tag:theconversation.com,2011:/global/topics/hearing-voices-network-32431/articlesHearing Voices Network – The Conversation2017-06-14T10:25:49Ztag:theconversation.com,2011:article/789642017-06-14T10:25:49Z2017-06-14T10:25:49ZParents, don’t panic if your child hears voices, it’s actually quite common<figure><img src="https://images.theconversation.com/files/173645/original/file-20170613-30067-wsj5h0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>Although the way we view and support people with mental health difficulties has improved over the years, experiences such as hearing voices and seeing visions are often still associated with “severe and enduring mental illness”. But what is less well-known about these <a href="https://www.hearing-voices.org/voices-visions/">voices and visions</a> is that they are <a href="https://theconversation.com/hearing-voices-is-more-common-than-you-might-think-66934">surprisingly common</a> – especially when growing up. </p>
<p>Around <a href="http://www.voicecollective.co.uk/wp-content/uploads/2015/09/Parents-Voices-and-Visions-Booklet-2014_web.pdf">8% of young people are thought to hear voices</a> at some stage in childhood, with up to 75% having a one-off experience of voice hearing. This makes hearing voices about as common for young people as having <a href="https://www.asthma.org.uk/about/media/facts-and-statistics/">asthma</a> or <a href="http://www.dyslexiaaction.org.uk/page/facts-and-figures-about-dyslexia-0">dyslexia</a>. For many children, then, it seems that hearing voices is <a href="http://www.hearing-voices.org/news/a-new-animation/">a pretty normal part of growing up</a>.</p>
<p>Research shows, the experience of hearing voices that others can’t hear – also called auditory verbal hallucinations in traditional psychiatric terms – is not usually upsetting for many children. The experience of hearing voices also <a href="https://www.theguardian.com/science/2015/jun/07/childhood-hallucinations-common-research-psychotic-schizophrenia-why">doesn’t tend to last too long</a> – meaning it can often be something children grow out of or overcome in time. </p>
<p>Nevertheless, for some young people, the experience can carry on for many years and cause confusion and distress – not only for the young person but for the family as a whole. </p>
<h2>Learning from young people</h2>
<p>Compared to adult voice-hearers, relatively little research or analysis has been carried out with young people who hear voices. Consequently, we don’t really know much about how young people make sense of these experiences or how they might look for help. </p>
<p>This is one of the main reasons why we have recently set up the <a href="https://www.facebook.com/youngvoicestudy/">Young Voices Study</a>. Over recent months, we have been <a href="https://twitter.com/youngvoicestudy?lang=en">working with young people</a> and their families to explore their views on what it’s actually like to hear voices in childhood and how parents can support their children through the experiences. </p>
<p>As well as speaking with young people and their parents or guardians in the northwest of England, we have also developed two online surveys that can be accessed internationally – one for <a href="https://mmupsych.eu.qualtrics.com/jfe/form/SV_9n99zXZM0iTc0bb">young people who hear voices</a> and one for their <a href="https://mmupsych.eu.qualtrics.com/jfe/form/SV_eLEKle2Mg511wj3">parents or guardians</a>. </p>
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<img alt="" src="https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173641/original/file-20170613-30067-flirjw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Accept your child and let them know it’s okay to feel different.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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<p>Although we are at an early stage of the research, the stories we have heard so far have offered useful insights into the complexity of these experiences.</p>
<p>Young people and their parents have described a huge range of experiences. Some young people have explained how their voices can be supportive, but also intrusive and distressing. We have also heard about a range of factors that make the voices helpful, comforting or problematic, as well as young people’s ideas about the support that would be helpful for others going through the same thing. </p>
<h2>Behind the label</h2>
<p><a href="http://www.julianjaynes.org/pdf/escher-romme-buiks-delespaul-vanos.pdf">Research with teenagers who hear voices</a> suggests that the ways young people make sense of their voices plays a crucial role in associated distress. So someone who considers hearing voices as a sign of “madness”, or as an uncontrollable power that can force them to take actions against their will, is likely to experience considerable distress. As such, they may try to “control” the experiences through either self-injury or substance use – both of which are unhelpful in the long-term. </p>
<p>But if people can take a “curious” and “accepting” view of their voices, many young people find that their voices can become <a href="http://www.intervoiceonline.org/support-recovery/a-practical-guide">a useful source of support</a> to help with other difficulties in life. As one of our participants said:</p>
<blockquote>
<p>[The voices] help me with problems I’m having and have actually helped me in school as well .</p>
</blockquote>
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<img alt="" src="https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/173637/original/file-20170613-30061-1wrzmst.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Not all voices are hard to hear.</span>
<span class="attribution"><span class="source">Pexels</span></span>
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<p>Our early data also highlights the importance of families’ reactions to the experience of hearing voices. This is because the reaction of parents is likely to influence how young people feel about their voices. </p>
<p>For instance, one young person who responded to our online survey explained how reactions from the adults around him not only upset and worried him, but also unsettled the voices. He said:</p>
<blockquote>
<p>No one would believe me and it would frighten them [the voices].</p>
</blockquote>
<p>And it is information such as this that can help us to understand the different layers of these experiences. These stories can also help us as researchers and clinicians to better comprehend the factors that can lead some children to become frightened or distressed when confronted with experiences that are not readily discussed or met with acceptance. </p>
<h2>Voicing needs and difficulties</h2>
<p>These personal stories from young people and their families also offer a unique opportunity to explore the extraordinary ways children cope with challenges.</p>
<p><a href="http://healthland.time.com/2010/01/26/hearing-voices-in-childhood-may-be-common/">Research</a> has shown that hearing voices can begin for a range of reasons, including after an operation or an acute fever – or in response to emotional distress. Voice-hearing can also be <a href="http://hearingvoicescymru.org/support/recovery-and-hearing-voices/">triggered by traumas</a>, such as bullying, loneliness, the loss of a loved one, abuse or neglect. </p>
<p>Our research builds on this and shows that while hearing voices can be a source of concern, it can also be a valuable coping strategy for some children. Indeed, one of our participants highlighted that his voices are “actually pretty cool”.</p>
<p>We also hope that our research will help to increase awareness and reduce social stigma around these experiences. This will mean young people who hear voices can be better supported and also encouraged to talk about their experiences more freely and without fear or shame.</p>
<hr>
<p><em>If you would like any further information, please email: youngvoicesstudy@mmu.ac.uk</em></p><img src="https://counter.theconversation.com/content/78964/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Around 8% of young people are thought to hear voices at some stage in childhood, making it about as common as having asthma or dyslexia.Sarah Parry, Senior Lecturer and Clinical Psychologist, Manchester Metropolitan UniversityFilippo Varese, University of ManchesterLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/766052017-05-03T10:37:35Z2017-05-03T10:37:35ZTwo simple questions that have changed the way people hear inner voices<figure><img src="https://images.theconversation.com/files/167679/original/file-20170503-21649-1raqxap.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://theconversation.com/beyond-madness-a-modern-approach-to-hearing-voices-14720">file404/www.shutterstock.com</a></span></figcaption></figure><p>Once the province of prophets, “hearing voices” is still shorthand for madness. And yet in the past 30 years, a new understanding has been created by voice-hearers themselves, as part of the <a href="https://doi.org/10.1093/schbul/sbu007">Hearing Voices Movement</a>. This suggests that uncovering the roots of the voice can potentially help the hearer.</p>
<p>Voice-hearing has traditionally been understood as a symptom of psychiatric illness, being most closely associated with schizophrenia. It has been referred to as a “<a href="http://dx.doi.org/10.1016/S0920-9964(03)00013-6">symptom of brain disease just like blindness</a>” and is typically treated with medication, which <a href="https://doi.org/10.1016/j.psychres.2010.12.013">can indeed help</a>.</p>
<p>So what has led to a different approach to hearing voices? First, there has been the rediscovery that <a href="https://doi.org/10.1093/schbul/sbu005">many people hear voices without distress or impairment</a>, and we are now able to pinpoint what can make voice-hearing problematic. There is <a href="https://doi.org/10.4088/JCP.09m05797yel">an 88% probability</a> of correctly guessing whether a voice-hearer is a patient or not from simply knowing one thing: whether the voices are nasty. Studies, <a href="https://doi.org/10.1093/schbul/sbw133">including some with “psychics”</a>, have also found that hearing voices frequently, and lacking control over them, is associated with it being a problem.</p>
<p>In addition, trauma has been found to be associated with hearing voices. In fact, suffering multiple childhood traumas is <a href="https://doi.org/10.1093/schbul/sbs049">associated with later voice-hearing</a> to approximately the same extent that smoking is with lung cancer. Not only does trauma increase the probability of voice-hearing, but the characteristics of the voices are <a href="http://dx.doi.org/10.1080/17522439.2013.816337">often related to such events</a>. However, the role of trauma in voice-hearing has historically been minimised, with hearers advised to chemically eliminate their voices, not to carefully explore them.</p>
<p>These insights have led to the creation of a new tool called the Maastricht Interview. This attempts to <a href="https://theconversation.com/beyond-madness-a-modern-approach-to-hearing-voices-14720">remedy the negativity</a> of many voices by exploring their potential links to the past of the hearer. </p>
<p>It has its roots in psychiatrist Marius Romme’s interactions with one of his voice-hearing patients, Patsy Hage, in the late 1980s. In conversation with Romme, he told me that he “discovered that as a psychiatrist I did not know anything about the experience of hearing voices, because my whole profession is trained not to go into the experience”. When Patsy talked to other hearers about her voices, it was Romme, the highly trained medical professional, who was “the one who did not understand”. </p>
<h2>Understanding voices</h2>
<p>But working closely with his partner, Dr Sandra Escher, and many other voice-hearers, Romme co-developed the interview. Speaking of it today, Romme said:</p>
<blockquote>
<p>We had never interviewed a voice hearer about their experience as that was forbidden in the profession. Still most psychiatrists don’t know what to ask. </p>
</blockquote>
<p>The purpose of <a href="http://www.hearingvoices.org.nz/index.php/helpful-pamphlets-and-information-sheets/59-the-maastricht-interview">the interview</a> is to find the answers to two key questions: “Who do the voices represent?” and “What problems do the voices represent?” The voice-hearer and the interviewer then work together to “break the code” of the voices, uncovering <a href="https://theconversation.com/hearing-voices-is-more-common-than-you-might-think-66934">the meaning of the voice</a> in relation to the person’s life history, which may not be readily apparent.</p>
<p>Dirk Corstens, a Dutch Psychiatrist, says he “almost always” uses the interview when a voice-hearer asks him for support. Hearers often remark to him that “no one has talked with me like that before”. Corstens finds the interview helps acknowledge hearers’ experiences, reduces feelings of isolation, and helps uncover how life events and related emotions may be driving the voices. In his experience, it has helped some hearers understand why the voices are speaking to them.</p>
<p>Likewise, Robin Timmers, who himself hears voices and is an <a href="http://hearingvoicesdu.org/project/robin-timmers/">expert by experience</a>, says that it helps hearers move from “being in the experience” to “thinking about the experience”. </p>
<p>Recovery does not necessarily mean the elimination of the voices. Instead, it can be living productively with them, as research psychologist Eleanor Longden has demonstrated. </p>
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<p>Sometimes, though, the voices may vanish. Corstens relates the example of a 54-year-old woman, long in psychiatric services, who heard a single voice. In the interview, her personal history was highlighted and she discovered that the voice emerged when she was sexually abused by her employer. The voice appeared to be similar to his voice – it stopped talking when she realised this.</p>
<h2>Voice-hearers as experts</h2>
<p>Voice-hearers, such as <a href="http://hearingvoicescymru.org/people#bullimore">Peter Bullimore</a>, who has been instrumental in setting up <a href="http://www.mindinbradford.org.uk/maastricht-conference">Maastricht Approach Centres</a> in the UK, are now training professionals to use the interview. </p>
<p>At the start of training, many attendees, who include a range of mental health professionals, may feel, as one put it “useless … because I’ve not known how to help”. After training, many feel they are better equipped to help the voice-hearers they work with. At a recent session, a psychiatrist reported that it “opened my eyes and understanding, gave me courage and inspiration and confidence about the ability to recover”. </p>
<p>Yet there are limitations to this approach. As Romme notes, not everyone will be helped by the interview. People’s anxiety about their voices may be too much or they may not feel able to revisit traumas. The evidence that the approach works is still limited to personal experiences and <a href="http://dx.doi.org/10.1080/17522439.2016.1185452">a small preliminary trial</a>. </p>
<p>There is no one single reason why people hear voices, and no one single way to help. For some, the answer will still be medication; for others, it may be the meanings that the Maastricht Interview can help uncover. It may even be both. But for those who report benefiting from the interview, their lives have been changed forever.</p><img src="https://counter.theconversation.com/content/76605/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Simon McCarthy-Jones receives funding from an Irish Research Council New Foundations scheme grant. He has previously undertaken volunteer work for the English Hearing Voices Network.</span></em></p>The Maastricht Interview has helped hearers understand why voices are speaking to them.Simon McCarthy-Jones, Associate Professor in Clinical Psychology and Neuropsychology, Trinity College DublinLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/669342016-10-21T12:24:34Z2016-10-21T12:24:34ZHearing voices is more common than you might think<figure><img src="https://images.theconversation.com/files/142504/original/image-20161020-8845-43mhxd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">It's common for elderly bereaved people to hear their deceased partner speak to them.</span> <span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-50772586/stock-photo-old-men-sitting-on-the-bench-by-the-sea.html?src=57UMYjkcsfi-UQArfbu4XQ-1-14">VVO/Shutterstock.com</a></span></figcaption></figure><p>Hearing voices that other people can’t is a meaningful experience. Like dreams, they can usually be understood in terms of one’s life experiences. Within mental health services, however, the prevailing medical model means some practitioners pay attention only to their presence, not their meaning. </p>
<p>Psychiatry’s diagnostic bibles, the American <a href="https://theconversation.com/uk/topics/dsm-5-2189">DSM-5</a> and the World Health Organisation’s ICD-10, portray auditory hallucinations as symptoms of a mental disorder called schizophrenia, which most psychiatrists believe <a href="http://pb.rcpsych.org/content/28/11/401">is caused by biochemical and genetic factors</a> rather than a meaningful response to life events and circumstances. Although less than 1% of the population receive this diagnosis, international surveys, in different cultures, find that about <a href="https://www.ncbi.nlm.nih.gov/pubmed/21574793">one in eight people experience auditory hallucination</a> at least once in their life. </p>
<p>I am one of those who has only heard voices once in their life (so far). The day after my friend died in a car accident, years ago, he spoke to me. Despite many years of working as a clinical psychologist to help people make sense of their voices, my first thought was: I’m going crazy. Then I realised he had just come to say goodbye, and it didn’t matter whether he really was there or I was imagining it.</p>
<p>There are many ways in which hearing voices varies, aside from frequency. Some people hear only bad voices. Others hear only good voices, supporting and reassuring them. Many hear both good and bad. For some the voices are of people they know. Some hear just the one voice, others hear many. For some the voices start as imaginary childhood friends and for others the first voice arrives much later in life.</p>
<p>A common feature, however, is that most voice hearers, when asked, <a href="https://books.google.co.uk/books/about/Making_Sense_of_Madness.html?id=BRcv3whgAsIC&redir_esc=y">ascribe meaning to their voices</a>, and reject the notion <a href="https://moh-it.pure.elsevier.com/en/publications/what-people-with-schizophrenia-think-about-the-causes-of-their-di">that they are meaningless expressions</a> of a chemical imbalance or some other supposed biological dysfunction. Perhaps the most obvious, and common, example of voices being meaningful are studies showing that most people over 60 who lose a life partner, will <a href="https://www.researchgate.net/publication/19141943_Hallucinations_of_Widowhood">hear or see their partner soon after their death</a>.</p>
<p>Negative voices are often related to adverse life events. Four studies of adults using mental health services found that the content of at least half of the voices of people who were physically or sexually abused as children was related to the abuse. For example, <a href="https://www.researchgate.net/publication/21083263_Persisting_Hallucinations_Following_Childhood_Sexual_Abuse">a study</a> of the psychiatric files of incest survivors found examples of a man and woman who had suffered sexual abuse as young children who heard voices accusing them of sleazy behaviour. Other studies report examples of the voices being the abuser. <a href="https://www.ncbi.nlm.nih.gov/pubmed/12689431">One study</a> described someone who was suffering ongoing sexual abuse by a violent relative, who heard the relative’s voice telling them to commit suicide. It is usually more helpful in these situations to ask if the person would like to talk about what happened to them rather than dismiss the voice as a meaningless symptom of brain disease.</p>
<p>There are countless historical examples of voices where the person hearing the voice is convinced they have meaning – Jesus and Joan of Arc among the most famous. However, the notion that voices are random expressions of a diseased brain, devoid of meaning, is a <a href="http://dx.doi.org/10.1080/17522430903420711">recent creation</a>, restricted to cultures where a medical model of human distress dominates.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/142505/original/image-20161020-8849-1u4cg8n.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Joan of Arc – when hearing voices wasn’t a medical disorder.</span>
<span class="attribution"><a class="source" href="http://www.shutterstock.com/pic-212819017/stock-photo-old-monument-of-jeanne-darc-joan-of-arc.html?src=B7tjqGlncneB2Ec93JkGZg-1-9">Denis Kuvaev/Shutterstock.com</a></span>
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<h2>An ordinary part of life</h2>
<p>Many cultures experience voices as completely normal. When I was living in New Zealand, a Maori colleague <a href="https://researchspace.auckland.ac.nz/handle/2292/3367">interviewed 80 Maori people</a> about what causes people to hear voices. For them, it was such an ordinary part of life that the question made little sense. As one respondent put it: “For me hearing voices is like saying hello to your family in the morning, it is nothing unusual.”</p>
<p>An exciting development in the last two decades is the emergence, all over the world, of peer-support <a href="http://www.intervoiceonline.org/2283/voices/understanding-voices/bereavement-and-hearing-voices.html">groups for voice hearers</a>. The members of these groups have much to teach us mental health professionals, especially about how to listen respectfully, and search for meaning, rather than dismissing people’s experiences as symptoms of an imagined illness which has no reliability or validity and trying to suppress those experiences with psychiatric drugs.</p>
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<p>Voices, like dreams, sometimes carry important messages about a problem that needs addressing, <a href="http://dx.doi.org/10.1080/17522430903384305">such as trauma earlier in one’s life</a>. Perhaps mental health professionals need to ask “what are the voices saying?” a bit more often, and as voice hearer Eleanor Longden explains in her <a href="https://www.ted.com/talks/eleanor_longden_the_voices_in_my_head?language=en">TED talk</a>, they should also ask: “What happened to you?”.</p><img src="https://counter.theconversation.com/content/66934/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>John Read is a member of the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis (<a href="http://www.isps.org">www.isps.org</a>) , and the Editor of the ISPS scientific journal Psychosis.
He is a supporter of the international Hearing Voices Network.</span></em></p>… and more meaningful.John Read, Professor of Clinical Psychology, University of East LondonLicensed as Creative Commons – attribution, no derivatives.