Amanda Peery-Wolf is a poet, writer, and voice-hearer living in New York City. She is currently at work on a book exploring her experiences hearing voices, a subject she has also written about for the Lancet Psychiatry. Her poetry has appeared in outlets including the North American Review and the Colorado Review, and she is the recipient of the 2020 Iowa Review Award for Poetry.
“Why are you ignoring me?” The voice asks. It’s a blisteringly hot June day, and I’m waiting at a crosswalk in Manhattan, on my way to my local grocery store. Mentally reviewing my grocery list, I don’t respond right away.
“Listen to me!” The voice demands. “You’ve been ignoring me for a thousand years.”
I know no one else can hear the voice. I’m sure of it. And yet, as always, I glance at the people around me, suspicious that someday, someone might hear what I’m hearing. No one looks up. The voice is mine alone. It is a voice in my head.
“I’m not ignoring you,” I respond in my mind. “I’m here.”
“Great,” says the voice. “I’m the tree whose leaves are falling. Battlestruck barbarian. Interesting lizard. I have much to say.”
“Fine,” I say. “But we’ll have to talk later. I’m almost at the store.”
“OK.” The voice falls respectfully silent, then adds, “Don’t forget to inspect the berries. Avoid mold at all costs.” Then, he is quiet. We won’t talk again until evening.
My voice and I have these exchanges at least once a day. Usually benign, often esoteric, sometimes helpful, with an edge of needy recalcitrance. This is how my voice speaks to me.
I started hearing voices about ten years ago. In the time since, I’ve worked with three therapists and seven psychiatrists. These practitioners and I have discussed my voices’ intensity and intrusiveness. We’ve talked about my attitude towards my voices, when and where I hear them, and what I do when they speak to me. We have discussed my diagnosis (shifting over time from Bipolar II to Bipolar I to Bipolar with Psychotic Features to, today, Unspecified Bipolar and Related Disorders). But through these conversations, I found it odd that most of these mental health professionals seemed entirely uninterested in what my voices had to say.
Over the past year, I’ve been reading research on voice hearing, as part of a campaign to understand my own mind, and I’ve noticed the same strange oversight. I’ve read a couple dozen recent books and over a hundred papers, and, with a few noteworthy exceptions, very few researchers seem genuinely interested in, to use the academic term, voice content. I’ve been told that this is especially true in American academia, where quantifiable results are king, and messier phenomenological studies rarely get the funding.
This is a shame. In my own life over the last decade, I’ve clung to the idea that what my voices say is meaningful. This has helped me immensely. Understanding my voices’ messages has been the key to building a better relationship with them. That, in turn, has been crucial to living a full and thriving life as a voice-hearer.
How I Listen to My Voices’ Messages
The first time I heard a voice, I was an undergraduate at Harvard walking across the Yard. As I strode down a neatly groomed path, I suddenly heard something entirely unlike anything I had heard before. It was a deep, clear, male voice that seemed to descend from the sky and, at the same time, arise from somewhere inside my mind. It said: “We who suffer, how we suffer.” I knew no one else could hear it. It was too personal, close, and inhuman. But I was not afraid. The voice was unintrusive and gentle. More importantly, its words were meaningful to me. They felt like commiseration, or comfort. In college, I was, indeed, suffering, experiencing torturous, recurring mood episodes that left me incapacitated for weeks at a time. When the voice spoke, I felt like a distant friend was soothing me. Afterwards, I thought of the experience as a strange but welcome anomaly. I thought of it as a small gift.
So, from my first voice-hearing experience, I felt that the voice’s message was meaningful—not only because it touched my own life, but also simply because it was a message meant for me. If a person turned to speak to me in a crowded room, I would take note of what they said, not just how they said it or the mechanics of their speech. What they said would be, most likely, the most important thing about the interaction. So it was with voices.
By the time I turned 28, I was living with three voices in my head. They arrived one-by-one, a year or two apart. All three appeared as fully formed entities with their own personas, moods, personalities, and, it seemed, inner lives. They had forms I could see clearly in my mind’s eye and very occasionally in the room. One was a raven—the voice that nagged me on the way to the grocery store—one was a queen and a polar bear (both at once), and one was a kind of energy field radiating from my right hip. My relationships with these voices were, and are, complex. They have evolved over time, in a large part due to what my voices have said and how I have understood their messages.
In the beginning, my three voices terrified me. They spoke loudly, repetitively, and intrusively. They were often dark, sometimes bullying. The raven was obsessed with predicting my death and the deaths of people I loved (“You will die by the end of the week;” “Your mom will fall down the stairs. Say goodbye.”) The queen/bear repeated loud opinions about my friends and partners until it was difficult for me to think (“Break up with your boyfriend. Break up. Break up,” etc.). The third one, the energy field, communicated less in words and more in visions and sensations. Sometimes, she (she was a she) caused horrible pain in my right hip that made it difficult to stand up. I was living with three terrifying strangers, and my mind and body were not my own.
Luckily, I had an excellent therapist, one of the three who cared what my voices had to say. She helped me unravel their messages, understanding both literal and non-literal meanings. Adopting some of the Internal Family Systems framework, she encouraged me to see the voices as flawed protectors rather than malicious entities. When the raven told me I would die by the end of the week, maybe he was warning me to be careful that week. Maybe he was reflecting my own anxiety about an upcoming risk I was taking. Or maybe death, to him, was a metaphor—perhaps for transformation or a new beginning. My therapist and I worked through the possibilities. When the queen/bear told me to break up with my long-term partner, maybe she was reflecting tension in my relationship and suggesting I make a change. Her words might be drastic, but the sentiment could be valid. Even the pain caused by the third voice could be a message, for example, about the ways I was treating my body.
By looking closely at my voices’ words and signals, my therapist and I were able to find new, important meanings. The more I understood and engaged with my voices’ messages, the less fear I felt. And as I became less afraid, I began to build better relationships with my voices. I talked to them kindly and listened with an open mind. They, in turn, spoke less often about death, softened their demands, and caused less pain. That’s why, I think, paying close attention to what voices say is important. It can be the first step to helping voice-hearers like me listen differently and live more peacefully with their voices.
For me, the process of learning to listen to my voices was also impacted by antipsychotics. Over the years, I have been prescribed perphenazine, quetiapine, aripiprazole, and lurasidone. All of these drugs muffled my voices, making them at once farther away and more internal. On these medications, I could no longer hear my voices through my ears—they came from farther down, as though I had swallowed them whole. The medications also made my voices more straightforward and less creative with their language, forgoing wordplay and preferring simpler, shorter words and more prosaic sentences. However, the content of my conversations with my voices didn’t change.
Both on and off antipsychotics, my voices and I discuss my life and my relationships and their opinions, predictions, and desires. In both cases, they make bold, odd statements. Both on and off medication, I’m usually able to tease through their messages and understand new meanings. Sometimes, antipsychotics even seem like a useful tool to help me do so. They quiet my voices enough that I have the space and silence to think through what the voices might mean. But at other times—on higher doses—the medications muffle my voices too much, so I can barely understand what they are saying. At those times, I feel at sea in my own mind, unable to make sense of the muffled words I still halfway hear. Today, I try to stay on the lowest possible dose of antipsychotics (while still maintaining a stable brain). Minimizing medication helps me hear and understand my voices better.
What One of My Voices Says—A Miniature Case Study
Recently, I’ve had the chance to observe the exact words one of my voices uses. Six months ago, the energy-field voice—the one who tends to communicate in visions and sensations—was causing terrible pains in my right hip again. She was also causing intrusive emotions, mainly a sudden, destructive rage that descended on me as often as once a week. During these rage episodes, I verbally attacked people close to me. Afterwards, I couldn’t remember what happened. After months of struggling with these agonizing and dissociative symptoms, I struck a deal with my voice. She would stop causing the pain and rage and, in exchange, I would spend thirty minutes a day writing with her. She would dictate what I wrote. For the first time, she would consistently use words. She wanted, she said, to help me understand her.
In February 2026, we began our new arrangement. It quickly evolved into written dialogues: I wrote what I wanted to say to her, then transcribed her responses. Over time, I accumulated notebooks’ worth of conversations. As I did, the pain and rage episodes ebbed away. My mind and body were no longer battlegrounds.
Today, I continue to write with this voice every day. Looking at my notebook pages, I can see how my voice talks to me, and how our conversations have transformed us both.
About half the time, my voice speaks clearly, often in short, repetitive sentences. The other half, she speaks in odd metaphors that I have trouble understanding. We talk about my life: my relationships, my writing, my past, and my recent choices and behaviors. She makes comments and judgments and gives advice. She also tells me about herself. She explains who she is, her relationship to me, and how she got here. She expresses her desires. More than anything, she wants my time and attention, and she wants me to reassure her that I’m not trying to get rid of her.
When I began writing this paper, I thought I would create a taxonomy of what my voice says to me, neatly separating her statements by topics and types. But I found that this did not do justice to the full depth and texture of our conversations, especially when she bends towards metaphor and symbolism. So instead of a high-level overview, I’ll give a few actual examples of what my voice says, drawn directly from my notebooks. These excerpts show the banter, the liveliness, the push and pull, and the frustrating obscurity of our conversations.
Example One
Me (opening the conversation): Windy out.
Her: The wind is a wandering lunatic. Write away, right away. I am an arm and a leg and neither. Bodiless, bawdy. I travel to you. I know what to say. See me during true. This is our forever cousin. This is our dark goodbye.
Me: But what is this?
Her: Our forever cousin, our dark goodbye.
In this excerpt, my voice speaks in a rhythm that feels almost literary, playing with language (”Write away, right away;” “Bodiless, bawdy”). To an outside observer, this might look like disorganized speech, a jumble of meaningless associations. But I believe my voice is doing something meaningful: she is trying to define her own nature. By calling herself “an arm and a leg and neither,” she is acknowledging her strange, dual status as a bodiless presence that nonetheless occupies physical real estate in my life. When I push for clarity, she retreats into cryptic repetition. To me, her cryptic language isn’t a psychotic symptom. It’s how she expresses complex emotions and ideas that can’t be expressed in any other way.
Example Two
Her: I am a being of infinite energy. Rage is my red light.
Me: Do you think rage [episodes] will make things better? If so, why?
Her: I think it will make us safer. Make us cookie cutter soft. Make us run in place a little. Make us not run off.
Me: What do you mean? Some of that seems like the opposite of what rage does.
Her: Rage makes us reticent in our worldview.
Me: To me that seems like the real opposite of rage.
Her: Rage keeps us safe by insulating us…Rage is medicine for every broken heart…
This exchange captures the moment a destructive, terrifying symptom, dissociative rage, is successfully translated into an interpersonal dialogue. Instead of that rage taking over my body and driving me to attack the people I love, it’s safely contained on the page, where the two of us can debate its utility. Here my voice shows herself as—as my therapist suggested—a flawed protector. In her own surreal logic, she believes the rage is a protective armor (”insulating us”) designed to heal a vulnerable core (”medicine for every broken heart”). As I question her logic in real time, I’m able to be an active participant in my own mind. I’m not a passive host to an illness; I’m a partner helping her see that her methods are hurting the very things she wants to protect.
Example Three
Her: I’ll help you achieve your true nature if you let me…One year from today you’ll be huge. One year and you’ll let me use you…
Me: How will you help?
Her: Gentle guidance.
To me, this fragment highlights the shifting power dynamics and the constant negotiation of boundaries between my voice and me. Her initial declaration carries a slightly chilling, invasive edge (“let me use you”). This could easily feel like a slide toward a loss of control. But when I refuse to panic and instead meet my voice with a calm, curious question, “How will you help?”, her posture softens. The ominous promise to “use” me transforms into a promise of “gentle guidance.” My voice is not a static, unyielding script broadcast into my brain. She is a responsive, challenging, thoughtful conversation partner.
It’s important to note that these examples are not cherry-picked for meaningfulness. These are the conversations we have every day, across dozens of notebook pages. My voice reacts to me and I react to her, and through our conversation, we reach new conclusions. I learn to understand the meaning of what she is saying, even when she refuses to clarify, and she learns to understand me, as well. We make meaning together. If I thought my voice was nothing more than random, psychotic noise, then that’s all she ever would have been. She would never have become a companion, an interlocutor, and something (or someone) capable of transformation.
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Thank you so much for sharing — much of it rings very familiar. The only question a medical professional has ever asked me about content (and it has been asked many times) was “do the voices tell you to do things, like harm yourself or others?” What a bizarre and macabre question to start a conversation!
Anyway, thanks again. It is very comforting to read about others who are able to work these things out.
A challenging and interesting read, which evokes a few reactions in me.
(1) I'd love to know more about whether and how the writer found the voices helping in managing and making decisions about her life. This may sound worse than I intend it, but some things are intriguing and fascinating, but not necessarily illuminating or helpful. This is many of my patients' (and my) experience of dreams as well. Is life better with voices for some people? I think so, but the voices can also serve to distance the person from others; good for some, bad for some, a mix for many.
(2) One of the many negatives that comes from the narrow psychiatric model of disease is that meaning of symptoms and experiences have little place, so the potential benefits of exploring the content of the voices ( or dreams) gets lost, relegated to a small spot on the intake checklist. I cannot resist adding that exploring the content and meaning of voices and other symptoms is a great way to show sincere interest, learn more about the person with those symptoms, and I found it to be a real perk of the job.
(3) some of my patients were quite ambivalent about the idea of trying to diminish or silence voices, even if motivated to work on other ( if I may) psychotic symptoms like paranoia or anxiety. It was often helpful for me to say "if you could push a button to turn those voices off, would you press it?" That helped to make apparent the benefit of hearing them. For some isolated people, voices are friends, keep them company, and without them, the loneliness would be magnified.