In Western psychiatry, hearing voices is often associated with psychosis and schizophrenia, carrying with it stigma that prevents many from speaking openly about their experiences. Yet research shows that a surprisingly large number of people without any diagnosed mental illness — in some studies, more than three-quarters of participants — have reported hearing voices.

In some cultures, these experiences are not only accepted but celebrated. Voices may be understood as spiritual guidance, messages from the divine, or practical advice for everyday life. This cultural lens reshapes how individuals live with such experiences — and how society responds to them.

Cultural interpretations of voices

Anthropologist Tanya Luhrmann of Stanford University, co-author of Our Most Troubling Madness, explains that cultural expectations heavily influence whether hearing voices is seen as illness or insight. The American Psychiatric Association’s DSM-5 lists auditory hallucinations as a central feature of psychotic disorders. Yet, in practice, acceptance varies.

In the U.S. and Europe, up to 80% of people grieving a loved one report sensing their presence — seeing, hearing, or even feeling them. By contrast, the Achuar people of Ecuador forbid mourning, fearing that visions of the dead endanger the living. Among Amazonian groups, the Siona interpret hallucinations from medicine or ritual as glimpses of an alternate reality, while the Schuar believe that ordinary daily life is the illusion and that visions reveal true reality.

Voices across continents

Cultural attitudes also shape emotional responses. A study comparing patients in the U.S., Ghana, and southern India found stark differences: Americans often described their voices as hostile or meaningless, while participants in Accra and Chennai were more likely to hear family members or God. These voices offered advice, reminders, and moral guidance.

In Chennai, over half the participants reported hearing the voices of close relatives, giving instructions such as preparing meals, bathing, or running errands. For some in Ghana, the voices were explicitly protective: “If I didn’t have these voices, I would have died long ago,” one participant said.

By contrast, American participants tended to see their voices as imaginary byproducts of the mind, often describing them with fear or disdain.

When Voices are Honored

In some societies, voices are treated as valuable connections to the spiritual world. In Ghana, for example, voices may be seen as communication with God. Anthropologists have documented similar acceptance among the Egba Yoruba in Nigeria, where hearing voices is regarded as commonplace and not cause for alarm.

Historically, anthropologists like Ruth Benedict and Jane Murphy observed that in non-Western contexts, people with symptoms resembling psychosis were sometimes honored rather than marginalized. Murphy noted that among the Yoruba, those who heard voices often openly demonstrated their experiences to others.

Why Culture Matters

Two concepts — porosity and absorption — help explain why some people are more receptive to voices. Porosity is the belief that external thoughts can enter the mind, while absorption allows a person to become deeply immersed in inner experiences, blurring the line between imagination and reality.

This openness may also influence recovery. Studies comparing patients in India, Canada, Nigeria, Pakistan, and Britain found significant differences. Indian patients, for example, were more likely to discontinue medication yet still function better socially, with fewer negative symptoms, than their Canadian counterparts.

Family involvement plays a major role. In Chennai, patients rarely attended clinics without relatives, which researchers linked to better outcomes. In contrast, Western norms of independence and strict confidentiality laws sometimes leave patients more isolated.

A different definition of “normal”

Across cultures, what counts as “normal” experience varies. In some places, seeing the dead or speaking with spirits is expected. In others, it is pathologized. As Luhrmann notes, many societies have words for thoughts moving between minds — concepts that in English might be called telepathy, magic, or divine inspiration.

The evidence suggests that how voices are perceived — as torment or as guidance — is shaped less by biology and more by culture. And in cultures where voices are accepted, those who hear them may find not just relief from stigma, but a sense of belonging.