Introduction to Writers’ Inner Voices

The idea that writers “hear” the voices of their characters is a common one. Some writers even go as far as to claim that the characters that people their narratives seem to somehow write themselves: that they, the writer, are a mere conduit for voices that appear to have lives all of their own.

The aim of the Writers’ Inner Voices project is to try to understand writers’ and storytellers’ inner speech and the role that the inner voice or voices play in the process of literary creation.

Many writers – from William Blake, to Charles Dickens, to Joseph Conrad, to Philip K. Dick – have written or talked about experiencing auditory verbal hallucinations, or hearing voices that others cannot hear. The Writers’ Inner Voices project also aims to explore what relationship there might be, if any, between writers’ experiences and the experience of hearing voices.

During the 2014 Edinburgh International Book Festival, as part of the Conversations with Ourselves strand of events, authors and storytellers were  interviewed about their creative process and finding out more about the ways that writers and storytellers imagine, hear, listen to and converse with the voices of their characters. You can read more about the project on the blog, where the interviews with authors and storytellers during the festival are kept.

https://writersinnervoices.com/

Mary Robson on ABC Radio

The Hearing The Voice Creative Facilitator Mary Robson was recently on ABC Radio talking with host Myf Warhurst about Hearing the Voice and its interdisciplinary approach to voice-hearing. 

She begins by talking about the different types of voices that people hear such as the inner critic, the voice that one may hear when reading silently, the experience of thinking that someone has heard one's voice being spoken aloud and one's internal voice that may, for example, remind us to switch off the cooker etc. 

She points out that many people associate the experience of hearing voices with mental illness, but then acknowledges that in certain cultures those who report hearing voices are regarded as being gifted or particularly spiritual.

Listen to Mary talk about how hearing voices doesn't have to be a sentence for life-time time suffering via the link below

https://hearingthevoice.org/2018/12/18/mary-robson-on-abc-radio/?subscribe=already#blog_subscription-3

The World is Never Quiet

Last night I visited Durham Town Hall to watch a rehearsed reading of The World is Never Quiet, a new play by David Napthine.

David was writer in residence for the world’s first major exhibition on voice-hearing – Hearing Voices: suffering, inspiration and the everyday – that took place at Durham University’s Palace Green Library from November 2016 to February 2017. David has used this experience to construct a play about Durham and its voice-hearers.

The event was held in a very grand room within Durham Town Hall. The layout of the room was cabaret style seating. 

After a brief introduction to the event, 9 actors took to the stage in an arched line facing the audience.

The narrative featured a range of individuals all of whom experienced hearing voices in some form. For example, one character, Carol, was caught in the middle of a nagging motherly voice and the voice of her better self. Another character experienced spiritual and religious voices. The narrative skipped from one actor to another, giving the impression that these voices were scattered around the city.

Given that this is a work in progress, the audience were encouraged to provide some feedback:

The grand setting of the Town Hall had an impact on my reading of the performance. I could not help but feel a distance between the actors and the audience. The formality of the hall placed me in an unfamiliar situation somewhat disconnected to contemporary society. The sense of grandeur that was created by the venue, did not seem appropriate for the play. My feeling of slight unease at being in such a venue made it more challenging for me to connect with the action. There was a sense of hierarchy and the actors were presenting to the audience as opposed to being integrated within the audience.

This was particularly true of one of the actors who exaggerated their lines in a way that was quite patronising and as though they were narrating and talking to a child. They were giving an account of hearing voices as opposed to some of the others who seemed to be sharing their experience of living with voices. This second approach was much more genuine and engaging.

I appreciated hearing the range of different types of voices that the characters experienced. I saw this as an effort to avoid conforming to the stigma that associates hearing voices with mental illness, psychosis and schizophrenia. I believe this is a real strength of the play and is commendable.

Overall, I found the narrative enjoyable, and think that with some simple adjustments to the staging and delivery of the lines, that the play could be really good.

http://hearingthevoice.org/2017/12/13/the-world-is-never-quiet-26-january-2018/

Emily’s Voices by Emily Knoll reviewed by Nancy Nyquist Potter

Emily’s Voices by Emily Knoll (Knoll Publications, 2017).

Reviewed by Nancy Nyquist Potter, Professor of Philosophy and Associate with the Department of Psychiatry and Behavioral Sciences at the University of Louisville.

Emily Knoll offers readers a first-person account of her experiences with voice-hearing, telling of her journey of fear and despair, and her growing path to understanding not only herself but the phenomenon as well. Her memoir is aimed at a young adult audience and is written accessibly but powerfully in the present tense, giving an immediacy and concreteness to Emily’s story. This memoir is extremely rich in conveying to readers a non-pathologizing way to think about voice-hearing and voice-hearers. It should be read not only by voice-hearers themselves, who will find comfort in her narrative, but also by mental health professionals, as it presents a challenge to the biomedical model of voice-hearing as evidence of psychosis. 

Phenomenology. 

Emily describes in detail the experiences of overwhelming emotions that accompany and sometimes lead up to voice-hearing. Terror, shame, confusion, anger, failure as work and education become too difficult, and low self-esteem are almost constant companions in her path toward knowledge, recovery, and employment. These varying emotions are conveyed clearly in ways that many readers can relate to and which may help them understand what Emily’s experience of being a voice-hearer has been. As Emily interprets them, her voices are separate from her (87). During one period of her early life, she develops eating disorders as a way to cope with her emotions. Later, she turns to alcohol, which she learns makes her feel more depressed and even suicidal. She also goes through agonizing periods of isolation, which serve to protect her but tend to increase the voices and her anguish. She longs for connection—to tell others what she was feeling, and she needs listeners who will understand and not treat her like she’s crazy. But as she begins to see psychiatrists who diagnose and medicate her, she fears that she is ‘trapped within a world of illness’ (108). ‘I’m not who I was before I cracked up,’ she screams at her mother (p. 90). Cycles of retreat and resistance are discouraging and defeating. She does have some close friends, such as Beth and Daniel, who listen, spend time with her, and stand by her, and the role of these people in her life cannot be over emphasized; friends keep her tethered to love and reality, and give her hope that she is capable, worthwhile, interesting, and fun just as she is.

Challenging the biomedical model. 

Emily’s experiences with mental health professionals illuminate the need for more clinicians to learn to think differently about voice-hearing and to challenge the prevailing model. While some clinicians in Emily’s story play a crucial role in departing from the biomedical model, others do so less. The question directly arises in Emily’s story of what the ontology of voice-hearing is and what meaning to make of it. Emily receives numerous diagnoses, including Borderline Personality Disorder, schizoaffective disorder, and schizophrenia; none of them seem to fit. Schizophrenia seems to be the most common diagnosis given, perhaps due to an ontological and epistemic commitment to categorizing voice-hearing as a symptom of psychosis. But, as I explain below, it has become increasingly clear that not all voice-hearers are mentally ill, and the question arises as to just what to make of such experiences and when to think of them as symptomatic and when not to. Causality is also a contested issue in voice-hearing. Emily, who as an adult is an academic student working towards her Master’s degree, is a brilliant, talented, and sensitive child when we meet her. Her childhood development occurs in the context of her father’s abandonment, pressure from her mother to be a high achiever, and tension between her grandmother and her parents. Early on, Emily draws on imaginative powers to entertain herself and to escape difficulty in daily life. She often needs to retreat from uncomfortable and tense environments. Yet it is not clear that her voice-hearing is caused by traumatic experiences. After undertaking considerable research into others with such experiences, Emily concludes that ‘This trauma paradigm risked being as reductive a model as the biomedical explanation that psychiatry gave for voice-hearing’ (154).

In terms of treatment, some clinicians suggest that she needs to lower her expectations, and they medicate her in ways that she finds are dampening her creativity (96). These forms of treatment are fairly common experiences for voice-hearers. But other clinicians normalize Emily’s voice-hearing, bringing together questions of ontology with questions about treatment and recovery. When Emily arrives at University, for example, her therapist Daphne Coton explains that ‘You can hear voices and not be psychotic,’ a position that some clinicians who are committed to the biomedical model of mental disorders may reject (154). Daphne also tells Emily that ‘the voices are parts of yourself’—an idea that seems antithetical to Emily’s belief that they are separate from her— and she asserts that no medication can make the voices go away. ‘We all hear inner voices,’ Daphne says to Emily. ‘It’s just that yours are outside your head. So you have to work hard to remind yourself that they come from within you. And that it’s your mind creating them’ (104). Later, when Emily tells Daphne, ‘I just wish that I was like the others, and I didn’t hear voices,’ Dr. Coton bluntly replies, ‘Well tough, you do. So you’ve got to think of ways to cope.’ A central part of Emily’s coping and recovery includes becoming part of a network of people who are talking about voice-hearing and reframing it so that it isn’t as stigmatizing and damaging (see below.) Many clinicians guide Emily toward communities with whom she can feel more comfortable. For instance, she is recommended to attending a ‘hearing voices’ training course to learn to facilitate peer support groups, and this somewhat alleviates isolation and stress by finding connection with others who will listen openly and respectfully and will be encouraging of change and growth.

An important message in Emily’s book is that there is no monolithic way to frame voice-hearing. Instead, there exist diverse experiences and many strategies of dealing with voices. Some reject their voices and yell at them to go away, others have a dialogue with them. Emily learns that some voice-hearers accept their voices and even welcome them.

Stigma 

Goffman describes stigma as an experience of being deeply discredited due to some characteristic or attribute of a person. He argues that, rather than thinking of stigma in terms of negative attributes, it is better to think of it as a relation between groups. In mental illness (or perceptions of it), the relation is that the stigmatizing attributes are always understood in the context of the ‘normals’ (Thachuk 141). ‘Public stigma encompasses negative stereotypes, prejudice and discriminative behaviours present in the general public, while self-stigma refers to internalization of these stereotypes, prejudices and discrimination’ (Vilhauer 2017, 6). Thus, stigma is part of a complex knowledge structure that negatively affects marked social groups (Corrigan 2004). In fact, Thachuk reports that people considered to have mental illnesses often find the stigma attached to them to be far more painful than ‘having’ the mental illness itself(141). Just referring to voice-hearing as ‘auditory hallucinations’ is stigmatizing, because hallucinations are clinically and popularly associated with schizophrenia and psychosis. Vilhauer (2017) found that media associates voice hearing with schizophrenia; she performed a literature review on damage experienced by voice-hearers who are stigmatized. Harms suffered by the stigma of voice-hearing include not being able to talk with others about the experience because of fear and shame; isolation; low self-esteem; and heightened stress of living alone with a confusing problem. Additionally, when mental health professionals hold low expectations for recovery, voice-hearers can become discouraged and trapped in illness (see 108; 173). These are all difficulties that Emily writes about in her memoir, where she makes vivid how destructive the stigma of voice-hearing really is.

Persistence. 

Emily’s story is one of struggle, terror, and pain—but it is also one of persistence. Readers come to see that lowered expectations of people who hear voices and have a diagnosis of psychosis are not always appropriate and may even be undermining. Despite mistakes, Emily continues to pick herself up, find avenues of recovery, and dedicate herself to playing the cello and to research on voice-hearing. In fact, I have permission to report here that Emily is a pseudonym for Roz Austin, who received her Ph.D. in 2017 from Durham University as a member of the ‘Hearing the Voice’ research project. Drawing on work in cultural and emotional geography, Dr. Austin’s survivor-researcher-led project investigates emotional aspects of the experience of hearing voices and demonstrates the significance of space and spatial metaphors in voice-hearers’ relationships with their voices.

Emily’s Voices is a poignant and ground-breaking memoir on the phenomenological experience of one voice-hearing person that plainly illustrates the fears, hopes, and strength it requires to face stigma and loneliness yet come out radiant. I was moved by reading this memoir and urge clinicians to read it and consider the limitations of the biomedical model and the successes of other treatment options for voice-hearers.


References


Corrigan, P. 2004. How stigma interferes with mental health care. American Psychologist: 614-625.

Thachuk, A. Stigma and the politics of biomedical models of mental illness. International Journal of Feminist Approaches to Bioethics, Special Issue: Feminist Perspectives on Ethics in Psychiatry, 4(1): 140-163.

Vilhauer, RP. 2017. Stigma and need for care in individuals who hear voices. Int. J. Soc Psychiatry, 63(1): 5-13.

Posted on JANUARY 19, 2018 by MDICLHUMANITIES

http://centreformedicalhumanities.org/emilys-voices-by-emily-knoll-reviewed-by-nancy-nyquist-potter/

Hearing Voices Doesn't Always Indicate Mental Illness, Study Says

BY DORY JACKSON 

@DORY_JACKSON 

'The study, published in academic journal "Brain," refers to these people as "voice-hearers." Researcher's discovered that those who can hear internal voices are better at deciphering concealed speech-like sounds. They wanted to find more beneficial ways to aid those who find their internal voices alarming.

"These findings are a demonstration of what we can learn from people who hear voices that are not distressing or problematic," Dr. Ben Alderson-Day, Research Fellow from Durham University and the study's lead offer, said in a EurekAlert press release. "It suggests that the brains of people who hear voices are particularly tuned to meaning in sounds, and shows how unusual experiences might be influenced by people's individual perceptual and cognitive processes."

The small study incorporated 17 people who didn't possess voice-hearing abilities and 12 who did, which is also known as auditory verbal hallucinations (AVH). Study participants with AVH did not suffer from mental illness. However, many people who have AVH suffer from schizophrenia or bipolar disorder. Both disorders are mental health conditions that allow sufferers to can hear internal voices.

Participants were instructed to listen to disguised speech sounds, also known as swine-wave speech, during an MRI brain scan. The voice-hearers detected hidden speech before they were informed it was there. Voice-hearers also noticed the speech at a quicker rate than those who had no prior-history of hearing voices. Exactly 75 percent of voice-hearers heard hidden speech sounds, whereas only 47 percent of non-voice-hearers confirmed these noises.

"These participants showed distinct neural responses to sounds containing disguised speech, as compared to sounds that were meaningless," study co-author Dr. Cesar Lima said in a Durham University news release. "This was interesting to us because it suggests that their brains can automatically detect meaning in sounds that people typically struggle to understand unless they are trained."

Up to 15 percent of the population has the ability to occasionally hear voices in their head without "distress," according to the study. Research also suggests that roughly one percent of the population experience more complex and continuous voice-hearing. Again, this does not indicate the need for psychiatric care.

The research is a part of Durham University's "Hearing the Voice" project. This project aims to gather stronger comprehension of the experience behind hearing a voice when no one else is present. Durham's researchers, who worked with University College London researchers to obtain the study's results, also wanted to increase their knowledge of voice-hearing by examining it through different perspectives.

http://www.ibtimes.com/hearing-voices-doesnt-always-indicate-mental-illness-study-says-2584427

Latest paper by Hearing the Voice - how voice-hearers can detect speech in unusual sounds

Hearing the Voice collaborated with Sophie Scott’s Speech Communication lab at UCL on a study investigating distinct processing of ambiguous speech in people with non-clinical auditory verbal hallucinations.

The study involved a group of people who regularly hear voices but do not find them distressing. The results showed that voice-hearers were quicker than control participants (with no experience of voice-hearing) at detecting hidden sentences in some ambiguous sounds known as sine-wave speech. Usually sine-wave speech requires training to be understood, but the study demonstrated that 75% of the voice-hearers could detect the hidden speech, even before being told to listen out for it. Voice hearers also appeared to recruit different brain areas, specifically when they listened to the sounds containing hidden speech.

To read the full paper please visit the link below

https://academic.oup.com/brain/article/doi/10.1093/brain/awx206/4085330/Distinct-processing-of-ambiguous-speech-in-people

Site visit - Story World, The Word, South Shields

This morning anthropologist David Dupuis and I had a fascinating meeting with Richard Barber, Cultural Development Officer at South Tyneside Council and Mike Hamilton Strategic ICT Manager at The Word, National Centre for the written word in South Shields.

We are beginning to work on an audio-visual installation that will be exhibited at The Word in April 2018, and the meeting today was specifically to get access to the room where the installation will take place and get an idea of the facilities that can be used. This is no ordinary room, in the Story World space it is possible to create a 360 degree surround sound and visual experience.

Today we saw it being used to full effect with a group of school children. The students were really impressed, as were we!

The visuals can be projected on all walls in the rooms, helping to create the atmosphere of actually being in the environment depicted in the scene. For example, space imagery can be used to transport you into space! With 5 projectors, there are various possibilities in terms of screening photographs or static images alongside moving image, using all or a selection of the walls, repeating images around the space, having different images appear at different times on different walls and so forth.

The room has proven to be very popular with school groups who have been doing creative writing exercises in there. The pupils write as they sit in the projected landscape listening to sounds from that specific scene. Teachers have commented how much the quality of the student's writing has improved since using the Story World facilities.

I am excited and really pleased to be using the space in a less conventional way, and am ever so grateful to the staff at the Word who are ever so helpful and enthusiastic.

Introducing David Dupuis

Social anthropologist, David Dupuis contacted me about my research having read my blog post via Hearing the Voice.

David is a Visiting Fellow at the Department of Anthropology of the University of Durham, funded by the Fyssen Foundation. In collaboration with the Hearing the Voice team, he is working on the experience of auditory verbal hallucinations (AVH), occurring in shamanic contexts, especially during the ayahuasca rituals and retreat times in the jungle.

David's doctoral dissertation focused on ritual innovations, modes of transmission of religious knowledge and the topic of therapeutic effectiveness in Takiwasi. During his PhD, David spent eighteen months in Takiwasi, a therapeutic community located in the Upper Peruvian Amazon. This therapeutical team includes medical doctors, psychologists and traditional healers using some mestizo shamanism practices. Medicinal plants – including the hallucinogenic brew ayahuasca – are used in rituals along with psychotherapy and speech groups. The rituals mix elements of Amazonian shamanism, Catholicism and the New Age.

David aims to advance his work in order to elaborate a cross cultural and comparative model of the arousal, socialization and control of AVH in various social contexts. His goal is to shed light on how cultural repertoires affect the nature and intensity of AVH, illustrating how culture affects our mental experiences. He is consequently planning to conduct further ethnographic fieldworks in order to collect new data with a view to better understand what he calls the socialization of AVH.

It was fascinating to hear about his experiences and the effect that the plants can have on people and their auditory verbal hallucinations. I am curious to find out more about the rituals, and the effects that the ayahuasca can have. The implications for the use of this plant are considerable.

David and I discussed how our research interests relate and began talking about potential collaborative ideas. I am looking forward to working with David and seeing how our ideas develop.

https://www.dur.ac.uk/directory/profile/?id=15779

https://durham.academia.edu/DavidDUPUIS