Making Sense of Voices Socially
Research type
Research Study
Full title
Understanding Voice-hearers’ Social Relationship with their Voices.
IRAS ID
317224
Contact name
Laura Williams
Contact email
Sponsor organisation
University of Edinburgh
Duration of Study in the UK
1 years, 4 months, 29 days
Research summary
Summary of Research
Many people with a psychosis diagnosis hear voices (around 70%). The way people interpret their voices differs greatly e.g. its power, how positive or negative it is; how ‘person-like’ it is; and the agency ascribed to them. Recently research has explored how people relate to their voices to understand how this influences people’s responses to them.Many people with this diagnosis have insecure attachment styles (i.e. approach relationships with fear/anxiety) and people with these attachments styles may also have difficulties with ‘mentalisation’. Mentalisation is the ability to understand one’s own and others’ mental state (i.e. thoughts, feelings and behaviours), which allows us to make predictions about people’s intentions and what they might do.
As being able to understand people’s mental states is important for developing and maintaining relationships, and people develop relationships with their voices, it may also follow that difficulties mentalising would have a negative influence on how people relate to their voices.
12-16 participants, who have a diagnosis of psychosis or schizophrenia will be recruited from services within NHS Lothian. Participants will be interviewed about: their view of their social relationship with their voices; their early attachment relationships with their caregiver; and what their voice-hearing experience is like.
The interviews will then be analysed using qualitative methods, to establish common themes which will enable theory to be developed. The researcher will also score the mentalising capacity observed in the transcripts. This will then be used to look at whether how good people are at mentalising impacts how they relate to their voices.
The study will help us to better understand how people see their voices as social beings and how they relate to them, and whether it is useful to consider people’s ability to understand their own and other’s mental state when applied to voices.
Summary of Results
This was an exploration of how people relate to their voices socially, using qualitative methods. This involved interviewing people that currently hear voices about these experiences. The voice-hearers were also interviewed about their early relationships with their parents, using an established pre-determined set of interview questions (called the Adult Attachment Interview), to develop an understanding of how people reflect on this. This was to measure people’s capacity for mentalising, which is a term that describes people’s ability to understand their own and other’s thoughts, emotions and intentions. Participants were also interviewed using an established interview measure about their general experiences of voice hearing, such as how often they hear them and how distressing they are.The study found that people relate to their voices just as they relate to real people, and that they do this by trying to understand their voices through the processes of establishing the voice’s identity and intentions, as well as comparing their experience of the voice to other social experiences. Participants tried to understand their voices’ characterisation (voices having distinct characters and identities); they tried to make sense of their voices’ ability to change things in the world around them; and their voices’ emotions. They also made comparisons between: how their voices changed in time and location; their own goals and their voice’s goals; the relationships between different voices they hear as well as how their voices treat other humans; and their voices and people in their external social world. People’s capacity for mentalising and how they understood their relationship with their voices was also explored. The study concludes that people make attempts to understand their voices through understanding: who the voice is; what it wants; how it feels and how similar or different it is to their other experiences. Mostly, people seem to be able to mentalise their voices’ emotions and intentions, even if reflecting on their early relationships is difficult for them.
REC name
South East Scotland REC 02
REC reference
23/SS/0019
Date of REC Opinion
9 Mar 2023
REC opinion
Further Information Favourable Opinion