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The 7 Differences between Hearing Voices in Schizophrenia & Dissociative Identity Disorder

The 7 Differences between Hearing Voices in Schizophrenia & Dissociative Identity Disorder.

We created a video and the following article to explain the 7 differences between hearing voices in Schizophrenia vs hearing voices in Dissociative Identity Disorder.

1. Outside voices vs inside voices. Debunked!

If you have been part of the online DID community, you might have heard that people with Schizophrenia hear voices coming from the outside, where as people with DID hear voices from the inside.

Well 2 weeks ago we were at the Uitgeverij Mens! congress about early childhood trauma and structural dissociation. Here we had the option to submit questions and this was one of them. I am very glad, that we got such a clear and precise answer.

In our poll in AlterNation (Our Plural Support Group on Facebook)
a 120 people said yes, they hear voices from the inside and are diagnosed with DID.
Then 45 people heard voices both from the inside and from the outside.
And 10 said they only hear voices from the outside.
It was people diagnosed with [DID and] Schizophrenia who pointed out,
that this inside vs outside voices theory, is incorrect and not what, or how their therapist had explained it to them.

2. Hearing voices in childhood

It was explained at the conference that people with DID start hearing voices generally before the age of 10. That makes sense in correlation to the various studies showing in childhood occuring overwhelming experiences, traumatic events and/or abuse, [amongst other ACE’s] are associated with DID. (DSM5)

3. Hearing voices constantly and consistently 

Those with Dissociative Identity Disorder hear their voices constantly and consistently.
Where as Schizophrenia has an unexpected onset and can come in waves.

4.  Hearing voices from the past

Those with DID hear voices and messages from the past. Where as the voices (and noises) that people with Schizophrenia hear, are not related or from the past. In DID it can be a voice, tone of voice, message or negative self talk that reflects the past.

5. Young parts

Those with Dissociative Identity Disorder (DID) hear multiple voices of younger parts. Who might have memories of their own. People with Schizophrenia here none or one child voice for example.

6. Hearing what to do messages

Both people with DID and people with Schizophrenia can hear voices with messages on what to do and/or which actions to partake in. In Schizophrenia, if someone is able to ignore the voice and the compulsion that comes with it, nothing happens. But in DID if you do not negate and negotiate with this ‘voice’ they eventually could take over, to do the action themselves. This is impossible in Schizophrenia.

7. Can be engaged by the therapist and outside people

The voices in Schizophrenia can’t really be engaged by an outside person. If you ask the voice of someone with Schizophrenia a question, the answer probably comes from the person with Schizophrenia, answer what they hear the voice say.
In DID it is possible and recommended to engage directly with the ‘voice’ –
This goes for both the client and the therapist.

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