Angels at our tables: New Zealanders' experiences of hearing voices

Abstract

The aim of this study was to explore the experience of hearing voices in the general New Zealand adult population. This included mapping the topography of voices and the impact of the experience on participants’ lives, exploring participants’ explanatory models, investigating coping strategies and support structures, and developing a model of the essence of hearing voices. Quantitative and qualitative analyses of questionnaire (n=154) and interview (n=50) data revealed a great diversity of experiences, both within and among participants. Of all topographical variables significantly related to emotional impact (content, form, duration, intrusiveness and control), voice content was the only significant predictor variable, accurately predicting the emotional response of 93.3% of participants. Overall, participants who valued their voice experiences tended to have spiritual beliefs, a more positive emotional reaction and less contact with mental health services. In contrast, participants who experienced mostly unwanted voices tended to have biological and/or psychological understandings of their voice experiences, a more negative emotional reaction to them, and increased contact with mental health services. Participants reported using a vast array of coping strategies, with varying degrees of success. Individualised techniques were reported to be the most effective, followed by setting aside a time to listen to the voices. In terms of help and support, participants called for a model of intervention that accepted their voice experiences as real, took an holistic approach incorporating contextual, cultural and spiritual factors, and worked with voice-hearers, their families and the public to provide information about voice phenomena and normalise the experience. Using a phenomenological approach, a model of the essential structure of hearing voices is proposed, comprising five components: the content of the voices is personally meaningful to the voice-hearer; the voices have a characterised identity; the person has a relationship with their voices; the experience has a significant impact on the voice-hearer’s life; and the experience has a compelling sense of reality. The implications of this research include validating voice-hearers’ perspectives of the experience, informing clinical work with voice-hearers, and informing the development of local and national-level services, such as a New Zealand Hearing Voices Network.