Abstract

What “voice-hearers” change to the listening of hallucinations ? I : Genesis of a movement

Objectives : Traditionally considered psychopathological auditory-verbal hallucinations, the voices heard by patients, but also by many people from the general population, are currently the subject of much attention from researchers, clinicians and public authorities. Auditory-verbal hallucinations are the most studied hallucinations. Several studies have shown their high prevalence of so-called “voices” in non-psychiatric individuals. From the 1980s, British and Dutch researchers have highlighted those individuals – adults and teenagers – who spontaneously developed strategies to cope with their voices. This research has been mixed with a movement of social protest carried by individuals – often mental health services users – living these hallucinations, sometimes in a mono-symptomatic and adaptive way. Quickly established as an international movement, the “voice-hearers” relativize but also fertilize the clinical knowledge on the listening of hallucinations. This paper proposes to introduce the somewhat symbolic genesis of this movement (the case of Patsy Hage treated by Marius Romme, and the media call to voice-hearers) and how it leads to reconsider the treatment of hallucinations and even their very definition.
Materials : This paper reviewed the main books and articles that launched the Hearing Voices movement since the 1980s, from the Netherlands. Then, to support our analysis, we used several selected critical commentaries on the experience of hearing voices.
Results : It appears from our analysis that the Hearing Voices movement disrupt the psychiatric landscape while succeeding in its legitimization. For clinicians, this movement changes the way we diagnose and treat hallucinations. For example, the part played by paranormal or spiritual interpretations of hallucinations requires repositioning the clinical setting with respect to the beliefs of the patient and those of the clinician.
Conclusions : Voice-hearers embody the public health problem posed by hallucinations experiences in the general population. They claim to represent “the voice of patient” and a lay knowledge in the clinical field. The success of this movement made it the figurehead of the broader movement of “recovery” which is currently challenging the psychiatric power in order to substitute it by other forms of management of mental health.

Keywords
voice-hearers – psychotic continuum – exceptional experiences – social psychiatry – beliefs – differential clinical practice

What “voice-hearers” change to the listening of hallucinations ? II : Researches on voice hearing

Objectives : Several studies have shown the high prevalence of experiences of acoustic-verbal hallucinations (so-called “voices”) in non-psychiatric individuals. From the 1980s was constituted an international movement – the “voice hearers” – who relativize but also fertilize the clinical knowledge on the listening of hallucinations. This paper proposes to question some of aspects of the debate on “voice hearers” when integrating it within the broader contemporary models attempting to account for “psychotic-like experiences” or “exceptional experiences”.
Materials : A brief review of scientific literature on these experiences help to compare psychiatric, psychoanalytic and more specialized researches on “voice-hearing”. We also compare classical clinical positions with new ones.
Results : It appears that “voice-hearers” introduce a reversal of some classical prejudices, in moving towards a treatment of psychotic-like experiences as if they were neurotic expressions. Paranormal and spiritual interpretations of voices are ubiquitous in many studies of voice hearing, and even are outstanding examples of salutogenic appraisals of psychotic-like experiences. The research on the type of appraisal along the axes of internal / external or personal / impersonal provides direct guidance on clinical intervention strategies.
Conclusions : No longer focusing on the “what” but rather on the “how” of hallucinations experiences helps to avoid some biases relative to the assessment of beliefs – especially unusual beliefs – in the clinical setting. As the figurehead of the broader movement of “recovery,” the Hearing Voices Movement offers a competitive clinical practice, but failed to provide a true differential clinical practice starting from a neutral name referring to several psychopathological pathways that need to be distinguished.

Keywords
voice-hearers – psychotic continuum – exceptional experiences – social psychiatry – beliefs – differential clinical practice