Coping with Voices

Research on the topic of coping with hearing voices and related experiences.

Baker P.K (1996) The Voice Inside: a practical guide to coping: Mind Publications, UK

Coleman R and M. Smith (1997) Victim to Victor: working with voices Handsell, Gloucester, UK

Coleman R (1996) From Power to Partnership, Handsell publications, UK

Coleman R (2006) Recovery – An Alien Concept, 2nd Edition, P&P Press Limited, UK

Julie Downs, (Ed), (2001), Coping with Voices And Visions, A guide to helping people who Experience hearing voices, seeing visions, tactile or other Sensations, Hearing Voices Network, Manchester, England

Sandra Escher; Philippe Delespaul; Marius Romme; Alex Buiks; Jim Van Os., (2003) Coping defence and depression in adolescents hearing voices. Journal of Mental Health, Volume 12, Issue 1, pages 91 – 99

Background:
The level of self-initiated coping defences in the face of auditory hallucinations reflects the degree to which the psychotic experiences are exceeding the person’s resources. As it has been suggested that individuals who feel overwhelmed by their psychotic experiences are also more likely to develop depression, greater levels of self-initiated coping defences should predict onset of depression in the context of auditory hallucinations.

Method:
Eighty adolescents (mean age 12.9 years, SD=3.1) who reported hearing voices were examined at baseline and followed-up three times over a period of 3 years. Fifty per cent were receiving professional care, but 50% were not in need of care. Baseline measurement of self-initiated coping defences and psychopathology were used as predictors of depression at follow-up.

Results:
Baseline level of self-initiated coping was strongly associated with baseline severity of positive psychotic symptoms. Coping at baseline, with the exception of active problem solving, predicted an increase in the level of depression over the follow-up period (OR=3.0, 95% CI: 1.4, 6.4), independent of baseline psychopathology, demographic characteristics, receipt of professional care and appraisals and attributions related to the voices.

Conclusions:
The results suggest that individuals who have a tendency to feel overwhelmed by the experience of voices, as evidenced by a more defensive style of response, are more likely to develop depression.

Falloon I.R.H. and Talbot R.E. (1981), Persistent auditory hallucinations: coping mechanisms and implications for management, Psychological Medicine, No.11, pp. 329 339

Romme M and Escher S: (Eds.), Accepting Voices (1993, second edition 1998), Mind Publications, London.

Romme M, Honig A, Noorthorn EO & Escher S (1992) Coping with hearing voices: an emanciapatory approach. British Journal of Psychiatry: Jul;161:99-103

Abstract A questionnaire comprising 30 open-ended questions was sent to 450 people with chronic hallucinations of hearing voices who had responded to a request on television. Of the 254 replies, 186 could be used for analysis. It was doubtful whether 13 of these respondents were experiencing true hallucinations. Of the remaining 173 subjects, 115 reported an inability to cope with the voices. Ninety-seven respondents were in psychiatric care, and copers were significantly less often in psychiatric care (24%) than non-copers (49%). Four coping strategies were apparent: distraction, ignoring the voices, selective listening to them, and setting limits on their influence.

Romme M and Escher S (eds) Understanding voices: coping with auditory hallucinations and confusing realities. First published by Rijksuniversitiet Maastricht, Limburg, Holland (1996) and English edition, Handsell Publications

Romme M and Escher S (2000) Making Sense of Voices – A guide for professionals who work with voice hearers. Mind Publications

M. Romme, A. Escher (1991) Empowering people who hear voices (paper presented at conference held in Liverpool) published in Cognitive Behavioural Interventions with Psychotic Disorders Eds. G. Haddock; P. Slade, Routledge, London, 1996

Sayer, J.; Ritter, S.; Gournay, K. (2000) Beliefs about voices and their effects on coping strategies. Journal of Advanced Nursing, 31(5), 1199-1205

Cognitive behavioural techniques are increasingly used as adjuncts to medication in the treatment of auditory hallucinations for people with schizophrenia. There are now literally hundreds of nurses trained in the use of cognitive behavioural interventions for psychosis. However, there is still disagreement about the nature of the cognitive processes that lead to deficits or biases in patients’ processing of information about their psychotic experiences. Using Chadwick & Birchwood’s Beliefs About Voices Questionnaire (BAVQ), the investigator collected data regarding voices from a sample of men and women being treated for schizophrenia by secondary mental health services. The investigator then carried out a cross-lagged panel analysis of the data.

The investigator found, as predicted, positive relationships between a resistive coping style and an attribution of malevolence to voices, and between an engaging coping style and an attribution of benevolence to voices. Coping and attributional styles were not necessarily stable over time. There was a non-significant difference between women’s and men’s attributions and coping styles. There was less fluctuation over time in the women’s scores on the BAVQ. This research shows that one cannot assume that either coping or attributional style becomes more stable over time. However, while there are strong relationships between attributions and coping styles, and particularly between malevolence and resistance and benevolence and engagement, these relationships are not necessarily mutually exclusive and some people in the study believe their voices to be both malevolent and benevolent.

These findings suggest that clinicians need to make a very careful assessment of attribution and coping with regard to hallucinations and that systematic reassessment is very important. Further research is necessary in both the phenomenology of attribution and coping, but also to relate these variables to other aspects of schizophrenic illnesses.

Tarrier N., Harwood S., Yusupoff L., Beckett R. & Baker A. (1990): Coping Strategy Enhancement (CSE): Method of Treating Residual Schizophrenic Symptoms. Behavioural Psychotherapy, No.18, pp. 283 293

Yusopoff and Tarrier N. (1996) Coping strategy enhancement for persistent hallucinations and delusions, pp. 86-103, in Cognitive, Behavioural Interventions with Psychotic Disorders, Routledge, London Therapy, Eds. Haddock G. and Slade P

2 responses to “Coping with Voices”

  1. Aubry Pierre

    Hello,
    I’m a French student (Psychology Master 1) working on a university research with the Maastricht questionnaire.

    I’m looking for “Romme M and Escher S (2000) Making Sense of Voices – A guide for professionals who work with voice hearers. Mind Publications” but it isn’t available anymore on Amazon. Do you know where i may find it ?
    Thanks for your help,
    Pierre Aubry

  2. Charity

    I have been hearing voices for years now. I have am seeking therapy for them.

Leave a Reply