Learning to Discern the Voices of Gods, Spirits, Tulpas, and the Dead

Abstract

There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events—and that there are some common features to these models across communities. All communities teach participants to “discern,” or identify accurately, the legitimate voice of the spirit or being who speaks. We also observe that there are roughly two methods taught to participants to enable them to experience spirits (or other invisible beings): trained attention to inner experience, and repeated speech to the invisible other. We also observe that all of these communities model a learning process in which the ability to hear spirit (or invisible others) becomes more skilled with practice, and in which what they hear becomes clearer over time. Practice—including the practice of discernment—is presumed to change experience. We also note that despite these shared cultural ideas and practices, there is considerable individual variation in experience—some of which may reflect psychotic process, and some perhaps not. We suggest that voice-like events in this context may be shaped by cognitive expectation and trained practice as well as an experiential pathway. We also suggest that researchers could explore these common features both as a way to help those struggling with psychosis, and to consider the possibility that expectations and practice may affect the voice-hearing experience.

Introduction

There has been a great interest in recent years in the experience of those who hear voices but do not appear to have a need for care.¹ The interest arises for two reasons. First, as scientific doubt has arisen about the specificity of the diagnosis of schizophrenia, scholars have become increasingly interested in the question of whether there is a continuum of psychosis.² This is the claim that the apparent symptoms of psychosis are not restricted to those who are ill, but found throughout the population to a greater or lesser degree.³ Scientists now debate what kind of continuum it is, whether it is a single continuum or whether there are several continua, and how much continuity there is between people who have isolated experiences and those who have a psychiatric diagnosis.^4,5 Second, new approaches to treating psychosis have suggested that social interventions may have a substantial impact on the frequency and distressing content of psychotic voices. Hearing Voices groups, for example, often teach members to explore the meaning of voice content. They often encourage patients to interact with their voices, as does Voice Dialogue Therapy and Avatar Therapy. Scholars thus have become interested in the kinds of training practices associated with existing social communities in which hearing voices is common and expected.

The goal of this paper is to discuss and compare different communities in which the felt experience of supernatural communication, including through the perception of voices, is common, and to understand their cultural models and practices. We discuss the cultural models that emerge in each group; the way each group identifies (or discerns) the presence of a supernatural voice; the practices used by the group to contact the voice and to experience it even more reliably and more vividly over time; and the recognition within each group that some voice-experiences are “crazy.” All authors are persuaded that the sense of communication is a felt phenomenal event for many participants in these communities. That is, we are persuaded that many participants in these communities have perceptual experiences.⁶

Methods

Eleven scholars familiar with different communities who report frequent voice and voice-like experience met eight times over the course of about a year, for about an hour per session, to discuss what they had learned from participants who were members of a social community in which people expected to hear immaterial beings speak. All had rich experience of at least one of these communities, and had interviewed participants in the community and described them in scholarly work. For the most part, the scholars (the authors of this paper) had worked together before on different projects and had met in the context of the International Consortium of Hallucination Research. We came from different disciplines: anthropology (Dupuis, Luhrmann); history (Powell); Psychiatry (Chen, Deeley, Powers); and Psychology (Alderson-Day, Corlett, Lifshitz, Moseley, Peters).

The communities comprised:

1. Mediums and medium-like new age practitioners (interviewed at Yale University, Durham University, and King’s College London).^7–12 Mediums experience themselves as talking with the dead, and with other immaterial beings, to receive information which is then communicated to other humans.

2. Tulpamancers, who create invisible companions, or “tulpas” (interviewed at Stanford University). Tulpamancers usually assume that they have brought their tulpas into existence through deliberate imaginative techniques, and that the human and the tulpa(s) share one human body.

3. Traditional religionists (okomfu) interviewed in Ghana.¹³ Okomfu chose their profession because they are “called” by the gods. Okomfu are then consulted by other humans who seek protection and information from those gods.

4. Evangelical Christians (interviewed at Stanford and the University of Chicago).¹⁴ These Christians (usually called charismatic) expect that Christians will have a back-and-forth dialogue with their God.

5. International ayahuasca drinkers (interviewed in the Peruvian Amazon).¹⁵ These individuals drink a hallucinogenic beverage, but their community assumes that they must learn how to see and hear spirits properly. Sometimes these communications continue after the biological effects of the ayahuasca have worn off.

All communities shared the understanding that there are spirits (or non-corporeal beings) that communicate, and that some humans (either because they are trained or because they are naturally gifted) are able to experience and recognize those communications.

The method of the paper is broadly anthropological. We proceed by identifying common ideas and practices within each community for the purposes of comparison. We focus here on events that are voice-like because the focus of much prior research has been on how such communications compare to voices experienced in psychosis, even though within these communities, participants also value other forms of what they take to be communication (visions, bodily indications of presence, out-of-body events and so forth). We hope that this inherently spare comparison may inspire further work.

Results

Cultural Models: Implicit and Explicit Beliefs and Expectations About Voices

Each community has cultural models about these hearing events that are presented implicitly or explicitly in classes, in casual interactions, in books, and online. By calling them “models” or “schemas,” we are pointing out that these are ideas and expectations that individuals infer from shared group discussion, reading and behavior.¹⁶ In some communities, these models may be explicitly laid out as propositions; in others, they are not. We also understand these models to be more or less hierarchically ordered within any individual’s understandings about the world. Some may operate more as “core” beliefs; others are more peripheral, or dependent. There is variation in the way such ideas are presented in communities and used by individuals. For mediums, for example, the idea that the dead can communicate could be considered to be a core belief, but the implicit model any individual uses to identify the “signal” of the communicating spirit may not, in fact, be widely shared. There may be a more basic “core” idea that the universe is “meaningful” – in other words, shaped by the purpose or intentions of a non-human mind or power.

Nevertheless we observe that some features of these cultural models appear to be shared across the different communities of mediums, tulpamancers, okomfo, evangelicals, and ayahuasca drinkers:

1. That communication with a non-corporeal being is possible (they send signals)

2. That training can shape the ability to discern a signal

3. That training can shape the experience of a signal

4. That training involves preparation, extended practice, and discernment

5. That (for some communities) good and bad spirits exist; if so, training involves distinguishing good and bad, attending to good, and disattending to bad

6. That there is often talk of talent, often with the idea that all can do the task, but that some will be better at it, find that it comes to them more easily, or find that they learn more readily.

7. That a detailed concern with phenomenological content is sometimes part of the cultural model, and sometimes not (eg, tulpamancers talk about what they experience in some detail with each other, while it is less clear that okomfo do)

8. That the signal is often, but not always, identified as supernatural.

We present below more detail on these observations (see table 1 for more information on the different communities).

Table 1.

Cultural Models of Voice Identity, Voice Discernment and Practices to Generate Voices

Community	Identity	Discernment	Practices
Okomfu	In Cape Coast, Ghana, “okomfo” are individuals who are understood to talk with the local gods, who are numerous and vary widely in power.They are practitioners of the traditional religion	A legitimate okomfo is understood to be called by the god; to resist the call, but nonetheless to be possessed by the god; to be trained to distinguish good spirit from bad. Gods are often described as speaking through an audible twittering of birds which the okomfo hears as containing words. Many okomfus also have a brafo, a special person who interprets what the god says when the god possesses the okomfo and speaks through the human. But the okomfo also report hearing the gods speak to them directly. Okomfu learn to recognize the god’s voice (and the voices of other gods) while in apprenticeship with an experienced okomfu.	Participants learn that they have been chosen by one (or more) gods. In apprenticeship, they learn to describe the gods. They are told to have frequent conversations with the gods, to dream about the gods, to acquire items liked by the gods and, eventually, to build each god an altar which holds familiar items liked by the god. They are repeatedly possessed by the god. They are given special drops in the eyes and the ears and told that these drops will help them to see and hear the gods.
Tulpamancers	Tulpamancers are people who create imaginal head-mates—invisible people whom they call “tulpas”. They believe that the human brain is capable of hosting multiple selves, and that with deliberate training, a dedicated practitioner (the tulpamancer, or host) can create another autonomous self (the tulpa) who can come to share their mind and brain, and sometimes also learn to possess their body.	Tulpa and host are expected to communicate mostly by way of inner speech (what the community calls “mindvoice”), but also via more vague, imagistic impressions (called “tulpish”). Some report audible voices at times. The key is that the response must feel like it emerges outside the agency of the tulpamancer--that there is a distinct someone else, the tulpa, who is speaking or moving or feeling. This first feeling of autonomy, of a separate person willfully acting within the confines of one’s own mind, is often taken as the moment of the tulpa’s “birth”, and many tulpas and tulpamancers celebrate these birthdays.They usually report that they recognize the tulpa’s voice.	Tulpamancers are offered many tulpa creation guides. New tulpamancers are encouraged to pick and choose techniques from different guides and see what works for them. Early guides taught readers that to invest hours into visualization and similar forms of sensory focus (called “imposition”). New tulpmancers would sit for hours at a time with their eyes closed, visualizing their tulpa’s ears (for example). In recent years, an approach of simply narrating one’s day to the tulpa has become more popular, and the old strict hour-counts have fallen out of favor. The newer idea is to behave as if there is already a full-blown tulpa present, and to speak to that tulpa as if they are there.
Western Ayahuasca drinkers	Ayahuasca is a mild hallucinogenic associated with indigenous spirituality and shamanism in Amazonia. While consuming it, many people report hallucination-like events. Beginning roughly in the 1990s, Europeans traveled to the Peruvian Amazon to participate in so-called shamanic ritual practices, adapted from older indigenous rituals, which involved the consumption of ayahuasca	The local guides who work in these centers usually invite participants to understand the voices and visions they experience while consuming ayahuasca in specific ways. The guides gradually transmit to participants the criteria that will allow participants to identify the somatic, emotional and cognitive signs which indicate the presence and nature of supernatural entities. Voices of evil beings are presented as accompanied by specific visions (demons, vermin, rats, terrifying visions), sensations of cold, negative emotions such as fear, and negative content (insults, criticism, discouragement etc.). Voices of ayahuasca are described as usually inducing joy, relief, and accompanied by pleasant sensations and specific visions (woman-snake, snakes, angelic visions or entities from the Catholic pantheon).	For most participants, visions and voices emerge during ayahuasca rituals and retreats in the forest. Ritual rules (prohibitions of interactions, speech and movement), ritual actions (songs, the use of perfumes, and so forth) and narratives play important roles in the training. There are introductory conferences before the rituals, and individual interviews and focus groups following the rituals. These practices are not found in the traditional uses of these substances by indigenous populations. The goal of the practices is to invite participants to focus their attention on their senses and perceptions and to develop socially normalized signs of interactions with supernatural entities.
Mediums	Mediums understand themselves to communicate with the dead. They are often associated with churches, schools, or institutions that describe themselves as spiritualist. Different mediums hold different beliefs about the specific nature of links between the spirit realm and physical realm, but most believe that mediums can receive messages from spirits which are intended for other people. Some talk about “Spirit Guides” which help the medium throughout life.	Most mediums describe “thought-like” voices that are not physically audible, and which consist of short words or phrases, which represent something the medium must interpret to convey a message. Some mediums report regular audible and externally located experiences that are seemingly more complex. Many mediums also speak of “hearing” spirit but also of “seeing” or “knowing.” Discernment focuses upon the presumed accuracy of the medium’s interpretation: if the interpretation is accurate, the medium had “genuine” contact.They contrast mediums who say, “I am getting an old woman who died in pain” to “I am getting a woman who died old, and I see an address—does 12 Colchester Place mean anything to anyone?” A “bad” medium does not offer details that can be falsified. Some report audible experiences.	Many mediums describe a process of “training,” during which the medium seeks to clarify and hone their experiences, at times focusing on the ability to exert voluntary control over them. Descriptions of this process vary widely, but the core is to calm and open the mind; to wait for communication; to demonstrate that the communication is real (a detail comes through that another person respond to); to feel confident that communication can happen; to recognize guides in the process and to develop a relationship with the guides. “Quieting the mind” is done through a variety of techniques, commonly including routine meditation, with the focus centering on either mindfulness and calming one’s thoughts, or intentionally connecting to spirits or spirit guides to get messages while in a focused attentional state. Mediums are clear that newcomers improve with practice.
Evangelicals	Modern charismatic evangelical Christian world expect that each person can have a back and forth relationship with God. The manuals and the teachings around hearing God present this as a skill that must be learned, but also suggest that God is always speaking—and that only some are able to hear.	People are asked to look for thoughts that stand out in some way from other thoughts. They tend to teach congregants to identify communications from God in the following way: Words from God are usually spontaneous. Congregants talk about God’s words “popping’ into their minds, or hearing words or experiencing images they had not expected. Words from God should be congruent with scripture. Pastors say that if someone thinks they have heard instructions to hurt themselves from God, that person has interpreted God incorrectly. Words from God should (usually) come with a feeling of peace. Words from God should be “tested.” One should expect that God will say the same thing again, or that other people should experience God saying similar things to them about the same question. Most such events are in the mind, but some participants report occasional audible events.	Evangelical practices around hearing God are diverse, but center around what is called prayer, which many would define as the practice of talking with God. In these settings prayer involves using the imagination to do something which the practitioner does not take to be imaginary. Pastors may, for example, encourage congregants to put out a ceramic cup of hot coffee for God, or set a dinner service for God, or go for a walk with God, with the idea that “props” will encourage the congregant to feel as if God is present like a person. People are also usually quite clear that in order to hear God speak, one must pray; that prayer is a practice that requires skill and effort; and that some people are more skilled and effective at hearing God speak than others. Over time (perhaps some months) congregants often do find that they are able to identify God’s voice in their minds.

Discernment

All communities emphasize the importance of learning a method to identify when a spirit (or tulpa) has communicated. We can call this “discernment,” a term often used within faith settings to describe how a spiritual voice is identified by a human.¹⁷ In each setting, there are explicit or implicit means used by participants to distinguish signal from noise. They also often distinguish types of signals (good spirit, bad spirit, dead human, astral contact, etc). Many signals are understood to be found in the mind; they are, in effect, thoughts that are not felt to originate from the human but from the immaterial other.

The following features were more or less common rules across communities to identify thoughts that did not originate from the human, but were understood to originate from the supernatural (or nonhuman) source:

1. The thought is more sudden/spontaneous than ordinary thoughts

2. The thought feels more autonomous/not created by the self

3. The thought is stronger/louder than ordinary thoughts

4. The thought feels vivid

5. The thought feels intentional, as if something is communicated

Discernment involves learning. Leaders and more experienced participants give feedback to newcomers. Feedback is likely important in shaping the experience of the signal; people do report that their experience of the signal changes over time. Tulpamancers are very actively involved in training their experiences and describing them to a shifting group of co-participants on line.¹⁸ Ayahuasca drinkers are explicitly taught about what to experience. Evangelicals are usually in groups of others with whom they share at least some of their experience. Novice okomfu are apprenticed to experienced okomfu in order to learn to hear the gods. Mediums take classes. These communities presume that the practice of discernment changes—to some extent—the experience that individuals have. Communities in which people are said to experience a spirit (evangelicals, okomfu, mediums) assume that some people will have experienced the signal (a voice) before they understand who has spoken.

It is also true that the rationale for discernment varies. Mediums seem to emphasize the evidential quality of the experience—the spirit gives the medium a detail they could not have known, and this detail is proof of the reality of spirit. Mediums are often quite conscious of needing to persuade an audience that they are truly in contact with the dead and, as a result, know things that ordinary humans in the audience could not. Ayahuasca drinkers say similar things, such as, “I could not have thought of that myself.” But the ayahuasca drinkers are less compelled to persuade an audience, because they are not performing to an audience. Christians become more concerned about discernment when the implications are consequential. One pastor remarked on a Sunday morning that if a congregant heard God say to be calm, the congregant should assume that God had spoken—but if a congregant heard God tell him to quit his job and move across the country, that congregants should pray with other members of the church so that they could discern together whether they were hearing God accurately.

Among the ayahuasca drinkers, people made a clear distinction between benevolent entities with whom it is possible to receive healing and teachings (e.g. the spirit of ayahuasca) through voices and visions, and malicious and pathogenic entities (demons, witches, etc.) that attempt to interact with participants during psychedelic rituals.

These patterns of discernment are embedded within specific social structures that are more or less engaged in policing the boundaries of what counts as a legitimate signal. The Catholic church, for example, is very actively involved in defining what counts as a vision or voice of the divine. There are of course rebels and controversies. The troubles of Jeanne D’Arc arose from differing interpretations of her voices—as demonic rather than divine. When evangelical leaders heard God say, before the 2020 US election, that Donald Trump would be elected, the election of Joseph Biden caused some to infer that they had been mistaken in their discernment—and others to insist that the election result was fraudulent. The communities of mediums, tulpamancers, ayahuasca drinkers, and okomfu were also sometimes concerned that there were illegitimate others who claimed to hear spirit, but did not (sometimes a concern of mediums) or that they are psychiatrically ill (sometimes a concern of tulpamancers).

The existence of these cultural models of discernment mean that some individuals may say that they have heard a voice, but may not, in fact, have had the kind of phenomenological event that could be identified as a voice. Evangelicals may find themselves motivated to insist that God has spoken to them, but when asked careful follow-up questions, the researcher can find that they are using a kind of rhetoric rather than describing a phenomenal event. When mediums perform on a stage it is often very important to them to insist that they have had had a genuine experience of spirit—whatever the individual has in fact experienced. There are also sometimes differences in expectations of performance between expert and novice. These expectations can lead to experiences that are “faked” or performed.¹⁹ This is a challenge for the researchers, as some experts may insist that they are having a certain kind of experience (e.g. they heard a voice with their ears) even though, from a phenomenal perspective, they did not have an audible experience. Careful questioning is important.

Training Practices Within the Group

We identified roughly two kinds of methods taught to participants as a means to lead them to experience spirits (or invisible others):

Attending to the detail of inner experience: people will sit and attend inwardly, focusing all their attention on inner experience. For some mediums, this could be described as like meditation. One is told to sit comfortably and to “ground” oneself. Sometimes the practitioner is given words to speak in the mind or images upon which to concentrate. These behaviors are thought to “open the medium up” to experiencing the communication. Tulpamancers deliberately cultivate inner experience (one could call this inner sense cultivation²⁰). This technique involves intense focus on visualizing or representing the desired voice. For the Western ayahuasca drinkers, people are asked to search for/visualize specific positive images by local epistemological authorities (i.e shamans). In the Christian tradition, this practice is described as “kataphatic” prayer and exemplified by Ignatian spirituality. Okomfo often have “props” which represent the gods, and elaborate mental images which symbolize them.

Speaking to the imagined other: This technique involves simply talking to the spirit or being presumed to be there. Tulpamancers sometimes simply narrate their day to another person who does not yet exist for them. One medium described herself as learning to talk to the spirits of the dead “as if” they were real, and seeking for a sense of response. Ayahuasca drinkers (who of course are consuming hallucinogens) are told to seek the spirit of the plant by local epistemological authorities (i.e shamans). Okomfu, once initiated, are told that they can now speak with the gods and to do so. Christians are sometimes invited to use what might be considered to be “props” (placing a second coffee up on the table for God, putting a shepherd’s staff in the place where one prays) to give themselves more confidence that Jesus/God will be there to hear.

These practices are not always named explicitly as training practices, but they emerge across the practice and literature in many communities. There is quite a bit of book reading and book-and--tradition borrowing across communities in the UK and US. Among the mediums, people know about other communities and other attempts to connect with spirit. They sometimes point to elaborated practice traditions in Christianity, in spiritualism, among Tibetan tantrics and so forth.

In these training practices, what a psychiatric scientist might call “trance” is both taught and often contested. Many practitioners use some kind of meditation-like practice. Mediums are often invited to sit quietly and listen. Some talk of “trance possession” in which the dead spirit speaks through the medium. Tulpamancers also learn to experience invisible beings through sitting quietly, and also sometimes experience possession in which the invisible other takes over the body and speaks for the human host. Okomfu are possessed by the spirits, and also hear the spirits independently of possession. When they are possessed, the spirits speak through them. For international ayahuasca drinkers, rituals may include possession experiences, but these are generally discouraged and perceived as pathogenic.²¹ Evangelicals do not use the word “trance,” but some speak in tongues and find that they enter a state in which times seems to flow differently.

In some communities, the effective use of practice becomes a marker to differentiate the well from those with mental illness. In several medium communities, there is a clear sense that being out of control is the marker of mental illness. Many mediums argued that one needed the mediumship training to manage the experience—one cannot be “a dripping tap.” People are proud that they can control the experience. One medium explained: “I wouldn’t want to be up all night listening to the spirits.” Another said, “If I couldn’t control them, I’d go crazy!” People in many practices also said that spirits could take advantage if one did not take control. They also said that as they learned control, they could do more with the spirits.

Differences Between Individuals

While there are shared expectations around when and how a voice is heard, and how to judge whether it is a real communication or not, participants in all social communities report widely varied experiences of voice-hearing. Some hear frequently, some rarely; some report words, some report impressions; some report more audible events, some report no audible events; some report events that feel interior, and some events that feel more exterior—and most people seem to experience many variations in their own experience.

Each social group recognized differences in individual experience and had boundaries for what counted as mentally ill: the person who says they are hearing from the dead, or experiencing a tulpa or the spirit of the plant, but who many people in the group think is psychiatrically ill.

In general, we found that people who were identified as having more negative and uncontrolled experiences that could not be controlled through practice, and who reported experiences less in line with consensual reality, were more likely to be regarded with suspicion. Some mediums interviewed by the London researchers, for example, said that spirits cannot tell one anything bad—if someone claimed that spirits did, that person was likely psychiatrically ill. Negative messages, they said, appear only early in the journey. If someone keeps getting negative messages, that person was “not one of us.”

We observed that some participants were able to “toggle” between clusters of cultural models depending on the social setting more easily than others. That is, some participants seem more able to adjust their explanations depending on what they think their interlocutor believes. They are more able to anticipate that people outside of the community may not share their views. Another term to describe this might be “audience awareness”: some individuals may be less able to adjust to audience expectations than others. These participants are less able to adjust seemed to be more likely to be identified as “not one of us” by the social group.

Discussion

The most important points here are that there are indeed many social communities in which spirits (or other immaterial beings) are understood to communicate; that people in these communities have phenomenal experiences of such spirits or beings communicating; that the capacity to have such experiences is thought to improve with practice; and that discernment and practice may shape what people experience.

That said, we agreed that it is hard to understand exactly what people experience. For example, it is often difficult to get a solid answer to how audible such voices are. This is in part because some participants seem to infer when asked if they can hear a voice with their ears, that they are being asked if everyone in the room can hear the voice—so even if the individual can hear the voice with their ears, they may say no to the question of whether the voice is audible. It is also in part because other participants assume that audibility is a condition of realness. Thus, asked if the voice is audible, they say yes because they think that the spirit genuinely exists outside of themselves, even though they do not have events that we would consider to be audible. It is important to probe carefully and with attention to the comparative phenomenology of other experiences. Within these communities, participants report audibility to different degrees. Most Christian evangelicals report audible events rarely, perhaps a handful of times. Many okomfu—but not all—report audible events more than once a week.

It is also difficult because it is genuinely hard for people to describe these experiences. For people with psychosis, many voice-like experiences are not audible, or “between” thought and audition.^22,23 The same appear to be true for mediums, ayahuasca drinkers, okomfo, evangelicals, and tulpamancers. They are often quite clear that it is difficult to describe these voice-like events with words.

In this light, it may be helpful to point out that some features of thought treated in the literature on psychosis as features of psychosis are, in fact, features of thought itself. Some ordinary human thoughts can be described as more vivid, more spontaneous, more loud, more intentional, than other thoughts. Ordinary human thought has texture. This texture is utilized by these communities to describe what kind of thoughts people experience and to identify them as communications from invisible others.²⁴

Moreover, the practices of these communities and the experiences that their members report suggest that cognitive expectations and sensory techniques change the quality of thought events. As researchers continue to ask about the experiential pathways through which people come to the events—psychosis, hypnosis, absorption, sleep—it is crucial to attend to cognitive expectations and sensory practice.²⁵

Two primary hypotheses emerge from these observations. First, the way the experience is identified (or discerned) may shape its character. Our authorship group shared the general sense (now framed in terms of predictive coding) that there is a relationship between expectation and, for want of a better term, experience, even as we acknowledge that for some who end up in these communities, the onset of the experiences is unbidden. We note that belief is a complicated term,^26,27 but something like that term is needed to capture what some scientists call high-level priors and what others might call symbols and propositions. Some of these priors may be foundational and implicit (e.g., “thoughts have independent power to act in the world”), some may be explicit (“the dead can talk with us”). It is possible that teaching those who experience distressing voices to attend to them in particular ways might alter the way in which those voices are experienced.

Second, specific practices of sensory attention may alter the character of these experiences.²⁸ We saw two dominant forms of attention trained within these communities: talking to invisible beings as if they were present, and attending to one’s inner senses in order to experience these beings more vividly. Ethnographic and historical research are clear that spiritual practices change spiritual experience; increasingly, experimental work also documents changes as well.^29–35 Spiritual practice among ayahuasca drinkers appears to shape what the hallucinogen elicits among those who drink it. Dupuis has proposed a model he calls “socialization of hallucination” to describe the way symbolic frameworks, verbal exchanges, and social interactions shape the psychedelic hallucinogenic experience.³⁶ It is possible that these practices of trained sensory attention might alter the character of potentially distressing voices. Indeed, these methods are resonant with those used to manage distressing voices by social practices, for example by Hearing Voices groups.

These two hypothesis suggest two ways in which these communities update beliefs: a “top down” process in which others provide testimony, hearsay, teaching and, as a result, a means to interpret sensation; and a “bottom up” process in which subjects experience an altered sensory flow. The recognition of a difference between more interpretation-like teaching and more practice-like repetition might suggest hypotheses that could be distinguished in a predictive coding framework. One fruitful locus for this work may be the shared circuitry implicated in explicit expectation, social cognition, associative learning, placebo effects, and voice-hearing.³⁷

We suggest that attention to the socialization processes we have outlined may provide an important “level of explanation,” to use a framework suggested by Hughdahl and Somer.³⁸ Such knowledge may complement and sharpen clinical, neuroscientific, and even molecular investigations. As we search for a deeper understanding of the nature of psychosis, of dissociative pathology, and of their potential mechanisms, it may be helpful to learn from the social communities in the general population in which people believe that spirits and beings communicate, and in which they learn how to hear them do so.