One of the most tragic, severe, and terrifying symptoms of mental illness is the hearing of voices. It is increasingly common to witness an agitated person on the street who communicates with someone not physically present. What exactly goes on when people hear voices? In most non-Western cultures, such voices of spirits are commonplace, and expected, but in a Western framework, theorists, theologians, and therapists tend to describe this phenomenon too simplistically, without enough credence paid to worldview frameworks and competing ideas of mental illness. Thus, the global evangelical is wise to revisit this topic of voices all the while mindfully avoiding the trap of materialistic skepticism on the one hand, and magical superstition on the other (Lewis, 9).
Modern psychoanalysis classifies these voices as a mental illness, that is, psychosis as a symptom of schizophrenia or dissociative identity disorder (DID, formerly MPD). They are hallucinations and delusions (Longden, 2017; Walsh, 2018), and while helpful in certain pragmatic ways (Lieberman, 2023; Hayward, et. al, 2018), these diagnoses are often merely approximations and do not account for spiritual causes (SAMHSA, van Os, 2010).
Obviously, demonology provides another assessment of the voices. While deliverance ministries and exorcists may or may not see a physiological-psychological component to this phenomenon, they attribute the symptoms to some sort of demonic presence and power. Of course, there is a spectrum within this demonological-preternatural position characterizing the extent to which mental illness plays a role in the manifestations of the voices. The canonized Roman Catholic organization International Association of Exorcists believes at least some of these symptoms are physiological (Bauer, 2022), whereas certain Pentecostal deliverance movements account for them as being wholly demonic (Tefo, 2022; Poskitt, 2018).
This paper will revisit this phenomenon of “hearing voices” and develop a theological, scientific, and pastoral approach. Physiological, sociological, and spiritual etiologies can be at play in auditory psychotic manifestations. More specifically, mental illness may be a gateway for the demonic; or—as Crooks advocates—demon possession can be parasitic upon somatic disease, psychiatric disorders, and stress conditions (Crooks, 2018).
This study will address the theological issues of etiology/causation of the voices. The symptoms of demon possession in the Bible (Mark 5, etc.) provide a standard by which to assess the voices. The interaction of the brain with soul/spirit intersects with how Satan/demons implant thoughts and, ultimately, attempt to take over the human being. Yet involuntary mental illness is different than “nominally voluntary” possession (Crooks, 2018), a key distinction.
Pastoral concerns will be directed to help sufferers. Because of comorbidity factors, a proper physiological and psychological diagnosis is a crucial initial step. Then, shepherding must funnel through Christ the Redeemer, Victor, and Healer, which encourages conversion and its assurance of forgiveness, regeneration, discipleship, and Christian community. This shepherding must also set parameters that reject demythologizing the Bible’s record and emphasize the power of the gospel of Christ (vs. the power of certain rites or rituals). Finally, such shepherding can be aided by ongoing support organizations (see SAMHSA, NAMI, etc.).