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For instance, the person may be told by the voices to harm the family members they most love. They may be told to give up their studies, sports, or the career they have worked at all their life.

They may be told to harm themselves in the most painful ways. Another reason the voices are so very effective is that there is no hiding place from them. Wherever the person goes, whatever they do the voices are always with them.

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A third reason that they are effective is that the sufferer has little or no control over them and may develop an overwhelming feeling of impotence in the face of them. In that way they avoid the trauma that they have come to realise is the inevitable consequence of not doing what the voices want.

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Another important factor which gives the voices power lies in their connection with the other experiences. Remember, the voices do not operate alone, but rather in combination with all of the other experiences such as delusions, all of which appear, to the sufferer at least, to be acting in concert and taking them in one particular direction. For instance, the voice hearer may hear voices which they then in turn believe are coming from God, angels or one of the saints. This combination of delusions and hallucinations makes the voices much more influential. This is reinforced if, as in many cases, the sufferer has a religious or supernatural structure to their delusions, as this will play an important part in legitimising the messages coming from the voices.

Persecutory or nasty voices are one of the most common and often one of the most disabling of symptoms for people living with schizophrenia. Their effect should not be underestimated by relatives and carers.


When they are really bad they can prevent you from doing even basic everyday things like getting out of bed and looking after yourself, and at their worst they can drive you to behave in ways that are strange or even dangerous. Sometimes the person hearing voices may have an audible conversation with them when there is no one else around.

Such conversations can become quite animated: they may argue with their voices or shout at them. Sometimes they may laugh or smile for no apparent reason, or become anxious or angry or shriek in distress. At other times you may find it difficult to get the persons attention when you are trying to talk to them. If you want to know what this is like, try switching the television and radio on at the same time and decipher what they are both saying.

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Some studies have found that when people with schizophrenia use alcohol or street drugs their voices will often get worse, 3 and as with the other psychotic symptoms the voices will also get worse when the sufferer is under pressure emotionally and psychologically, particularly if they are experiencing open hostility. Some work has been carried out into the use of cognitive behavioural therapy to treat voices. The initial results are promising but not consistent, and the jury is still out on this although CBT may be more effective in helping people to cope with delusions.

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See also our information sheet on Coping with Voices. Living with schizophrenia was set up by people who have direct personal experience of the condition using their own personal funds and relies on donations to continue its work.

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