Changing Relationship with Voices: New Therapeutic Perspectives for (original) (raw)
Related papers
Changing relationship with voices: new therapeutic perspectives for treating hallucinations
Clinical Psychology & Psychotherapy, 2008
A growing body of research on verbal hallucinations shows the importance of beliefs about and relationships with the voices for their pathological course. In particular, beliefs about the omnipotence of the voices and the need to control them, and relationships with them that involve efforts to resist or fi ght them, have shown themselves to be more pathogenic than effective. Likewise, treatments aimed at eliminating the voices, be they based on medication or 'traditional' cognitive-behavioural therapy, have not always been successful. A series of strategies focused on changing relationships with the voices instead of trying to eliminate them-including mindfulness, acceptance, experiential role plays and re-authoring lives-is emerging as a new perspective for the treatment of hallucinations. All of these strategies are based on the person, not on the syndrome, which also represents a new conception of the problem, in a phenomenological-social perspective, alternative to the predominant medical conception.
Changing relationship whit voices: New therapeutic perspectives for treating hallucinations
Clinical Psychology & Psychotherapy
A growing body of research on verbal hallucinations shows the importance of beliefs about and relationships with the voices for their pathological course. In particular, beliefs about the omnipotence of the voices and the need to control them, and relationships with them that involve efforts to resist or fi ght them, have shown themselves to be more pathogenic than effective. Likewise, treatments aimed at eliminating the voices, be they based on medication or 'traditional' cognitive-behavioural therapy, have not always been successful. A series of strategies focused on changing relationships with the voices instead of trying to eliminate them-including mindfulness, acceptance, experiential role plays and re-authoring lives-is emerging as a new perspective for the treatment of hallucinations. All of these strategies are based on the person, not on the syndrome, which also represents a new conception of the problem, in a phenomenological-social perspective, alternative to the predominant medical conception.
Schizophrenia bulletin, 2014
Hallucinations Research considers the current status and future directions in research on psychological therapies targeting auditory hallucinations (hearing voices). Therapy approaches have evolved from behavioral and copingfocused interventions, through formulation-driven interventions using methods from cognitive therapy, to a number of contemporary developments. Recent developments include the application of acceptance-and mindfulness-based approaches, and consolidation of methods for working with connections between voices and views of self, others, relationships and personal history. In this article, we discuss the development of therapies for voices and review the empirical findings. This review shows that psychological therapies are broadly effective for people with positive symptoms, but that more research is required to understand the specific application of therapies to voices. Six key research directions are identified: (1) moving beyond the focus on overall efficacy to understand specific therapeutic processes targeting voices, (2) better targeting psychological processes associated with voices such as trauma, cognitive mechanisms, and personal recovery, (3) more focused measurement of the intended outcomes of therapy, (4) understanding individual differences among voice hearers, (5) extending beyond a focus on voices and schizophrenia into other populations and sensory modalities, and (6) shaping interventions for service implementation.
2014
Despite an increasing volume of cross-sectional work on auditory verbal hallucinations (hearing voices), there remains a paucity of work on how the experience may change over time. Aims: The first aim of this study was to attempt replication of a previous finding that beliefs about voices are enduring and stable, irrespective of changes in the severity of voices, and do not change without a specific intervention. The second aim was to examine whether voice-hearers' interrelations with their voices change over time, without a specific intervention. Method: A 12-month longitudinal examination of these aspects of voices was undertaken with hearers in routine clinical treatment (N = 18). Results: We found beliefs about voices' omnipotence and malevolence were stable over a 12-month period, as were styles of interrelating between voice and hearer, despite trends towards reductions in voicerelated distress and disruption. However, there was a trend for beliefs about the benevolence of voices to decrease over time. Conclusions: Styles of interrelating between voice and hearer appear relatively stable and enduring, as are beliefs about the voices' malevolent intent and power. Although there was some evidence that beliefs about benevolence may reduce over time, the reasons for this were not clear. Our exploratory study was limited by only being powered to detect large effect sizes. Implications for clinical practice and future research are discussed.
Auditory verbal hallucinations: Dialoguing between the cognitive sciences and phenomenology
Phenomenology and the …, 2010
Auditory verbal hallucinations (AVHs) are a highly complex and rich phenomena, and this has a number of important clinical, theoretical and methodological implications. However, until recently, this fact has not always been incorporated into the experimental designs and theoretical paradigms used by researchers within the cognitive sciences. In this paper, we will briefly outline two recent examples of phenomenologically informed approaches to the study of AVHs taken from a cognitive science perspective. In the first example, based on Larøi and Woodward (Harv Rev Psychiatry 15:109–117, 2007), it is argued that reality monitoring studies examining the cognitive underpinnings of hallucinations have not reflected the phenomenological complexity of AVHs in their experimental designs and theoretical framework. The second example, based on Jones (Schizophr Bull, in press, 2010), involves a critical examination of the phenomenology of AVHs in the context of two other prominent cognitive models: inner speech and intrusions from memory. It will be shown that, for both examples, the integration of a phenomenological analysis provides important improvements both on a methodological, theoretical and clinical level. This will be followed by insights and critiques from philosophy and clinical psychiatry—both of which offer a phenomenological alternative to the empiricist–rationalist conceptualisation of AVHs inherent to the cognitive sciences approach. Finally, the paper will conclude with ideas as to how the cognitive sciences may integrate these latter perspectives into their methodological and theoretical programmes.
Hearing voices – the histories, causes and meanings of auditory verbal hallucinations
(Psychosis) Psychological, Social and Integrative Approaches
The meanings and causes of hearing voices that others cannot hear (auditory verbal hallucinations, in psychiatric parlance) have been debated for thousands of years. Voice-hearing has been both revered and condemned, understood as a symptom of disease as well as a source of otherworldly communication. Those hearing voices have been viewed as mystics, potential psychiatric patients or simply just people with unusual experiences, and have been beatified, esteemed or accepted, as well as drugged, burnt or gassed. This book travels from voice-hearing in the ancient world through to contemporary experience, examining how power, politics, gender, medicine and religion have shaped the meaning of hearing voices. Who hears voices today, what these voices are like and their potential impact are comprehensively examined. Cutting-edge neuroscience is integrated with current psychological theories to consider what may cause voices and the future of research in voice-hearing is explored.
Auditory verbal hallucinations as dialogical experiences
The purpose of this study is to offer a model in which auditory verbal hallucinations (AVHs) can be conceptualized as dialogical experiences. This model is of interest in that it integrates several different perspectives (phenomenological, cognitive, social, and evolutionary) and the findings of empirical research on the subject. Hallucinations are understood as the product of a state of consciousness in which the self is dissociated into different positions or perspectives. After reviewing the most relevant results of psychological research, dialogical self theory is proposed as the theoretical framework for understanding hallucinatory experiences. It is argued that the voices possess a series of characteristics, pragmatic properties, relationships with the voices similar to their social surroundings, and more dissociative experiences in people who experience voices than in those who do not, with which they may be considered a dialogical experience. Finally, a model attempting to integrate psychological research on AVHs within the framework of dialogical self theory is presented.