Some are open enough and able to communicate with these entities in their everyday waking and talking consciousness. They report that each type of Entity or Power communicates in a different way, usually more akin to direct telepathic linkage, than to voices in the sky. The clarity of the communion or vision depends upon the other intelligence in question, and on the clarity, knowledge and understanding of the human involved. These people are not all schizophrenics suffering from delusions and hallucinations. That is a different type of phenomena involving mental insanity and disordered personalities.
True visionaries are healthy and balanced.
They recognize the difference between their own inner voices and those from beyond. Even those who are not open to inspiration themselves, can still be indirectly touched by study of the creative expressions of the clearest and wisest of those who are truly inspired. Clear and profound inspirational Messages of general significance to all of humanity appear from time to time for that purpose. Although seldom appreciated in their own time, in later years they can have a broad impact and appeal. That is one reason the School of Wisdom Series of books and records begins with New Age Visions as Volume 1.