Listening to the Voices? How relationships with voices change over time, and developments in therapeutic interventions for voice-hearing.

Abstract

This research project investigated voice-hearing as an experience, and the interventions aimed at supporting people who struggle with hearing voices.
A systematic review of the literature surrounding voice-hearing interventions was undertaken. It found a wide range of different interventions, but a limited evidence-base supporting them. Different approaches to voice-hearing were identified, and a continuum posited, whereby voice-hearing approaches ranged from regarding voices as something to be ‘managed’, to considering them something to be ‘engaged with’. Different models of intervention were investigated: Cognitive, Relational, Mindfulness-based, and what the author termed a Meaningful Experience model. Goals of these different interventions were identified, and a superordinate goal of reducing voice-hearing distress noted. Therapeutic methods and change-mechanisms were identified. It was noted that a continuum exists whereby approaches to voice-hearing, and intervention methods move ‘away from’ the voices, seeing them as something to be ‘managed’, or ‘towards’ the voices, seeing them as something to be engaged with. A relationship between approaches towards voice-hearing, and intervention methods seemed apparent. The research project investigated how voice-hearing relationships change and develop over time. Seven participants were interviewed. Narrative Analysis was used to analyse the transcripts, considering plot, coherence, characterisation and cultural positioning. A prototype ‘story-arc’ was created against which participants relationship developments could be mapped. There were six ‘chapters’ and an ‘epilogue’: First Experiences; Into the Chaos; Meet the Neighbours; The Unwanted Visitor; Turning points; and Making Friends. There appeared to be a relationship between narrative coherence and positive voice-hearing relationships. The importance of access to positive voice-hearing narratives and cultural positions appeared important both in terms of encouraging the development of positive voice-hearing relationships, and in increasing the sense of agency of the voice-hearer.

Date of Award	25 Sept 2019
Original language	English
Awarding Institution	Bangor University
Supervisor	Mike Jackson (Supervisor)