Relating to voices: Exploring the relevance of this concept to people who hear voices (original) (raw)
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Clinical Psychology & Psychotherapy, 2010
Current psychological models of voice hearing emphasise the personal meaning that individuals attribute to the voice hearing experience. Recent developments in theory and research have highlighted the importance of the relationship between the hearer and the voice. This study aims to contribute to this area of research, by exploring the experience and usefulness of a new form of 'Relating Therapy' that aims to modify distressing relationships with voices. Semi-structured interviews were conducted with ten participants and explored the experience and usefulness of a pilot of Relating Therapy: three therapists, three voice hearers, two relatives and two referrers. Interviews were transcribed and analysed using Interpretative Phenomenological Analysis. Three themes that emerged from the analysis are presented for discussion: engaging with the therapeutic model; developing a new relating style; and how change is described and defi ned by participants. This study is consistent with the growing body of theory and research that highlights the interpersonal nature of the voice hearing experience. It also offers tentative support for a therapeutic framework that aims to modify distressing relationships with voices as a means of bringing about positive change. Clinical implications and areas for future research are outlined.
The voice and you: development and psychometric evaluation of a measure of relationships with voices
Clinical Psychology & Psychotherapy, 2008
The experience of hearing voices has recently been conceptualized within a relational framework. Birtchnell's Relating Theory offers a framework capable of exploring the power and intimacy within the relationship between the hearer and the voice. However, measures of relationships with voices derived from the theory, such as the Hearer to Voice (HTV) and Voice to Hearer (VTH) by Vaughan and Fowler, have lacked robust psychometric properties. Data were available from 71 participants who completed the HTV and VTH, and analysis of these data generated a new 29-item measure, the Voice and You (VAY), capable of assessing the 'interrelating' between the hearer and the voice. The VAY was completed by a further 30 participants and was found to be internally consistent, stable over time and associated with other measures of the voice-hearing experience. The VAY offers a psychometrically stable measure of the relationship between the hearer and the voice. It may be used as an adjunct to the clinical interview and/or a measure of outcome.
The experience of hearing voices: An interpretative phenomenological analysis
This article presents an analysis of two case studies of people who hear voices. In accordance with a phenomenological approach, the meanings which the participants attribute to their voices are highlighted in the analysis (specifically in relation to the nature and origin of the voices) and the influence which these interpretations have on their efforts at managing and reducing their disruptive effects is explored. It is concluded that if this analysis has accessed general processes in voice hearers’ experiences, therapeutic practitioners may need to work with voice hearers in promoting psychologically satisfying meaning-making around their experiences, from which contextualised responses to managing the voices can be developed.
Relating therapy for people who hear voices: A case series
Clinical Psychology & Psychotherapy, 2009
This paper presents a series of cases to explore the development and value of a form of relating therapy for people who hear voices. The therapy is theoretically underpinned by Birtchnell's Relating Theory and offers a therapeutic space where hearers can explore and seek to change the relationship with their predominant voice. Five cases are presented to illustrate the processes of: (1) exploring similarities between relating to the voice and relating socially; (2) enhancing awareness of reciprocity with the voice-hearer relationship; and (3) using assertiveness training and empty chair work to facilitate change. Results were encouraging as change in control and/or distress was apparent for four of the cases. Changes in patterns of relating to voices were also apparent.
A tripartite relationship theory of voice hearing: a grounded theory study
Psychosis, 2022
Background: People hearing voices and in receipt of mental health treatment can experience distressing and disempowering relationships with their voices and other people. Practitioners lack knowledge and confidence to know how to help people when distressed by their voice hearing. Previous research has predominantly situated voice hearing within individual voice hearers but identified that mental health treatment contexts foster power imbalances that undermine practitioner-patient relationships, illustrated commonly through coercion, and experienced as traumatic. Less is known about voice hearing within these treatment contexts, both in terms of voice hearers' experiences of hearing voices and practitioners' experiences of providing treatment for voice hearing. This thesis aimed to advance current knowledge and understanding of the relational dynamic involving voice hearers, voices and practitioners, through investigating individual experiences of hearing and treating voices within clinical contexts, in order to develop theoretical explanation of voice hearing and provide an approach that supports people distressed by their voices and practitioners providing treatment. Methods: This was a qualitative study that utilised a constructivist Grounded Theory methodology to explore the experiences of voice hearers (n=15), through semi-structured interviews, and practitioners (n=18) through focus group discussions (n=3). These findings were synthesised in order to construct the final theory. Findings: A tripartite relationship theory situates experiences of voice hearing during mental health treatment within a clinical context, mediated through a voice hearer-voice-practitioner relationship. This consists of five theoretical constructs: Personal bully, Level of agency, Interpersonal dynamic, Who's making sense, and Medication: helping or hindering. Conclusions: A novel theory, grounded in voice hearers' and practitioners' experiences, expands on current knowledge about voice hearing and contributes towards a philosophical shift of situating voice hearing within relationship and clinical contexts rather than the prevailing individual-centric approach. Recommendations are made at policy, service and individual levels.
Background: Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. Materials: Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). Discussion: The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. Conclusion: Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.
International Journal of Social Psychiatry, 2017
Background: Auditory verbal hallucinations (AVHs) played an important role in the psychiatric diagnostics, but in the last few decades the diagnostic-free complex phenomenological understanding of the phenomena of voice hearing became the focus of studies. Materials: Six semi-structured interviews with recovering voice hearers were conducted and analysed using interpretative phenomenological analysis (IPA). Discussion: The self-help group gives significant help in identification and dealing with the voices; therefore, it serves as turning point in the life story of voice hearers. Conclusion: Applying self-help group in clinical context contributes to better outcomes in treatment of voice hearers.
Voice hearers’ experiences of the Making Sense of Voices approach in an NHS setting
Psychosis, 2020
The Making Sense of Voices (MsV) approach (Romme & Escher, 2000) has become established within large sections of the voice hearing community, as well as being adopted by some professional mental health workers. However, there has been limited research to assess this intervention. A recent case series using the MsV approach (Steel et al., 2019) reported promising results across a number of standardised outcome measures. The current study reports on the voice hearers' experience of having received the MsV intervention, through the use of 'exit interviews' conducted as part of the case series. Individual participants' experiences indicated a range of reactions to the intervention. Positive outcomes appeared to relate to a better understanding of voice hearing experiences and a greater sense of control over voices. Not all participants reported a positive experience of communicating with their voices. Outcomes are discussed within the context of potential common and distinct 'ingredients' of the MsV approach, compared to other approaches to working with distressing voices.