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When researchers listen to people who hear voices

Yale Medicine Magazine, 2019 - Spring

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The line between mental illness and genius has long been known to be razor-thin. Yale researchers stumbled upon evidence of this fragile boundary while researching auditory hallucinations in schizophrenia.

The last thing you’d expect Yale School of Medicine brain researchers to do is hang around with psychics, let alone enlist them in their research. But that’s exactly what Albert Powers, MD, PhD, HS ’16, assistant professor of psychiatry, and Philip Corlett, PhD, FW ’10, associate professor of psychiatry, have been doing since 2014.

Even more surprising, the unusual partnership has produced insights that could one day revolutionize the diagnosis and treatment of schizophrenia.

“The irony is not lost on me,” says Corlett, with a broad grin.

Corlett and Powers’ unlikely journey into the world of psychics began when they resolved to better understand the phenomenon of schizophrenic patients who experience auditory hallucinations, colloquially known as “hearing voices.” The researchers wanted to study people who’d had similar experiences but didn’t seek or appear to need treatment. Thanks to recent research, the pair knew that such people are surprisingly common. As much as 8 percent of the population reports experiencing auditory hallucinations on a regular basis (13 percent hear them at least occasionally), compared to just 1 percent who are diagnosed with schizophrenia. Where to find them? The pair considered charismatic Christians, practitioners of Santeria, practitioners of voodoo, crystal healers, and self-proclaimed druids. None panned out.

One day while riding the bus home, Corlett noticed the large number of storefronts offering psychic readings. Perhaps people who go to psychics would fit the bill, he thought. Powers and Corlett reached out to the president of the American Association of Psychics’ Connecticut chapter, who informed them they were looking for clairaudients—psychics who use voices in their heads to give readings and, the clairaudients believe, communicate with the dead.

Powers started going to association meetings and psychic fairs with another researcher, Adina Bianchi, to talk with clairaudients, Corlett says. Almost immediately, they believed that they had found their study subjects. To confirm their hunch, the researchers asked the psychics to undergo a battery of tests, including brain scans and an extensive survey that included questions designed to unmask fakers. The psychics passed with flying colors, leading Corlett and Powers to conclude that they hear voices much like schizophrenic patients do, but with key differences—the voices are friendly, they can be controlled, and hearers consider them a gift instead of a burden.

The clairaudients have proven enthusiastic participants, Corlett adds. “One of the wonderful things about working with this group is they are delighted that we are taking them seriously,” he says. “We said, ‘We have no interest in debunking. We agree to disagree [on the cause of the voices], but we believe you are having real experiences.’”

One volunteer for the study was Brittany Quagan, who says she first heard voices as a young girl. At 15 or 16, the voices became a serious problem, leading to years of therapy and drug treatment. Her breakthrough came at 21, when a work colleague who was a psychic suggested the voices were evidence of psychic powers, not mental illness. Quagan says she became convinced that her friend was right after Quagan recounted facts about a co-worker’s recently deceased relative to the surprised co-worker.

After her revelation, Quagan says that she quickly gained control of the voices—one is a man, the other a woman with a British accent. She stopped taking medication and turned her life around. She quit her job and began giving psychic readings full time.

“I call them guides,” she says of her voices. “It’s almost like calling a friend, ‘Hey, come here!’ That’s how I connect to them.”

Powers and Corlett’s study subjected the psychics, people diagnosed with schizophrenia, and non-voice-hearers to a simple Pavlovian test devised at Yale in the late 19th century. A light and a sound are paired, with the sound becoming steadily fainter and eventually ceasing. The brain, however, continues to perceive the sound even when it’s not there. Researchers can use the test to induce a minor hallucination—hearing a sound when there is none—in anyone.

The test results were startling, the patients with psychosis and the psychics were five times more likely than non-voice-hearers to perceive a sound when there was none. Brain scans done during the testing showed that the same parts of the two groups’ brains were activated when they perceived sounds that were not there.

The findings, which Corlett and Powers published in the August 11, 2017, issue of Science magazine, have huge potential for the diagnosis and treatment of schizophrenia. Treatments could eventually include devices to short-circuit brain activity that causes hallucinations and behavioral strategies to forestall psychosis, the researchers say.

“I’d say we’ve made a massive leap forward in terms of conceptual understanding, and what we’re trying to do next is turn that into something useful for patients,” Corlett says.

The psychics will remain vital partners in their ongoing work, both men say. Powers has gone a step further, he has hired voice hearer and test subject Quagan, who is in the final stages of obtaining her therapist’s license, as his new lab manager. While Quagan remains convinced that her voices and psychic powers are real, she has come to accept that they may have a neurological component.

“Whether what we [psychics] do is real or not, I’m not going to argue,” Quagan says. “We all have different beliefs. But the underlying narrative for all of us is that we found a way to cope. We found a way to work with our experiences. Because of that, we were able to move away from what could have been a downward spiral.”

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