Hearing Voices: Rachel’s Experience Might Surprise You

Hearing voices is much more common than you might think.


The experience of hearing voices is common and much more variable than previously thought, a new study finds.

Many people who do not have a psychiatric diagnosis hear voices.

It is thought between 5 and 15% of people will experience hearing voices at some point in their lives (scroll down for Rachel’s story).

Researchers asked 153 people about their experiences of hearing voices.

Most of them (81%) said they heard more than one voice, with 70% saying they heard specific characters.

Only around half the people said their voices were purely sounds they heard.

Almost half said they were more thought-like voices or somewhere in between sounds and thoughts.

Two-thirds of people also reported feeling bodily sensations while hearing voices.

These included tingling or hot sensations in the hands or feet.

Dr Nev Jones, one of the study’s authors, said:


“By and large, these voices were not experienced simply as intrusive or unwanted thoughts, but rather, like the auditory voices, as distinct ‘entities’ with their own personalities and content.

This data also suggests that we need to think much more carefully about the distinction between imagined percepts, such as sound, and perception.”





Rachels’ story

Rachel Waddingham is a former psychiatric patient who has successfully rejected the labels, and the medications, to live alongside her voices.

She says:


“I hear about 13 or so voices.

Each of them is different — some have names, they are different ages and sound like different people.

Some of them are very angry and violent, others are scared, and others are mischievous.

Sometimes, I hear a child who is very frightened.

When she is frightened I can sometimes feel pains in my body — burning.

If I can help the voice calm down, by doing some grounding strategies, the burning pains stop.

Since going to a Hearing Voices Group, I have found ways of making sense of and coping with my voices.

I no longer feel terrorised by them even though some of them say some very frightening things.

I now have a family of voices and have a better relationship with them.

I can make a choice about how I respond to them — whether I listen to them, and how I reply.

Some of them are now much more helpful — they can be a window to my feelings, letting me know about a problem that I have in my life that I need to address.

Although in our society, people who hear voices are often seen as ‘mad’ or ‘crazy’, I do think things are changing.

I find that lots of people are interested in voice-hearing.

Many people have told me about experiences they have had — either in their childhood, or as an adult.

It’s as if by talking about voices we are starting to de-stigmatise the experience and opening the door for others to speak openly too.

As long as we believe that voices are signs of pathology and illness, it makes little sense to really explore a person’s lived experience.

Instead we try to suppress or eliminate the voices as far as possible.

Listening to them seems ‘crazy’.

Still, in my experience it can be really useful to be interested in people’s lived experience of voice-hearing.

Every one of us is different, and being curious about my experiences was one of the first steps to dealing with them.

This research is a step forward.

If we want to understand more about voice-hearing, it makes sense to ask a voice-hearer — and be willing to modify our perception of what it means to hear voices based on their answers.

For me, the word ‘voices’ isn’t sufficient.

I use it, but it hides the embodied parts of my experience for which I have few words to describe.

I would like to live in a world where we are curious about one another’s experiences and seek to understand rather than pathologise.

Everyone has a story and the world would be much kinder if we started to listen to it.”

The study is published in the journal Lancet Psychiatry (Woods et al., 2015).

You can read more about Rachel’s story at her website.

SOURCE:

http://www.spring.org.uk/2015/03/hearing-voices-rachels-experience-might-surprise-you.php(accessed 10.5.15)

The voices heard by people with schizophrenia are friendlier in India and Africa, than in the US

When a patient with schizophrenia hears voices in their head, is the experience shaped by the culture they live in? Tanya Luhrmann and her colleagues investigated by interviewing twenty people diagnosed with schizophrenia living in San Mateo, California; twenty in Accra, Ghana; and twenty others in Chennai India. There were similarities across cultures, including descriptions of good and bad voices, but also striking differences.

In San Mateo the interviewees talked about their condition as a brain disease, they used psychiatric diagnostic terms to describe themselves, and their experiences were almost overwhelmingly negative. Fourteen described hearing voices that told them to hurt others or themselves. Eight people didn't know the identity of their voices and few described having a personal relationship with their voices.

By contrast, in Chennai, the interviewees frequently spoke of their relationships with their voices - that is, they heard the voices of relatives or friends, giving them advice or scolding them. These patients rarely used diagnostic terms, and rarely talked of voices instructing them to commit violence. Instead, distress, when it occurred, usually arose from their voices talking about sex. Nine interviewees described voices that were significantly good - in terms of being playful or entertaining.

In Accra, yet another picture emerged. Most of the interviewees here mentioned hearing God. This isn't simply a case of this sample being more religious - the interview groups in all three locations were predominantly religious. Half the interviewees in Accra reported that their voice hearing was mostly or entirely positive. Others frequently emphasised the positive. Use of diagnostic labels was rare, as were incitements to violence by voices.

Luhrmann and her team said their most striking finding was that the experiences of voice hearing in the two non-Western samples were less harsh and more "relational" - that is, patients perceived their voices as other people, who could not be controlled. The researchers believe this difference is likely due to Western cultures emphasising independence and individuality - in which case heard voices are experienced as a violation - whereas African and Asian cultures emphasise how each person's mind is interwoven with others. "We believe that these social expectations about minds and persons may shape the voice-hearing experience of those with serious psychotic disorder," the researchers said.

These results need to be replicated with larger samples matched more precisely for illness severity, and with more tightly controlled measures (the current study was deliberately qualitative and exploratory). If replicated, the findings would imply the experience of hearing voices in schizophrenia is to some extent malleable, which could have exciting therapeutic implications. Indeed, it's notable that the outcomes for patients with schizophrenia outside the West, especially in India, are known to be more positive - perhaps because of the way patients relate to their voices. "The harsh violent voices so common in the West may not be an inevitable feature of schizophrenia," the researchers said.
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Luhrmann, T., Padmavati, R., Tharoor, H., & Osei, A. (2014). Differences in voice-hearing experiences of people with psychosis in the USA, India and Ghana: interview-based study The British Journal of Psychiatry DOI: 10.1192/bjp.bp.113.139048

 

SOURCE:

http://digest.bps.org.uk/2014/07/the-voices-heard-by-people-with.html?utm_source=BPS_Lyris_email&utm_medium=email&utm_campaign=Newsletter(accessed 19.8.14)

 

What's it like to hear voices that aren't there?

Traditionally, when a person says they can hear voices that don't exist in external reality (not to be confused with inner speaking: http://www.bps-research-digest.blogspot.co.uk/2013/12/the-science-of-how-we-talk-to-ourselves.html), psychiatry has treated this as a sign of mental illness. However, it's become clear in recent years that many people hear hallucinated voices without it causing them distress. To improve our understanding of how voice-hearing becomes problematic it's clear we need to understand more about the different ways that people experience hearing voices.

Now Lucy Holt and Anna Tickle have published a "meta-ethnographic synthesis" of what we know so far about the varieties of people's voice-hearing experiences. The researchers trawled the peer-reviewed literature using key-word searches to find studies of adequate quality that involved asking adults to describe their voice-hearing experiences first-hand. This process uncovered seven papers, published between 2003 and 2011, involving the first-hand accounts of 139 people aged 19 to 84 (52 per cent were women).

Holt and Tickle analysed the papers looking for recurring themes in people's descriptions of their voice-hearing. The results are fascinating and some insights potentially useful for clinicians. The first theme is that most people gave the voices they heard an identity - often they named them, or they attributed a gender to them. Some people heard voices that belonged to real people encountered in the past, other voices were seen as belonging to God or a spiritual force.

Another important theme was the amount of power that people perceived their heard voices as having, and, related to that, how much power they felt they had over them. There was a continuum such that some people felt completely powerless over their heard voices, while others felt they could take them over. Intriguingly this appeared to be related to the explanations people gave for their heard voices. Those who subscribed to a biomedical account, believing that their voices were caused by a chemical imbalance in the brain, tended to feel less in control of their voices. The perceived power of voices was also linked to the voices' identity, particularly if they were attributed to an authoritarian figure.

People also spoke of the strategies that their voices used to maintain power, such as criticising the person and exploiting his or her weaknesses. Other participants described strategies they used to regain control of their voices, such as using distraction or, opposite to that, deliberately engaging with the voices.

The way that heard voices affected people's relationships was another theme. People described how hearing voices made it difficult to lead an ordinary life. Heard voices could interfere with social relationships, for example by making critical comments about friends or family. But voices could also play a beneficial role by reducing loneliness. "I have not got many friends … so the only thing I can stay very close to are the voices and I do stay very close to them," said one person.

Yet another theme related to whether people saw a distinction between their own thoughts and the voices they heard. Most people recognised a clear difference between the two, perceiving heard voices as "coming from outside the self but manifested inside the body". One exception to this was a study conducted in a psychiatric setting. Here most of the participants endorsed a biomedical explanation for their voices, and they saw their heard voices and own thoughts as one.

Holt and Tickle said their review contained useful insights for therapists, most of all by showing that "'voice hearing' is clearly not a homogenous experience." The findings also suggest ways that therapists might help their clients who hear voices, for example by boosting their feelings of self-worth. Therapists could also benefit by realising that heard voices sometimes have an adaptive function.

Unfortunately, the quality of the studies identified in this review was disappointing. Many failed to provide quotes from participants; others failed to acknowledge the influence of the researcher's own interpretative stance on the results. "It is evident that the quality of research investigating the first person perspective of hearing voices warrants improvements," Holt and Tickle said.

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SOURCE:

BPS RESEARCH DIGEST: http://www.researchdigest.org.uk/

Holt L and Tickle A (2013). Exploring the experience of hearing voices from a first person perspective: A meta-ethnographic synthesis. Psychology and psychotherapy PMID: http://www.ncbi.nlm.nih.gov/pubmed/24227763

In the A-level syllabus. AQA spec A, A2, psychopathology. AQA spec B, A2, psychology of atypical behaviour option. Edexcel, A2, clinical psychology. SQA higher, domain psychology of individual differences, atypical behaviour.

Further reading. The same voices, heard differently? http://bps-research-digest.blogspot.co.uk/2008/10/same-voices-heard-differently.html