Trauma & Dissociation Journal

Hearing voices, dissociation, and the self: A functional-analytic perspective

Abstract

In the current article, we review existing models of the etiology of voice hearing. We summarize the argument and evidence that voice hearing is primarily a dissociative process involving critical aspects of self. We propose a complementary perspective on these phenomena that is based on a modern behavioral account of complex behavior known as relational frame theory. This type of approach to voice hearing concerns itself with the functions served for the individual by this voice hearing; the necessary history, such as trauma, that establishes these functions; and the relevant dissociative processes involving self and others. In short, we propose a trauma–dissociation developmental trajectory in which trauma impacts negatively on the development of self through the process of dissociation. Using the relational frame theory concept of relations of perspective taking, our dissociation model purports that trauma gives rise to more coordination than distinction relations between self and others, thus weakening an individual’s sense of a distinct self. Voice hearing experiences, therefore, reflect an individual’s perceptions of self and others and may indicate impairments in the natural psychological boundaries between these critical related concepts. One clinical implication suggested by this model is that therapeutic intervention should understand the behaviors associated with a sense of self that is fragile and threatened by others. Relations with self and others should be a key focus of therapy as well as interventions designed to enhance a coherent distinct sense of self.

Authors: C. McEnteggart , Y.Barnes-Holmes, J. Dillon, J. Egger & J.Oliver

Published in: Journal of Trauma and Dissociation

Publisher: Taylor and Francis

Date: 8th January 2016

Link: http://www.tandfonline.com/doi/abs/10.1080/15299732.2016.1241851?journalCode=wjtd20

Israel Journal of Psychiatry

Improving community mental health services: The need for a paradigm shift

Abstract

Background: It is now over half a century since community care was introduced in the wake of the closure of the old asylum system. This paper considers whether mental health services, regardless of location, can be genuinely effective and humane without a fundamental paradigm shift.

Data: A summary of research on the validity and effectiveness of current mental health treatment approaches is presented. Limitations: The scope of the topic was too broad to facilitate a systematic review or meta-analyses, although reviews with more narrow foci are cited.

Conclusions: The move to community care failed to facilitate a more psychosocial, recovery-focused approach, instead exporting the medical model and its technologies, often accompanied by coercion, into a far broader domain than the hospital. There are, however, some encouraging signs that the long overdue paradigm shift may be getting closer.

Authors: Longden, Eleanor. Read, John. & Dillon, Jacqui.

Published in: Israel Journal of Psychiatry and Related Sciences, 53(1), pp. 22-30.

Date: 10 Feb 2017

Link: https://doctorsonly.co.il/wp-content/uploads/2016/08/05_Longden_Improving-Community.pdf

How much evidence is required for a paradigm shift?

Acta Psychiatrica Scandinavica

‘Commentary on “Does social defeat mediate the association
between childhood trauma and psychosis?”:

How much evidence is required for a paradigm shift?’

 

Psychosis Journal Cover

Editorial: Voices in a Positive Light

 

Psychosis Journal Cover

 

What does it mean to think of voices ‘in a positive light’?

 

For the contributors to this first special issue of Psychosis, it means challenging any model that understands voice-hearing solely as the meaning-less symptom of an underlying disease, deficit, or dysfunction. Mainstream biomedical psychiatry’s account of auditory verbal hallucinations we regard as phenomenologically impoverished, actively disempowering, over-invested in unsupportable distinctions between ‘normal’ and ‘pathological’ voices, and ill-equipped to investigate or make sense of what is now known about the link between voice-hearing and people’s life experiences. As a result, its efforts to midwife recovery from the impairment that can be caused by some voices are at best incomplete and, at worse, actively harmful. Without downplaying the need for further investigation and critique of these dominant models, our goal in this special issue is to foreground positive approaches both to the experience of hearing voices and to the way this is conceptualised and researched.

 

 

 

Psychosis Journal Cover

Hearing Voices Peer Support Groups: A Powerful Alternative for People in Distress

Psychosis Journal CoverABSTRACT:

Hearing voices peer support groups offer a powerful alternative to mainstream psychiatric approaches for understanding and coping with states typically diagnosed as “hallucination”.  In this jointly authored first-person account, we distill what we have learned from 10 years of facilitating and training others to facilitate these groups and what enables them to work most effectively in the long term. Having witnessed the transformative power of these groups for people long considered unreachable as well as for those who receive some benefit from standard psychiatric treatment, we describe effects that cannot easily be quantified or studied within traditional research paradigms. We explain the structure and function of hearing voices peer support groups and the importance of training facilitators to acquire the skills necessary to ensure that groups operate safely, democratically, and in keeping with the theories and principles of the Hearing Voices Network.  The greater use of first-person experience as evidence in deciding what works or doesn’t work for people in extreme distress is advocated; randomized designs or statistically significant findings cannot constitute the only bases for clinical evaluations.

 

Just Saying It As It Is: Names matter; Language Matters; Truth Matters

Clinical language has colonised experiences of mental distress and alienation. Consequently, many accounts of healing and recovery seem to be about a decolonising process, a reclaiming of experience (Dillon and May, 2002). These counter narratives, which offer diverse representations of survival in adversity (hooks, 1993), follow in a long tradition of protest literature (Hornstein, 2002). From slavery abolitionists and suffragettes, to feminists and black and gay civil rights activists, who have repudiated dominant, oppressive ideologies via the language of discrimination, to challenge injustice. Many of us within mental health activism have argued that it is crucial to decolonise the medicalised language of human experience in order to contest the dominant paradigm of the biomedical model of madness and distress. After all, fighting for the rights of those labelled mentally ill, is the last great civil rights movement (Dillon et al, 2013).

Just Saying It As It Is: Names matter; Language Matters; Truth Matters

 

 

Clinical language has colonised experiences of mental distress and alienation. Consequently, many accounts of healing and recovery seem to be about a decolonising process, a reclaiming of experience (Dillon and May, 2002). These counter narratives, which offer diverse representations of survival in adversity (hooks, 1993), follow in a long tradition of protest literature (Hornstein, 2002). From slavery abolitionists and suffragettes, to feminists and black and gay civil rights activists, who have repudiated dominant, oppressive ideologies via the language of discrimination, to challenge injustice. Many of us within mental health activism have argued that it is crucial to decolonise the medicalised language of human experience in order to contest the dominant paradigm of the biomedical model of madness and distress. After all, fighting for the rights of those labelled mentally ill, is the last great civil rights movement (Dillon et al, 2013).

 

The Work of Experience Based Experts

Judi Chamberlin died in January, 2010 (Hevesi 2010). This chapter consists of a shortened version of Judi’s chapter in the first edition of Models of Madness, followed by a summary on the effectiveness of user led services and an account of the Hearing Voices Movement by Jacqui Dillon, Peter Bullimore and Debra Lampshire