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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.

 

 

 

Exciting new Hearing Voices Research & Development Fund in USA

Hearing Voices Research & Development Fund

http://femhc.org/Giving.aspx#Hearing_Voices_Research__Development_Fund

The Hearing Voices Research and Development Fund has been established to advance the development of the Hearing Voices Approach in the U.S. The Project was created by Gail A. Hornstein, Professor of Psychology at Mount Holyoke College, and Jacqui Dillon, National Chair of the Hearing Voices Network in England, who have been working together for 10 years to bring new approaches to understanding and coping with voice hearing.

Background
People who hear voices, see visions, or experience other extreme states often end up being diagnosed as psychotic (usually with schizophrenia) and a poor prognosis. The medications which have routinely been prescribed for such patients since the 1950s are effective for some but not for others, and even when they do work, their benefits typically diminish over time, while destructive physical and psychological side effects become increasingly problematic. Hearing voices in particular remains a challenge for many, many patients even after they have been tried on every possible medication over many years, and continues to be seen by many psychiatrists as a “treatment-resistant” symptom.

Hearing Voices Approach
For the past 25 years, the Hearing Voices Network – an international collaboration of professionals, people with lived experience, and their families and friends – has been working to develop an alternative approach to coping with voices, visions, and other extreme states that is empowering and useful and does not start from the assumption that people who have these experiences suffer from a chronic illness. A large body of research data, published in major professional journals, now provides support for key aspects of this approach (see references below), and the hundreds of peer-support groups that have developed in 20 countries around the world are enabling voice hearers – even those who have been chronically disabled – to learn to cope more effectively or rid themselves of the negative effects of their voices. These groups are now starting to spread across the US, but the lack of a systematic program for training potential facilitators and others interested in incorporating HVN’s work into their research or teaching is holding the United States back from being able to offer this effective, community-based psychosocial alternative to the current risky practice of large-dose, long-term treatment with (usually multiple) medications.

Hearing voices peer-support groups offer a safe place for people to share their experiences of voices, visions, tactile sensations and other unusual experiences and perceptions. People meet together to help and support each other, to exchange information, and to learn from one another’s coping strategies. Groups also offer an opportunity for people to accept and “live with voices” in a way that enables them to regain some control over their lives.

The situation in the US stands in striking contrast to that of other countries. For example, England (a country with a population of 60 million) has 180 hearing voices groups, and Denmark (a country of 5 million) has several dozen, whereas the US, with its population of over 300 million, currently has only about 15. The fund will support the development of HVN groups across the US by providing a systematic program of training that will create a network of hearing voices peer-support groups in key centers in each region of the country. Participants will be selected using a rigorous model in which mental health professionals and voice hearers collaborate in an intensive shared learning experience that equips them to apply HVN’s concepts and methods to the creation of positive alternatives for people diagnosed with psychosis.

Hearing Voices Research
The fund will also support a research study to provide the kinds of basic phenomenological descriptions of the voice hearing experience that have become increasingly essential to other research in this area.

Even though more and more researchers have become interested in investigating the complexities of voice hearing in and of itself (as opposed to treating it simply as one of a number of so-called “positive symptoms” of schizophrenia), the lack of a clear identification of the defining characteristics and significance of the experience for voice hearers makes it difficult to compare results across different studies. In addition, as colleagues from HVN have highlighted in their work (see references below), there is no evidence for the standard assumption that patients who hallucinate cannot articulate the triggers, contextual variability, or meaning of their experiences. The few phenomenological studies that have been conducted thus far demonstrate clearly that understanding the subjective experience of voice hearers themselves is essential to the ultimate effectiveness of any intervention designed to help them.

The Foundation for Excellence in Mental Health Care

We are a group of scientists, psychiatrists, researchers, public policy analysts, users and providers of mental health services, philanthropists, and community members that formed The Foundation for Excellence in Mental Health Care to find and promote the best ways to achieve long-term recovery and help people with mental health challenges to thrive.

The Foundation was established in response to nationwide interest in Robert Whitaker’s book, Anatomy of an Epidemic, and the desire to examine existing research, create support for new innovative research and programs, and sponsor symposia to build a new paradigm of care that focuses on long-term recovery and wellness. 

Strong evidence demonstrates that our 25-year long over-reliance on a purely medical model has not advanced mental health recovery. The number of individuals diagnosed with “chronic mental illness”, disabling enough to place them on the Social Security roles has tripled since 1987.

The Foundation has established a Scientific Advisory Committee and Community Advisory Committee to guide our activities of mental health reform.

For More Information:
www.hearing-voices.org
www.intervoiceonline.org
www.hearingvoicesusa.org
www.gailhornstein.com
www.jacquidillon.org

Selected References
Beavan, V. (2011). Towards a definition of “hearing voices”: A phenomenological approach. Psychosis: Psychological, Social and Integrative Approaches, 3, 63-73.

Dillon, J. (2006, November). Collective voices. Open Mind.

Dillon, J. and E. Longden (2012) Hearing voices groups: Creating safe spaces to share taboo experiences. In M. Romme and S. Escher (eds.), Psychosis as a personal crisis: An experience-based approach. London: Routledge.

Honig, A., M. Romme, B. Ensink, S. Escher, M. Pennings and M. Devries (1998). Auditory hallucinations: A comparison between patients and non-patients. Journal of Nervous and Mental Disease, 186, 646-651.

Hornstein, G.A. (2009). Agnes’s Jacket: A Psychologist’s Search for the Meanings of Madness. New York: Rodale Books. (UK edition, with a new introduction, PCCS Books, 2012)

Johns, L.C., J. Y. Nazroo, P. Bebbington and E. Kuipers (2002). Occurrence of hallucinatory experiences in a community sample and ethnic variations. British Journal of Psychiatry, 180, 174-78.

Lakeman, R. (2002). Making sense of the voices. International Journal of Nursing Studies, 38, 523-531.

Martin, P.J. (2000). Hearing voices and listening to those that hear them. Journal of Psychiatric and Mental Health Nursing, 7, 135-141.

Romme, M. and S. Escher (1989). Hearing voices. Schizophrenia Bulletin, 15, no. 2, 209-216.

Romme, M. and S. Escher (eds.). (1993; 2nd ed. 1998). Accepting Voices. London: MIND Publications.

Romme, M. and S. Escher (1996). Empowering people who hear voices. In G. Haddock and P. Slade (eds.), Cognitive Behavioral Interventions with Psychotic Disorders. London: Routledge, pp.137-150.

Romme, M. and S. Escher (2000). Making Sense of Voices: A Guide for Mental Health Professionals Working with Voice-Hearers. London: MIND Publications.

Romme, M. and S. Escher (2005). Trauma and hearing voices. In W. Larkin and A. Morrison (eds.) Trauma and Psychosis: New Directions for Theory and Therapy. London: Routledge.

Romme, M., S. Escher, J. Dillon, D. Corstens and M. Morris (eds.). (2009). Living with Voices: 50 Stories of Recovery. Ross-on-Wye, UK: PCCS Books.

Romme, M., A. Honig, E.O. Noorthoorn and S. Escher (1992). Coping with voices: An emancipatory approach. British Journal of Psychiatry, 161, 99-103.

Sayer, J., S. Ritter and K. Gournay (2000). Beliefs about voices and their effects on coping strategies. Journal of Advanced Nursing, 31, 1199-1205.

Mental Health Campaigners Welcome New Book About Schizophrenia

Published in The Guardian, 5th July 2011.

Mental health campaigners welcome book about schizophrenia.

The letters, journals and scribbled observations of David, diagnosed with schizophrenia, have been collated for a new book.

By Mary O’Hara

Schizophrenia is perhaps the most widely misunderstood and misrepresented of all serious mental illnesses in popular culture and media. So, when first-person accounts offering insights into the experience of someone who has lived with schizophrenia come along, they tend to be welcomed by mental health campaigners as an antidote to misinformation. Such has been the case with David’s Box, a new book documenting the journals and letters of a young man diagnosed with the illness in 1964 who took his own life seven years later.

Read more: http://www.guardian.co.uk/society/2011/jul/05/schizophrenia-journals-davids-box

Mental Health Campaigners Welcome New Book About Schizophrenia

The letters, journals and scribbled observations of David, diagnosed with schizophrenia, have been collated for a new book.

A positive piece published in the Guardian, 5th July 2011 by Mary O’Hara about this important new book – David’s Box: The journal and letters of a young man diagnosed as schizophrenic, 1960-1971, for which I have written a foreward.

http://www.guardian.co.uk/society/2011/jul/05/schizophrenia-journals-davids-box

Recovery, Discovery and Revolution: The Work of Intervoice and the Hearing Voices Movement

 

Contributors include Peter Beresford, Mary Boyle, John Cromby, Jacqui Dillon, Dave Harper, Eleanor Longden, Midlands Psychology group, Joanna Moncrieff, David Pilgrim, Phil Thomas and Jan Wallcraft.

 

This book contests how both society and Mental Health Services conceptualise and respond to madness. Despite sustained criticisms from academia, survivor groups and practitioners, the bio-genetic model of madness prevails and therefore shapes our very notions of what madness is, who the mad are and how to respond. This dominant yet narrow view, at the heart of the psychiatric system, is misinformed and misleading as well as fraught with tensions between the provision of care and the function of social control. How and why does this system continue? What can be done to change it?
 
Encompassing both academic analysis and practical application, Madness Contested brings together nurses, service-users, psychiatrists, psychologists, practitioners, and academics who promote alternative ways to understand and approach madness. Their contributions debate questions such as: What are the processes and forms of power involved in the current system? What interests are at play in maintaining dominant theories and practices? What are the alternative conceptualizations of madness? Can practice incorporate openness, modesty and a desire for equality? The perspectives are broad yet complimentary.
 
Of interest to all those interested in critical debates and alternative models of madness and mental health care, including: academics, practitioners, service users, survivors, carers, students.
For further information please see this link: http://www.pccs-books.co.uk/products/madness-contested-1/#

Or downlead the flyer: MadnessContestedEdsColesKeenanandDiamond

The Hearing Voices Network – “The Freedom to Hear Voices”: The Hearing Voices Movement

Psychology, Mental Health and Distress is a groundbreaking new text from John Cromby, David Harper and Paula Reavey. Whereas other texts are structured by diagnostic categories and are biologically reductive, this book places biology as well as the experience of distress itself in its social, cultural and historical context.

 Key Features:

  • Offers a wealth of case stories to portray the reality of living with distress and stimulate class discussion 
  • Fully informed by current experimental, qualitative and theoretical psychological research including research into hearing voices
  • Includes a chapter authored by those with first-hand experience of mental health services, ensuring your students understand the nuances of this emotionally charged and often controversial topic

Features additional contributions by renowned figures including Professor Richard Bentall, Professor John Read, psychiatrist and researcher Joanna Moncreiff and campaigner and Chair of the Hearing Voices Network, Jacqui Dillon among others.

See link for further information: http://www.palgrave.com/products/title.aspx?pid=280329

Download flyer: CrombyHarper&Reaveyflyer

 

Hearing Voices Groups: Creating Safe Spaces to Share Taboo Experiences

 

Psychosis as a Personal Crisis seeks to challenge the way people who hear voices are both viewed and treated. This book emphasises the individual variation between people who suffer from psychosis and puts forward the idea that hearing voices is not in itself a sign of mental illness.

In this book the editors bring together an international range of expert contributors, who in their daily work, their research or their personal acquaintance, focus on the personal experience of psychosis.

Further topics of discussion include:

  • accepting and making sense of hearing voices
  • the relation between trauma and paranoia
  • the limitations of contemporary psychiatry
  • the process of recovery.

This book will be essential reading for all mental health professionals, in particular those wanting to learn more about the development of the hearing voices movement and applying these ideas to better understanding those in the voice hearing community.

 

Demedicalising Misery: Psychiatry, Psychology and the Human Condition.

Demedicalising Misery: Psychiatry, Psychology and the Human Condition. Co-edited with Mark Rapley  and Joanna Moncrieff. Published by Palgrave Macmillan.

Thomas Szasz (1960) suggested that the myth of ‘mental illness’ functions to ‘render more palatable the bitter pill of moral conflict in human relations’. The medicalization of distress enables the mental health professions to manage the human suffering that they are confronted with, and also the suspicion that there is little that they can do to help. But the medicalization of misery and madness renders people unable to comprehend their experiences in ordinary, meaningful terms. In this collection we restore to everyday discourse a way of understanding distress that, unlike contemporary psychiatry and psychology, recognises and respects the essential humanness of the human condition. De-medicalizing Misery is a shorthand term for this project. The book resists the psychiatrization and psychologization of human experience, and seeks to place what are essentially moral and political – not medical – matters back at the centre of our understanding of human suffering.

Notes on Contributors
Preface; R.Dallos
Carving Nature at its Joints? DSM and the Medicalization of Everyday Life; M.Rapley, J.Moncrieff & J.Dillon
Dualisms and the Myth of Mental Illness; P.Thomas & P.Bracken
Making the World Go Away, and How Psychology and Psychiatry Benefit; M.Boyle
Cultural Diversity and Racism: An Historical Perspective; S.Fernando
The Social Context of Paranoia; D.J.Harper
From ‘Bad Character’ to BPD: The Medicalization of ‘Personality Disorder’; J.Bourne
Medicalizing Masculinity; S.Timimi
Can Traumatic Events Traumatise People? Trauma, Madness and ‘Psychosis’; L.Johnstone
Children Who Witness Violence at Home; A.Vetere
Discourses of Acceptance and Resistance: Speaking Out About Psychiatry; E.Speed
The Personal Is the Political; J.Dillon
‘I’m Just, You Know, Joe Bloggs’: The Management of Parental Responsibility for First-Episode Psychosis; C.Coulter & M.Rapley
The Myth of the Antidepressant: An Historical Analysis; J.Moncrieff
Antidepressants and the Placebo Response; I.Kirsch
Why Were Doctors so Slow to Recognise Antidepressant Discontinuation Problems?; D.Double
Toxic Psychology; C.Newnes
Psychotherapy: Illusion With No Future?; D.Smail
The Psychologization of Torture; N.Patel
What Is To Be Done?; J.Moncrieff, J.Dillon & M.Rapley
Figure: Papers Using Term ‘Antidepressant’ On Medline 1957-1965
Index

‘Despite longstanding awareness of the limitations of the medical model when applied to difficulties of human behavior and adjustment, the fields of psychiatry and psychology continue to accede to the pressures of medicine and the drug industry in their conceptualization of these human realities. Ironically, however, this medical model, eager as it is to fit so much of people’s experience into diagnostic categories, is a social construction. This book represents a significant effort to de-mystify, de-medicalize, and reclaim important aspects of the human condition.’ – Kenneth D. Keith, Professor, Department of Psychological Sciences, University of San Diego, USA

 

De-Medicalizing Misery has assembled an impressive cast of leading mental health experts. Together they challenge the simplistic and pessimistic biological model of human distress that has, with eager support from the pharmaceutical industry, dominated the mental health field for far too long. This evidence-based, humane and optimistic book not only explains where biological psychiatry went wrong, it spells out the alternatives.’ – John Read, University of Auckland, New Zealand and Editor of ‘Models of Madness’

 

  ‘The psychiatrist or psychologist is expected to do something for every patient sitting in front of him or her, but how robust is the intellectual basis of psychiatric science when psychiatric ‘diseases’ are merely symptom clusters – clustered by us, not by nature? We are in indeed in the age of the medicalization of everyday life, when Lord Layard, economist and architect of the IAPT programme, can write in the BMJ that ‘mental illness’ has taken over from unemployment as our greatest social problem. But what is the test of ‘mental illness’? In DeMedicalizing Misery the authors examine some of the domains lamentably absent from orthodox psychiatry and psychology training programmes, with their medical model focus, and in so doing raise the IQ of the whole debate. And not just for clinicians.’ – Dr Derek Summerfield, Consultant Psychiatrist & Senior Lecturer, Institute of Psychiatry, King’s College, London, UK.
 

Authors: MARK RAPLEY is Professor of Clinical Psychology at the University of East London, UK. He is the author of The Social Construction of Intellectual Disability, Quality of Life Research and, with Susan Hansen and Alec McHoul, Beyond Help: A Consumers’ Guide to Psychology.
 
JOANNA MONCRIEFF is Senior Lecturer in the Department of Mental Health Sciences at University College London, UK and a Practising Consultant Psychiatrist at the North East London Foundation Trust. She has spent her academic career re-evaluating the nature and efficacy of psychiatric drugs and exploring the history and politics of psychiatry. She is the co-chair of the Critical Psychiatry Network, and has campaigned against the dominance of the biomedical approach to psychiatry, the extension of psychiatric coercion and the influence of the pharmaceutical industry, in alliance with service user groups. She is the author of The Myth of the Chemical Cure (Palgrave Macmillan), A Straight Talking Introduction to Psychiatric Drugs, and numerous papers and book chapters.
 
JACQUI DILLON is the National Chair of the Hearing Voices Network, UK, and a Director of Intervoice – the International Network for Training, Education and Research into Hearing Voices. She is a campaigner, international speaker and trainer specialising in hearing voices, psychosis, dissociation and trauma. She is the co-editor of Living with Voices: An Anthology of 50 Voice Hearers’ Stories of Recovery. She has published numerous articles and papers, is on the editorial board of the journal Psychosis: Psychological, Social and Integrative Approaches and is a member of the collective for Asylum, The Magazine for Democratic Psychiatry.