excluding known causes like drugs or epilepsy. Trauma sometimes plays a major role, sometimes a minor role, and sometimes no role at all. Distinct phenomenological patterns in voice-hearing may reflect different salience of trauma for those who hear voices.
Hearing voices is well studied in psychosis, but unusual perceptions in other senses and in other mental health conditions are often overlooked. This narrative review examined voices and altered perceptual experiences across psychotic, mood, and anxiety disorders. Key findings include: these experiences vary widely within individuals and across diagnoses, often involving multiple senses; existing research focuses mainly on trauma and brain processes as causes; current theories mostly address only voices; new treatments need to be broader; and there are major issues with how these experiences are defined and how they differ across cultures. The review calls for better assessment tools and more consistent research methods, and emphasizes including patients' own perspectives and cultural context.