Home » Schizophrenia » Internal Auditory Hallucinations & Compulsive Commands

Internal Auditory Hallucinations & Compulsive Commands

Asked by on with 1 answer:

I’ve been having emotional issues for a few years. Nonetheless, these have been somewhat manageable. However, I became increasingly paranoid this winter. I thought that people were trying to poison me, I feared that family members were going to kill me. I was aware that these thoughts were illogical, but I couldn’t shake the fear that they caused me. I would get panic attacks thinking that I drank from a poisoned water fountain. I thought that someone had put small rips in my ice cream sandwich packaging because there was only one that didn’t have tiny rips in it. I refused to eat this one because I assumed some reverse psychology was being pulled and the ones without the rips were fine. I thought that this was mostly caused by anxiety but there are other symptoms that lead me to believe it is something more:

For a while now, I have been feeling that there are two men in my mind commanding me to do things. It’s messed up my driving, because they command me to do weird things while I’m on the road like turn around and backtrack and switch lanes, etc. They also make me do lots of other weird things. However, I am aware that these two men are most likely a manifestation of my compulsions projected on two “imaginary friend” type characters. These are not auditory hallucinations, but they do speak to me.

Recently I have been having what I believe to be internal auditory hallucinations. At first I thought it was just hypnagogia because it would happen when I was lying in bed with my eyes closed at night. They didn’t seem to be coming from in the room or anything either, they were almost like very loud thoughts popping out of nowhere in my head. Sometimes I couldn’t even tell what they were saying. They were random and some of them would speak all at once together. I wasn’t worried at this, in fact, I found them to be quite the amusing. However, they are popping up when I am fully awake now. I can be sitting up in bed with my eyes open and they speak to me but they are still just as confusing.

What is the difference between these controlling thoughts vs. these hallucinations? I hear that psychotic illnesses can get worse gradually, let me know if this is possible.

Internal Auditory Hallucinations & Compulsive Commands

Answered by on -


I’m not certain if there is any difference between the symptoms you have described. Recent studies have shown that about five percent of the population hears voices. A single symptom does not necessary mean that mental illness is present but people who hear voices often have a mental illness or are at a greater risk of developing a mental illness than someone who does not hear voices.

You are correct that psychosis can worsen gradually. Without treatment, psychosis typically progresses to a full-blown psychotic episode. It is imperative that psychosis is treated sooner rather than later.

Early intervention could delay or ultimately prevent a psychotic episode. Psychotic episodes can be prevented with medication and other specialized treatments.

Your letter did not mention whether you have sought treatment. If not, you should. If you are experiencing the early stages of psychosis, treatment could prevent a psychotic episode and you want to do everything in your power to achieve that outcome. Please take care.

Dr. Kristina Randle

Internal Auditory Hallucinations & Compulsive Commands

Therapists live, online right now, from BetterHelp:

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2018). Internal Auditory Hallucinations & Compulsive Commands. Psych Central. Retrieved on November 24, 2020, from
Scientifically Reviewed
Last updated: 8 May 2018 (Originally: 25 Aug 2015)
Last reviewed: By a member of our scientific advisory board on 8 May 2018
Published on Psych All rights reserved.