Hearing Voices Movement
Encyclopedia
Hearing Voices Movement is a philosophical trend in how people who hear voices
are viewed. It was begun by Marius Romme
, a professor of social psychiatry
at the University of Limburg in Maastricht
, the Netherlands
; and Sandra Escher, a science journalist, who began this work after being challenged by a voice hearer as to why they could not accept the reality of her voice hearing experience.
Followers of the Hearing Voices Movement advocate the use of techniques employed by those who have successfully coped with their voices. This can include acceptance and negotiation with the voices.
was established in England, with the active support of Romme. In following years, further networks have been established in other countries including Italy, Finland (1995), Wales, Scotland, Switzerland, Sweden, Austria, Germany (1998), Norway, Denmark, Japan (1996), Israel, New Zealand, Australia and the USA (2006).
In 1997 a meeting of voice hearers and mental health
workers was held in Maastricht to discuss developing the further promotion and research into the issue of voice hearing. The meeting decided to create a formal organizational structure to provide administrative and coordinating support to the wide variety of initiatives in the different involved countries. The new network was called INTERVOICE (The International Network for Training, Education and Research into Hearing Voices). INTERVOICE holds annual steering group meetings, encourages and supports exchanges and visits between member countries and the translation and publication of books and other literature on the subject of hearing voices. INTERVOICE was incorporated in 2007 as a not for profit company under UK law. Its president is Marius Romme.
INTERVOICE is supported by people who hear voices, relatives and friends and mental health professionals including nurses, psychiatrists and psychologists. INTERVOICE members assert that the most important factor in the success of their approach is the importance placed on the personal engagement of the people involved, meaning that all participants are considered an expert of their own experience. They see each other first as people, secondly as equal partners, and thirdly as all having different but mutually valuable expertise to offer. This can either be through direct experience of hearing voices or having worked with voice hearers (and/or a desire to be involved).
INTERVOICE is critical of psychiatry
in relation to the way the profession generally understands and treats people who hear voices and holds that their research has led them to the position that schizophrenia
is an unscientific and unhelpful hypothesis which should be abandoned.
The Hearing Voices Movement regards itself as being a post-psychiatric organisation, positioning itself outside of the mental health world in recognition that voices, in their view, are an aspect of human differentness, rather than a mental health problem and that, as with homosexuality
(also regarded by psychiatry in historical times as an illness), one of the main issues is about human rights
. As with homosexuality, members of the movement intend to change the way society perceives the experience, and psychiatry's attitude will follow.
The Hearing Voices Movement is also seeking more holistic health
solutions to problematic and overwhelming voices that cause mental distress than what it regards as the generally reductionist, disease
based model offered by mainstream psychiatry. Based on their research, they hold the opinion that many people successfully live with their voices and that in themselves voices are not the problem. For this reason they are prepared to accept a range of explanations offered by people who hear voices, including spiritual ones and assert that recovery (see recovery model
) from overwhelming voices can be achieved by seeking to understand the meaning of the voices to the voice hearer. This approach informed the British television documentary Voices in My Head (2005) by director David Malone
.
A detailed and neutral account of the significance of the Hearing Voice Movement entitled "Can You Live With the Voices in Your Head?" was published in New York Times Magazine in 2007. Its author Daniel B. Smith writes that the movement's
, Schreber
, and Janet's patient 'Marcelle', amongst others, to show how we have moved the experience from a socially valued context to a pathologised and denigrated one. Foucault
has argued that this process can generally arise when a minority perspective is at variance with dominant social norms and beliefs.
Romme et al. (1999) finds that these important connections can be addressed using cognitive behaviour therapy (CBT) and self-help
methods.
Romme describes a three phase model of recovery.
and the practises of mental health
services through much of the Western World
.
Brown et al. (1998) finds that 23% of people diagnosed with a psychotic illness experience positive symptoms that are resistant to medication. It has been reported that only a minority (roughly 35%) obtain significant benefits from antipsychotic drug treatment. Further, there is a range of secondary problems and withdrawal effects associated with both traditional and atypical antipsychotic drugs.
The movement also focuses on the complexity of the experience of hearing voices. In addition, emotional problems (such as depression
and anxiety
) are found in 25–40% of those diagnosed with psychosis, and the risk of suicide is increasingly recognised.
Apart from the issue of medical effectiveness, 'getting better' must be as much a personal process, to do with the nature of the experience, as a medical one. Many service users have reported negative experiences of mental health services because they are discouraged from talking about their voices as these are seen solely as symptoms of psychiatric illness.
Slade and Bentall (1988) conclude that the failure to attend to hallucinatory experiences and/or have the opportunity for dialogue about them is likely to have the effect of helping to maintain them.
Romme (1991) describes several case stories to show how the acceptance or non-acceptance of voice hearing is socially and culturally determined, which can influence the outcome of treatment with people diagnosed with schizophrenia
. Baker (1995) suggests that the extent to which nurses accept the experience of people they believe to have psychotic disorders has an effect on the extent to which they can discuss it with them. Martin (2000) describes the creation of an environment conducive to discussing the experience. Such strategies do not demand textbook answers, but emerge from service users living, in a supported way, with the experience of voice hearing.
Increasingly, in acknowledgement of the methodological weaknesses, poor prognostic power, symptomatic variability and general weaknesses inherent in the diagnostic validity of the term schizophrenia, the psychological literature has increasingly tended to focus on specific or discrete symptoms or aspects associated with it.
Thus, there has been a rapid growth in research investigating theory and treatment of strange beliefs, attention
and concentration
deficits, self-esteem
, family processes (such as the Expressed Emotion literature), to mention but a few, as well as 'voices'. In addition, recent developments in the theory and treatment of post-traumatic stress disorder
and dissociative conditions offer new understandings emphasising the close links between severe trauma in earlier life and voice hearing subsequently along with other potentially very disabling psychological symptoms. Romme et al., for example report that the disability incurred by hearing voices is associated with previous trauma and abuse, in some way (Romme et al., 1998). Similarly, in a follow-up study (Romme et al., 1999) find that these important connections can be effectively addressed clinically using a mixture of psychological therapy and self-help methods.
Romme and Escher (2000) have developed a method they call "Making sense of voices" to explore the problems in the life of the voice hearer that lie at the roots of the hearing voices experience. This approach was adopted as a consequence of the results of the studies they carried out, that they claimed, showed that to hearing voices, in itself, is not a symptom of an illness, but in most people is a reaction to severe traumatic experiences that made the person powerless, and are in effect, a kind of survival strategy.
In an intriguing study, Birchwood et al. (2000) found close parallels between the experience of subordination by voices and the experience of subordination and marginalisation in social relationships generally. This suggests that distress arising from voices may not only be linked to voice characteristics but also social and interpersonal beliefs based on life experience.
A range of other psychological and psychosocial treatment approaches are also reported in the literature. In Slade and Bentall (1988) a number of psychological strategies and the evidence supporting their efficacy are reported in terms of distress and anxiety reduction as well as in the frequency and/or intensity of the voice hearing experience.
The importance of respecting and supporting voice hearers' own capacity to develop their own understandings and personal coping resources has been emerging in recent years (Warnes et al. 1996). In a single case study, Davies (1999) was able to demonstrate the value of a diagological approach, which supported the voice-hearers' own development of a meaningful and helpful personal narrative. McNally and Goldberg (1997), as has Romme and Escher (1994, 1998) emphasised the importance of the individuals own coping resources and beliefs in developing effective intervention strategies. They identified a variety of ways in which 'self-talk' and other naturalistic coping strategies can be actively deployed towards managing voices and related experiences. Warnes (1996, 1999) discusses the value of interventions that maximises and supports the person's own experience of control of their experience.
Researchers are also seeking to discover what are the distinctive features of positive experiences (including pleasurable ones) of auditory hallucinations in people with psychosis who experience both positive and negative voices, and amongst people in the "normal" population. Beavan's research, for instance, found nearly half the people who heard voices said their hallucinations were mostly friendly or helpful.
, Sandra Escher, Jacqui Dillon, Mervyn Morris, Dirk Corstens (Editors), Living with Voices: 50 Stories of Recovery (2009), Publisher PCCS Books in association with Birmingham City University
, United Kingdom, ISBN13 9781906254223
This new study is based on 50 stories of voice hearers who claim to have recovered. The accounts are intended to form an evidence base for the effectiveness of hearing voices approach alongside an analysis of the hearing voices experience outside the illness model, resulting in accepting and making sense of voices. This book seeks to demonstrate that it is possible to overcome problems with hearing voices and to take back control of one’s life.
The central message of the book is that the path to recovery from overwhelming voices can be achieved by addressing the main problems voice-hearers describe – the threats, the feelings of powerlessness, the anxiety of being mad – and helping them to find their way back to their emotions and spirituality and to realise their dreams. This book also claims to hold true for those who have been given a diagnosis of schizophrenia. At the heart of this book are the stories of fifty people who have recovered from the distress of hearing voices, it documents how they have changed their relationship with their voices in order to reclaim their lives.
and Sandra Escher (2010), Publisher PCCS Books, United Kingdom, ISBN 978 1 906254 35 3
Children Hearing Voices provides support and practical solutions for the experience of hearing voices. It is in two parts, one part for voice-hearing children, the other part for parents and adult carers. Escher and Romme have over twenty-five years experience of working with voice-hearers, pioneering the theory and practice of accepting and working with the meaning in voices. The children's section: This book has mainly been written for children who hear voices. The information in this book is largely derived from a three-year study amongst 80 children and adolescents who were interviewed about their experiences; children who ranged in age from 8 to 19 years at first contact. Little is known about voice hearing in children. Most people still have this notion that it is a disease for life. In this book, readers will find extensive information about how to look differently at voice hearing; learning to deal with it and discovering what might help to cope with the voices. The parents'/adults' section: It became increasingly clear to us how little information parents of children hearing voices were getting and that if parents found information, it was almost always based on the assumption that voice hearing was a serious disease. The authors noticed that the children of those parents who determined to search and go their own way were doing better. This book is for these parents.
Auditory hallucination
An auditory hallucination, or paracusia, is a form of hallucination that involves perceiving sounds without auditory stimulus. A common form involves hearing one or more talking voices...
are viewed. It was begun by Marius Romme
Marius Romme
Marius Anton Joannes Romme is a Dutch psychiatrist. He is best known for his work on hearing voices and regarded as the founder and principal theorist for the Hearing Voices Movement....
, a professor of social psychiatry
Social psychiatry
Social psychiatry is a branch of psychiatry that focuses on the "interpersonal" and cultural context of mental disorder and mental wellbeing. It involves a sometimes disparate set of theories and approaches, with work stretching from epidemiological survey research on the one hand, to an indistinct...
at the University of Limburg in Maastricht
Maastricht
Maastricht is situated on both sides of the Meuse river in the south-eastern part of the Netherlands, on the Belgian border and near the German border...
, the Netherlands
Netherlands
The Netherlands is a constituent country of the Kingdom of the Netherlands, located mainly in North-West Europe and with several islands in the Caribbean. Mainland Netherlands borders the North Sea to the north and west, Belgium to the south, and Germany to the east, and shares maritime borders...
; and Sandra Escher, a science journalist, who began this work after being challenged by a voice hearer as to why they could not accept the reality of her voice hearing experience.
Followers of the Hearing Voices Movement advocate the use of techniques employed by those who have successfully coped with their voices. This can include acceptance and negotiation with the voices.
The movement
The Hearing Voices Movement can be said to have been established in 1987, by Romme and Escher, both from the Netherlands, with the formation of Stichting Weerklank (Foundation Resonance), an organization for voice hearers and others interested in this phenomenon. In 1988, an organization The Hearing Voices NetworkHearing Voices Network
The Hearing Voices Network is a self-help user-run organization for people who experience auditory hallucinations . Although members may have a psychiatric diagnosis, the group promotes an alternative approach, where voices are not necessarily seen as signs of mental illness.-Description and...
was established in England, with the active support of Romme. In following years, further networks have been established in other countries including Italy, Finland (1995), Wales, Scotland, Switzerland, Sweden, Austria, Germany (1998), Norway, Denmark, Japan (1996), Israel, New Zealand, Australia and the USA (2006).
In 1997 a meeting of voice hearers and mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
workers was held in Maastricht to discuss developing the further promotion and research into the issue of voice hearing. The meeting decided to create a formal organizational structure to provide administrative and coordinating support to the wide variety of initiatives in the different involved countries. The new network was called INTERVOICE (The International Network for Training, Education and Research into Hearing Voices). INTERVOICE holds annual steering group meetings, encourages and supports exchanges and visits between member countries and the translation and publication of books and other literature on the subject of hearing voices. INTERVOICE was incorporated in 2007 as a not for profit company under UK law. Its president is Marius Romme.
INTERVOICE is supported by people who hear voices, relatives and friends and mental health professionals including nurses, psychiatrists and psychologists. INTERVOICE members assert that the most important factor in the success of their approach is the importance placed on the personal engagement of the people involved, meaning that all participants are considered an expert of their own experience. They see each other first as people, secondly as equal partners, and thirdly as all having different but mutually valuable expertise to offer. This can either be through direct experience of hearing voices or having worked with voice hearers (and/or a desire to be involved).
INTERVOICE is critical of psychiatry
Psychiatry
Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual abnormalities...
in relation to the way the profession generally understands and treats people who hear voices and holds that their research has led them to the position that schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
is an unscientific and unhelpful hypothesis which should be abandoned.
The Hearing Voices Movement regards itself as being a post-psychiatric organisation, positioning itself outside of the mental health world in recognition that voices, in their view, are an aspect of human differentness, rather than a mental health problem and that, as with homosexuality
Homosexuality
Homosexuality is romantic or sexual attraction or behavior between members of the same sex or gender. As a sexual orientation, homosexuality refers to "an enduring pattern of or disposition to experience sexual, affectional, or romantic attractions" primarily or exclusively to people of the same...
(also regarded by psychiatry in historical times as an illness), one of the main issues is about human rights
Human rights
Human rights are "commonly understood as inalienable fundamental rights to which a person is inherently entitled simply because she or he is a human being." Human rights are thus conceived as universal and egalitarian . These rights may exist as natural rights or as legal rights, in both national...
. As with homosexuality, members of the movement intend to change the way society perceives the experience, and psychiatry's attitude will follow.
The Hearing Voices Movement is also seeking more holistic health
Holistic health
Holistic health is a concept in medical practice upholding that all aspects of people's needs, psychological, physical and social should be taken into account and seen as a whole. As defined above, the holistic view on treatment is widely accepted in medicine...
solutions to problematic and overwhelming voices that cause mental distress than what it regards as the generally reductionist, disease
Disease
A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...
based model offered by mainstream psychiatry. Based on their research, they hold the opinion that many people successfully live with their voices and that in themselves voices are not the problem. For this reason they are prepared to accept a range of explanations offered by people who hear voices, including spiritual ones and assert that recovery (see recovery model
Recovery model
The Recovery Model as it applies to mental health is an approach to mental disorder or substance dependence that emphasizes and supports each individual's potential for recovery...
) from overwhelming voices can be achieved by seeking to understand the meaning of the voices to the voice hearer. This approach informed the British television documentary Voices in My Head (2005) by director David Malone
David Malone (independent filmmaker)
David Malone, author of The Debt Generation, is also director of acclaimed documentaries on philosophy, science and religion originally broadcast in the UK by the BBC and Channel 4.-Work:Malone's work includes...
.
A detailed and neutral account of the significance of the Hearing Voice Movement entitled "Can You Live With the Voices in Your Head?" was published in New York Times Magazine in 2007. Its author Daniel B. Smith writes that the movement's
- brief against psychiatry can be boiled down to two core positions. The first is that many more people hear voices, and hear many more kinds of voices, than is usually assumed. The second is that auditory hallucination — or “voice-hearing,” H.V.N.’s more neutral preference — should be thought of not as a pathological phenomenon in need of eradication but as a meaningful, interpretable experience, intimately linked to a hearer’s life story and, more commonly than not, to unresolved personal traumas.
Position
The position of the hearing voices movement can be summarised as follows:- Hearing voices is not in itself a sign of mental illness.
- Hearing voices is experienced by many people who do not have symptoms that would lead to diagnosis of mental illness.
- Hearing voices is often related to problems in life history.
- If hearing voices causes distress, the person who hears the voices can learn strategies to cope with the experience. This is often achieved by confronting the past problems that lie behind the experience.
Movement history
In an overview of the challenging new research and practise initiatives developing across Europe, Baker charts the progress made from a view of voice hearing as bizarre and dangerous towards a recognition of voices as real, meaningful, and related to people's lives. This recognises that the experience can be overwhelming and deeply distressing, but also, that the attempt to understand their meaning can be part of a solution.Leudar and Thomas
In a recent book, Leudar and Thomas (2000): Voices of Reason, Voices of Insanity, review almost 3,000 years of voice-hearing history, including that of SocratesSocrates
Socrates was a classical Greek Athenian philosopher. Credited as one of the founders of Western philosophy, he is an enigmatic figure known chiefly through the accounts of later classical writers, especially the writings of his students Plato and Xenophon, and the plays of his contemporary ...
, Schreber
Daniel Paul Schreber
Daniel Paul Schreber was a German judge who suffered from what was then diagnosed as dementia praecox. He described his second mental illness , making also a brief reference to the first illness in his book Memoirs of My Nervous Illness...
, and Janet's patient 'Marcelle', amongst others, to show how we have moved the experience from a socially valued context to a pathologised and denigrated one. Foucault
Michel Foucault
Michel Foucault , born Paul-Michel Foucault , was a French philosopher, social theorist and historian of ideas...
has argued that this process can generally arise when a minority perspective is at variance with dominant social norms and beliefs.
Romme and Escher
The work of Romme and Escher provides a theoretical framework for these new initiatives, and provides much of the impetus for the self-help movement in recent years. They demonstrate:- Not everyone who hears voices becomes a patient. Over a third of 400 voice hearers in Holland had not had any contact with psychiatric servicesPsychiatric ServicesPsychiatric Services is a peer-reviewed academic journal publishing research on psychiatry. It is published monthly by American Psychiatric Association , and is edited by Howard H. Goldman....
. These people either described themselves as being able to cope with their voices and/or described their voices as life enhancing. - Romme cites demographic research indicating that hearing voices in itself is not a symptom of an illness, but is apparent in 2–4% of the population (some research gives higher estimates); and even more (about 8%) have peculiar personal convictions, also known as delusionDelusionA delusion is a false belief held with absolute conviction despite superior evidence. Unlike hallucinations, delusions are always pathological...
s, and do so without being ill. His own research has provided further verification of this. - Comparisons between people. People who cope well with their voices and those who did not show clear differences in terms of the nature of the relationship they had with their voices.
- People who cope better also differed in terms of the kinds of strategies they adopted to manage their voices and its personal impact.
- 70% of voice hearers reported that their voices had begun after a severe traumaticPsychological traumaPsychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...
or intensely emotional event, such as an accident, divorce or bereavement, sexual or physical abuse, love affairs, or pregnancy. Romme et al. (1998) found that the onset of voice hearing amongst a 'patient' group was preceded by either a traumatic event or an event that activated the memory of an earlier trauma. There was a high association with abuse. These findings are being substantiated further in an on-going study with voice hearing amongst children. - Some people who hear voices, regardless of being able to cope with this or not, may have a burning need to construct a personal understanding for their experiences and to talk to others about it without being designated as madInsanityInsanity, craziness or madness is a spectrum of behaviors characterized by certain abnormal mental or behavioral patterns. Insanity may manifest as violations of societal norms, including becoming a danger to themselves and others, though not all such acts are considered insanity...
. - A long-term developmental process of psychological adjustment was identified by surveying the considerable range of experience and the negotiation methods that people reported. Romme has developed this approach with several studies showing that hearing voices can be associated with memories of emotionally 'undigested' events, usually connected with key relationships.
Romme et al. (1999) finds that these important connections can be addressed using cognitive behaviour therapy (CBT) and self-help
Self-help
Self-help, or self-improvement, is a self-guided improvement—economically, intellectually, or emotionally—often with a substantial psychological basis. There are many different self-help movements and each has its own focus, techniques, associated beliefs, proponents and in some cases, leaders...
methods.
Romme describes a three phase model of recovery.
- Startling. Initial confusion; emotional chaos, fear, helplessness and psychological turmoil.
- Organization. The need to find meaning, arrive at some understanding and acceptance. The development of ways of coping and accommodating voices in everyday living. This task may take months or years and is marked by the attempt to enter into active negotiation with the voice(s).
- Stabilisation. The establishment of equilibrium, and accommodation, with the voice(s), and the consequent re-empowermentEmpowermentEmpowerment refers to increasing the spiritual, political, social, racial, educational, gender or economic strength of individuals and communities...
of the person.
Alternative to medical model
The Hearing Voices Movement reflects significant disenchantment with the medical modelMedical model
Medical model is the term cited by psychiatrist Ronald D. Laing in his The Politics of the Family and Other Essays , for the "set of procedures in which all doctors are trained." This set includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and...
and the practises of mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...
services through much of the Western World
Western world
The Western world, also known as the West and the Occident , is a term referring to the countries of Western Europe , the countries of the Americas, as well all countries of Northern and Central Europe, Australia and New Zealand...
.
Brown et al. (1998) finds that 23% of people diagnosed with a psychotic illness experience positive symptoms that are resistant to medication. It has been reported that only a minority (roughly 35%) obtain significant benefits from antipsychotic drug treatment. Further, there is a range of secondary problems and withdrawal effects associated with both traditional and atypical antipsychotic drugs.
The movement also focuses on the complexity of the experience of hearing voices. In addition, emotional problems (such as depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...
and anxiety
Anxiety
Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. The root meaning of the word anxiety is 'to vex or trouble'; in either presence or absence of psychological stress, anxiety can create feelings of fear, worry, uneasiness,...
) are found in 25–40% of those diagnosed with psychosis, and the risk of suicide is increasingly recognised.
Apart from the issue of medical effectiveness, 'getting better' must be as much a personal process, to do with the nature of the experience, as a medical one. Many service users have reported negative experiences of mental health services because they are discouraged from talking about their voices as these are seen solely as symptoms of psychiatric illness.
Slade and Bentall (1988) conclude that the failure to attend to hallucinatory experiences and/or have the opportunity for dialogue about them is likely to have the effect of helping to maintain them.
Romme (1991) describes several case stories to show how the acceptance or non-acceptance of voice hearing is socially and culturally determined, which can influence the outcome of treatment with people diagnosed with schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
. Baker (1995) suggests that the extent to which nurses accept the experience of people they believe to have psychotic disorders has an effect on the extent to which they can discuss it with them. Martin (2000) describes the creation of an environment conducive to discussing the experience. Such strategies do not demand textbook answers, but emerge from service users living, in a supported way, with the experience of voice hearing.
Increasingly, in acknowledgement of the methodological weaknesses, poor prognostic power, symptomatic variability and general weaknesses inherent in the diagnostic validity of the term schizophrenia, the psychological literature has increasingly tended to focus on specific or discrete symptoms or aspects associated with it.
Thus, there has been a rapid growth in research investigating theory and treatment of strange beliefs, attention
Attention
Attention is the cognitive process of paying attention to one aspect of the environment while ignoring others. Attention is one of the most intensely studied topics within psychology and cognitive neuroscience....
and concentration
Concentration
In chemistry, concentration is defined as the abundance of a constituent divided by the total volume of a mixture. Four types can be distinguished: mass concentration, molar concentration, number concentration, and volume concentration...
deficits, self-esteem
Self-esteem
Self-esteem is a term in psychology to reflect a person's overall evaluation or appraisal of his or her own worth. Self-esteem encompasses beliefs and emotions such as triumph, despair, pride and shame: some would distinguish how 'the self-concept is what we think about the self; self-esteem, the...
, family processes (such as the Expressed Emotion literature), to mention but a few, as well as 'voices'. In addition, recent developments in the theory and treatment of post-traumatic stress disorder
Post-traumatic stress disorder
Posttraumaticstress disorder is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,...
and dissociative conditions offer new understandings emphasising the close links between severe trauma in earlier life and voice hearing subsequently along with other potentially very disabling psychological symptoms. Romme et al., for example report that the disability incurred by hearing voices is associated with previous trauma and abuse, in some way (Romme et al., 1998). Similarly, in a follow-up study (Romme et al., 1999) find that these important connections can be effectively addressed clinically using a mixture of psychological therapy and self-help methods.
Romme and Escher (2000) have developed a method they call "Making sense of voices" to explore the problems in the life of the voice hearer that lie at the roots of the hearing voices experience. This approach was adopted as a consequence of the results of the studies they carried out, that they claimed, showed that to hearing voices, in itself, is not a symptom of an illness, but in most people is a reaction to severe traumatic experiences that made the person powerless, and are in effect, a kind of survival strategy.
Recent work
Recent work has focused on beliefs about voices in addition to the voices themselves. Chadwick, Birchwood and Trower (1996) and Bentall (1994) have proposed a number of psychological theories for understanding the experience of hearing voices and the beliefs associated with them. Chadwick and Birchwood, 1997) reported marked reductions in voice hearing, and associated distress based on their cognitive model.In an intriguing study, Birchwood et al. (2000) found close parallels between the experience of subordination by voices and the experience of subordination and marginalisation in social relationships generally. This suggests that distress arising from voices may not only be linked to voice characteristics but also social and interpersonal beliefs based on life experience.
A range of other psychological and psychosocial treatment approaches are also reported in the literature. In Slade and Bentall (1988) a number of psychological strategies and the evidence supporting their efficacy are reported in terms of distress and anxiety reduction as well as in the frequency and/or intensity of the voice hearing experience.
The importance of respecting and supporting voice hearers' own capacity to develop their own understandings and personal coping resources has been emerging in recent years (Warnes et al. 1996). In a single case study, Davies (1999) was able to demonstrate the value of a diagological approach, which supported the voice-hearers' own development of a meaningful and helpful personal narrative. McNally and Goldberg (1997), as has Romme and Escher (1994, 1998) emphasised the importance of the individuals own coping resources and beliefs in developing effective intervention strategies. They identified a variety of ways in which 'self-talk' and other naturalistic coping strategies can be actively deployed towards managing voices and related experiences. Warnes (1996, 1999) discusses the value of interventions that maximises and supports the person's own experience of control of their experience.
Researchers are also seeking to discover what are the distinctive features of positive experiences (including pleasurable ones) of auditory hallucinations in people with psychosis who experience both positive and negative voices, and amongst people in the "normal" population. Beavan's research, for instance, found nearly half the people who heard voices said their hallucinations were mostly friendly or helpful.
Living with Voices: 50 Stories of Recovery (2009)
Living with Voices: 50 Stories of Recovery: Marius RommeMarius Romme
Marius Anton Joannes Romme is a Dutch psychiatrist. He is best known for his work on hearing voices and regarded as the founder and principal theorist for the Hearing Voices Movement....
, Sandra Escher, Jacqui Dillon, Mervyn Morris, Dirk Corstens (Editors), Living with Voices: 50 Stories of Recovery (2009), Publisher PCCS Books in association with Birmingham City University
Birmingham City University
Birmingham City University is a British university in the city of Birmingham, England. It is the second largest of three universities in the city, the other two being the Aston University and University of Birmingham...
, United Kingdom, ISBN13 9781906254223
This new study is based on 50 stories of voice hearers who claim to have recovered. The accounts are intended to form an evidence base for the effectiveness of hearing voices approach alongside an analysis of the hearing voices experience outside the illness model, resulting in accepting and making sense of voices. This book seeks to demonstrate that it is possible to overcome problems with hearing voices and to take back control of one’s life.
The central message of the book is that the path to recovery from overwhelming voices can be achieved by addressing the main problems voice-hearers describe – the threats, the feelings of powerlessness, the anxiety of being mad – and helping them to find their way back to their emotions and spirituality and to realise their dreams. This book also claims to hold true for those who have been given a diagnosis of schizophrenia. At the heart of this book are the stories of fifty people who have recovered from the distress of hearing voices, it documents how they have changed their relationship with their voices in order to reclaim their lives.
Children Hearing Voices - What You Need to Know and What You Can Do
Children Hearing Voices - What You Need To Know and What You Can Do: Marius RommeMarius Romme
Marius Anton Joannes Romme is a Dutch psychiatrist. He is best known for his work on hearing voices and regarded as the founder and principal theorist for the Hearing Voices Movement....
and Sandra Escher (2010), Publisher PCCS Books, United Kingdom, ISBN 978 1 906254 35 3
Children Hearing Voices provides support and practical solutions for the experience of hearing voices. It is in two parts, one part for voice-hearing children, the other part for parents and adult carers. Escher and Romme have over twenty-five years experience of working with voice-hearers, pioneering the theory and practice of accepting and working with the meaning in voices. The children's section: This book has mainly been written for children who hear voices. The information in this book is largely derived from a three-year study amongst 80 children and adolescents who were interviewed about their experiences; children who ranged in age from 8 to 19 years at first contact. Little is known about voice hearing in children. Most people still have this notion that it is a disease for life. In this book, readers will find extensive information about how to look differently at voice hearing; learning to deal with it and discovering what might help to cope with the voices. The parents'/adults' section: It became increasingly clear to us how little information parents of children hearing voices were getting and that if parents found information, it was almost always based on the assumption that voice hearing was a serious disease. The authors noticed that the children of those parents who determined to search and go their own way were doing better. This book is for these parents.
See also
- Interpretation of Schizophrenia
- Ross Institute for Psychological TraumaRoss Institute for Psychological TraumaThe Ross Institute for Psychological Trauma is a psychiatric hospital in Dallas, Texas in the United States founded by Colin A. Ross in 1991, treating adults suffering from depression, self-mutilation, suicide ideation, anxiety, dissociative schizophrenia, dissociation and substance abuse...
- Trauma model of mental disordersTrauma model of mental disordersTrauma models of mental disorders emphasize the effects of psychological trauma, particularly in early development, as the key causal factor in the development of some or many psychiatric disorders .Trauma models are typically founded on the view that traumatic experiences...
- Social construction of schizophreniaSocial construction of schizophreniaSocial Constructionism, a branch of sociology, queries commonly held views on the nature of reality touching on themes of normality and abnormality within the context of power and oppression in societal structures....
Articles
- Treatment of Schizophrenia Challenged In Western Australia The NewsMaker (Australia) 9 June 2011, "The Psychiatrist, the psychologist and the ex patient: a frank discussion on schizophrenia" Dr Dirk Corstens from the Netherlands, award-winning psychologist Eleanor Longden, and ex patient and Voices advocate Ron Coleman, discuss their expertise and experience on schizophrenia and voice hearing, as well as share innovative ways on the treatment of schizophrenia and management the experience.
- A first-class recovery: From hopeless case to graduate The Independent (UK) 25 October 2009, Eleanor Longden was a diagnosed schizophrenic and heard menacing voices in her head for 10 years.
- Embracing the dark voices within BBC News Online (UK), 3 September 2009
- I talk back to the voices in my head The Guardian (UK), 4 April 2009
- A dialogue with myself The Independent (UK), 15 April 2008, When Ruth began hearing voices, she turned to a controversial drug-free therapy programme. Now, her story is told in a powerful TV film
- Listening Cure Time/CNN (USA), 21 February 2008
- Can You Live With the Voices in Your Head? New York Times (USA), 25/03/2007
- Voices carry Boston Globe (USA), 25/03/2007
- The mad doctor: The extraordinary story of Dr Rufus May, the former psychiatric patient The Independent (UK), 18 March 2007
- Mad Medicine: A New Group for People Who Hear Voices Celebrates Mental Diversity Portland Mercury June 25 2009
External links
- Hearing Voices Network Australia (HVNA) A collection of Hearing Voices Groups and affiliated members (such as service providers, consumers, carers and friends) working toward promoting recovery, acceptance and education.
- HEARING VOICES NETWORK AOTEAROA NZ- Te Reo Orooro Te Reo Orooro - providing information & support for voices & visions
- Stemmehørernetværket i Danmark Hearing Voices Network Denmark
- Hearing Voices Network England
- SUOMEN MONIÄÄNISET RY Hearing Voices Network Finland
- Hearing voices (auditory hallucinations) Information from the Mental Health Foundation (UK)
- Hearing Voices Ireland (HVI) Started in 2006 to ‘promote and foster acceptance of ‘voice hearing’ as a valid human experience’.
- Hearing voices that are distressing: Self-help resources and strategies National Empowerment Center (USA)
- Hearing Voices: mainly in Dutch language
- Hope Hearing Voices Network NSW, Australia The primary objective of HVNNSW, is to establish, facilitate and support self help groups for voice hearers, throughout Metropolitan Sydney, as well as regional NSW.
- INTERVOICE: International Network for Training, Education and Research into Hearing Voices
- Intervoice Oberösterreich – Netzwerk Stimmenhören Hearing Voices Network Austria
- Italy Hearing Voices Network
- Netzwerk Stimmenhören Website of German HVN formed in 1997
- "The voice inside: A practical guide to coping with hearing voices"
- Audio of Will Hall Talk at Canada Hearing Voices Gathering Toronto, 2010
- Echoes (Shetland Hearing Voices Group)
- Stichting Weerklank Resonance, Netherlands: A foundation for and by people with: Hearing voices, Special psychic experience, Psychotic experiences, Extrasensory experiences
- Hører stemmer Hearing voices Network Norway
- http://www.HVN-Canada.bravehost.com/ Hearing voices Canada
- Portland Hearing Voices Portland Oregon USA
Publications
- Romme, M. & Escher, A. (July 1989). "Effects of mutual contacts from people with auditory hallucinations." Perspectief no 3, 37-43.
- Romme, M. & Escher, A. (1990). "Heard but not seen." Open Mind 49, 16-18.
- Romme, M. & Escher, A. (9 November 1991). "Sense in voices." Open Mind 53.
- Romme, M. & Escher, A. (December 1991). "Undire le Voci." Spazi della Menten 8, p 3-9.
- Romme, M., Honig, A., Noorthoorn, O., Escher, A. (1991) "Coping with voices: an emancipatory approach." British Journal of PsychiatryBritish Journal of PsychiatryThe British Journal of Psychiatry is a peer-reviewed medical journal published monthly by the Royal College of Psychiatrists containing original research, systematic reviews, commentaries on contentious articles, short reports, a comprehensive book review section, and a correspondence column...
161, 99-103. - Romme, M. Honig, A. Noorthorn, E. O. & S. Escher (1992) "Coping with hearing voices: an emancipatory approach". 'British Journal of Psychiatry.
- Romme, M. & Escher, A. (Eds.) (1993, 2nd edition 1998) Accepting Voices, MIND Publications, London.
- Romme, M. & Escher, A. (Eds.) (1996) Understanding voices: coping with auditory hallucinations and confusing realities . First published by Rijksuniversitiet Maastricht, Limburg, Holland and also new English edition, Handsell Publications.
- Romme, M. & Escher, A. (2000) Making Sense of Voices - A guide for professionals who work with voice hearers MIND Publications.
- Assiz, Christine. (6 January 1991) "Heard but not seen". The Independent.
- Baker, P.K. (1990) "I hear voices and I'm glad to!". Critical Public Health, No. 4, 1990, pp 21–27.
- Baker, P.K. (1995) "Accepting the Inner Voices". Nursing Times, Vol. 91, No 31, 1995, pp 59–61.
- Baker, P.K. (1996) The Voice Inside: a practical guide to coping. Mind Publications.
- Baker, P.K. (1996) Can you hear me, a research and practice summary. Handsell UK.
- Barret, T.R. and Etheridge, J.B. (1992) "Verbal hallucinations in Normals I: People who hear voices". Applied Cognitive Psychology, Vol. 6, pp. 379–387.
- Benthall, R.P. (1990) "The illusion of Reality: a review and integration of psychological research into psychotic hallucinations". Psychological Bulletin, no. 107, pp. 82–95.
- Bentall, R.P., Claridge, G.S. & Slade, P.D. (1988) "Abandoning the Concept of "Schizophrenia": Some Implications of Validity Arguments for Psychological Research into Psychotic Phenomena". British Journal of Clinical Psychology, Vol.27, pp. 303–324.
- Bentall R.P., Claridge, G.S. & Slade, P.D. (1989) "The Multidimensional Nature of Schizotypal traits: A factor analytic study with normal subjects". British Journal of Clinical Psychology, Vol.?
- Bentall, R.P., Haddock, G. and Slade, P.D. (1994) "Cognitive Behaviour Therapy for persistent auditory hallucinations: from theory to therapy". Behavioral Psychotherapy No. 25, pp. 51–56.
- Bentall, R.P., Jackson, H.J. & Pilgrim, D. (1988) "Abandoning the concept of "schizophrenia: Some implications of validity arguments for psychological research into psychotic phenomena". British Journal of Clinical Psychology No. 27, pp. 303–324.
- Bentall, R.P., Kaney, S. & Dewey. M (1991) "Paranoia and Social Reasoning: An Attribution Theory Analysis". British Journal of Clinical Psychology No. 30, pp. 13–23.
- Bentall, R.P. and Slade, P.D. (1995) "Reliability of a scale for measuring disposition towards hallucinations: a brief report". Person. Individ. Diff. Vol 6, No. 4, pp. 527–529.
- Blackman, Lisa. (2001) Hearing Voices, Embodiment and Experience. Free Association BooksFree Association BooksFree Association Books is an innovative project started in 1980s London. It arose as the brainchild of Bob Young and colleagues, who, disillusioned by the decline of the liberatory movement, began a search using psychoanalysis to understand the problems of liberation...
, London. - Bentall, R. & Haddock, G. (1990) "Cognitive behaviour therapy for persistent auditory hallucinations". Behaviour Therapy 25: 51 - 66.
- Chadwick, P.D.J. and Birchwood, M.J. (1994) "Challenging the omnipotence of voices: A cognitive approach to auditory hallucinations". British Journal of Psychiatry No. 164, pp. 190–201.
- Coleman, R and Smith, M. (1997) Victim to Victor: working with voices. Handsell, Gloucester, UK.
- Cullberg, J. (1991) "Recovered versus non-recovered schizophrenic patients among those who have had intensive psychotherapy". Acta Psychiatrica Scandinavica Vol. 84, pp. 242–245.
- Downs, Julie (Ed). (2001) Starting and Supporting Voices Groups: A Guide to setting up and running support groups for people who hear voices, see visions or experience tactile or other sensations. Hearing Voices Network, Manchester, England.
- Downs, Julie (Ed). (2001) Coping with Voices And Visions, A guide to helping people who Experience hearing voices, seeing visions, tactile or other Sensations. Hearing Voices Network, Manchester, England.
- Ensink, B. (1992) Confusing Realities: A study of child sexual abuse and psychiatric symptoms. Amsterdam, VU University Press.
- Ensink, B. (1993) "Trauma: A study of child abuse and hallucinations". Accepting Voices, Eds M. Romme and S. Escher.
- Eaton, W.W., Romanoski, A., Anthony, J.C., Nestadt, G. (1991) "Screening for psychosis in the general population with a self report interview". Journal of Nervous and Mental Disease 179, pp 689–693.
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- Freedland, John (April 22, 1995) "Hearing is believing". The Guardian.
- Grierson, Mike (1991) "A Report on the Manchester Hearing Voices Conference November 1990". Hearing Voices Network.
- Haddock, G., Bentall, R.P. and Slade, P. (1996) "Psychological treatments for auditory hallucinations, focussing or distraction?". Cognitive, Behavioural Interventions with Psychotic Disorders Routledge, London Therapy, Eds. Haddock G. and Slade P, pp. 45–71.
- Haddock, G., Bentall, R.P. and Slade, P.D. (1993) "Psychological treatment of chronic auditory hallucinations: two case studies". Behavioral and Cognitive Psychotherapy 21: 335-46.
- Haddock, G. and Slade, P. (1996) Empowering people who hear voices in cognitive behavioral interventions with psychotic disorders. Routledge, London.
- Heery, M. W. (1989) "Inner Voice Experiences: an exploratory study of 30 cases". Journal of Transpersonal Psychiatry, vol. 21, no. 1, pp. 73–82.
- Holmes, Doug. (15 February 1999) Hearing Voices: Hillary, Angels, and O.J. to the Voice-Producing Brain. Shenandoah Psychology Press.
- James, Adam (2001) Raising our Voices: History of the Voice hearing movement". Handsell, UK.
- Jaynes, J. (1976) The origin of consciousness and the breakdown of the bicameral mind. Houghton Mifflin, Boston.
- Leudar and Thomas, P. (1994) "Guidelines for Establishing Pragmatic Aspects of Voices". Voice Hearer Talk. Manchester: Department of Psychology, University of Manchester.
- Leudar, I., Thomas, P., Johnston, M. (1992) "Self Repair for in dialogues of schizophrenics: effects of hallucinations and negative symptoms". Brain and Language 43: 487-511.
- Leudar, I., Thomas, P., Johnston, M. (1994) "Self monitoring in speech production: effects of verbal hallucinations and negative symptoms". Psychological Medicine.
- Leudar, I., Thomas, P., McNally, D. and Glinsky, A. (1997) "What can voices do with words? Pragmatics of verbal hallucinations". Psychological Medicine.
- Leudar, I., Thomas, P. Voices of Reason, Voices of Insanity - Studies of Verbal Hallucinations (2000) Routledge/Psychological Press.
- Lineham, T. (1993) "Hearing is Believing". New Statesman and Society, 26.3.93, pp. 18–19.
- Lockhart, A. R. (1975) "Mary's Dog is an Ear Mother: Listening to the Voices of Psychosis". Psychological Perspectives Vol. 6, No 2, pp. 144–160.
- Miller, L. J., O'Connor, R. N. & DiPasquale, T. (1993) "Patients' Attitudes Toward Hallucinations".$ American Journal of Psychiatry, Vol. 150, no.4, pp. 584–588.
- Posey, T.B. and Losch, M.E. (1984) "Auditory hallucinations of hearing voices in 375 normal subjects". Imagination, Cognition and Personality, vol 3, no.2, pp. 99–113.
- Rector and Seeman (1992) "Auditory Hallucinations in Women and Men". Schizophrenia Research, vol 7, pp. 233–236.
- Sarbin, T. R. (1990) "Towards the Obsolescence of the Schizophrenia Hypothesis". The Journal of Mind and Behaviour vol. 11. No. 3/4, pp. 259–283.
- Siegel, Ronald. Fire in the Brain: Clinical Tales of Hallucination. Dutton Books, New York, 1992.
- Sidgewick, H. A. (1894) "Report on the census of hallucinations, Proceedings of the Society of Psychical Research". No. 26, pp. 25–394.
- Slade, P. D. (1993) "Models of Hallucination: from theory to practice" in David, A.S. and Cutting, J. (Eds.) The Neuropsychology of Schizophrenia, Earlbaum, London.
- Slade, P.D. and Bentall, R.P. (1988) Sensory Deception; towards a scientific analysis of hallucinations, Croom Helm, London.
- Stephens, G. Lynn and Graham, George. (May 2000) When Self-Consciousness Breaks: Alien Voices and Inserted Thoughts, Philosophical Pychopathology Series, Bradford Books; ISBN 0-262-19437-6
- Tarrier N., Harwood S., Yusupoff L., Beckett R. & Baker A. (1990) Coping Strategy Enhancement (CSE): Method of Treating Residual Schizophrenic Symptoms Behavioural Psychotherapy, No. 18, pp. 283–293.
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- Watkins, John. (1998) Hearing voices - A Common Human Experience. by Hill of Content Publishing, Melbourne, Australia; ISBN 0-85572-288-6
- Yusopoff and Tarrier N. (1996) "Coping strategy enhancement for persistent hallucinations and delusions". Cognitive, Behavioural Interventions with Psychotic Disorders. Routledge, London Therapy, Eds. Haddock G. and Slade P.