“The first time that I heard this voice, I was very much frightened,” the prisoner testified. “When I heard it for the third time, I recognized that it was the voice of an angel … The voice said to me: ‘Go into France!’ I could bear it no longer.”

Joan of Arc, who spoke these words before her execution in 1431, is just one of many notable voice-hearers cited in the literature of Intervoice, an advocacy organization for individuals living with auditory hallucinations. Other examples include Sigmund Freud, Winston Churchill, Socrates, William Blake, and Mahatma Gandhi. According to Intervoice founder Dr. Marius Romme, the lives of these extraordinary figures demonstrate the frequently benign nature of recurring hallucinations.

In many cases, Romme’s research has suggested, the phenomenon can even prove beneficial. “The problem,” he writes, “is not hearing voices, but the inability to cope with the experience.” In 1987, after two decades of clinical work, the Dutch psychiatrist began promoting a drug-free therapy in which patients were encouraged to accept and analyze their voices.

At that time, Romme’s method was the antithesis of mainstream psychiatry. A 1973 Science article, “On Being Sane in Insane Places,” describes an experiment that exposed prevailing attitudes towards hearing voices. In the experiment, eight “pseudo-patients” made appointments at 12 different U.S. hospitals. The pseudo-patients complained of hearing voices that repeated the words “empty,” “hollow,” and “thud.” All were diagnosed with schizophrenia and given anti-psychotic medication. The pseudo-patients were held for between seven and 52 days, even though they had immediately ceased their simulated symptoms upon admittance.

Today, with decades of additional research and drug development to draw from, Western medicine still offers little else to those experiencing auditory hallucinations. Research even suggests that common treatments might be exacerbating the condition. In regards to schizophrenia, the World Health Organization states that “a substantial body of evidence shows a more benign course and better outcome in developing countries [than in developed countries].” As a recent Stanford study indicates, voices in nations like India and Ghana, are significantly more likely to be friendly than voices in the United States.

After examining how schizophrenia-related symptoms are viewed in different cultures, Ethan Watters concludes in his book Crazy Like Us that the stigma of diagnosis and its isolating effects are to blame for the disparity. Developing countries tend to have explanations for the condition, such as spirit possession, that exculpate individuals and preserve their existing identities. The beliefs also sustain family and community relationships with the afflicted. These modalities are at the heart of Romme’s methods.

I traveled to the medieval city of Tilburg in the Netherlands to experience what Romme calls the “hearing-voices approach.” Romme’s protégé of 32 years, Dr. Dirk Corstens, was giving a workshop on the practice to seven voice-hearers. I sat down with Corstens and patients Michel and Angie (who declined to provide their surnames), to learn more about living with voices.

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Morin: What happened here today?

Corstens: We tried to motivate people to talk a little more about their voices. Most of them never talk about them. Often, the voices forbid you to talk about them. Professionals also often don’t know how to approach the subject. The first day is a difficult day. You have to build trust.

Morin: What did they talk about?

Corstens: They told their stories about how they cope with voices, and we started to demonstrate what we call the “construct.” In the construct, you find the relationship between what happens in people’s lives and their voices. We try to make sense of the voices.

Morin: Can you give an example of that?

Corstens: Today, we worked with a 43-year-old woman named Marie. She hears eight voices. The voices don’t have names, but she can differentiate them. They talk to her and to each other throughout the day. First, we explored how many voices there are, how old they are, their gender, and whether they have a name or not.

Morin: How do you use that information?

Corstens: We analyze every voice and try to explore what the characteristics are. So, these three voices—numbers 1, 6, and 8—are very aggressive and negative. They shout at Marie, “You are nothing! You have to die! Swallow pills! You have to mutilate yourself!” And they are there all day and every day, especially at night when she tries to sleep. There’s this child of three who is always crying. There’s this 18-year-old boy who criticizes her. And then, not very often, there’s this man who tries to protect Marie from the 18-year-old boy. There’s also this eight-year-old female voice—she’s playful and always tries to cheer Marie up, but the voice becomes angry if Marie doesn’t cheer up—which she rarely does. The group of voices, which she calls “the trustees,” shouts words to interrupt her conversations.

Morin: What do the traits of the voices indicate?

Corstens:  They help us understand what problems these voices represent. A lot of it has to do with Marie being rejected, having no self-confidence, and not being able to make decisions herself. We try to find out when these voices started. In her case, they started when she was 27 and had final exams at university. But, it was all related to the divorce of her parents when she was six, and witnessing violence at home—being bullied, etcetera. All these things come back in the voices.