Article Text

Download PDFPDF

Hearing spiritually significant voices: A phenomenological survey and taxonomy
  1. Christopher C H Cook1,
  2. Adam Powell1,
  3. Ben Alderson-Day2,
  4. Angela Woods3
  1. 1Theology and Religion, Durham University, Durham, UK
  2. 2Psychology, Durham University, Durham, Durham, UK
  3. 3Institute for Medical Humanities, Durham University, Durham, UK
  1. Correspondence to Professor Christopher C H Cook, Theology & Religion, Durham University, Durham, UK; c.c.h.cook{at}


Whereas previous research in the medical humanities has tended to neglect theology and religious studies, these disciplines sometimes have a very important contribution to make. The hearing of spiritually significant voices provides a case in point. The context, content and identity of these voices, all of which have typically not been seen as important in the assessment of auditory–verbal hallucinations (AVHs) within psychiatry, are key to understanding their spiritual significance. A taxonomy of spiritually significant voices is proposed, which takes into account frequency, context, affect and identity of the voice. In a predominantly Christian sample of 58 people who reported having heard spiritually significant voices, most began in adult life and were infrequent experiences. Almost 90% reported that the voice was divine in identity and approximately one-third were heard in the context of prayer. The phenomenological characteristics of these voices were different from those in previous studies of voice hearing (AVHs). Most comprised a single voice; half were auditory; and a quarter were more thought-like (the rest being a mixture). Only half were characterful, and one-third included commands or prompts. The voices were experienced positively and as meaningful. The survey has implications for both clinical and pastoral work. The phenomenology of spiritually significant voices may be confused with that of psychopathology, thus potentially leading to misdiagnosis of normal religious experiences. The finding of meaning in content and context may be important in voice hearing more widely, and especially in coping with negative or distressing voices.

  • Medical humanities
  • psychiatry
  • theology

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

View Full Text

Statistics from


  • Twitter @cchcook, @aldersonday, @literarti

  • Contributors CCHC was the originator of the study and contributed to all aspects of the study: planning, questionnaire design, subject ascertainment, data analysis and writing of the paper. AP undertook initial data analysis and contributed to writing the first draft of the paper. BA-D contributed to the planning of the study, including questionnaire design, set up the online survey and managed the data, contributed to writing the paper. AW contributed to planning of the study, questionnaire design and writing of the paper.

  • Funding The research was supported by a grant from Wellcome Trust (reference number 108720/Z/15/Z).

  • Competing interests Wellcome Grant.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was obtained from the ethics committee of the Department of Theology and Religion, Durham University. No approval or ID numbers are issued by this committee. The name of the corresponding author and the title of the paper will be sufficient for identification. Consent was included within the online survey.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Data for this study are not available, under terms of participant consent, for sharing outside the research team.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.