Research Papers

We have gathered together a variety of published research papers on hearing voices, the Hearing Voices Movement, HVGs, and therapies that now include work with psychosis which were once contraindicated.
 

Taking with Voices: Exploring what is expressed by the voices people hear

Dirk Corstens, Eleanor Longden, Rufus May
Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue, whereby a facilitator directly engages with the voice(s) in order to heighten awareness and understanding of voice characteristics. The method provides insight into the underlying reasons for voice emergence and origins, and can ultimately inspire amore productive relationship between hearer and voice(s). We discuss the rationale for the approach and provide guidance in applying it. Case examples are also presented.  Download Report.
 

The Voices Others Cannot Hear

Simon McCarthy-Jones and Eleanor Longden.
The biological disease conception of auditory verbal hallucination holds that their causes and treatment are directed by biology alone, that their discussion is detrimental and their content arbitrary. An alternative view sees voice-hearing as a widespread and meaningful human experience, encouraging a dialogue with the voices in order to discover what they mean and change the hearer’s relationship with them. Is it possible to reconcile these two views? Download document.
 

Emerging Perspectives From the Hearing Voices Movement: Implications for Research and Practice

Dirk Corstens, Eleanor Longden, Simon McCarthy-Jones, Rachel Waddingham, Neil Thomas
The international Hearing Voices Movement (HVM) is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the HVM is the notion that hearing voices is a meaningful human experience, and in this article, we discuss the historical growth and influence of the HVM before considering the implications of its values for research and practice in relation to voice hearing. Among other recommendations, we suggest that the involvement of voice-hearers in research and a greater use of narrative and qualitative approaches are essential. Challenges for implementing user-led research are identified, and avenues for future developments are discussed. Download document.
 

Work-related experiences of people who hear voices: an occupational perspective

Lisa Craig, Dr Josh Cameron, Dr Eleanor Longden
Hearing distressing voices can be a significant mental health challenge, potentially disrupting working lives. Yet few studies have explored voice-hearing in relation to employment. This study aimed to understand the work-related experiences of voice-hearers, including the impacts on their working lives and their corresponding self-management strategies. Download Document.
 

The Challenges And Opportunities Of Social Connection When Hearing Derogatory And Threatening Voices:

Bryony Sheaves, Louise Johns, Emma
Cernis, Laura Griffith, The McPin Hearing Voices Lived Experience Advisory Panel, Daniel Freeman
Relationships with other people are important determinants of the course of psychosis, yet social isolation is common. This study sought to learn about the patient experience of being around other people when hearing derogatory and threatening voices. The challenges that social interactions bring to people who hear distressing voices are likely to be different to those of other experientially distinct psychotic experiences (e.g., grandiose delusions). They may also differ according to voice presentation (companionate or commanding vs. threatening voices). This paper therefore focuses on the experience of being around other people in the context of one specific presentation: derogatory and threatening voices.  Download Document.
 

Emerging Processes Within Peer-Support Hearing Voices Groups: A Qualitative Study in the Dutch Context

Barbara Schaefer, Jenny Boumans, Jim van Os, Jaap van Weeghel
HVGs differ from regular psychoeducation and group therapy in that they have a focus on group ownership rather than following a predetermined, guideline-based structure. All HVG participants are considered experts due to their lived experience. Thus, no single expert exists, and all group members are experts. Members make decisions about how the group is run and what is talked about together. The HVGs provide a tool to help group members make sense of and cope with their voices on their own terms and in their own way through talking about their experiences and asking each other questions. Consistent with the Hearing Voices Movement’s founding principles, diverse explanations are accepted for the origins of voices, and voice-hearers are encouraged to take ownership of their experiences and define them for themselves. Download document.
 

Investigating the Lived Experience of Recovery in People Who Hear Voices

Adèle de Jager1, Paul Rhodes, Vanessa Beavan, Douglas Holmes, Kathryn McCabe1, Neil Thomas, Simon McCarthy-Jones, Debra Lampshire, and Mark Hayward
Although there is evidence of both clinical and personal recovery from distressing voices, the process of recovery over time is unclear. Narrative inquiry was used to investigate 11 voice-hearers’ lived experience of recovery. After a period of despair/exhaustion, two recovery typologies emerged: (a) turning toward/empowerment, which involved developing a normalized account of voices, building voice-specific skills, integration of voices into daily life, and a transformation of identity, and (b) turning away/protective hibernation, which involved harnessing all available resources to survive the experience, with the importance of medication in recovery being emphasized. Results indicated the importance of services being sensitive and responsive to a person’s recovery style at any given time and their readiness for change. Coming to hold a normalized account of voice-hearing and the self and witnessing of preferred narratives by others were essential in the more robust turning toward recovery typology. Download Document.
 

EMDR in Psychosis: Guidelines for Conceptualization and Treatment

Berber Van Der Vleugel, Paul Bont
A significant proportion of clients with psychosis have experienced childhood trauma and suffer from comorbid post traumatic stress disorder. Research indicates that exposure to distressing early life events plays an important role in the emergence and persistence of psychotic symptoms—either directly or indirectly. The Two Method Approach of EMDR conceptualization and recent findings on reprocessing of psychosis-related imagery fit with the existing cognitive models of psychosis. This article presents a series of preliminary guidelines for conceptualizing EMDR treatment in psychosis, which are based on both theory and clinical experience and are illustrated with case examples. Several obstacles andrelated treatment strategies for using EMDR in psychosis are described. EMDR in psychosis can very well be combined with other standard interventions such as psychotropic medication and cognitive behavioural therapy. Download document.
 

Talking With Voices Using the Voice Dialogue Method

TalkingToVoices-DialogueMethodDirk Corstens, Marius Romme. From: ‘Directieve therapie’ 2008
Epidemiological research of the past twenty years has shown that hearing voices with the characteristics of auditory hallucinations, occurs in two to four percent of the population. In the majority of cases, there is no mental disorder present. Recently, this was also demonstrated by the Dutch NEMESIS study, a screening of seven thousand people. Often, social workers are surprised by this fact, as they only meet people who are actually bothered by the voices. Moreover, research has shown that the difference between those who become patients and those who do not, is linked to the attributes that are given to fear of the voices and to their power. There is no doubt that hearing voices is often attendant on symptoms as depression, anxiety, dissociation, suicidal tendencies and persistent beliefs. About one third of the people that hear voices suffer to such an extent that they seek professional help. However, there are countless voice hearers that have taught themselves or each other, how to deal with the voices. Various mental disorders involve hearing voices. In treating voice hearers, we focus on the symptom itself and the consequences experienced in daily life. Through the years, cognitive psychologists have developed various methods to treat voice hearers. Without exception, their methods aim at enabling the voice hearer to deal with the voices. Methods from behavioral therapy and cognitive psychology are mostly used for this purpose. Download document.
 

iMAgery-Focused Psychological Therapy for Persecutory Delusions in PSychosis (iMAPS): A Novel Treatment Approach

Christopher D.J. Taylor, Penny E. Bee, James Kelly, Gillian Haddock
Intrusive mental imagery and negative beliefs about self and others are frequently reported problems for individuals who experience psychosis, but there are few treatment approaches that have specifically targeted these. Intrusive mental images and negative schema have been identified as potential maintaining factors for persecutory delusions. These can range from paranoia-related recurrent intrusive images (e.g., being attacked by others, being followed by unknown figures who mean you harm) from the past or “flash-forward” future paranoia related intrusive mental images. In this article we outline clinical issues and adaptations of an imagery-focused approach for persecutory delusions. Drawing on a number of sources including a systematic literature review, a qualitative study exploring core beliefs, an experience sampling study and techniques from existing manuals and approaches, we adapted these imagery approaches to work with images and schema. The close links between imagery and core beliefs highlighted an opportunity to also use imagery rescripting approaches to transform negative schema and reduce persecutory delusions. Individuals with psychosis often want help with intrusive mental images and negative beliefs; adapted evidence-based imagery focused interventions can be used and the interventions may also help to reduce persecutory delusions. Download document.
 

The Lancet – Hearing Voices: Tracing The Borders Of Normality

Volume 2, March 2015.
In their subsequent research, Romme and Escher examined why some people could cope independently with hearing voices, whereas others found such experiences distressing and tended to come to the attention of mental health services. They suggested that the degree of distress related to voices was associated with how an individual appraises them. For example, the degree of perceived intrusiveness of voices might be associated with greater distress and a need for mental health care. Such research sowed the seeds for the Hearing Voices Movement, which advocates an alternative attitude to the experience of hearing voices than is usually found within mainstream psychiatric services. Rather than viewing voices as a fundamental sign of mental illness, proponents of the movement suggest they are unusual, but ultimately understandable experiences that often relate to traumatic or problematic life events. As such, they can be experienced by anyone, whether or not they have other symptoms that require a psychiatric diagnosis. Importantly, they believe that a person can develop coping strategies to deal with their voices, primarily by confronting the life events that lie at their core. Download Document.
 

The Linguistics Of Schizophrenia: Thought Disturbance As Language Pathology Across Positive Symptoms

Wolfram Hinzen, Joana Rossello
On a common view, language is a vehicle for communication, grounded in pre-existing thought, which provides its content. On this view, delusional symptoms like a person’s belief that he is Jesus Christ are typically classed as disturbances in ‘thought’ rather than language: language merely ‘reflects’ an underlying disturbance in the thought process, without being an aspect of its etiology. If language is merely a tool, and this tool is detached or broken, we would then expect that thought could stay the same, and vice versa. Download Document.
 
^{Talking Voices do not own the intellectual property, nor the copyright, of any of the above documents.}