Hope, Hopelessness and Hearing Voices Groups

A personal account on hearing voices groups from Akiko Hart published in the journal Psychosis


In a recent submission to the journal Psychosis, Akiko Hart, writes a first-person account titled “When we lose hope: experiences from Hearing Voices groups.” Reflecting on her experiences in Hearing Voices groups, she writes on the importance and role of hope in mental health care. She draws attention to the notion that hope and hopelessness can — and often do — co-exist.

“For me, holding hope is saying or thinking – I hear your hopelessness, and why hope might feel too heavy, or futile, or unbearable for you right now so I will hold hope for you, because I believe in you.”

Akiko works for Mind in Camden and manages a series of projects for people who hear voices, see visions or have unusual sensory experiences or beliefs. The main focus of the work is to set up services, including peer support groups, in the community, for young people, in prisons, secure units and in detention centres. Akiko is also a trustee of Hearing Voices England and was previously Director of Mental Health Europe. Akiko’s interests include hearing voices and psychosis, how we sit with and understand distress, and peer support.

She writes that even though hope is at the core of the group process, it is often hard to hold hope for yourself and receive hope from others. While we need hope to continue trying to get better (whatever that may mean for the person) it can often feel burdensome to carry.

“Hope felt like a sack of potatoes they were dumping on me. Here is all the hope I and everyone else have for you please take it o us because it’s too heavy for us to carry.”

Because of the weighty-ness of hope, one of the strengths of the Hearing Voices groups is that the group holds hope:

“. . . in a Hearing Voices group, I’m not sure that hope even needs to be articulated with words. It’s there in the room because the group exists. . . the very fact that there is a group means there is hope. . .  And sometimes within a group, we are able to hold hope together, briefly, in that hour. . .”

Akiko goes on to write, very honestly, that often in the work when hope is overshadowed by hopelessness, one can feel helpless.

“. . . I’m not always able to hold hope in a way that feels helpful. I have had friends who have struggled, who feel stuck and who want to die. And, against all my training, all my theory, my immediate response is to offer hope, to push it on them, to try and make them see it. You can make it, I believe in you, you are strong. (Please live. Please live.)””

“Why am I telling her she is strong when she feels weak and broken? Why am I telling her she can make it when she is telling me she is done? It is, I think, because I feel helpless.”

This notion of hope and hopelessness co-existing is reminiscent of the research carried out by Larry Davidson on recovery. In a 2007 review, Davidson & Roe write on the concept of “recovery in” and “recovery from” mental “illness.” In this framework, “recovery from” is defined as a return to “normal”, pre-“illness” state, characterized by an amelioration of symptoms that allows the individual to return to “normal” levels of functioning. “Recovery in” accepts that some of the experiences may not go away, and “refers to the process of living one’s life, pursuing one’s personal hopes and aspirations, with dignity and autonomy, in the face of the ongoing presence of an illness and/or vulnerability to relapse.”

Just as recovery can exist with the “symptoms” and “experiences,” hope can exist with challenges, setbacks, dark places, and hopelessness.  It is the acknowledgment that ‘illness’ and health are not and do not have to be black or white, but that they can co-exist, that allows for a more honest understanding of human experience to emerge. Akiko beautifully depicts this existence:

 “. . . as dark as it was, it wasn’t all hopelessness. I could still laugh, I could look at my daughter’s face and wonder at her beauty – and also, in the same moment, want to die. It wasn’t all or nothing. The hopelessness and hope were layered and intertwined.“

In this thoughtful account, we are presented with a complex reality of hope, hopeless and helplessness in the context of mental health care that we are challenged to face.

“. . . hopelessness usually engenders in me complex feelings of both hopelessness and helplessness. And yet, I work in mental health, where hopelessness is a daily occurrence. And isn’t mental health about helping people?“



Hart, A. (2017). When we lose hope: experiences from Hearing Voices groups. Psychosis, 1-4. (Link)

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Bernalyn Ruiz
MIA Research News Team: Bernalyn Ruiz-Yu is a Postdoctoral Fellow in the Department of Psychiatry and Biobehavioral Sciences at the University of California, Los Angeles. She completed her Ph.D. in Counseling Psychology from the University of Massachusetts Boston. Dr. Ruiz-Yu has diverse clinical expertise working with individuals, families, children, and groups with a special focus on youth at risk for psychosis. Her research focuses on adolescent serious mental illness, psychosis, stigma, and the use of sport and physical activity in our mental health treatments.


  1. No. The premise is finehope/hopelessness but no. No mention of trauma and s second person account versus the actual article. Please stop publishing these pieces. I find them a waste of time and energy.The are masked as helpful when really they are the same old same old,
    The once now and then interesting depth filled articles are almost not worth reading.
    Central American,South American, DACA, and the Hispanic view of past and present common treatment oractice would be much more interesting and helpful.The livesif so many activists have Ben lost. Presents to all of them. Speak your true voice.

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  2. “And isn’t mental health about helping people?“ That was not my experience, my experience is “mental health” was solely about attempting to take away hope by defaming a person to her family with a “lifelong, incurable, genetic mental illnesses,” then massively poisoning her.

    How less hopeful can the “mental health” industry be than to claim people can never recover? I didn’t buy in, despite the fact the drugs did give me “voices” (via anticholinergic toxidrome poisoning) since in reality I had no family history of such BS. But that did not stop doctors, who did not know me or my grandmother, from literally defaming me and my grandmother in my medical records. How immature and ungodly disrespectful can doctors get? “You’re mama” isn’t immature enough, doctors stoop to defaming people’s beloved grandmothers.

    I do hope the “mental health” industry does some day become about helping people, rather than just gas lighting people to cover up child abuse, which is actually what today’s “mental health” industry is currently all about, according to their own medical literature.

    Although if the “mental health” industry does get out of the business of turning child abuse victims and their concerned parents into the mentally ill with the psychiatric drugs, they won’t have much business at all given today, “the prevalence of childhood trauma exposure within borderline personality disorder patients has been evidenced to be as high as 92% (Yen et al., 2002). Within individuals diagnosed with psychotic or affective disorders, it reaches 82% (Larsson et al., 2012).”

    I do have hope that by exposing the “mental health” industry as being actually nothing more than primarily a bunch of pedophile protecters and empowerers, that the “mental health professionals” might get out of the child abuse denying and covering up business. I agree hope is important.

    And what’s good is the satanic, psychotomimetic “voices” do go away, once one is weaned off of the psychiatric drugs, and heals from the drug withdrawal induced super sensitivity manic psychosis. Lucky for me, my drug withdrawal induced “voices” all agreed with me, we all thought that satanic pedophiles are disgusting. And now many on the internet also agree.

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  3. In reality it was hope – hopelessness – helplessness.

    Helplessness is the intrinsic feeling you may have working within mental health care.

    The nice, articulate young woman was showing how hearing voices group administer hope if you feel helpless to support someone in their recovery. That is how I read it anyway.

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