‘Can’t You Hear Them? The Science and Significance of Hearing Voices’ by Simon McCarthy-Jones sets out to bring together biology-based, and trauma-based theories on the experience of hearing voices. This is an ambitious objective as traditionally those fields of inquiry have remained quite distinct from one another; each evolving significantly within their separate silos. However, McCarthy-Jones is well placed to consider both. He is part of the Hearing Voices Movement, and of the Department of Psychiatry at the University of Dublin, Trinity College, where he conducts research into the genetics and neuroimaging of voice hearing, and into the consequences of child sexual abuse. ‘Can’t You Hear Them?’ takes the reader on a journey into voice hearing that is as academically informed as it is humanising and personalising – making sure that the individual is not lost amid academic endeavour.

First ‘Can’t You Hear Them?’ brings the reader close to the subject of voice hearing, by presenting individual accounts of the experience. Next, a broader lens is taken, and the reader is presented with a history of what voice hearing has been thought to represent across time and cultures. Here, theories of voice hearing are presented and discussed within their social, religious, and political milieus. This allows the reader an opportunity to consider the many factors which have shaped the evolution of theories and research in this field. For example, hearing voices has been thought to have been caused by an excess of black bile, by angels, by the ‘schizophrenogenic’ mother, and by a brain abnormality; the latter being the basis for the biomedical model of hearing voices.

Next, McCarthy-Jones invites the reader to consider the complex workings of the human brain. He reviews biology-led theories of voice hearing, summarising, and critiquing a considerable body of research which has been generated by magnetic resonance imaging (MRI) and functional MRI studies in particular. ‘The Galaxy in your Head’ (Chapter 22) takes the reader on a fascinating journey through the intricacies of the brain. Here, and in the following chapters, McCarthy-Jones discusses neurology (including neurodevelopmental theories of voice hearing), biogenetics, neuropsychology, and pharmacological interventions for voice hearing with such impressive clarity, humour, and conviviality that even the non-medically trained reader is likely to find material that is accessible and engaging.

The neurological mechanisms associated with speech production, language, hearing, and perception are explained and discussed, bringing the reader further and further into a seemingly never-ending labyrinth of neural networks so bewilderingly complex at times, that the reader might feel tempted to put the book down, and to leave McCarthy-Jones – clearly a competent neurological adventurer – to continue his quest alone. After all, this is dense reading material. However, McCarthy-Jones’s ability to convey complex and abstract ideas with refreshing simplicity helps to keep the reader engaged, as does the inclusion of quirky and unexpected smatterings of humour.

Next, McCarthy-Jones moves on to discuss and critique the evidence-base around possible links between child abuse that is sexual, physical, or emotional in nature, and later experiences of hearing voices. In doing so he draws on one of the most widely accepted sources of medically scientific ‘truth’; the 1964 US Surgeon Generals Report on whether smoking caused health problems. He also reviews research which has investigated possible relationships between trauma and voice hearing exploring the findings of psychosocial, psychological, and neurological studies. Pharmacological responses, and talking therapies are critiqued for the efficacy.

Finally, contemporary ideas around recovery styles, biological theories, and psychosocial theories of voice hearing are presented and discussed before McCarthy-Jones begins to draw some interesting conclusions around the possible pathways to voice hearing. The evidence (rather than the ideology) presented suggests that there are multiple causes of voice hearing. Accordingly, McCarthy-Jones invites the reader to consider the need for a suite of clinical responses to cater to the heterogeneity among voice hearers. He illustrates this point by citing interesting research which has identified different responses-styles among those who hear voices; those who turn towards their voices, and those who prefer to turn away.

What is impressive about this book is McCarthy-Jones’s ability to straddle multiple perspectives, and his ability to consider multiple sources of data before distilling these for the reader. What becomes evident as one reads this work, is just how dynamic a field of inquiry this is.

So, does McCarthy-Jones achieve the cross-theoretical synthesis of literature on voice hearing that he ambitiously set out to achieve? He does, and in doing so he highlights both what we do know, and what we do not know about the subject, and offers some helpful guidance to inform future research in this field. He is an engaging narrator, and this book is an intelligent, informed, entertaining, and surprisingly accessible read, despite the often dense and complex nature of the material being covered. All the while, the personal accounts of those who hear voices helps to keep the reader close to the ‘subjects’ who are ultimately the most important subject throughout.

Conflicts of Interest

None.