Hearing voices : a psychological perspective

This article focuses on the experience of living with auditory hallucinations, or hearing voices. Research findings from studies exploring emotional well being in people who hear voices are reviewed. Existing psychological theories of distress and coping are considered in an attempt to make sense of the findings and to question the notion that psychological processes involved in hearing voices are discontinuous from those that occur in the general population. Coping behaviour and distress in voice hearers appear to be linked to individuals' appraisals of voices and personal and environmental resources. Consistent with a cognitive model, beliefs about the identity, purpose and power of voices, perceived level of personal control, self-esteem and self-evaluation seem particularly salient. Individuals' social context also appears influential, with positive and negative aspects of relationships and individuals' broader experience of stigma influencing adjustment. The broad psychological frameworks of Gilbert's (1992) evolutionary theory and Lazarus and Folkman's (1984) cognitive-phenomenological theory are drawn upon to integrate empirical findings. Clinical implications are considered; holistic multi-level intervention is indicated.