You’re going to be late for that meeting; you haven’t even left the house. But where’s your wallet? It’s not in your pocket, it’s not in your bag – come on, come on, you’ve got to find it. Where on Earth could it be? If you’re like me, that “come on, come on” will be sounding vividly in your head as you stomp from room to room. You’re issuing a silent instruction to yourself. But how does this inner voice really work? What purpose does it serve? Does everyone hear something similar? These are some of the questions that Charles Fernyhough sets out to investigate in The Voices Within.
Fernyhough is an interesting fellow. A professor at Durham University, he began his career in developmental psychology, with a focus on social, emotional and cognitive development. But in recent years he has shifted his attention to the study of psychosis – particularly the phenomenon of voice-hearing, in which the inner voice is not the speaker’s own, helpfully assisting in the search for a lost wallet, but seemingly external, often frightening, dismissive or commanding.
People who experience this are often simply labelled “schizophrenic” – a “highly misunderstood term”, Fernyhough writes. The word, coined in 1908 by the Swiss psychiatrist Eugen Bleuler, invokes alarm: “The sound of its sibilant label triggers fear and prejudice.” One of the aims of this book is to question that prejudice and to consider other ways of thinking about these “external” voices, setting them on a continuum with the dialogue we all conduct with ourselves.
But it is more than merely science that informs the author’s attention to how the sound of a word can influence its effect on its hearers. Fernyhough is also a novelist and not a little of this book is concerned
with another expression of the inner voice – the creation and consumption of fiction. When Fernyhough asked 1,500 people whether they heard the voices of fictional characters in their heads, 80 per cent said that they did; one in seven “said that those voices were as vivid as hearing an actual person speaking”. Many novelists report the experience of building their characters as being observational as much as it is creative. Fernyhough quotes David Mitchell describing his occupation as a kind of “controlled personality disorder . . . To make it work, you have to concentrate on the voices and get them talking to each other.” Fernyhough’s fine description of how it feels to read fiction is an expert blend of the scientific and artistic:
The voices we encounter in a novel can express our desires, threaten our safety, challenge our morals and speak of what cannot be said. They take us into a place of expanded possibilities where we can try on other identities. Through their expert control of these fictional voices, novelists lead us into a controlled dissolution of the self, and then bring us back safely to who we are.
What happens when that dissolution of the self is not controlled? Fernyhough introduces us to Jay, who hears the voices in his head as having different accents, pitches and tones. There is Adam, who lives with a voice he knows as the Captain; the Captain is a hard taskmaster, ordering Adam around, berating him, letting him know who’s boss. And yet, while Adam struggles with the Captain, he doesn’t long for his disappearance. “It feels like you’ve got a mate looking out for you as well,” Adam says.
The Dutch psychiatrist Marius Romme is a pioneer of the Hearing Voices Movement, which aims to remove the stigma often attached to the phenomenon of voice-hearing and instead pays attention to the information (about childhood trauma, for example) that those voices bring to the surface. Fernyhough discusses this approach with sensitivity and warmth.
The trouble is, as the author demonstrates, that discovering what is going on in the individual’s brain isn’t simple. Although voices, as he writes, can give us clues to “the fragmentary constitution of an ordinary human self”, the nature of that self – how my self makes itself distinct from your self, whether the voices in my head “sound” different to the ones in yours – is one of the central problems of both philosophy and science. Fernyhough doesn’t skimp on the science when demonstrating the difficulties that arise from “self-reporting”: inner voices must, by necessity, always be described by the person experiencing them.
The book traces in detail (the footnotes are just as interesting as the text) the various attempts to pin down inner voices, whether those involve MRI scans or something called “Descriptive Experience Sampling” (DES), by which volunteers describe exactly what they are thinking when a beeper goes off in their ears. Yet there is still a fascinating gap between science and experience: it remains impossible to express what those voices really sound like to each person who hears them.
The voices within have always been with us and this is a book of history as well as one concerned with science and art. In centuries past, our ancestors seemed rather more certain of the source of the voices that rang inside them. Fernyhough doesn’t neglect those who knew that what they heard was the voice of God – or the gods.
His discussion of Margery Kempe, the 14th-century English mystic whose recounting of her spiritual life lays claim to being the first autobiography written in the language, is particularly sensitive. And he is careful of the retrospective “reductionist dishing-out of diagnoses” when it comes to figures such as Kempe, or Julian of Norwich, or Joan of Arc. His role as a scientist does not prevent him from recognising Kempe’s experience as what it must have been for her – “an inner conversation with a very special substance: the relationship between a woman and her God”. The brain’s conversation was once perceived as mystic. Even if that is no longer wholly the case, much mystery remains.
The Voices Within: the History and Science of How We Talk to Ourselves by Charles Fernyhough is published by Profile Books/Wellcome Collection (319pp, £16.99)
This article appears in the 25 May 2016 issue of the New Statesman, The Brexit odd squad