When God Talks Back: Understanding the American Evangelical Relationship with God, Luhrmann 2012, ch 8:

Many years ago I was spending time, as an anthropologist, in a psychiatric clinic, observing the way young psychiatrists come to identify and interpret mental illness, when a disheveled man was admitted to the unit. He was grimy and unkempt, and he spoke grandly of his great astronomical work. He was intermittently incoherent. No one doubted that he needed to be hospitalized. At first, the resident described his astronomical theories as yet another of his psychotic symptoms. Then, on a whim, the resident went to the library, looked the man up, and found his articles. He really had done great astronomical work.

The hallucinations associated with psychosis are frequent. They can occur many, many times each day-even continuously, like a curtain of rain-when the person is ill. They are extended. People don't just hear a single phrase, like "Get off the bus," although many psychotic hallucinations are short, like "Jerk." People have long, back-and-forth conversations with their voices, and they hear back-and-forth conversations about them in the third person. ("He's so stupid. Look at him, he's going to get on that bus." "He should be under that bus, not in it.") These hallucinations are unpleasant, even horrific, and they are not associated with practice, at least not in any straightforward way.2 They are also spontaneous: they happen to you, and you are at their mercy.
That is not the way people in the Vineyard hear God speak. When I sat down with individuals and asked whether they had ever heard God's voice outside their head or heard any voice when they were alone, or had any other unusual experience, they told me about one experience, or maybe a handful. The moments did meet psychiatric criteria for hallucinations: people were clear that the voice had come from outside and that they had heard it with their ears, or that the touch or vision felt as if external. Yet the pattern and quality of the experience was quite different from that in psychosis, and there was no associated pathology.
For the most part, sensory overrides-moments when sensory perception overrides an existing stimulus-are rare. They are brief. And while they are quite startling (it is disconcerting to have God speak out of the backseat and say, "I will always be with you"), they are certainly not distressing....Another sign that distinguishes the congregants' voice-hearing from psychotic voice-hearing is that congregants are acutely aware of what their audience might think of their experience. When evangelicals speak of hearing God, they do not in general have an audible voice in mind. In fact, the many manuals that teach you to hear God speak specifically suggest that most people do not hear God speak audibly, although they often first give examples of audible moments of hearing God's voice. Dallas Willard's Hearing God, for instance, lists what are clear auditory experiences of God (Moses, Saint Augustine, Saint Teresa, George Fox) and then remarks, as if with a deprecating cough, that an interior or inner voice is the preferred way of hearing from God.3 In American culture, hearing voices is associated with madness. Because congregants know that hearing voices is not, in general, a good sign, they hadn't mentioned their experiences to many people before I asked them directly whether they had ever heard an audible voice. Sometimes I was the first person they'd told.

Another difference is the sense of compulsion in the voice. A naïve observer might think that God's voice would have the quality of absolute compulsion: you must, just as Abraham knew he must when God ordered him to sacrifice his firstborn son. Psychotic hallucinations sometimes have this quality. Psychiatrists call them "command" hallucinations. Patients feel pushed into complying by a force beyond their will, even though in fact they often resist for years before they act. They feel that they must jump out the window when ordered, even if they manage not to. God's voice, however, did not have this absolute quality for the congregants I knew. For example, Elaine was trying to describe what to do with her life when God told her what to do: "The Lord spoke to me clearly in April, like May or April. To start a school." "You heard this audibly?" "Yeah." "Were you alone?" "Yeah, I was just praying. I wasn't praying anything really, just thinking about God, and I heard, 'Start a school.' I immediately got up and it was like, 'Okay Lord, where?' " But she never did. She never felt she had to. She became a missionary for a few years, and for a while during that period she thought about starting a school. She thinks she still might. That was the way congregants interpreted God, even when he spoke in an imperative. They assumed he might not mean "right now." They also used those criteria of discernment: test the interpretation, judge it against God's character, and so forth. They assumed that what they heard might be colored by their own psyche.5

What I saw at the Vineyard has been seen by other anthropologists in other charismatic churches. The anthropologists Simon Dein and Roland Littlewood persuaded forty members of a Pentecostal church in London, more than a third of the congregation, to complete a questionnaire on spiritual experience. Then they interviewed the twenty-five out of the forty who said that they had heard God speak audibly. Sometimes it was hard for the anthropologists to decide if the voice had, indeed, been heard as if from a source external to the head, but it was clear to the congregants that the voice had not been their own internal thoughts. In fifteen of the cases, the anthropologists were confident that the voice had been audible and experienced as external. For most of those congregants, those experiences were rare. Often they had happened only once.

We asked people to fill out a short questionnaire often used as a broad-gauged screening scale for mental illness. There was no significant relationship between absorption and that scale; nor was there a significant relationship between the scale and the way people answered the question of whether they had ever heard a voice when alone.9 At the end of our long interview, we asked our subjects a series of questions about experiences associated with psychosis. For example: Have you ever thought that you were being followed or spied on? Have you ever thought that your thoughts are being broadcast so loudly that other people know what you are thinking?10 Only 14 of 124 said yes to any one of the nine questions in a way that made us wonder whether they might be reporting a psychotic experience (although they were not actually diagnosable with psychiatric illness). Even then, we had often coded a "yes" because we could not be clear that they were not reporting a psychotic experience. That is, we coded cautiously.
Now, those subjects who did say that (for example) when they walked though the cafeteria, they felt other people drawing thoughts from their minds, did mostly report that they had odd sensory experiences. That is, ten of the fourteen subjects who were marked "yes" on one of the psychosis questions also said yes to the question about hearing a voice when alone. That lends support to the claim made by some psychiatric epidemiologists that there is a "psychotic continuum": that psychotic symptoms are distributed widely in the population.11
And yet there were fifty people who reported hearing a voice who said no to all those psychosis questions. Five out of every six people who reported having heard a voice when alone reported none of the other symptoms associated with psychosis-even when we coded cautiously and carefully. Moreover, their reports of sensory override experiences were quite similar to those of the Vineyard congregants. They had important spiritual experiences in which God spoke audibly or they saw an angel, or in which they had some other sensory awareness of the supernatural, and those events were rare, brief, and not distressing.12
In fact, this pattern appears to be widespread in the normal population. Sensory overrides are much more common than most middle-class Americans think. The first study that established this fact is one of the largest and most thorough that has ever been conducted, and it has been ignored for years because its authors were focused on something no modern psychiatrist believes. This is a shame, because it is a remarkable document, a scrupulously careful and massive report, four hundred pages in tiny nineteenth-century typeface, packed full with data.
In 1889 the newly founded Society for Psychical Research set out to demonstrate that people survived after death by asking a large number of people whether they had ever seen anyone or heard from someone who was not materially present...Collection went on for three years. It stopped when the number of answers piled up to 17,000. Nearly 16,000 of those were English. The rest came from the United States, Russia, and, improbably, Brazil. William James was responsible for the American sample. You can still find his letter to the editor of The New York Times, published in 1890, where he calls for people to help.
Two thousand two hundred and seventy-two people said yes to the Sidgwick question. Sifting through them, the committee threw out responses that, when they read further on Schedule B, seemed not to be hallucinations after all-dreams, or reports of hearing mysterious footsteps, or anything that might have been an accidental overhearing. They threw out reports of visions seen with closed eyes, mysterious lights seen out of doors, anything experienced during fever, anything seen out of the corner of the eye, and the vague shapeless forms one sees occasionally between sleep and awareness. They also threw out reports of vague sounds without human speech-no laughing, sighing, groaning, whistling, or ghostly shrieks. By the time they were finished, 26 percent of the answers where details had been provided on Schedule B were gone. So then they threw out 26 percent of all the "yes" answers on Schedule A where the collector hadn't provided details on Schedule B. That left 1,684-nearly 10 percent of everyone they asked: 8 percent of the men, and 12 percent of the women. Only a quarter of these subjects reported having had more than one hallucination. Most of the hallucinations-84 percent of them-had a visual element: people reported seeing something, although they often reported hearing or feeling something as well. Many were associated with intense emotion.
The collectors thought that these rates were underestimates. They found that people often forgot or hesitated to mention what they sometimes called "trivial" experiences. They noticed that people were far more likely to report experiences in the year just preceding than in earlier years. In fact, when they looked at the experiences reported in the previous year, half had occurred in the previous month: "As the years recede into the distance the proportion of hallucinations that occurred in them to those which are forgotten, or at least ignored, is very large."16

The basic story told by the Census of Hallucinations has held up over the following century. If you simply ask people whether they have ever heard a voice when they were alone, or seen something that could not be seen by someone else, and you do not put the question in a religious form or prompt people with examples, roughly 10 to 15 percent of Americans and British will say yes, and for the most part they will report sensory overrides that are rare, brief, and startling but not distressing. In 1948 the American branch of the Society for Psychical Research published a repeat of the census, curious about whether such experiences might take place less often in the bustling commercialism of the mid-twentieth century. They carried it out by mail, using the resources and presumably the sample-collecting skills of one of the new survey firms. They used almost the same language that the original census had used. And they got more or less the same ballpark figure that the original census had reached. Roughly 14 percent of the 1,519 replies reported some kind of visual, auditory, or tactile hallucination. Over half included a visual element. Less than a third were only auditory. Most people reported just one. Nearly twice as many women as men reported hallucinations, and among those who reported having more than one, there were almost three times as many women as men.18

In the late 1980s, the National Institute for Mental Health-no haven for wide-eyed optimists-carried out what came to be called the Epidemiologic Catchment Area Study. The sample was tightly regulated, the field surveyors were rigorously trained, and the data were electronically entered and analyzed, not tabulated on piles of fraying index cards. They went to five cities-New Haven, Baltimore, Durham, St. Louis, and Los Angeles-and interviewed more than 18,500 people across the socioeconomic spectrum. Unlike the previous two studies, this one focused clearly on psychiatric illness. Subjects were asked a series of questions based on the standard psychiatric diagnostic manual, questions about depression and anxiety and thoughts of suicide and pain. The hallucination questions were embedded in a series of questions about psychosis: for example, "Have you ever believed that you were being secretly tested or experimented on?" You would imagine that people would be skittish about saying yes.
And yet the numbers came out more or less the same.20 The interviews asked about visual, auditory, and somatic experiences in questions like: "Have you ever had the experience of seeing things or a person that others who were present could not see-that is, had a vision when you were completely awake?" Thirteen percent of the subjects said yes: 10 percent of the men and 15 percent of the women. The great majority of the experiences were nondistressing, although the ratio of distressing to nondistressing was greater for auditory experiences than for visual ones. At a one-year follow-up, nearly 5 percent of the subjects (somewhat fewer subjects were reinterviewed) reported a hallucination that year alone. As in the previous studies, women reported more hallucinations than men. While the Sidgwick work had suggested that women were more imaginative, the authors of this study just thought that women remembered or reported these events more accurately; in the one-year follow-up, the rates for men and women were close. The one real difference from the Sidgwick study appears to be that the late-twentieth-century subjects reported somewhat fewer visual hallucinations than those one hundred years earlier.

The two psychologists reported that they gave the questionnaire to 375 undergraduates in a psychology class, emphasizing that "hearing voices" meant hearing a voice fully aloud "as if someone had spoken." Over 70 percent said yes to at least one of the six awake hallucination questions. I have given the scale to an undergraduate class five times. Before I hand it out, I explain that unusual sensory experiences are far more common than most people think and that I am curious about how many of them have experienced something like that. Each time, over 50 percent of the class says yes to one. The scale does not ask for a frequency, but looking at the sheets the undergraduates hand in, it is clear that what they report are far from daily experiences. (Few say yes to the dead grandmother question.) And in all of the classes, the more statements someone endorsed on the absorption scale, the more examples they endorsed on this one.23

Some researchers argue that those who struggle with distressing voices cannot bear to hear their own self-loathing thoughts as their own, and so they allow themselves to identify those thoughts as external in order to protect themselves. Not everyone agrees. But this negative, self-destructive pattern of hearing distressing voices appears to be universal and recognized as illness in all corners of the world. Actually, one of the more curious features of the combination of distressing voices, delusions, and cognitive dysfunction that we identify as schizophrenia is that it may be quite recent. Psychosis goes all the way back (the Greeks certainly knew madness; think of the Bacchae). But schizophrenia may have emerged with industrialization24... Gottesman 1991 develops the claim that schizophrenia is a recent illness in human history; certainly Midelfort 2000, in its effort to locate psychosis in early modern German history, came up with surprisingly few instances, although as he points out, psychosis slips through the historical record. The most authoritative account of psychiatric illness is typically presented in Kaplan and Sadock's Comprehensive Textbook of Psychiatry, which is where I would direct readers interested in schizophrenia (Sadock, Sadock, and Ruiz 2009). A shorter and more contemporary argument is Freedman 2010.

Augustine wants, badly, to be a Christian, but he believes that to be a true Christian, he must renounce sex, and he just cannot bring himself to do it, the way so many who desperately want to be thin still reach for the refrigerator door: "I fought with myself and was torn apart by myself." At the height of the crisis, knowing what he should do yet unable to commit himself to do it, he throws himself at the foot of a fig tree and weeps with abandon. "Suddenly a voice reaches my ears from a nearby house. It is the voice of a boy or girl (I don't know which) and in a kind of singsong the words are constantly repeated: 'Take it and read it. Take it and read it.' At once my face changed … I could not remember that I had heard anything like it before."26 Augustine tells us that he decides that it is a divine commandment to read the Bible. He picks up the book and opens it at random, and his eyes fall on a passage about abjuring wantonness. His hesitation dissolves, and he converts fully and forever.
Augustine gives us good reasons to believe that this was an auditory hallucination. He does not think the child's voice was the accidental overhearing of a human voice: "I could not remember that I had ever heard anything like it before." He tells us that he heard the voice with his ears ("a voice reached my ears") and he gives it a source location ("from a nearby house"). This is the kind of evidence that a psychiatrist uses to judge whether a person has indeed had an auditory experience. And note these other features of the experience: it is a singular event, the only time in the Confessions that Augustine reports such a moment; and what is powerful for him is not the intrinsic quality of command in the voice but that he interprets it as divine. Augustine experiences an unusual event that he can make sense of within his religious framework, that is supported by other people (his friends and mother were overjoyed), and that makes him intensely happy.

In 1858, near a tiny French town called Lourdes, a young peasant girl claimed to see a beautiful young girl in the woods, clad in spotless white. When she told her mother, her mother beat her for the lie. But Bernadette went back to the place where she had seen the beautiful young girl, and the girl reappeared and thanked her for the holy water she had brought. Soon other people came to see, despite the mother's doubts and despite the authorities who soon forbade the visits. By the tenth time Bernadette saw the apparition, eight hundred people came to watch-but they watched Bernadette, her face immobile and translucent, not the apparition.29

And yet while intense desire and expectation play their role, what is most striking about Lourdes and Medjugorje and Fatima and the many other places where the divine is perceived to break in to the everyday is that for all the intensity and yearning, sensory overrides do not take place that often. They are obdurate even in the face of overwhelming longing, even when the divine-at least in believers' minds-is truly present. That surely is the most impressive teaching of the postcrucifixion story. Christ is risen; some disciples see. But they do not see for long. They do not see clearly. And they do not all see. That is what gives the story its ring of psychological truth. Christ is not perceived the way people with psychosis see or hear hallucinations. He is seen rarely, briefly, and without distress, despite the great wish of his followers to see him once again among them.

There are other accounts of long and vivid hearings in our spiritual traditions. Moses took down the commandments. Muhammad received the entire Koran. The psychological state these men experienced at the time is long lost to us, if indeed the men even existed as men. The historian Ann Taves uses the experience of contemporary figures who hear long dictations to argue that the two men who received the Hebrew commandments and the Koran were probably in a trancelike state of intense absorption while receiving the material.36 Certainly they are described as being in a nonnormal frame of mind. Moses, off with God for forty days and forty nights, returns from a final encounter with a radiant face; Muhammad, in a desert cave, felt that his soul was being ripped away. Taves points out that JZ Knight, who channels a 35,000-year-old spiritual warrior named Ramtha, shifts in and out of altered states, much as the turn-of-the-last-century mediums delivered volumes of wisdom from sages dwelling beyond ordinary human life while they, the mediums, were deep in trance.

 In the late 1990s, a Dutch psychiatrist, Marius Romme, and one of his patients spoke on national television about the experience of hearing voices and asked people who heard voices to contact them. Seven hundred of them did, and 450 of them had heard audible voices. Many of those voice-hearers did, in fact, meet criteria for psychotic illness. They didn't like their voices and felt that they couldn't cope with them, and they wanted someone to help them make the voices go away. But not all of them. One hundred fifty of the people who wrote in didn't seem particularly troubled by their voices, and yet they seemed to hear them often, even daily.

(A 2005 Gallup poll found that 42 percent of Americans believe in demonic possession.)39 Many evangelical books explain how to recognize and deal with demonic spirits. The most influential is probably Charles Kraft's Defeating Dark Angels, which has sold thousands of copies.40 Kraft is an anthropologist, now retired, at Fuller Theological Seminary. In Defeating Dark Angels, he argues that Africans are more spiritually effective because they have the wherewithal to deal with the demons Americans refuse to acknowledge.

In this new life of intense, focused prayer, hours and hours of prayer, Grace found herself more alert than usual, as if her senses were somehow heightened. She was quick to notice the atmosphere of a place, as if she could sniff out evil. She would walk into a restaurant and immediately sense some evil, and she would know she had to pray in order to get rid of something spiritually bad. It was as if the world were drenched with a darkness that not everyone could see, that she had never seen before. She was much more conscious of God's presence, and much more conscious of evil. Once she woke up thinking that someone was trying to rape her: "I woke up and it felt like I was struggling against this figure. Then I saw it. It was kind of dark, and as soon as I shouted Jesus, it kind of flew out of my room."44 She paused to give me some advice. "You always need to shout Jesus."

To the extent that prayer techniques can help make more real a loving God, they can also make more real a leering demon. Of course, it is hard to draw the causal arrow. Grace eventually just stopped the behavior that made her feel odd. Had the circumstances of Sarah's life not been so difficult, perhaps she too could have turned away. There is also the possibility that the bare circumstances she confronted-son and husband both at such terrible risk-were such that without any talk of demons, she would have become dangerously, suicidally depressed. One might also infer that Grace and Sarah were drawn to demons because the negative images spoke to them, rather than being imposed on them through the church. But it was hard for me to avoid the conclusion that ruminating on demons is dangerous, even when the goal is to rid the world of them, even when they may not actually exist, because when people are drawn into working with demons, they become more psychiatrically vulnerable-not because the demons are necessarily real, but because through the intense practice of prayer the demons become real to the those who pray, and haunt them.
What we carry in our minds really can become our world if we encourage it and allow it to be present. That is the promise of faith and also its curse. God-concepts and spirit-concepts are not neutral. They have great power for those for whom they are real, and when they are real for those who embrace them, they can be a problem, especially when they are negative. That is the risk for the high-absorption practitioners who learn to make them real: that the evil spirits become more real for them, as well as the good spirits. It is not a necessary risk. Not all the prayer warriors I met went down the path of spiritual warfare. Many got deeply caught in prayer without worrying about demons and their evil presence. But for those who did, it could be costly. Those who did were the only Christians I spoke with who seriously worried out loud to me about being crazy.
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