Hearing voices is a well researched experience, found in both schizophrenia and the general population. Previous research investigating the unusual experience has reinforced cognitive psychology concepts such as beliefs, power, core beliefs about the self, intent and identity. It has been suggested that these factors all mediate individual coping with the experience. Coping with voices is a clinically significant area of research pioneered by Romme and Escher and requires careful consideration. Kelly‘s Personal Construct Psychology and the repertory grid technique were used in the study to compare two ways of coping with voices: engaging and resisting coping. The groups were compared on the repertory grid measures of construed distance between the self and the voice, salience of the self and voice, and tightness of the overall construct system. In a sample of 18 voice hearers, the Beliefs about Voices Questionnaire- Revised (BAVQ-R), a measure of psychological distress (OQ45.2) and Kelly‘s repertory grid were administered. The study also used three case examples and content analysis of construct poles applied to the dominant voice and the self as coper to supplement the quantitative analysis with a more in-depth exploration. Resisting coping was found to be associated with a greater construed distance between the self and the voice, a more salient view of the voice, and a tighter construct system. However, neither resisting nor engaging coping was associated with psychological distress. In addition, voice malevolence was associated with distancing oneself from the voice, suggesting that distancing was an adaptive coping strategy used, possibly as a way to preserve selfhood. The study therefore added to the list of mediating factors between the voice hearing experience and the coping strategy adopted. As a result, the repertory grid showed some scope in assessing the three areas of interest. The findings suggest that clinically, voice hearers can best be supported by adopting the appropriate relational approach with the voice (closeness or distance), reducing the salience of the voice and moving through Kelly‘s Creativity and Experience Cycle.

Hallucinations are often seen as a serious symptom of mental illness. Nonetheless, recent decades have produced a body of evidence that documented the presence of hallucinations even in non-clinical samples. Therefore, focusing on these samples is critical for improving understanding of processes underlying auditory hallucinations. The present study examines cognitive mechanisms that have been proposed to influence proneness to auditory hallucinations. A battery of experimental measures is implemented to assess some of the mechanisms implicated in the aetiology of hallucinations. Source monitoring, cognitive inhibition, bottom-up processes, working memory and traumatic experiences were measured in a laboratory study of 52 participants. Findings suggest that proneness to hallucinations is associated with impaired top-down processing and early traumatic experiences. No association between other cognitive mechanisms and hallucination proneness, contrary to previous evidence, has been found. This indicates that impaired source memory, working memory and bottom-up processing impairments might distinguish clinical and non-clinical hallucinators. An alternative implication of these findings points at issues with reproducibility in the hallucination research. Keywords: Auditory verbal hallucinations,...

Many attempts have been made to explain the nature of auditory verbal hallucinations (AVH) or the phenomenon of “hearing voices”. In the contemporary discussion of auditory verbal hallucinations, the raw material of the voices of AVH is seen as either inner speech, a spontaneously activated auditory experience, or imagined speech. Some contemporary theories of AVH are self-proclaimed self-monitoring theories which claim that AVH are the result of a failure of self-monitoring of some raw material, while other theories claim that AVH are produced without a self-monitoring failure. In this paper, I argue that even the theories that claim to not rely on self-monitoring, are in fact selfmonitoring theories. I argue that any viable theory of AVH will need to be a self-monitoring theory. Further, I argue that Daniel Gregory’s imagined speech self-monitoring theory is the most parsimonious and complete of the explanatory theories of AVH since it is able to explain characteristics that other theories cannot, including AVH that take place in what seem to be the voices of others, perceived spatial location, intensity of sound, multiple voices, and the intermittent nature of AVH. Further, I show that the imagined speech theory can be well integrated into a general understanding of schizophrenia, while still retaining its explanatory power for all populations that experience AVH, not just schizophrenics, and that for these reasons, it is the strongest contemporary explanatory theory of auditory verbal hallucinations. / Många försök har gjorts för att förklara naturen av auditiva verbala hallucinationer (AVH) eller fenomenet att "höra röster". I den samtida diskussionen om auditiva verbala hallucinationer ses råmaterialet till rösterna i AVH som antingen inre tal, en spontant aktiverad auditiv upplevelse, eller inbillat tal. Vissa samtida teorier om AVH är självutnämnda teorier om självövervakning som hävdar att AVH är resultatet av ett misslyckande i självövervakningen av något råmaterial, medan andra teorier hävdar att AVH produceras utan ett misslyckande i självövervakning. I den här uppsatsen hävdar jag att även de teorier som påstår att de inte är beroende av självövervakning i själva verket är det. Jag hävdar att varje användbar teori om AVH måste vara en teori om självövervakning. Vidare argumenterar jag att Daniel Gregorys Imagined Speech Theory är den mest sparsamma och fullständiga av de förklarande teorierna om AVH eftersom den kan förklara egenskaper som andra teorier inte kan förklara, inklusive AVH som äger rum i vad som verkar vara andras röster, upplevd rumslig placering, ljudintensitet, flera röster och AVH:s intermittenta karaktär. Vidare visar jag att The Imagined Speech Theory kan integreras väl i en allmän förståelse av schizofreni, samtidigt som den behåller sin förklaringskraft för alla populationer som upplever AVH, inte bara schizofreniker, och att den av dessa skäl är den starkaste samtida förklaringsteorin för auditiva verbala hallucinationer. / De nombreuses tentatives ont été faites pour expliquer la nature des hallucinations auditives verbales (HAV) ou le phénomène des "voix entendues". Dans la discussion contemporaine sur les hallucinations auditives verbales, la matière première des voix des HAV est considérée comme étant soit un discours intérieur, soit une expérience auditive activée spontanément, soit un discours imaginé. Certaines théories contemporaines de l'HVA sont des théories autoproclamées d'autosurveillance qui prétendent que l’HVA est le résultat d'un échec d'autosurveillance d'une certaine matière première, tandis que d'autres théories prétendent que l’HVA est produite sans échec d'autosurveillance. Dans cet essai, je soutiens que même les théories qui prétendent ne pas reposer sur une autosurveillance, sont en fait des théories d'autosurveillance. Je soutiens que toute théorie viable de l’HAV devra être une théorie d'autosurveillance. En outre, je soutiens que la théorie de l'autosurveillance de la parole imaginée (The Imagined Speech Theory) de Daniel Gregory est la plus parcimonieuse et la plus complète des théories explicatives de l’HAV puisqu'elle est capable d'expliquer des caractéristiques que les autres théories ne peuvent pas expliquer, y compris les HAV qui a lieu dans ce qui semble être la voix des autres, la localisation spatiale perçue, l'intensité du son, les voix multiples et la nature intermittente. En outre, je montre que la théorie de la parole imaginée peut être bien intégrée dans une compréhension générale de la schizophrénie, tout en conservant son pouvoir explicatif pour toutes les populations qui font l'expérience des HAV, pas seulement les schizophrènes, et que pour ces raisons, c'est la théorie explicative contemporaine la plus solide des hallucinations auditives verbales.

The aims of this study were to explore professionals’ and clients’ experiences of diagnosis and treatment of auditory verbal hallucinations with a view to identifying important clinical issues for counselling psychologists. Six professionals, three psychologists and three psychiatrists, who had worked with people who hear voices, alongside four clients who hear voices, volunteered and participated in a semi-structured interview. These interviews were transcribed and analysed using Interpretative Phenomenological Analysis (IPA) as described by Smith, Flowers and Larkin (2009). A table of super-ordinate and sub-ordinate themes was created as a result of this analysis. A number of themes arose from both groups of participants’ experiences. The main themes that arose for the professionals was: professional ambivalence; varying theories on causes of voices; perspectives on diagnosis and formulation; perspectives on medication; thoughts on working therapeutically; and, thinking on recovery. The themes that arose from the clients’ experiences were feelings about diagnosis and experiences of treatment. This research concludes that there is professional ambivalence in working with people who hear voices that is caused by a lack of certainty about the causes of the phenomenon alongside a lack of training in working with clients who have symptoms of psychosis. This impacts clients in several ways. The clients in this study were not offered the option to have any involvement in their own care and none of them were offered therapy as a treatment option. The study also concludes that psychiatric diagnosis does not consider all pertinent information related to clients’ issues which can lead to inconsistency in the diagnosis of clients who hear voices.