People who hear voices can learn a range of practical skills that reduce the distress those voices cause, even when the voices themselves do not fully disappear. Research consistently finds that most self-managed strategies help more with the emotional impact of hallucinations than with their frequency, which is an important distinction that shapes how clinicians and voice hearers approach the problem.1PubMed. Auditory hallucinations: a review of psychological treatments The toolkit is broader than many people realize, spanning everything from simple physical techniques you can use in the moment to structured therapy programs and peer support networks.
Physical and Sensory Techniques That Work in the Moment
Some of the simplest coping strategies involve using your body to compete with the voice activity happening in your brain. One of the best-studied examples is humming. In a study that tested several ways to interfere with the speech muscles, humming a single note softly reduced self-reported hallucinations by about 59 percent.2Schizophrenia Bulletin. Subvocal Activity and Auditory Hallucinations: Clues for Behavioral Treatments? The logic is straightforward: auditory hallucinations appear to involve the same brain circuits used for inner speech, so engaging those circuits with a competing task can dampen the voice signal. Other oral motor activities, like reading aloud or singing, work on a similar principle, though humming stood out for its simplicity and effect size.
Beyond speech-based interference, many voice hearers report that distracting activities like listening to music, exercising, or engaging in conversation reduce voice intensity or at least make the voices easier to tolerate.3PubMed. Auditory hallucinations: a review of psychological treatments For musical hallucinations specifically, ambient noise or background sound can soften mild to moderate episodes.4PubMed. The mind with a radio of its own: a case report and review of the literature on the treatment of musical hallucinations The common thread across all these techniques is that they fill up sensory or cognitive bandwidth, leaving less room for hallucinated content. Earbuds playing music, a podcast, or even white noise can serve as a portable version of this approach.
What makes physical strategies particularly useful is that they require no special training, no appointment, and no technology beyond what most people already carry. They are not a replacement for deeper work with a therapist, but they can serve as a first line of defense when voices flare up unexpectedly.
Building a Personal Coping Plan
A more structured approach called Coping Strategy Enhancement, or CSE, treats each person’s existing coping habits as raw material to be refined rather than replaced. The process typically unfolds over a handful of sessions. In the first session, a clinician interviews the person to identify what tends to trigger voice activity, such as anxiety, low mood, nighttime, or high-stress situations, and what the person already does in response. Some of those existing responses help, and some make things worse. The next sessions focus on selecting the strategies that show promise, tweaking how and when they are used, and testing those modifications in daily life.5PubMed Central. Coping strategy enhancement for the treatment of distressing voices in young people: A service evaluation within routine clinical practice
The appeal of CSE is its brevity and practicality. A pilot study of this brief intervention found that voice-related distress dropped with a large effect size, and more than half of participants experienced a reduction that was clinically meaningful.6PubMed Central. Coping strategy enhancement for the treatment of distressing voices in young people: A service evaluation within routine clinical practice A separate evaluation in French-speaking voice hearers found similar results: a significant drop in voice-related distress after the intervention, again with a large effect size.7PubMed. Coping Strategy Enhancement for Auditory Verbal Hallucinations Within Routine Clinical Practice The key insight is that people usually already have coping tools. The problem is that those tools are used inconsistently or in ways that could be improved with minor adjustments. A person who finds music helpful might benefit from choosing specific playlists in advance, keeping earbuds on hand, and learning to apply the strategy earlier in the escalation rather than waiting until distress peaks.
Changing Your Relationship With the Voices
Not all coping strategies aim to make voices quieter or less frequent. A growing body of work suggests that changing how you relate to voices, rather than trying to silence them, can substantially reduce distress. Mindfulness-based approaches encourage people to notice voices without automatically reacting to them. Research has found that a more mindful, observing stance toward voices, combined with self-compassion, is linked to lower distress and less severe voice experiences.8PubMed Central. Mindfulness of voices, self-compassion, and secure attachment in relation to the experience of hearing voices
Compassion-focused therapy takes this a step further. Many people who hear hostile or critical voices fall into a pattern where the voices feel dominant and the person feels subordinate, trapped in something that resembles a bullying relationship. Compassion-focused approaches help people recognize when that threat-based dynamic is active and gradually shift toward a sense of safety and self-kindness.9PubMed Central. Compassion Focused Approaches to Working With Distressing Voices In a case series of people who heard malevolent voices, compassion mind training led to reductions in depression, anxiety, and paranoia, and the voices themselves became less persecuting and more reassuring over time.10PubMed. Compassionate mind training with people who hear malevolent voices: a case series report
This relational approach does not ask people to pretend the voices are pleasant. It asks them to stop fighting the voices in ways that escalate fear and distress. For some voice hearers, the shift from “I have to make this stop” to “I can notice this without it controlling me” is the single biggest change in quality of life.
Cognitive-Behavioral Therapy for Voices
Cognitive-behavioral therapy adapted for psychosis, often called CBTp, remains one of the most-researched psychological treatments for auditory hallucinations. The therapy helps people examine and test their beliefs about voices, such as the belief that a voice is all-powerful or always right, and develop new behavioral responses. A web-based CBTp program called “Coping with Voices” was designed to make this type of therapy more accessible. In a pilot study, participants who used the program showed significant reductions in the overall severity of their hallucinations, including how much they perceived voices as an outside entity and the intensity of negative commentary from voices.11PubMed. Web-based cognitive-behavioral therapy for auditory hallucinations in persons with psychosis: a pilot study
Teaching cognitive-behavioral strategies has also been shown to benefit people with learning disabilities who hear voices, a population that is often overlooked in research. A case report documented decreases in subjective distress, reduced need for as-needed medication, improved mood, and greater use of positive coping strategies after learning these skills.12British Journal of Learning Disabilities. Teaching Psychological Strategies for Managing Auditory Hallucinations Teaching self-management strategies that combine physiological, cognitive, and behavioral techniques has been found to produce improvement in a majority of patients studied.13Egyptian Nursing Journal. Efficacy of teaching self-management strategies on auditory hallucinations among schizophrenic patients
When Voices Give Commands to Harm
Command hallucinations, voices that tell a person to hurt themselves or others, represent one of the most dangerous and distressing forms of voice hearing. They require specific attention because the stakes are higher and the emotional pressure is intense. A study evaluated a 10-session course that taught behavioral strategies for managing persistent voices in outpatients with schizophrenia. Among participants, the rate of command hallucinations to harm oneself dropped from 44 percent at baseline to 24 percent after the course, and it stayed at 24 percent a full year later. Commands to harm others decreased from 21 percent to about 16 to 17 percent over the same period. Participants also reported improvements across all measured characteristics of their voices, along with reduced anxiety and depression.14PubMed. Behavioral management of command hallucinations to harm in schizophrenia
The fact that these benefits held at one year is encouraging. Command hallucinations are often treated as a medication-only problem, but this evidence suggests that structured behavioral training can meaningfully shift how people respond to dangerous voice content, reducing both the presence of commands and the broader distress surrounding them. Anyone experiencing command hallucinations should be working with a mental health professional, but the coping skills taught in these programs give people concrete tools for the moments between appointments.
Peer Support and Hearing Voices Groups
One of the most widespread grassroots coping resources for voice hearers is the Hearing Voices Group, a peer-led support format that started in the Netherlands in the late 1980s and has since spread to dozens of countries. These groups operate on a fundamentally different premise from clinical treatment: rather than focusing on symptom elimination, they create a space where people can share their experiences, develop personal understandings of what their voices mean, and learn strategies from others who have been through similar experiences.15PubMed. Strategies for the Management of Voices Shared in a Brazilian Hearing Voices Group
A systematic review of Hearing Voices Groups and similar self-help formats found that participants reported several consistent benefits. These groups reduced isolation, improved social and coping skills, and gave members a better understanding of the meaning and context of their voices.16PubMed. Benefits of Hearing Voices Groups & Other Self-Help Groups for Voice Hearers: A Systematic Review For many voice hearers, the simple experience of being in a room with people who understand what they are going through, without judgment, is itself therapeutic. The social dimension of coping is easy to underestimate: voices tend to be more intrusive when a person is isolated, bored, or stressed, and belonging to a group addresses all three of those triggers at once.
Digital Tools and Smartphone Apps
Technology is opening up new ways for voice hearers to practice coping skills between therapy sessions and in the flow of daily life. Ecological momentary intervention, or EMI, uses smartphone prompts to remind people of their coping strategies at the moments they actually need them. Rather than recalling what a therapist suggested days or weeks earlier, a person receives a nudge on their phone, sometimes tailored to the intensity of what they are experiencing.17PubMed Central. Potential Applications of Digital Technology in Assessment, Treatment, and Self-help for Hallucinations Blending this kind of digital support with face-to-face therapy sessions has been explored as a way to make coping skills stickier, with participants using a smartphone app to self-monitor and self-manage voices alongside four in-person therapy sessions.18Internet Interventions. Client experiences of blending a coping-focused therapy for auditory verbal hallucinations with smartphone-based ecological momentary assessment and intervention
One dedicated app called Temstem was developed in cooperation with voice hearers themselves. It offers two main modes. The first, called Silencing, uses incompatible language processing to try to interrupt voice activity, working on a similar principle to humming or reading aloud. The second, called Challenging, uses dual-task exercises inspired by EMDR to reduce the emotional charge and vividness of voice memories. Both modes are delivered through language games.19Internet Interventions. Momentary effects of Temstem, an app for voice-hearing individuals: Results from naturalistic data from 1048 users These digital tools are not substitutes for professional support, but they fill an important gap: the hours and days between sessions when a person is on their own with their voices.
Avatar therapy is another technology-assisted approach. In this treatment, a person creates a digital avatar that represents the voice they hear and then engages in structured dialogue with it, facilitated by a therapist who controls the avatar’s responses. A Cochrane review comparing avatar therapy with supportive counseling found that avatar therapy produced better outcomes on a general psychotic symptom measure in the short term, though the evidence was rated as low certainty.20PubMed Central. Avatar Therapy for people with schizophrenia or related disorders The approach is still being refined, but it represents a creative use of technology to externalize the voices and practice interacting with them in a controlled setting.
Trauma-Informed Coping for Voice Hearers
A substantial proportion of people who hear voices have histories of trauma, and for many, the content of the voices directly connects to traumatic experiences. This changes what effective coping looks like. Standard distraction-based strategies may be less helpful if the voices are rooted in unprocessed traumatic memories, because the underlying emotional material keeps reasserting itself.
Imagery rescripting is one trauma-focused approach that has been adapted for voice hearers. In this technique, a person revisits a distressing memory in imagination and changes the outcome, introducing safety or control where there was none in the original experience. Dissociation, where a person mentally disconnects from the present, can be a challenge during this work. Grounding and self-soothing techniques, as well as strategies to reduce the level of negative emotion, have been found effective at preventing or interrupting dissociation during imagery rescripting sessions.21Cognitive and Behavioral Practice. Managing Dissociation in Imagery Rescripting for Voice Hearers With Trauma: Lessons From a Case Series These grounding techniques, such as focusing on physical sensations, naming objects in the room, or using a specific soothing scent, can also be practiced as standalone coping skills for moments when voices intensify outside of therapy.
A relational approach to working with voices and dissociative parts in complex trauma has shown that over the course of treatment, aggressive commands from voices can soften, internal communication between different parts of the self can increase, and the person develops greater capacity to pause, reflect, and respond intentionally rather than reactively.22PubMed. A different way of listening: A relational approach to working with voices and dissociative parts in complex trauma For trauma-affected voice hearers, coping is not just about managing the sound of a voice. It is about addressing the emotional charge that the voice carries.
Cultural Differences in How People Cope
The coping strategies people choose are shaped by culture in ways that are sometimes dramatic. A study comparing voice hearers in Saudi Arabia and the United Kingdom found that while patients in both countries had several coping mechanisms, the preferred approaches differed substantially. The majority of Saudi Arabian participants used strategies rooted in their religious practice, such as prayer, reciting scripture, and seeking spiritual support. British participants were more likely to use distraction or physiologically based approaches like listening to music or engaging in physical activity.23PubMed. Coping with auditory hallucinations: a cross-cultural comparison between western (British) and non-western (Saudi Arabian) patients
This finding matters for anyone working with voice hearers or seeking help themselves, because it suggests there is no single “correct” coping strategy. What works is partly a function of what feels meaningful and familiar. For a person whose life is organized around religious practice, prayer may be as effective as the humming technique described earlier, not because they share a mechanism, but because both give the mind something engaging to do at a moment of distress. Clinicians who insist on purely secular, evidence-based strategies without acknowledging what already works within a person’s cultural framework may inadvertently strip away effective tools. The best approach is collaborative: start with what the person is already doing, evaluate whether it helps, and build from there.
Voices at the Edge of Sleep
Not all auditory hallucinations are signs of a psychotic disorder. Hypnagogic hallucinations, which occur at the boundary between waking and sleep, are common in the general population. They can range from hearing your name called to hearing fragments of speech or music. A case report described a 17-year-old with anxiety who heard voices exclusively at sleep onset, a pattern that had not been previously reported in the literature. These hallucinations can occur as an isolated phenomenon, as part of narcolepsy, or in association with anxiety and mood disorders.24PubMed Central. An Anxious 17-Year-Old Girl Who Hears Voices Only at Sleep Onset
For people whose voices occur primarily around sleep, the coping strategies look different from those aimed at daytime hallucinations. Good sleep hygiene, reducing pre-sleep anxiety, and understanding that hypnagogic hallucinations are a normal neurological event rather than a sign of “going crazy” can all reduce distress. If you hear voices only as you are falling asleep or waking up, and they do not occur during the day, it is worth mentioning this pattern to your doctor, because the explanation and treatment path may be entirely different from what applies to persistent daytime voices.
How Families and Siblings Can Help
Voice hearing does not happen in isolation. Family members, especially siblings, are often deeply affected and uncertain about how to respond. Research exploring the experiences of people whose siblings heard voices during adolescence has pointed to the value of including family members in the support process. Suggestions from this work include creating spaces where siblings can receive guidance and support, providing education about what voice hearing actually involves, and involving siblings in family-based interventions.25SAGE Journals (Clin Child Psychol Psychiatry). Exploring Experiences of People With Siblings Who Hear Voices During Adolescence: A Narrative Study Recognizing and including siblings in care strengthens the support network around the person who hears voices while also looking after the well-being of family members who are navigating their own confusion and worry.
For families, the most useful starting point is often education. Understanding that voices are a symptom many people learn to manage, that they do not automatically mean someone is dangerous, and that the voice hearer is not choosing to have this experience can shift the household dynamic from fear to support. Asking “What helps when the voices are loud?” is a more productive question than “Are you hearing things again?” The former treats the person as the expert on their own experience, which is exactly the stance that the most effective coping frameworks adopt.