I hear voices because of my dissociative identity disorder (DID), but I’m not psychotic. Hearing voices is a symptom experienced by many people who have DID. These auditory hallucinations are not the same as those experienced in psychosis; they are internal rather than external. Hearing voices is a normal part of having DID, but is a misunderstood symptom.
I Hear Voices but the Criteria for DID Does Not Include Hearing Voices
There are five criteria required for a diagnosis of dissociative identity disorder according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). None of the criteria required for diagnosis involves auditory hallucinations or the experience of hearing voices.
This lack of inclusion makes hearing voices a less understood experience of DID. People reading the DSM-5 criteria may dismiss their symptom as a sign of something else and clinicians may assume that a client who hears voices is experiencing something other than DID.
Stigma Surrounding the Experience of Hearing Voices
Even as mental health awareness increases, there is still substantial misunderstanding and stigma surrounding people who hear voices. If someone overhears a person talking to themselves, they often assume that person is psychotic. Even more harmful is when a person opens up about their experience of hearing voices only to be put down or called crazy. Whether hearing voices is caused by schizophrenia, psychosis, or dissociative identity disorder, it does not make a person crazy or any less worthy of care and compassion.
I’m Not Always Honest When Asked If I Hear Voices
I’ve been asked the question dozens of times — whether in person or in filling out forms: Do you hear voices that only you can hear?
Sometimes the question is worded a little differently, but the point is still the same. The question gives me anxiety every time I have to answer it. There’s an inner battle I have with myself. Do I answer honestly or just let it go and say “no?” I hesitate every time. But each time a clinician asks, I say “no.”
Why? Because there is a tendency, even today, to assume that anyone who hears voices is experiencing psychosis. I made the mistake of telling someone about the voices I heard, and they labeled me as schizophrenic. The voices were not because of any psychosis; they were the voices of my alters, or parts — a normal experience of having DID.
I never want to go through that again. I was prescribed strong anti-psychotic medication, which did nothing for me. I had a wrong diagnosis that led to the wrong treatment. It was a disheartening experience for me, and, unfortunately, I’ve met others who have experienced the same.
Education is key, not only for people in general but for clinicians as well. Hearing voices doesn’t automatically mean someone is psychotic. There needs to be a change in the way psychiatric evaluations are worded, and in the way clinicians approach clients who hear voices. Acceptance and understanding can be extremely validating.
Maybe one day, I can be completely honest when someone asks if I hear voices.