Study Explores Benefits of Hearing Voices Groups for Psychosis

A national US study on hearing voices groups finds that they perform numerous healing functions for users experiencing psychosis.

Ayurdhi Dhar, PhD
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In a new article published in Psychosis: Psychological, Social, and Integrative Approaches, Gail Hornstein from Mount Holyoke College and her colleagues investigate how hearing voices peer support groups (HVGs) work for a diverse range of participants.

Hornstein identifies six themes she believes are integral to the efficacy of HVGs: prioritizing self-determination, de-emphasizing behavioral targets and pressure to change, respecting multiple frameworks of understanding, non-judgmental curiosity through organic dialogue with nothing “off-limits,” egalitarian collaboration among members, and fostering genuine relationships inside and outside of meetings.

“These groups seem able to serve multiple functions simultaneously, thereby allowing individuals with diverse needs to get them met in the same context,” Hornstein writes.

Although biomedical explanations for psychosis are still common, researchers are presenting more evidence that solely medication-based treatments for psychosis are likely less effective and have far more side effects than initially thought.

As the biomedical explanations for psychosis come under increasing scrutiny, many therapists and service users are seeking non-drug therapies to alleviate mental suffering. The use of non-drug therapies like Hearing Voices Groups (HVGs) is associated with service users feeling more autonomy and less skepticism about treatment and alternatives to medication have shown promising results in early research.

Prior research has established that HVGs can improve social and emotional well-being among members while promoting overall positive changes in their lives. HVGs can also offer alternative, non-pathologizing narratives for voice hearers, allowing them to understand hearing voices in their own terms rather than adopting the stigmatizing biomedical view of psychosis as a brain disease.

The current research began with an open-ended questionnaire examining 111 HVG participant’s voice-hearing histories, experiences within the group, and impact of group participation. The researchers then selected 15 participants representing the diversity of experience present in the original sample to participate in more in-depth follow-up interviews.

Hornstein and colleagues then performed a phenomenological analysis to identify the essential qualities of the participant’s experience. The result was six themes identified as essential to the efficacy of HVGs: prioritizing self-determination, de-emphasizing behavioral targets and pressure to change, respecting multiple frameworks of understanding, non-judgmental curiosity through organic dialogue with nothing “off-limits,” egalitarian collaboration among members, and fostering genuine relationships inside and outside of meetings.

HVGs emphasize self-determination by allowing members to attend however frequently they would like with no outside referral necessary. Participants may interact with others or maintain silence and are encouraged to explore any topics they choose in whatever way they find helpful.

These groups encourage members to set goals for themselves, but they do not judge or police these goals. There is no prescribed structure or path for self-improvement inherent in the logic of HVGs, and behavioral targets and pressure to change are de-emphasized in favor of exploring the complexities of the voice-hearing experience.

Participants are encouraged to understand their voice-hearing experience on their own terms, and no one narrative is emphasized over any other. This means the biomedical explanation of voice-hearing is on equal footing with the alien-implanted technology explanation during these meetings. There is a strict rule that participants do not criticize each other’s narrative around voice-hearing.

HVGs help stimulate curiosity around psychological life by allowing participants to question atypical experiences and unusual understandings of more common experiences. While nothing is off-limits, the group also encourages non-intrusion. You may ask any question, but silence is considered as legitimate an answer as a full and detailed explanation.

Egalitarian collaboration emanates from the view that each member is an “expert by experience.” Therefore the facilitators take no leading role during the meeting but rather model the values of inclusiveness and democracy. All views are accepted, and none are privileged, whether they come from grizzled experts or brand-new participants.

These groups also emphasize the formation of genuine relationships both within and beyond the group meetings. The sharing of personal contact information between facilitators and participants is common, and fostering friendships is important for the group to positively affect its members. There is also an ethos of confidentiality present in these relationships as group members will not seek outside intervention in any circumstance unless requested.

The authors believe these six features of HVGs allow them to function effectively for a hugely diverse group of people by offering a unique constellation of support not present in any other form of therapy. HVGs offer qualities similar to 12-step programs in that they are not time-limited, and participants can come however often they please. Still, HVGs are more improvisational, allow members to tell their stories in any number of ways, and do not prescribe one single narrative through which to view the voice-hearing experience.

HVGs also have some things in common with psychotherapy in that they both encourage the exploration of meaning in difficult experiences. However, HVGs do not assume any pathology on the part of the participants and allow for more organic “crosstalk” between members than the traditional psychotherapeutic structure.

The author concludes that HVGs offer several unique approaches that are invaluable in understanding voice-hearing. Not only can these groups be effective on their own, but “it may well be that participating in these groups can equip voice hearers to make use of mainstream services with a greater degree of self-determination, allowing for a richer experience across multiple domains.”

The authors acknowledge that in using a phenomenological analysis, it is possible to miss functions of the HVGs in their participant’s narratives due to the participant’s inability to articulate them. Hornstein and her colleagues also acknowledge that the 15 participants called for the follow-up interviews may not have represented the full depth of experience present in the HGVs.

The current research examines how HVGs help their participants. By prioritizing self-determination, de-emphasizing behavioral targets and pressure to change, respecting multiple frameworks of understanding, non-judgmental curiosity through organic dialogue with nothing “off-limits,” egalitarian collaboration among members, and fostering genuine relationships inside and outside of meetings, HVGs allow their participants to understand their experience in a way that is meaningful and useful to them while providing a social support system of others with similar experiences.

 

 

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Hornstein, G.A., Branitsky, A. & Putnam, E.R. (2021): The diverse functions of hearing voices peer-support groups: findings and case examples from a US national study, Psychosis, DOI: 10.1080/17522439.2021.1897653 (Link)

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Ayurdhi Dhar, PhD
MIA Research News Team: Ayurdhi Dhar is assistant professor of psychology at Mount Mary University. She is the author of Madness and Subjectivity: A Cross-Cultural Examination of Psychosis in the West and India (to be released in September 2019). Her research interests include the relation between schizophrenia and immigration, discursive practices sustaining the concept of mental illness, and critiques of acontextual and ahistorical forms of knowledge.

12 COMMENTS

    • Psychosis like all psychiatric terms and labels are mostly subjective and depend what is assumed as “correct”. For example in the PANSS psychosis scale someone can be labeled psychotic for disagreeing with psychiatry and being too hostile towards the psychiatrists. Hostility to people proclaiming you get less rights than criminals because you are stupid and mentally defective sounds like an expected response. Though I lack insight so what do I know?

      Back in the day slaves and racial minorities who didn’t agree they were inferior races were labeled as psychotic. Women who got upset about being treated as mules also got labeled as mentally ill. Regardless of intent, psychiatry silences people. It turns those silenced into easy targets for bullies and criminals. Society recognizes this truth considering a common arguing tactic is to tell someone they are off their drugs, and/or mentally ill.

    • PSYCHOSIS
      It is Possible to make Recovery from Schizophrenia / Chronic Schizophrenia / Schizo Affective Disorder by Carefully Stopping Psychiatric Treatment (with Basic Suitable Psychotherapy).

      PSYCHOSIS IRELAND
      Psychosis Ireland
      Psychosis Ireland

      MENU AND WIDGETS
      Researchers
      Members of the Irish Psychosis Research Network (IPRN)
      Prof. Mary Cannon, Department of Psychiatry, RCSI

      Mary Cannon is Professor of Psychiatric Epidemiology and Youth Mental Health in the Department of Psychiatry at the Royal College of Surgeons in Ireland, Dublin. Her research area of interest is the study of early life risk factors for psychosis and other mental disorders. Her current research programme focuses on psychotic symptoms in childhood and adolescence which index risk for later mental illness and could provide a significant opportunity for prevention. She won a Doctor Award (Psychiatry) in 2013 from the Royal Academy of Medicine in Ireland and was listed on the Thompson Reuters Highly Cited Researcher list in 2014.

      Keywords: epidemiology, developmental risk factors, neuroimaging, neurocognition, mixed methods

      Dr. Ian Kelleher, Dept of Psychiatry RCSI.

      Ian Kelleher is Research Lecturer in Neurological and Psychiatric disorders at the Royal College of Surgeons in Ireland. He completed his Medical degree at Trinity College Dublin and his PhD at the Royal College of Surgeons in Ireland. He is a Member of the College of Psychiatrists of Ireland. His research focuses on psychotic symptoms and disorders in children, adolescents and young adults.

      Keywords: Epidemiology; Phenomenology; Neurocognition; Children and Adolescents

      Prof. David Cotter, Department of Psychiatry, RCSI

      My research interest is the neuropsychiatry of psychiatric disorders.

      My first expertise and training was in the cytoarchitectural investigation of brain and the neuronal and glial cell populations within it, in schizophrenia, major depression and bipolar disorder. I was awarded two MRC clinical training fellowships in the UK to undertake this work. My main early contribution in this field has been the observation that there is a cortical glial cell deficit in the brains of subjects with major depression and schizophrenia. I have also been among the first to describe cortical neuronal size reductions in major depression and bipolar disorder.

      Subsequently, supported by funding from the Welcome Trust through a University Award (2002-2006) and the HRB, SFI and NARSAD, I have pursued a Neuroproteomics Research Programme involving subjects with major psychiatric disorders. In collaboration with internationally recognised experts in proteomic research (Professor Mike Dunn and Dr Gerard Cagney) I have employed a variety of protein separation methods and used gel-based and non-gel based proteomic methods and published studies showing synaptic and mitochondrial changes in the brains of subjects with major psychiatric disorders.

      I am currently funded as an HRB Clinician Scientist and as part of this work with my group to identify predictive plasma protein biomarkers schizophrenia. Subsequent HRB funding has allowed me to address this same question using metabolomic and lipidomic approaches. Work submitted for publication has now identified age 11 biomarkers of psychotic disorders at age 18.

      My current focus is now extending beyond schizophrenia to the study of young people at risk of all mental disorders. The aim is that by identifying those at risk of mental disorders before they become unwell that future psychiatric illness can be prevented.

      Keywords: Mental disorder, proteomics, synapse, inflammation

      Dr. Edgar Lonergan, Department of Psychology-Cork Kerry Community Healthcare & RISE EIP Service

      Edgar Lonergan is Principal Clinical Psychologist with HSE South, and Lead for Psychological Interventions in Psychosis with RISE (Early Intervention in Psychosis Service in Cork).

      A graduate of NUI Galway, Edgar worked in a variety of clinical settings within the HSE before specialising in Early Intervention in Psychosis.

      His research interest is the area of Neuropsychological functioning in First Episode Psychosis. His current research is focused on the use of the CANTAB neuropsychological assessment protocol to investigate changes in cognitive functioning and positive symptom change in psychosis.

      Edgar is also chair of the Open Dialogue Group who are currently evaluating the use of an Open Dialogue approach with people experiencing a First Episode of Psychosis.

      Prof. Kieran C Murphy, RCSI

      A graduate of UCD, he moved to the UK in 1994 where he completed two research fellowships and obtained a PhD in psychiatric genetics at Cardiff University. In 1999, he moved to the Institute of Psychiatry, Psychology and Neuroscience, Kings College London as Senior Lecturer in Behavioural Genetics. He subsequently returned to Dublin in 2002 when he was appointed Professor & Chairman, Department of Psychiatry, Royal College of Surgeons in Ireland and Consultant Psychiatrist at Beaumont Hospital, Dublin. His research interests include the genetics of psychiatric disorders and the assessment and neurobiology of behavioural phenotypes in genetic and neuropsychiatric disorders with particular reference to 22q11 Deletion Syndrome. In addition to clinical interests in Liaison Psychiatry and Neuropsychiatry, he also runs a Behavioural Genetics clinic in Beaumont Hospital in association with the Department of Clinical Genetics at Our Lady’s Children’s Hospital, Crumlin.

      Keywords: genetics; behavioural phenotypes; 22q11 Deletion Syndrome

      Dr. Paddy Power, St Patrick’s hospital & TCD

      Dr Paddy Power trained in adult psychiatry, initially in Ireland, then Australia, and completed training in child & adolescent psychiatry in London. He joined the Early Psychosis Prevention and Intervention Centre EPPIC in Melbourne in 1993 and in 1998 became its Deputy Medical Director. In 2000, he moved to the South London & Maudsley NHS Trust to establish an early intervention service called the Lambeth Early Onset (LEO) service. Three of its four teams were set up with development and research grants and incorporated randomised controlled trials as part of their evaluation. In March 2010, Dr Power moved to Dublin to establish a youth mental health service (18 – 25 year olds) at St. Patrick’s University Hospital.

      Dr Power’s research and publications include epidemiology of psychosis, RCTs of antipsychotic medication, CBT and psychosocial interventions, suicide prevention interventions, youth mental health, effectiveness of mental health law, cannabis & psychosis, and health economic evaluations. Dr Power was R&D Lead for the Borough of Lambeth. He set up the London Early Intervention Research and Services Networks and co-hosted the 2006 IEPA meeting in Birmingham. He was chairperson of the (Youth Mental Health) SIG of ACAMH, Ireland and the Early Intervention Working Group of the College of Psychiatrists of Ireland. He is an executive member of the International Association of Youth Mental Health (IAYMH) and on the team that successfully bid for the forthcoming IAYMH conference in Dublin September 2017.

      Keywords: Youth Mental Health; Early Intervention in Psychosis; Health Service evaluations

      Dr. Simon McCarthy Jones, Department of Psychiatry, TCD.

      Simon’s research focuses on the phenomenology of auditory verbal hallucinations (‘hearing voices’), the causes of this experience, the various meanings given to the experience and their historical background, and what can be done to support people distressed by this experience. My work on causation includes neuroimaging research, genetic research, and a focus on the role of traumatic life-events in the aetiology of this experience. My latest book on this topic, Can’t You Hear Them? The Science and Significance of Hearing Voices was published by Jessica Kingsley in April 2017.

      Keywords: Hallucinations, neuroimaging, trauma, hermeneutics, history.

      Prof. Paul Fearon, St Patrick’s Hospital & Department of Psychiatry, TCD.

      Paul Fearon graduated in Medicine from University College Dublin, and after 5 years postgraduate training in general medicine, he specialised in psychiatry. He completed his training at the Maudsley Hospital, London and was a consultant general adult psychiatrist there for 7 years. As a senior lecturer at the Institute of Psychiatry in London, he headed the Section of Social Psychiatry and Epidemiology. He returned to Dublin to take up his post in St. Patricks Hospital and Trinity College Dublin in 2008 where he is Clinical Professor in Psychiatry, Deputy Medical Director and a General Adult Consultant Psychiatrist. He has published over 100 peer-reviewed papers, largely in the areas of the epidemiology and the role of socioenvironmental factors in schizophrenia and bipolar disorder.

      Prof. Aiden Corvin, Department of Psychiatry, TCD.

      More to follow…

      Dr. Ken O’Reilly, Department of Psychiatry, TCD.

      Ken holds a BSc. In psychology, and graduated with a Masters in Counselling Psychology in 2004 from Trinity College Dublin (TCD), and a Doctorate in Clinical Psychology from University College Dublin (UCD) in 2009. He is strongly influenced by the paradigms of evolutionary psychology, behavioral genetics, and cognitive psychology. In 2011, he took up a joint appointment with the Central Mental Hospital (CMH) and the Department of Psychiatry TCD, where he holds the position of assistant professor of clinical psychology. Achievements include: carrying out the first epidemiologically valid investigation of the level of cognitive impairment experienced by forensic patients with schizophrenia or schizoaffective disorder; demonstrating the importance of cognitive impairment for functional outcomes for forensic patients; exploring potential iatrogenic effects that medications may have on cognition and functional outcomes; conducting a randomized controlled trial of cognitive remediation for a national cohort of forensic patients involving fifty six sessions of therapy. In 2016 Ken and his collaborators won an open access research award from Irelands health service executive (HSE) within the category of mental health. Ken’s primary research interests involve critiquing, developing, and evaluating psychological treatments; treatment moderators such as cognitive impairment; and improving functional outcomes for forensic mental health patients; in addition to the training of clinicians and service evaluation. He has a particular interest, in the psychological motivations underpinning homicide and serious acts of violence.

      Prof. Declan McLaughlin, Department of Psychiatry & St Patrick’s hospital, TCD.

      Declan M McLoughlin PhD MRCPI MRCPsych FTCD is Research Professor of Psychiatry in St Patrick’s University Hospital and Trinity College Dublin, Ireland. He qualified from University College Dublin in 1986 and trained in general medicine and psychiatry in both Dublin and London. His research interests include electroconvulsive therapy and other brain stimulation techniques for neuropsychiatric disorders, treatment resistant depression, depressive psychosis, and molecular psychiatry. For more details see the Depression Neurobiology Research Group webpage. Recent projects are supported by the Health Research Board (Ireland) and NARSAD (USA).

      Keywords: depression, electroconvulsive therapy, meta-analysis, clinical trials, molecular biomarkers

      Prof. Ted Dinan, Department of Psychiatry, UCC.

      Ted Dinan is Professor of Psychiatry and a Principal Investigator in the APC Microbiome Institute at University College Cork. He was previously Chair of Clinical Neurosciences and Professor of Psychological Medicine at St. Bartholomew’s Hospital, London. Prior to that, he was a Senior Lecturer in Psychiatry at Trinity College Dublin. He has worked in research laboratories on both sides of the Atlantic and has a PhD in Pharmacology from the University of London. He is a Fellow of the Royal Colleges of Physicians and Psychiatrists and a Fellow of the American College of Physicians. His main research interest is in the role of the gut microbiota in stress related disorders. He has also worked extensively on the regulation of the hypothalamic-pituitary-adrenal axis. In 1995 was awarded the Melvin Ramsey Prize for research into the biology of stress. In 2019 he was ranked by Expertscape as the number 1 global expert on the microbiota. His current research is funded by Science Foundation Ireland, the Health Research Board and European Union FP7. He has published over 500 papers and numerous books on pharmacology and neurobiology. He is on the Editorial Boards of several journals.

      Dr. Dara Cannon, Department of Anatomy & NICOG, NUI Galway

      Dr Dara M Cannon(NUI Galway). Dara is an academic scientist at the National University of Ireland Galway specializing in research on bipolar disorder and psychosis using modern medical imaging techniques as well as teaching cadaveric and radiological neuroanatomy. She directs the Clinical Neuroimaging Laboratory with Professor Colm McDonald, Head of Psychiatry at UCHG and NUI Galway. She received her BSc in biochemistry and PhD in neuropsychopharmacology from UCD and specialized in in vivo medical imaging at the National Institutes of Mental Health, NIH in the USA. Currently, Dr Cannon leads a Health Research Board funded study to better understand the cholinergic contribution to bipolar disorder using MRI.

      Keywords: neuroimaging, diffusion MRI, tractography, connectivity, network analysis

      Prof. Gary Donohoe – School of Psychology & NICOG, NUI Galway

      Gary Donohoe was appointed to the school of psychology as professor of psychology in July 2013. Following the completion of his Doctoral training in Clinical Psychology at Trinity College Dublin, Gary undertook a research fellowship in the TCD neuropsychiatric genetics research, where he earned a PhD in Cognitive Genomics and began the cognitive genomics lab. He was appointed an assistant professor in TCD’s school of medicine in 2006, and associate professor in 2009, where he was responsible for the school of medicine psychology program until 2013. Gary’s research focuses on understanding the genetic and neural basis of cognitive deficits associated with psychosis, and the development of therapeutic programs for overcoming these deficits. Gary continues to lead the Cognitive Genetics and Cognitive Therapy (CogGene) group, members of which are based between the school of psychology NUIG and TCD, where he holds the position of adjunct Professor in the school of medicine and principal investigator in the Trinity College Institute for Neuroscience. Gary also continues to be clinically active in mental health service delivery.

      Prof. Colm McDonald – Depart of Psychiatry & NICOG, NUI Galway

      Colm McDonald is Professor of Psychiatry at National University of Ireland, Galway, and Consultant Psychiatrist at Galway Roscommon Mental Health Services. He completed his basic clinical training in Dublin and then moved to the Institute of Psychiatry in London, where he completed his clinical and research training and received his PhD. He is Vice Dean of the NUIG Deanery for postgraduate basic specialist training in psychiatry, Director of the Clinical Neuroimaging Laboratory at NUI Galway and co-director of the Centre for Neuroimaging and Cognitive Genomics (NICOG).

      His clinical research program focuses on investigating neurobiological and neuroimaging abnormalities associated with major psychotic and affective disorders, as well as health services research. His research projects have been supported by the Wellcome Trust, Medical Research Council, Health Research Board, Royal Society, National Alliance for Research on Schizophrenia and Depression, Irish Research Council and Mental Health Commission. He has authored 200 original publications in peer reviewed journals.

      Dr. Derek Morris – Dept of Biochemistry & NICOG, NUI Galway

      Derek Morris graduated with a B.Sc. in Biotechnology from the National University of Ireland, Galway in 1998. In 2001, he completed his PhD in molecular genetics at the Department of Psychological Medicine, Cardiff University. He subsequently joined the Neuropsychiatric Genetics Research Group in TCD as a research fellow and was awarded a HRB Postdoctoral Career Development Research Fellowship in 2003. In 2006, Dr. Morris was appointed Lecturer in Molecular Psychiatry within the Dept. of Psychiatry in TCD and in 2013 moved to NUI Galway where he is now Lecturer in Biomedical Science.

      Dr. Morris’ research interests are the development of novel methods for mapping genes for complex diseases and the application of high-throughput genomics technologies to the detection of risk genes for schizophrenia and bipolar disorder. He has extensive experience of genome-wide association studies and using SFI funding, set up TrinSeq, the first next-generation sequencing lab in Ireland in 2008. He is currently President of the Irish Society of Human Genetics. His contribution to the Cognitive Genetics Group is study design and the management of bio-sample resources and genetics data used for ongoing studies.

      Dr. Brian Hallahan – Dept of Psychiatry & NICOG, NUI Galway

      Dr. Brian Hallahan is a senior lecturer in psychiatry at National University of Ireland, Galway and Consultant Psychiatrist, West Galway Mental Health Services. He completed his basic clinical training in Galway and then moved to Dublin. He engaged in research in Beaumont Hospital, which resulted in him attaining his MD degree. He subsequently worked in the Institute of Psychiatry in London focusing on neuroimaging research in Autism Spectrum Disorders and returned to Ireland to complete his higher training. Dr. Brian Hallahan worked as a consultant psychiatrist in the Roscommon Mental Health Services before commencing his present post in 2012.

      Dr. Hallahan clinical research interests include structural neuroimaging of schizophrenia, bipolar disorder and autism spectrum disorders.

      Dr. Ciaran Mulholland – Dept of Psychiatry, Queen’s University Belfast

      I am a consultant psychiatrist with the Northern Health and Social Care Trust in Northern Ireland and a Senior Lecturer in the Centre for Medical Education at The Queen’s University of Belfast. I am also a Visiting Professor to the Bamford Centre at the Faculty of Health and Life Sciences, School of Psychology, University of Ulster.

      I am Clinical Co-lead for an innovative service for young people with “at risk mental states” in the Northern Trust-the “STEP” Service and Clinical Director of the Northern Ireland Psychological Trauma Regional Clinical Network. I am one of two Research Leads of the Northern Ireland Clinical Research Network Mental Health Special Interest Group.

      I have a research interests in first episode psychosis and “At Risk Mental States”. I have a particular interest in the impact of childhood trauma on mental health outcomes in young adulthood. I am a Principle Investigator on the Northern Ireland First Episode Psychosis Study (NIFEPS). I have a particular clinical and research interest in the impact of violence in the local context of Northern Ireland on mental health outcomes.

      Keywords: first episode psychosis; at risk mental states; psychological trauma

      Dr. Ciaran Shannon – School of Psychology, Queen’s University Belfast

      I am a Consultant Clinical Psychologist and Assistant Course Director for the D.Clin.Psych. at the School of Psychology in Queens University Belfast. I also work in the Northern Health and Social Care Trust. In this post I manage specialist mental health psychology services and I am currently developing, along with Prof Ciaran Mulholland, a colleague from the school of medicine, a service for young people at risk of psychosis, the first of its kind in Ireland. While I have a broad range of experience with clients with a variety of mental health problems, my clinical practice is primarily in the area of delivering Cognitive Behaviour Therapy for psychosis and for preventing psychosis.

      I am also currently a member of editorial board of Psychosis: Psychological, Social And Integrative Approaches, and a member of Threshold’s professional practice committee (a mental health charity in Northern Ireland). I am past chair of ‘Rehability’ (another mental health charity in NI).My primary research interest lies in exploring the links between psychosis and traumatic experience and have published widely in this area. I am also developing a research programme focusing on how we can prevent psychosis developing in at risk young people. I am interested in the effects of trauma on mental health and functioning more generally and how we can intervene post-trauma to improve mental health. I have an interest in how mental health services should respond and what treatments should be provided to those who have experienced trauma and psychosis.

      Keywords: psychosis; prevention; trauma; abuse.

      Prof. Mary Clarke, Department of Psychiatry, UCD.

      Professor Mary Clarke completed undergraduate medical training in University College Dublin. She trained in medicine and neurology and then in psychiatry. In 1998 she was awarded a two year research fellowship funded by the Stanley Medical Research Institute that allowed her to develop her interest in the clinical and epidemiological aspects of first episode psychosis. She was appointed as Consultant psychiatrist to St John of God hospital in 2001 where she specialized in substance misuse and psychosis. She took up the post of Clinical Lead of the DETECT early intervention service in psychosis service in 2011. She was appointed as Senior Lecturer in Psychiatry to UCD in 2008 and as Clinical Professor in 2014. Her research programmes focus on longitudinal studies of first episode psychosis and early intervention. She has an interest in developing interventions to improve outcome in psychosis. She is a fellow of the Royal College of Psychiatrists UK and the Royal College of Physicians in Ireland.

      Keywords: Psychosis, epidemiology, outcome, recovery

      Supported by RCSI

  1. “Participants are encouraged to understand their voice-hearing experience on their own terms, and no one narrative is emphasized over any other. This means the biomedical explanation of voice-hearing is on equal footing with the alien-implanted technology explanation during these meetings. There is a strict rule that participants do not criticize each other’s narrative around voice-hearing.”

    Has Mad in America tilted so far to the Left that it can’t see a HUGE issue with this statement? Does validating other people’s experiences mean the total rejection of any kind of baseline for truth or facts at minimum?

    I like a lot of what HVG does, but this is NOT one of them, and that Mad in America would uncritically make this statement, a website dedicated to the refutation of the biomedical model of mental health, is a sad statement on the loss of…I don’t know exactly what, but I’m truly flabbergasted.

    I validated most of the things my wife told me about her voices, but when she told me they were ‘aliens’ I gently pushed back, and slowly over time, her views changed to something more in line with a perspective that would facilitate her healing. We still have divergent perspectives on her ‘voices’ so it’s not that I think there is only one ‘truth’ but this is a low point in the fight for a better way if one can’t gently help others find a perspective better in line with basic facts.
    Sam

  2. May I say that I love Hearing Voices Groups?

    I have been sitting in them for many years, off and on. To me they are the beacon in the darkness. A little known fact about them is that as well as being venues where your torment is taken seriously they are occasionally places of healing laughter as shared suffering meets affectionate shared advice. They remind me of some kind of intimate, private, teepee flapping smokey tribal gathering. Your sense of illness gets understood the way “you” see it. I liken it to some cancer cottages where groups of patients with cancer get to describe their “own” experience of cancer and their “own” meanings that they derive about their “own” cancer. This sense of “Your illness is YOURS” is wonderful because you feel like a pioneer of a country, your internal landscape, that everyone is eager to hear all about. We all get to hear about each others illness symptoms as if our illnesses are metaphorical countries. And what vibrant lively countries those are! I make no apology for saying illness because in my experience my schizophrenia is a felt illness, whether anyone agrees with the notion that there is a disgnosis of schizophrenia or not. I respect those searching for better terms to fit my experience of my unique illness but a child like to use its own preferences when ill. The Hearing Voices Groups let you listen to your inner child and speak or cry or sing from that vital life source. As someone who quit antipsychotics it used to pain me that others in such groups could not join me in that part of my emancipation but I understood that they needed to cling onto whatever belief was supportive to them in their own estimation, and as they spoke of wanting to increase their meds or heed the instructions of medical professionals I wanted to pull the comfortable rug from under their complaicency and make them like carbon copies of me. But looking back I soon saw that this “rescue the pill popping idiot” attitude was from me a kind of bullying colonialism into their own unique country. A colonialism no better than the ships in bottles invading the shores of their souls from the pharmaceutical conquistadors. So I understood that treasuring someone means not making them a walking talking mirror of you, but treasuring how much they are NOT you.
    I feel all of us in the Hearing Voices Groups felt, though it was never spoken, the sanctity and reverence of this kind of treasuring. It requires the grace and humility to be “aim-less” in relation to others in the group.This is rare in different sorts of therapy groups, where too rigid a structire csuses a bid for empowerment and ushers in power bids and hen pecking preachiness. Aim-lessness avoids egotistical saviouring that so often needs others to need our unwanted rescueing of their way of doing “their” country. The Hearing Voices Groups are beyond agenda. But I sense a change acoming. New brooms are wanting to institute sweeping changes that their statistics and data show could “improve” the Hearing Voices Groups. How can you perfect upon aimlessness? The peace from aimlessness is the gold standard of all healing.

  3. A commenter suggests that the word “psychosis” means “can I have some money”.

    That may have been a joke on my humourless migrainey day so I apologise grovellingly if I missed the quip, but with the greatest respect I have to say that to me the term “psychosis” does not mean that. Although I do see how the psychotic suffer a lot of socio economic deprivations and so if any person would probably be in need of a little money it is probably those psychotic folks driven mad through abject pennilessness and a traumatic lack of food, warmth and shelter. To me the term “psychotic” describes my own personal despair of having hallucinations and delusions and paranoia and all manner of awful miseries that are not the same as depresson or anxiety or PTSD flashbacks or eating disorders or phobias or obsessive compulsive disorder. I had no psychosis until my adulthood. Prior to that I experienced all of the above and was even hospitalised and sectioned for some of them. I can only speak for myself and say that none of those bare any resemblence to the unending hell of what I have now, relentless psychosis and schizophrenia. I am all for those in the mental health activism community defining a chummy egalitarian togetherness amongst all mental illnesses as we all broadly struggle to envisage reforms at the quarry face together, but to use the body as a metaphor for a moment here…a broken pinkie finger will never be terminal cancer. And those with a broken pinkie finger who go in in life to get metaphorical terminal cancer will be glad of their own dedicated treatment options or home nurses who understand distinction between the two.

    Whether one loves or loathes a “term” like psychosis is a matter of personal freedom of choice. It means severe to me. Severe distress or severe chaos or severe anguish or severe fear. But I get nowhere with the ignorant masses if I tell them I cannot stop carrying out bizarre instructions due to severe fear. They will smirk and say THE WHOLE PLANET HAS SEVERE FEAR. What this then sets off is a “what’s so special about your severe fear?”.

    Having been instructed to go to a railway line at three am in the morning by my “severe fear” to save an invisible being from jumping in front of a high speed train, I can vouch for the fact that “psychosis” is so much more than severe fear…and on a train track “psychosis” is so much more than a broken pinkie finger.

    And because spending a night on a train track is so freezing cold the “psychotic” are in need of better weatherproof coats, and maybe shoes, than those with a broken pinkie finger. And so I do not begrudge the psychotic all the financial help they need.

    All this is not to suggest that a better term than “psychotic” could not be mooted. Language is fluid and changes all the time. And I myself in no way wish to get in the road of any progressive thrust towards a noble emancipation that even overhauls the very utterances of babbling babies at the breast, I am all for change…change is inventive and thrilling…though I am even more for “freedom of choice to change” if you feel it is right for your experience of the world.

    I hope this has not made a sat upon squashed picnic hat out of what was maybe simply a thing said benevolently and whimsically. My humble apologies for sounding headachey. I do indeed have a blazing, agonizing headache and must go and lie down now….and doubtless wake up horrified at my own pomposity.

    • Your experiences are horrible, you have my sympathy. However I think the original comment was aimed at psychiatrists and researchers who make very good livings poisoning people or doing useless research while people like you are ignored, shunned or locked up and drugged.

      I personally would like all the money these people get taken back and given to you and people who support people like you.

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