Hearing Voices in Your Head: Causes and the Limits of Explaining Them as Possession

This is general educational material by the author, not a medical diagnosis or a religious ruling for an individual case. Independent specialist review has not yet been completed. Do not stop a medication or change its dose based on this article; discuss care with a qualified professional.

A person may say, “I hear a voice in my head,” and one family member may assume possession while another assumes schizophrenia. The sentence alone is not enough for either conclusion. Before looking for an explanation, we need to know what the person means by “voice,” when it happens, and how much it affects daily life and safety.

There are different causes and circumstances associated with hearing voices, including conditions related to mental or physical health, sleep, medications or substances. Professional assessment looks at the whole picture, not at one isolated sentence.^[1][2] Islamic belief in the existence of jinn has its textual basis, but that belief does not make every experience of hearing a voice evidence that its cause is a jinn.^[6]

This distinction between an experience and its interpretation is one of the questions raised by the novel «أم عباس لجلب الحبيب وردّ المطلّقة». Here we examine the real-world question through independent sources, then return to its literary use in the novel.

What does a person mean by “voice”?

The phrase may refer to speech that the person hears while others do not, to a disturbing recurring thought, or to talking to oneself internally. So we ask about the experience before naming it: are you describing hearing speech, or a thought that keeps intruding? Does it happen around sleep? What follows from it?

Medical sources treat auditory hallucinations and intrusive thoughts as different concepts. The National Institute of Mental Health explains that psychosis is a group of symptoms that can include hallucinations, delusions and disorganized thinking, and that assessment requires a professional.^[2] In obsessive-compulsive disorder, unwanted recurring thoughts or compulsions may interfere with daily life.^[3]

The examples below can help formulate the question for a clinician; they are not a table for self-diagnosis:

Clarifying the experience protects the person from beginning the conversation with an accusation. They do not need to have perfect terminology; they can describe what is happening in their own words and leave the assessment to someone able to examine the context.

Why are there multiple medical possibilities?

The UK National Health Service notes that hallucinations can be associated with mental-health or neurological conditions, substances or medicines, and may also occur temporarily with sleep deprivation or around falling asleep and waking.^[1] This is a list of possibilities to assess; it does not mean that every voice equals a severe condition or that a reader can select a diagnosis from the list.

The National Institute of Mental Health also explains that psychosis does not have a single cause. It can be associated with schizophrenia, bipolar disorder or severe depression, as well as other factors including some medicines, substances and sleep deprivation. Experiencing psychosis also does not necessarily mean that a person will be diagnosed with schizophrenia.^[2]

The questions that matter therefore vary by case: when the experience began, accompanying changes, sleep, medications and substances, health history, and its effect on work, study or self-care. Sharing these details can help assessment and does not justify stopping a medicine or changing its dose without consulting the prescriber.^[2]

How can an internal experience feel like another voice?

One scientific hypothesis is that some hallucinations are related to disruption in distinguishing the source of internally generated activity. When a person prepares to speak, signals linked to that preparation affect auditory processing; researchers study how this coordination may differ in some patients rather than simply saying that they are “imagining things.”^[8]

In an original study published in PLOS Biology in 2024, researchers compared 20 patients with schizophrenia who had auditory verbal hallucinations with 20 patients with schizophrenia who did not. They recorded electrical brain responses during speech-preparation tasks and also used comparison data from healthy participants in a previous study. The patients were clinically stable and receiving medication.^[8]

They did not observe a statistically significant reduction in the auditory response during general speech preparation in either patient group compared with listening without preparation. When participants prepared a specific syllable, the pattern of response enhancement differed: in the hallucination group, enhancement appeared for the syllable that did not match the prepared one. The results and modelling supported a hypothesis of impaired coordination between speech production and auditory processing.^[8]

This is experimental evidence for a possible mechanism in a specific sample, not a final explanation for every voice. The small groups, medication use and reliance on earlier healthy-control data limit generalization. Nor does an electrophysiological pattern in a research task automatically become a clinical test that settles the cause of a reader’s experience—or a test for the existence of jinn.^[8]

The relevance to Maryam is clear: feeling that a voice is alien describes an experience worth hearing and assessing, but it does not by itself identify the source. We do not use the study to diagnose the character; it shows why moving from description of an experience to a claim about its cause requires additional evidence.

Voices around sleep are not the same question in every case

The NHS page on sleep paralysis explains that a person may be conscious while waking or falling asleep yet temporarily unable to move or speak, and may feel that someone is in the room or that something is pressing on them.^[4] This is a specific context with a recognized medical description.

But not every voice heard at night should be called sleep paralysis; the presence of a voice alone does not establish sleep paralysis. What matters is describing the timing and what happened with movement and awareness, then seeking assessment when distress persists or affects daily life. For more detail, read the guide to sleep paralysis and jathoom.

Distinguishing sleep-related experiences from waking experiences prevents two leaps: turning every unusual nighttime experience into a supernatural attack, and turning every unusual experience into the same medical diagnosis.

What does a cross-cultural study of voice-hearing say?

In an interview study published in The British Journal of Psychiatry in 2015, Luhrmann and colleagues compared 60 participants: 20 each in San Mateo in the United States, Chennai in India and Accra in Ghana. Participants met inclusion criteria related to schizophrenia; the sample was not a random sample of the general population.^[5]

The researchers found differences in how participants described the voices and their relationship to them. Experiences in the US sample were comparatively harsher and more threatening, while more personal relationships appeared in the other two samples. But the groups differed in age, clinical circumstances and care settings, and the numbers were small. The study therefore supports a question about the role of cultural context; it does not prove that culture is the sole cause, nor does it measure or disprove the existence of jinn.^[5]

The important addition for this report is to pay attention to the person’s language and to what the experience means to them while preserving the limits of comparison. The name a person gives the voice does not become proof of its source, and one study does not become a verdict on everyone in three countries.

How do we separate belief in jinn from explaining a particular voice?

The existence of jinn is stated explicitly in Surah al-Jinn, which begins by mentioning a group of them who listened to the Qur’an.^[6] Within Islamic belief, discussion of jinn therefore rests on a text rather than being merely a psychological metaphor.

But evidence for the existence of jinn does not by itself identify the cause of one person’s experience. Saying “I believe jinn exist” is different from saying “it has been established that the voice this person hears is caused by a jinn.” The second claim is about a specific case and cannot be established merely by the label given to the voice or by what the voice says.

That is the limit of inference adopted in this article. It is not a claim that medicine has tested all aspects of the unseen. Medical assessment investigates symptoms and causes that can be examined, and seeks to reduce suffering and risk. Respecting belief does not require confirming an unverified explanation or subjecting a person to coercion in the name of that explanation.

Does “waswasa” mean the same thing in religion and medicine?

Surah al-Nas mentions “the evil of the lurking whisperer” and “who whispers into the hearts of humankind.” In his commentary on verse 4, Ibn Kathir reports explanations concerning Satan’s whispering and withdrawal when God is remembered, and in his commentary on verse 6 he presents the view of whispering from devils among humans and jinn.^[9]

But we should not automatically equate this religious use of “waswasa” with obsessive-compulsive disorder as a medical diagnosis, or with auditory hallucinations as a perceptual experience. Similar words do not make the concepts identical: medical diagnosis requires assessment of pattern, impact and context, and the verses do not provide a clinical criterion for identifying the source of a particular voice.^[2][3][9]

The same applies to a person’s response to dhikr. The interpretation that the whisperer withdraws when God is remembered is not a medical protocol in which the person’s calm or the persistence of a voice can be used to determine the cause of a case. We do not infer weak faith from continuing distress, nor do we infer proven possession from improvement alone. The religious text retains its domain, while assessment of an individual case retains its own questions and evidence.

For more on the texts and their contexts, read Does Islam affirm the existence of jinn? Qur’an, Sunnah and the limits of inferring possession. To understand the difference between a symptom, a diagnosis and an interpretation, read Possession or Mental or Neurological Disorder?.

What if the voice insults me or mentions personal things?

The content of a voice can make the experience frightening and convincing to the person hearing it. But its content is not, by itself, a test of its source. Asking what the voice says is useful for understanding distress, risk and context; asserting the identity of the speaker requires evidence different from the intensity of the experience.

If the problem is an intrusive thought, the NHS page on OCD notes that unwanted thoughts can be frightening or repulsive, and that having them does not mean a person will act on them.^[7] This reassurance should not be generalized to every situation: an actual desire or plan to harm, or voices commanding harm, requires urgent help.^[1]

It is important for the person to describe the difference between fear of a thought and an actual intention, and between repetitive thinking and an experience of hearing. This article can help begin that conversation; it does not replace assessment.

When should we seek help?

The NHS advises seeking medical help for hallucinations. It treats voices telling someone to harm themselves or others, sudden confusion, or rapidly worsening hallucinations as reasons for immediate help.^[1] If there is immediate danger, contact local emergency services or the nearest emergency service; the UK phone numbers in the source do not apply to every country.

In a non-emergency assessment, try to describe when the experience began, how often it happens, sleep, medications and its effect on daily life. You do not need to settle the cause before asking for help. The National Institute of Mental Health also emphasizes involving the person in decisions about care and goals.^[2]

What can happen after assessment?

When psychosis is diagnosed, the National Institute of Mental Health explains that care may combine psychotherapy, appropriate medication, family support, and help with continuing school or work. The plan is chosen according to the person’s needs and preferences; it is not one prescription for everyone who has heard a voice. NIMH also notes that earlier access to care is associated with better prospects for recovery, and that recovery is possible.^[2]

The story therefore does not end when a name is put on the experience. The next question is how a person regains daily life and decision-making capacity, and who helps them do so. Family can support that process; disagreement over the interpretation of a voice should not become a reason to exclude the person from the conversation. This directly connects to Maryam’s question in the novel: do others hear her suffering, or do they only talk about its cause?

How does the dark margin use this question in «أم عباس»?

The dark margin on pages 184–185 comes after the scene of the episode and the voices. It raises possibilities involving seizures, dissociation, hallucinations and intrusive thoughts, and states: “The scene alone is therefore not enough to prove possession.” It then returns to a literary question about a voice that knows where Maryam hurts.

Literarily, the movement between explanation and question doubles the reader’s uncertainty. In the real-world report, however, the question does not become a conclusion about the cause of the voices. The alleged voice’s knowledge of the character’s pain belongs to the construction of the story; it is not an independent research experiment.

The wording of the question itself deserves attention: does the fact that the speech is painful and precise make it information from an external source? Not necessarily. Emotional precision is one thing; proving access to information that was unavailable to the person is another. We cannot cross from the first to the second without evidence. The neuroscience study does not test knowledge of Maryam’s secrets, and the fictional scene does not prove its hypothesis about Maryam.

The final question in the margin functions as a horror device: after giving the reader a possible explanation, it restores doubt with the word “why.” Its literary power comes from delaying resolution, while the research strength of this report comes from identifying what has actually been established and what remains a question. Preserving that difference protects the value of the novel; we do not need it to function as a clinical experiment in order to take the fear of its characters seriously.

The importance of the comparison becomes clearer beside Sheikh Ahmad’s stance on pages 194 and 200: the doctor continues, and Maryam remains the focus of care. The novel therefore gives ambiguity room while also presenting different ways of responding to the person who is suffering.

We can analyze this choice without diagnosing Maryam or treating the manuscript as a documented clinical case. Medical sources explain real-world phenomena within their limits, religious texts clarify the domain of belief, and the novel explores what happens to a person when others compete to interpret their experience.

For information about the work and its current status, see the official page for «أم عباس لجلب الحبيب ورد المطلقة».

Frightening thoughts can occur without an experience of hearing a voice; read Do Intrusive Thoughts Mean I Want to Do It? to understand the difference between a thought, intention and the limits of OCD.

Sources and reading locations

أم عباس لجلب الحبيب وردّ المطلّقة

A forthcoming psychological-horror novel by Ahmed Alhafiz. Explore its world and current status, then read the related research files according to the question that interests you.

Explore the novelRead about jinn and the limits of inference