Talking with Voices
Although hearing voices that other people can’t (‘auditory hallucinations’) is a common human experience, it can sometimes cause a lot of distress and be difficult to cope with. Research has shown that this may often happen when voices are related to negative emotions and/or to stressful events in the voice hearer’s life. As such, health services are recognising that it can be helpful to provide psychological therapy to people who struggle with hearing voices. Such treatment may reduce feelings of distress and help people find new ways of coping.
Talking With Voices (TwV) is a new form of therapy for voice hearers that comes from the work of the International Hearing Voices Movement. It involves a combination of psychosocial education, psychological formulation, and dialogical engagement whereby a therapist directly interacts with the voice(s) by asking them questions which the voice hearer repeats back out loud.
Over time, the therapist learns more about the voice(s) in order to support the voice(s) and voice hearer to develop a more peaceful, positive relationship. In addition, the therapist and voice hearer work together to try and understand how the voice(s) may relate to particular problems in the person’s life.
Talking with Voices is led by Chief Investigator Eleanor Longden. Eleanor is herself a voice hearer who used similar approaches to aid her own recovery.
When Eleanor was at university, she started hearing voices. At first they were benign, but over time became increasingly antagonistic and dictatorial. Being encouraged to see her voice ‘not as an experience but as a symptom’ created fear and resistance in Eleanor - something she describes as ‘a kind of psychic civil war’. Diagnosed with schizophrenia, hospitalized and medicated, Eleanor’s mental health deteriorated significantly, and all the while, her mental health status was used as a ‘catalyst for discrimination’.
However, through the support of her mother, a doctor that didn’t give up hope and others, Eleanor was able to start to see her voices as a ‘meaningful response’ to traumatic life events. This allowed her to start to understand her voices, open up a dialogue with them, and finally, live together in peace and mutual respect.
Ten years after the voice first came, Eleanor graduated with the highest degree in Psychology her university had ever given, and one year later, the highest Masters. Today, Eleanor works tirelessly to support the recovery of others who are distressed by their voices, and in 2015 she was commended for this work with a Deputy Prime Minister’s Mental Health Hero Award.
Of Talking with Voices, Eleanor said,
“Hearing voices no one else can hear is reported by individuals from a wide range of backgrounds. However, while many voice-hearers live happily with their experiences for some it can be a source of great distress. Current support usually focuses on medication or talking therapies like Cognitive Behavioural Therapy, and fortunately these are helpful for many people. However, we know that not everyone benefits from these approaches and that’s where Talking with Voices comes in.
“Talking with Voices is a new type of therapy that emphasises changing the relationship between the person and the voices they hear. It tries to do this in two main ways: firstly, by exploring possible links between what the voices say and painful emotions and events in the person’s life, and secondly by engaging directly with the voices by asking them questions. The voice-hearer repeats the voices’ responses back to the therapist, who acts as a kind of mediator between them. Over time, the voices and the voice-hearer are supported to work together to develop a more peaceful, positive relationship.
“People have been interacting with their voices long before this intervention came along and the concept of voice dialogue has a strong tradition in the user-led Hearing Voices Movement. However, there’s currently no controlled evidence for using this technique in the NHS and we hope this trial can help with that. As a voice hearer myself it’s exciting to research the types of approaches that helped my own recovery and GMMH has been such a welcoming and supportive place to do this. In this respect I’m especially grateful to all our participants who’ve been so incredibly generous with their time and input. The experiences and insights they’ve shared will be invaluable for taking the intervention forward and showing us how to make it as useful and accessible as we possibly can.
“Now the trial has finished recruiting our next step is distributing surveys amongst service-users and staff within the Trust and we look forward to gathering a range of opinions on different aspects of Talking with Voices, as well as voice hearing more generally. These responses represent a vital combination of personal and professional expertise that can inform us of the issues people feel are important and help guide our development of a definitive clinical trial in the future.”
The Talking with Voices Team
Here is what the team had to say about what Talking with Voices means to them: