I wonder though about the step from hearing to acting.

I once auditory hallucinated a single syllable as I was waking up, like someone speaking loudly, almost shouting from right in my face. That was disconcerting enough. There’s a visceral element to it that’s not just a conversation with an uninvited guest.

Despite the hallucinations themselves by no means implying insanity, it’s easy to imagine them wearing you down psychologically if they’re a regular occurrence. Anecdotes about them range all the way from harmless to anxiety inducing sensory overload.