Hearing Voices Groups Provide Meaning Through Peer Support

A new qualitative analysis of insights from hearing voices group members reveals multiple benefits for individuals experiencing psychosis.


Amid growing concerns about the effectiveness of traditional psychiatric treatments, it is crucial to investigate and advocate for alternative forms of mental health support. One such option is Hearing Voices Peer Support Groups (HVGs), which have proven to have a positive impact on a wide range of individuals dealing with psychosis.

A new study, led by Gail A. Hornstein from the Department of Psychology and Education at Mount Holyoke College and colleagues, set out to analyze the effectiveness of HVGs.

Departing from conventional research methods that prioritize “professional” perspectives, Hornstein and colleagues conducted a phenomenological analysis of survey responses from HVG members across the United States and sought to identify the unique benefits of HVGs as experienced and described by group members themselves.

The results revealed the following four distinct types of benefits gained from HVG participants:

“Our results suggest that HVGs provide a unique context where members have the opportunity to: (1) examine voice hearing as an experience in itself; (2) discern the meanings of such experiences and understand voices in a biographical context; (3) validate cultural or spiritual frameworks for voice-hearing; and (4) create a sense of shared experience and camaraderie with other voice-hearers from a range of backgrounds.”

Hearing Voices Groups are based on Marius Romme’s approach, which suggests that paying attention to voices, rather than using a pathologizing framework to make sense of or categorize them, can be useful. These peer-support groups provide a safe, nonjudgmental space for individuals dealing with similar challenges to ask themselves and others detailed questions to better understand their experiences. There are 24 national HVG networks worldwide, and many members report benefits such as reducing distress and isolation and receiving unique forms of support.

The researchers write:

“While these characteristics of HVGs are clearly experienced as beneficial by group members, no study to date has investigated why certain outcomes come to be seen as beneficial, which specific forms of distress they alleviate, and how these processes occur.”

They express that this type of understanding is crucial in promoting more widespread use of HVGs. Thus, they set out to further advance knowledge of HVGs by asking, “When HVGs operate according to their stated principles, what are their perceived benefits, and how do certain features come to be seen as beneficial by group members?”

The study included data from a diverse group of 119 HVG members across the United States, who completed an open-ended questionnaire describing their voice hearing history, experiences within the group, and the impact of group participation.

The researchers used an inductive phenomenological method, working with a collaborative team of voice-hearers and researchers, to analyze the responses articulating experiences in HVGs.

They explain that “the goal of a phenomenological analysis is to articulate the implicit structure of a given experience, i.e., what makes it different from other types of experience, and what specific meanings it has for a range of individuals.”

The researchers found the following four distinct types of benefits gained from HVG participation, benefits which are not mutually exclusive, nor should they be understood as one being more beneficial than another.

  1. An opportunity to examine voice hearing in itself

The authors write that a major benefit of discussions at HVG meetings is that they challenge the automatic coupling of voice-hearing and negative, pathological connotations of psychosis.

The nature of HVG discussions is that they are curious and nonjudgmental. Thoughtful questions allow for contextualizing voice hearing and promote uncovering experiential nuances that might have otherwise gone unnoticed.

This results in greater self-acceptance and less alienation from one’s own experience. The study includes the experience of one particular participant who reports that the HVG groups provide a safe space to openly speak about their experiences as a part of human life rather than pathology.

  1. Discerning meaning and understanding voices in context

HVGs provide a place for individuals to explore the origins and significance of personal experiences, leading to an understanding of the voices as potentially meaningful for their lives.

For example, some participants found that the voices may be directing their attention to distressing past traumas or other complex emotions or memories.

The authors write:

“For some participants, seeing voices as purposeful rather than as random occurrences facilitated a process of self-acceptance and biographical continuity. They began to view their minds as functional, perhaps even adaptive, having the capacity to come up with creative solutions to complex and often overwhelming problems, and not only as sites of pathology.”
  1. Validating cultural significance

Some individuals expressed their cultural contexts, for voices were either disregarded or challenged by others.

HVGs offered a safe space for individuals with a cultural rather than a psychiatric perspective on their voice hearing to be respected and explore the emotions and memories tied to these experiences. This led to an increased sense of legitimacy and a greater sense of identity cohesion and authenticity.

  1. Establishing camaraderie

HVGs made participants feel less alone and offered a unique kind of camaraderie that was deeper than simply “gathering and socializing.”

The authors found that HVGs offer a unique experience for individuals with unusual sensations, perceptions, and beliefs to have a nonjudgmental context to cope and talk with others. They write:

“Sharing a space in these groups was not just an opportunity to be with others, but also a way to see oneself reflected in others and, as a result, to feel supported and protected by them.”

Notably, the researchers found the above benefits to be true for many regardless of whether individuals experienced a change to their voices themselves. When allowing the participants to define what is considered “beneficial” in treatment, rather than how a clinician would, they noticed that some people value their voices and don’t want the voices themselves to change, but only the distress they are experiencing.

The results of this study further emphasize the importance of peer-support inclusion, lived-experience knowledge, and uplifting alternative treatment options for psychotic experiences that are dictated by those with lived experiences. Hearing Voices Groups appear to be a beneficial option for members to provide a support system and contextualize their experience in a meaningful way that strays from harmful practices and interventions.




Hornstein, G. A., Branitsky, A., & Robinson Putnam, E. (2024). The benefits of hearing voices groups: More findings from a US national study. Psychosis, 1–11. https://doi.org/10.1080/17522439.2024.2351848 (Link)



  1. There are many layers of consciousness, so many layers of interpretation: the mental layer of consciousness will see the conceptual structure of the non-ordinary experiences. The feeling and heart will experience the emotional vibration behind the experience, and will have associations of all kinds with the experience. The sensations will react like the animal spirits within us always do, afraid and curious of the new, wanting to understand but also wanting to be through. We can think of them as traumatised energies of consciousness that need to be understood and healed by the brain through perception and understanding, but I want to give you a yet deeper grasp of this phenomena by describing it from the karmic and then spiritual layers of consciousness. I don’t even know this myself so will be interested in what he hands write.

    The karmic level of consciousness is related to the material but is spiritual energy organised as a transpersonal structure by the process of human judgement. On the level of the individual, what happens is that we judge each other, not realizing that judgement causes a spiritual injury to the judged, but this is ‘justice’ if the judgement prevails, and ‘injustice’ if the judgement ends up being negated by the development of human understanding. Ultimately, understanding dissolves all judgement, but one has to understand within the human being that these judgements are false, non-facts, because if the human being believes them, they are subject to them.

    The clearest explanation I can give, actually, is a first hand account, an example n=1, me. I was being pursecuted by coercive movements of thought and feeling that I took to be some kind of guide, and it ended up tricking and trapping. It was only through persistent observation and understanding that I uncovered what they were. It was the spiritual energies of people I knew, many of whom were living, but also ancestral pressures, and they were trying to impose their judgements on the organism and force the organism to carry out actions that conformed to the judgements they were trying to impose on me. Why did this happen? Because the march of perception and understanding was approaching the doors of the unconconscious, which is precisely those forces within us which either feel unable to sign up to the conscious program of action (such as traumatised energies), or those downright opposed to the conscious program of action, which include the forces of judgement from others (judgement sends out spiritual energy of a corresponding vibration as a communication to the other consciousness of the judgement, and that vibration and energy join and add to the ego mass which is really, believe it or not, those very unconscious, traumatised or oppositional forces within you which conceal themselves as ‘me’. I know this is a radically different understanding then the one that the ego is the social process pretending to be me, but they are both facts, not theories, just facts on different levels, the mental and the karmic. If the judgement prevails, the negative energies contrinue to harvest from the organism through punishing movements of thought and feeling, and this can go on forever. But the judgement doesn’t prevail or fail according to the truth. The truth is that all judgment is false, errored, because it is mere human judgement that dissolves when there is perception and understanding. It is a disease of the mind, from this point of view, one caused by the social and historical process, a means of the purposive mutual negation of all egos by all egos, a form of mass mutual social regulation of each other. But these energies turn obviously evil when their in crisis, such as when your perception and understanding is going to illuminate them. That is the only reason that weed can precipitate the experiences – because it makes you more aware and sensitive, and contrary to our social prejudices, it is infinitely preferable to resolve these karmic complexes (which are traumatic complexes on the social and emotional levels) then to let them continue to eat away at you, potentially for eternity. I see the crown of thorns as a metaphore for the spiritual consequences of human judgement, because it is punishing and false. Life is intrinsically innocent and good, and can only be perverted by ignorance and violence.

    But if you observe and understand all the complexes, on the spiritual level you are resolving karmic complexes and therefore the energy within these systems is recycled, and the process yields spiritual understanding which means spiritual stuff going on, but the brain and organism is not the spiritual. It is something sustained by the spiritual (the Mother) and observed by awareness (the Father). So think how misguided all of psychiatry is. These secrets are and will continue to be revealed through the explosion of interest in trauma and psychadelics. When the link is made between the Shamanic non-ordinary experiences and what we call psychosis, the West might realize what an appalling mistake it has made, one that has injurred the prospects of human consciousness as a whole, and imperralled the very existence of Mother Earth. The native Americans and other natural stewards of the Earth may have been our origin, but like all origins, it is both the highest and the ultimate destination of the journey.

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  2. I’ve never gone to a HVM meeting, but have thought about it, since I still believe in God. And He does still move me, and give me a yes shake of my head, when I’m right.

    “An opportunity to examine voice hearing in itself,” because having your entire life declared “a credible fictional story,” by a deluded psychiatrist, is a bad place to be.

    “Discerning meaning and understanding voices in context” is important, including for those who believe in an intelligent designer of the universe, and God.

    “Validating cultural significance,” is also important, especially now that we all live in an American society – with “mental health professions” – that now drug Americans up for queries about, and belief in, the Holy Spirit and God.

    I agree, “Establishing camaraderie,” is important … and it’s terribly sad that some of the mainstream, paternalistic American religions have instead chosen to “partner” with the Holy Spirit blaspheming, God denying, scientific fraud based, “mental health professions” instead.

    So I agree, further research into people’s “voices,” or merely movements in my case, is highly wise.

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