Title: Muses, Madmen, and Prophets
Author: Daniel B. Smith
Publisher: The Penguin Press
Genre: Non-fiction
Year Published: 2007
Number of Pages: 272
Binding: Hardcover
ISBN: 978-1-59420-110-3
Price: $24.95

Reviewed by Marcello Jun de Oliveira

When I was a teenager I dated a wonderful girl whose father was a diagnosed schizophrenic. For most of the couple of years I was a part of her family he was institutionalized, with only brief home stays drastically cut short by relapses and subsequent hospitalization. The emotional toll on the family was not small, and understandably much of the family dynamics revolved around this particular situation. He was a gentle and relatively benign man, and his intellectual prowess and interpersonal skills progressively deteriorated, in large part as a result of large doses of anti-psychotic medication. He did, however, suffer greatly, and inflicted suffering on his family, because of the voices he heard.

As many people who suffer from schizophrenia, he has what is termed "Verbal Auditory Hallucinations". He would hear voices, in multiple tones and genders, some helpful and soothing, some religious and preachy, some accusatory, and some controlling and violent. The latter generated most of the havoc and forced much of the intervention, despite being by far the less frequent form.

My personal wariness of "Auditory Hallucinations" as a phenomenon only waned during medical school, when theoretical training during my psychiatric rotation suggested that "Auditory Hallucinations" of various forms can and do occur under non-pathological circumstances. Nevertheless, in practice, we were constantly reminded to check for psychotic or schizophrenic signs whenever such were mentioned. I might've even erred on the overzealous side!

Daniel Smith has had an even greater reason to be wary. Both his father and his paternal grandfather experienced this very particular form of "Auditory Hallucinations": they heard voices; articulated, coherent, independent voices.

Mr. Smith's search for meaning and understanding, both in a personal and a familial sense, led him to thoroughly research the subject of "voice-hearing". Pouring through the experiences of a varied gamut of people who live with (sometimes suffering through, sometimes greatly profiting from) hearing voices, sifting through the medical research, and gleaning over the historical trends towards the phenomenon, he has reached a better comprehension of his father, his family, and himself. And he takes us through his journey!

The book "Muses, Madmen, and Prophets" is not intended to take a scholarly approach to the subject of "Auditory Hallucinations" in general, or "Verbal Auditory Hallucinations" in specific. Although he has obviously become very acquainted with the scientific (and much of the philosophical) approaches to the issue, his is a story of a personal journey of self-discovery, and the book reads as such: fast, engaging, personal, and arousing.

Smith still does his homework very well. Aptly he intersperses well-placed comments on current medical approaches, medical history, historical cultural approaches, and amply illustrates everything regaling his readers with anecdotes.

Smith opens the book prefacing his planned structure (academic approaches chapters discussing the phenomenon, intermittently interrupted by informal chapter-essays into his personal foray onto the phenomenon) and disclaiming his book for a lay audience only (although his bibliographical references allow for those who wish to research deeper - bibliographical essays on his sources might've helped even further).

On his prelude chapter, Smith retells his personal encounter with "voice-hearing" in his family. Apparently his grandfather heard voices throughout most of his life, and it was a joyous and uneventful idiosyncrasy. His father, on the other hand, suffered terribly through most of his life on account of his voices. This stark contrast, and Smith's own realization of his father's silent suffering - and a little of his personality as a result of this suffering, brought him to his search.

Smith spends his first two chapters ably presenting to the lay reader some fundamental knowledge (well illustrated by well-explained, for a lay audience, scientific research) on the complex topic of the neuro-physiology of hearing, and how that applies to "voice-hearing". Deftly he covers the cutting-edge, and controversial, research into the neurological foundations of the conscious decision-making abilities (or lack thereof), and the vast contrast of perception suffered by voice-hearers of utter inability of self-control. Most people might have only the perception of control over their thoughts (or might actually hold that control), while voice-hearers have that control utterly wrenched from them.

His next three chapters deal with arguably his most important and central themes. He discusses how voice-hearing have and can affect people in an artistic ("muses"), religious ("prophets"), and psycho-cultural ("madmen") sense.

Religious figures who have experienced "Verbal Auditory Hallucinations" in various forms, such as Muhammad or Joseph Smith or John Bunyan parade his chapter discussing people who have accepted and embraced their voices and transformed them into a force for good or change or piety! Fascinating is the mention of a 1960s psychological study that clearly demonstrates that people prone to "Auditory Hallucinations" are more likely to be credulous and faith-oriented. Artistic automatic writing and other forms of inspirational sources are illustrated in poets and writers who also embrace their "Verbal Auditory Hallucinations" for a greater purpose.

For me, personally, his more poignant, and centrally thematic chapter, discusses the cultural trends in their historical contexts regarding "Verbal Auditory Hallucinations". More importantly, how it has moved from being culturally acceptable as a spiritual phenomenon (either for evil or for good) to a post-enlightenment stigma of craziness and that of a social pariah! Smith minutely traces this movement and convincingly argues the need for a further movement towards a more open and accepting approach to the phenomenon - one that precludes the need for stereotyping pathology where none exists and unduly burdening individuals with fears of mental malady and social reclusion (such as his father suffered).

Smith mentioned a 1970s Stanford study that I found fascinating. David Rosenthal attempted to measure the medical community's ability to diagnose the mental healthy from the unhealthy by sending volunteers to institutions with one and only one symptom: "Verbal Auditory Hallucinations"! Fascinatingly, all were hospitalized, the vast majority diagnosed with schizophrenia and medicated! Smith then recounts how a Spanish Catholic nun in the 16th century escaped the Inquisition by establishing a distinction between voice-hearing that is spiritually based and voice-hearing that is simply a malaise (como enferma). Smith argues that not all voice-hearing is pathological, and promptly exemplifies his point by recounting the great successes of a Dutch support movement and of British non-profit movement HVN (Hearing Voices Network) whereby people learn to cope and embrace their "Hallucinations".

"The problem… is not the stigma associated with mental illness. Nor is it the malevolence of psychiatry. It is, rather, the practical and often immeasurable effects of language: the soft tyranny of offering a single pathological term for an experience that, both historically and in the present, reaches into more varied and more exalted forms of human consciousness than is typically assumed." (pages 83-84)

In his last personal essay before the final stretch, Smith recounts his effort to experience voices through sensory deprivation, and ends up realizing - and sharing - the true nature and ultimate goal of his search. His candid prose and very personal exposition is quite moving.

The last portion of the book involves three chapters devoted to three case studies. Historical analyses of the voices experienced and the subsequent personal dramas ensued in wholly disparate cultural contexts is indeed fascinating, informative, highly illustrative, and somewhat entertaining. Smith recounts the tales of the Greek philosopher Socrates, the French heroine Saint Joan of Arc, and the German Supreme Court Judge Daniel Paul Schreber (immortalized in writing and thru analysis by none other than Sigmund Freud). Despite the captivating and titillating read these stories afforded, the highly tragic and to some extent pathological (especially for the latter) nature of these biographies might have been better balanced - the better to serve the main theme (ie.voice-hearing as a natural phenomenon) of the book - with more experiences of well-adjusted coping voice-hearers. To Smith's credit they are all to found in the book, but these three biographies towards the end of the book
left a little bitter melancholic taste.

The book is a fascinating read. It is informative, it is well researched, it is a light and fast read, and it has raised awareness and opened my mind to a condition people unfortunately suffer in needless silence and isolation.