Mike White & Mary Robson on ‘A Rehearsal Room for Arts and Hearing Voices’ followed by an ‘Art Therapy Taster Session’ led by Andrew Walker, Joint Special Interest Group in Psychosis, 30 July 2014, 5.30pm – 7pm

Durham University and Tees, Esk and Wear Valleys (TEWV) NHS Foundation Trust Joint Special Interest Group for Psychosis (JSIGP) is open to all staff working in either the Trust or University.  However, it will be of particular interest to those staff working in ‘psychosis services’ or who are involved in research within the field. A warm welcome is also extended to any service users who would like to attend. The group meets on a regular basis to discuss a wide range of topics and speakers.

The next meeting, featuring a presentation by Mike White and Mary Robson (Durham University) on ‘A Rehearsal Room for Arts and Hearing Voices’ will be held on Wednesday July 30th 2014 from 5.30 – 7pm in the Birley Room, Hatfield College, Durham University (20 on this map).

Mike and Mary’s presentation will be followed by an ‘Art Therapy Taster Session’ led by Andrew Walker, an art therapist from the TEWV NHS Foundation Trust.

Mike White is Research Fellow in Arts and Health at The Centre for Medical Humanities, Durham University and Mary Robson is the Centre’s Associate Artist for Arts in Health and Education

Abstract: Arts projects exploring the condition of voice hearing appear under-represented and insufficiently grounded in the exploratory field of arts in mental health. This talk considers the possible points of engagement for developing projects on a widely diverse spectrum of arts in health practice in both healthcare and social settings.  It posits the creation of an ethical and boundaried congenial space for the drama-based exploration of voice-hearers’ narratives to investigate their meaning and produce participatory art works from research-guided practice in arts in health.

Places are limited for this event.  If you would like to reserve a place, please complete our 
online registration form.

For more information about the event, please contact Victoria Patton.

Service users and their families and friends who attend meetings of the Joint Special Interest Group for Psychosis can receive an honorarium of £20 plus travelling expenses.  For more information and to obtain the relevant claim forms, please contact Valentina Short.

If you would like to receive information about future JSIGP meetings via email, please sign up to the JSIGP mailing list.

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‘What Kinds of People Hear Voices?’ by Charles Fernyhough

152356-157702In his blog ‘The Voices Within’ for Psychology Today, HtV’s Charles Fernyhough writes:

In my last post, I noted that public perceptions of voice-hearing (due in part to distorted media representations) get the science of voice-hearing very wrong. In a new article1, we have reviewed the evidence around whether voice-hearing is always a sign of mental illness. The paper is published in the journal Schizophrenia Bulletin, and it is open access, meaning that you can read it for free here.

Our review stems from a working group of the International Consortium on Hallucination Research, which was founded in 2011 with a view to intensifying research into fascinating and often troubling experiences like auditory verbal hallucinations (AVHs). Drawing together academics and clinicians from the UK, Norway, Germany, Italy, Australia, Belgium, and the Netherlands, the working group set out to understand the state of research into AVHs that occur in individuals who do not need psychiatric care. The group presented their findings at a meeting in Durham, UK, in September 2013.

The idea that voice-hearing can be a part of normal experience is not a new one. At the end of the 19th century, the London-based Society for Psychical Research asked the following question of 17,000 members of the public: had they ever, when awake, had the impression of seeing or hearing or of being touched by anything which, so far as they could discover, was not due to any external cause? Around 3% of respondents reported having heard voices. A recent review of such surveys showed that population rates of AVHs have varied between 0.6% and 84%, depending on the exact question being asked. A best guess is that around 5-15% of the population have had infrequent or one-off voice-hearing experiences, with about 1% having more complex and extended voice-hearing experiences in the absence of any need for psychiatric care.

One way of making sense of these findings is in terms of the idea that unusual experiences like voice-hearing exist on a continuum that connects normal experience to psychiatric symptoms. The idea is that hearing voices is something that happens to all sorts of people, and all of us are prone to it to a greater or lesser extent. In our paper, we consider whether there might actually be two kinds of continuum at work.

One has been termed a continuum of experience. The idea is that voice-hearing exists at one end of a spectrum that includes everyday experiences like day-dreaming and intrusive thoughts. The other continuum is a continuum of risk, on which people differ in their risk of developing problems resulting from these experiences. The evidence for the commonness of voice-hearing experiences points to a continuous distribution in the typical population (that is, a smooth curve, rather than a categorical break between groups of people). Evidence for the second continuum, though, is less clear-cut. It may be that there are some types of people who are prone to develop distressing psychotic experiences, and thus ending up needing care.

We also reviewed similarities and differences between the experiences reported by those who seek help with their voices, and those who don’t. The two groups don’t differ very much in what their voices are like, in terms of loudness, location, number of voices, personification, etc. The voices of those who seek care tend to be more unpleasant and more frequent, and voice-hearers in this group feel less in control of them. Intriguingly, there is no real evidence that neural processes underlying the voice-hearing experiences differ between the two groups. On the basis of current evidence, voices seem to work in the brain in the same way, whether you seek care or not.

There is much more to be learned about the voices heard by people in nonclinical groups. One intriguing finding is that voices in those who don’t seek care appear earlier in life than more distressing ones. You might expect the opposite: that people who are most troubled by their voices will have been putting up with them for longer. Very little data exist on the timecourse of AVHs over the lifespan, and this interesting finding needs to be confirmed by further research.

So what are we to make, then, of the clinical significance of voice-hearing? One view is that voice-hearing can be likened to a cough: something which could be a symptom of a deeper problem, but often isn’t. That’s a useful way of thinking about it, but it doesn’t quite work. As the work of the Hearing Voices Movement has shown, people enter into relationships with these experiences; their voices have personal significance for them. Coughs do not figure in people’s acts of meaning-making in quite the same way.

Astonishingly, the latest edition of the ‘psychiatrist’s bible’, DSM-5, appears not to recognise this evidence for the continuity of hallucinatory experiences. Its wording (pp. 87–88) implies that hallucinations may be considered within the range of normal experience only if they occur on the fringes of sleep (so-called hypnagogic and hypnopompic hallucinations), or if they occur as part of religious experience in certain cultural contexts. American psychiatry is heavily invested in the idea of schizophrenia as a progressive brain disease, and voice-hearing is often seen as the cardinal symptom of that (vigorously contested) psychiatric category. Rather than evaluating the evidence for nonclinical hallucinatory experiences, the authors of DSM-5 have simply ignored it.

Voice-hearing is part of normal experience for many people. That is not to say that it cannot also be extremely distressing and a cause for people to seek help. The sooner we come to appreciate that voice-hearing is something that happens to people, rather than merely a symptom of a diseased brain, the sooner we will close in on a genuinely humane and enlightened understanding of the experience.

 

 

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Hearing the Voice and Edinburgh International Book Festival present ‘Conversations with Ourselves’, 9-25 August 2014

edinburgh-international-book-festival-2014-coverHearing the Voice is delighted to be part of a series of literary and cultural events designed to explore a rich and enigmatic feature of human experience – hearing voices when no one is speaking – at the Edinburgh International Book Festival this year.

Conversations with Ourselves places Charles Fernyhough, Angela Woods, Patricia Waugh and Christopher Cook alongside established authors, clinicians and voice-hearers in a series of interviews, panel discussions and story-telling workshops.

The talks and workshops will take place between 9 and 25 August 2014 at the Edinburgh International Book Festival in Charlotte Square Gardens, Edinburgh.

The events provide a unique opportunity to explore a wide range of topics relating to the latest academic research into voice-hearing and other unusual mental states, including psychosis and recovery; voice-hearing and spirituality; the relationship between voice-hearing, inner speech and creativity; and hearing voices in childhood and adolescence.

In order to complement Conversations with Ourselves, Hearing the Voice will be launching the ‘Writers Inner Voices’ project – a qualitative study of literary creativity, designed to explore the complex ways in which writers experience the voices, presence and agency of the characters and people they bring to life in their writing.

Janet Smyth, Children’s and Education Programme Director of the Edinburgh International Book Festival, says: ‘The Edinburgh International Book Festival has always encouraged writers and audiences to explore all aspects of the literary creative process. We are delighted to be working with Durham University’s Hearing the Voice project, and to have the support of the Wellcome Trust, in presenting a series of talks and workshops examining the medical, spiritual and literary aspects of hearing voices.’

GUEST TICKETS FOR MEMBERS OF THE VOICE-HEARING COMMUNITY

Hearing the Voice and the Edinburgh International Book Festival see Conversations with Ourselves as a unique opportunity to raise public awareness, reduce stigma and discrimination, and challenge preconceived opinions about hearing voices and other usual mental states.

We warmly welcome voice-hearers, ‘experts by experience’ and mental health service users to participate in Conversations with Ourselves and would be delighted to hear your thoughts and opinions on the events in the series.

To this end, we are pleased to announce that ten complimentary tickets for each event have been reserved for members of the voice-hearing community, mental health services users and people with lived experience of psychosis.

The free tickets have been generously provided by the Edinburgh International Book Festival.

So if you have personal experience of hearing voices or other unusual mental states and would like to attend one of the events in Conversations with Ourselves, please complete our online application form, indicating the three events you would most like to attend in order of preference.

We will do our best to accommodate your requests, but please note that priority will be given to people local to the Edinburgh International Book Festival and those living in Scotland and the North-East of England. After this, tickets will be allocated on a first-come first-served basis.

The deadline for completing the online application form is 15 July 2014, but please do register your interest as soon as possible.

Tickets must be collected from the venue at least one hour before the event starts, and any uncollected tickets will be released for public sale.

THE PROGRAMME

Conversations with Ourselves examines the medical, spiritual and literary aspects of hearing voices. Too often viewed as a sign of psychological illness, this series of events places voice-hearing in a broader context, exploring the effects of inner monologues, imaginary childhood friends and the demands character voices place on a novelist.

The Voices in Our Head
9 August 2014, 5 pm
Scottish Power Foundation Studio

The first sign that a book works is when the characters talk back to their author, and literature can represent our internal voices unlike any other artform. A panel of award-winning novelists, Nathan Filer, Edward Carey and Matthew Quick talk about their relationships with their characters and their inner voices, exploring how a writer hears and channels the creative voice that drives a narrative or character.

Best (Imaginary) Friends Forever
15 August 2014, 5 pm
Scottish Power Foundation Studio  

Remarkably, statistics show that childhood imaginary friends stay with people throughout their lives. Why do youngsters need these friends and where do they go when children grow up? Pip Jones, the author of Squishy McFluff, and Michael Marshall Smith, who has written We Are Here, reflect on the world of imaginary friends with child psychologist, novelist, and director of Durham University’s Hearing the Voice project, Charles Fernyhough.

You Are Not Alone
17 August 2014, 4 pm
Royal Bank of Scotland Garden Theatre      

An established authority on the teenage brain, Nicola Morgan has now written The Teenage Guide to Stress. Dawn McNiff’s novel Little Celeste follows an 11 year old who finds herself with a baby only she can see. In Donna Cooner’s Skinny, an overweight teenager hears a vicious and undermining voice. Together these authors discuss how stress can turn into psychosis, and why talking to someone is a vital first step to coping.

Making Meaning of the Voices
18 August 2014, 5 pm
Scottish Power Foundation Studio

People with severe mental health issues are often stigmatized by society. From drugs to psychiatry, solutions are complex and expensive. Eleanor Longden, a voice hearer and a qualified psychologist joins James Ley, a playwright who explores his bi-polar disorder in his writing, and Robin Murray, professor of psychiatric research at King’s College London, to discuss how hearing voices and other problems can be ‘creative and ingenious survival strategies’. 

Chaired by Dr Angela Woods, Senior Lecturer in Medical Humanities and Co-Director of the Hearing the Voice project at Durham University.

Has Psychiatry Silenced God?
22 August 2014, 2 pm
Scottish Power Foundation Studio

Through history, divine intervention has influenced great artists, thinkers and leaders, and the voice of God is a distinct and separate presence in the minds of many people today. Author and former Bishop of Edinburgh, Richard Holloway, leads a discussion with writer Sara Maitland and psychiatrist and theologian Chris Cook to explore how religious beliefs and creative inspiration define our consciousness.

The Moth
23 August 2014
, 8 pm
Baillie Gifford Main Theatre

To celebrate the UK launch of their first book, which collects together 50 of their best stories, we invited The Moth, the legendary US storytelling organisation, to create a special one-off evening of stories inspired by our strand of events, Conversations with Ourselves. Join an eclectic cast of storytellers from around the world and all walks of life for a uniquely intimate evening of tall tales and surprises.

The full details of the Edinburgh International Book Festival programme and can be found on the  EIBF website. Tickets for the general public are on sale here.

Any queries about the complimentary tickets for members of the voice-hearing community should be directed to Victoria Patton.

EIBF_colour_logo1

 

 

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Summer Workshops from Rachel Waddingham: ‘Living with Voices’ & ‘Working with “Taboo” and “Violent” Voices’, July & August 2014

Do you hear voices or care for someone who hears voices?  If so, then you might be interested in the following workshops from Rachel Waddingham.

LIVING WITH VOICESScreen Shot 2014-06-26 at 08.39.31

Saturday 12 July 2014, 10.00 – 4.30pm
Rm 2.23, Augustine House
Rhodaus Town, Canterbury, CT1 2YA

Research suggests that hearing voices is a fairly common human experience that is not, in and of itself, indicative of a mental health problem. If we know where to look, succesful voice-hearers can be found in the pages of history books, spiritual traditions & the media.

However, when someone feels overwhelmed by the power and intensity of the voices they hear – knowing that Gandhi and Lady Gaga heard voices doesn’t always help.
This workshop explores ways we can better support people who feel disempowered by the voices they hear. Informed by the principles of the Hearing Voices Network, it explores the way in which we can support people to transform their relationship with difficult voices & reclaim their lives.

This one day event explores:

  • The diversity of voice-hearing experiences and their impact on people.
  • Different models of understanding voices.
  • Having safe & respectful conversations with people about the voices they hear.
  • Ways of coping with distressing voices, emotions & overwhelming beliefs.
  • Strategies for exploring, and improving, people’s relationship with their voices.

To book your place on this event, please click here.

WORKING WITH ‘TABOO’ & ‘VIOLENT’ VOICES

Tuesday 22 July 2014, 9.30 - 4.30pm  Screen Shot 2014-06-26 at 08.41.32
Victim Support, Alliance House
6 Bishop Street, Leicester, LE1

Tuesday 5 August 2014, 9.30-4.30pm
Rm 2.23, Augustine House, Rhodaus Town, Canterbury, CT1 2YA

Whilst hearing voices is often a taboo in western cultures, being linked with media stereotypes and images of ‘madness’, there are some kinds of voices that are even harder to talk about – ‘taboo voices’.

Taboo Voices may include ones that speak of violent and/or sexual themes – things that the voice-hearer, and those around them, find very distressing. They can be extremely graphic, sometimes overlapping with violent thoughts, impulses or disturbing visions.

Taboo voices can feel very powerful and overwehlming, but they are also the kind of voices that many find very hard to talk about with others – for fear of judgement.

This one day event explores:

  • The experience and its impact on voice-hearers and their wider network.
  • Understanding our own reactions and feelings about ‘taboo’ voices and the way this impacts on our actions/decisions.
  • Re-framing ‘violent’ and ‘taboo’ voices and exploring personal meaning.
  • Ways of thinking about, and minimising, risk of violence.
  • Working with taboo/violent voices in a safe and supportive way.

To book your place on ‘Working with “Taboo” and “Violent” Voices’ in Leicester on 22 July 2014, please click here.

To book your place on ‘Working with “Taboo” and “Violent” Voices’ in Kent on 5 August 2014, please click here.

These workshops are suitable for anyone interested in supporting people who hear voices, including voice hearers, family members, nurses, therapists, psychologists, social workers, youth workers, support workers & more ..

All courses are priced at £85 waged & £50 unwaged (or low waged). CPD Certificates are included. A limited number of £25 places are available for service users/carers.

For more information, please contact Rachel Waddingham and/or download the relevant flyer:

 

 

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New Podcast: Alison Brabban on ‘Treating Psychosis Without Antipsychotics: Is it an Option?’

This podcast features Alison Brabban (Durham University and Tyne, Esk & Wear Valleys NHS Foundation Trust) on ‘Treating Psychosis Without Antipsychotics: Is it an option?’.  It was recorded at a meeting of the Durham University and TEWV NHS Foundation Trust Joint Special Interest Group in Psychosis in the Joachim Room at Hild-Bede College at Durham University on Wednesday 28 May 2014.

Alison is a Consultant Clinical Psychologist at the TEWV NHS Foundation Trust and an Honorary Senior Clinical Lecturer in the Mental Health Research Centre at Durham University.

Abstract: Antipsychotic drugs are usually the first line of treatment for psychosis, and clinical guidelines report clear benefits in terms of symptom reduction. Nevertheless many patients are dissatisfied with pharmacological treatment with 74% of patients choosing to discontinue their drugs over 18 month.  Evidence is also emerging that suggests that the effectiveness of these drugs has been overestimated, whereas the severity of their adverse effects has been underestimated.   Despite this no genuine treatment choice exists beyond medication.  This presentation reports on the first research trial to treat psychosis without medication: a randomised controlled trial of Cognitive Behavioural Therapy for those with psychosis refusing to take antipsychotics.  It will consider whether treatment of psychosis without medication might be a possibility.

If you would like to listen to more lectures in the Hearing the Voice lecture series, please visit our podcast page.

 

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‘Voices in the News’ by Charles Fernyhough

5515785440_b87256b9d0_nIn his blog ‘The Voices Within’ for Psychology Today, our project director Charles Fernyhough writes:

‘Negative attitudes about mental illness are slow to change. In one analysis of data from the 2006 US General Social Survey, 62% of respondents said that they would be unwilling to work with a person with schizophrenia; 60% expected that someone with schizophrenia would be violent towards others. The authors reported little change from equivalent data collected ten years earlier. These negative attitudes towards mental illness can have profound effects on the lives of those with a diagnosis. Visits from neighbours dry up; social invitations decline. And the effects on patients’ perceptions of themselves can be far-reaching, with so-called ‘self-stigma’ associated with lower self-esteem, avoidance of treatment and reduced adherence to it, and increased risk of hospitalization1

Although the effects of negative public attitudes to schizophrenia and other disorders have been the focus of some research, attitudes to specific unusual experiences such as voice-hearing have not received much attention. A recently published study2 set out to investigate whether media reports of the experience match up with what the science says. The author, Ruvanee Vilhauer from Felician College, New Jersey, looked at a sample of 181 newspaper articles from the US, obtained from a database that provided access to over 5,600 sources including national and regional newspapers. Among the search terms were ‘auditory hallucination’ and ‘hearing voices’. Articles that met the criteria from a one-year period in 2012–2013 were included in the analysis. The papers sampled ranged from the New York Times to small local papers.

Once collected, the articles were analysed through a method known as content analysis. Each article was coded according to whether it contained a suggestion that voice-hearing could occur in psychologically healthy people; whether it suggested that hearing voices was a symptom of mental illness, medical conditions or drug use; whether it linked voice-hearing to criminal behaviour, violence or suicide; whether it suggested a link between hearing voices and supernatural or religious factors; whether it suggested that treatment can beneficial; and whether voice-hearing could ever be associated with positive attributes such as creativity.

The results were sobering. 84% of the articles contained no suggestion that voice-hearing can be ‘normal’. That positive view was contained in only 23 of the 181 articles, five of which were a review of Oliver Sacks‘s book Hallucinations, which has a clear anti-stigma message. Another ten of these more positive articles put voice-hearing in religious or spiritual context, for example considering the case of Joan of Arc.

Most of the articles (81.8%) connected voice-hearing to mental illness. In some cases, auditory verbal hallucinations were simply equated with insanity. Some articles linked voice-hearing to a tragic lack of control (for example, ‘When a psychologist asked him afterward [after he had killed 3 people] why he went with guns to his school, he said, “I had no choice,” referring to auditory hallucinations commanding him to do so.’) Another common assumption was that hallucinations are frightening (‘deeply scary’, in one article).

When a specific diagnosis was mentioned, schizophrenia was predictably the most common (37% of articles sampled). Some articles recognized that voices occur in other disorders, such as bipolar disorder anddepression. Several linked voice-hearing to drug use, including marijuanaand alcohol. More than half of the articles linked voice-hearing to criminal behavior, mostly involving violent crimes. In just under half (47%) of the articles, voices were linked to violence towards others. In just under a fifth, a link was made to suicide or suicidality.

Positive correlates of voice-hearing were thin on the ground. Ten articles linked voice-hearing to creativity (four of these were reviews of Sacks’s book). A further 13 linked the experience to other positive attributes such as spirituality.

The study has a few limitations. Firstly, public understanding of voice-hearing is likely to be different in countries outside the US: for example in Europe, where the international Hearing Voices Movement is well established. As the author admits, the sample size was relatively small. And the study’s design means that no causal connections can be drawn between mistaken media representations and increased stigma.

The author’s conclusion was that ‘the news media examined tend to present a misleading and largely pathologizing view of AVH’. These misperceptions are important because media reports are arguably a barometer of public understanding of an issue, and can also shape those understandings, worsening the problem of stigma. They can also negatively affect how voice-hearers themselves react to and interpret their experiences.

Above all, these media stereotypes about voice-hearing fly in the face of research that shows that hearing voices can be an ordinary part of many people’s everyday lives. That’s the topic of the next post.’

1Wahl, O. (2012). Stigma as a barrier to recovery from mental illness.Trends in Cognitive Sciences, 16, 9-10.

2Vilhauer, R. P. (in press). Depictions of auditory verbal hallucinations in news mediaInternational Journal of Social Psychiatry. (You can access the full text through Academia.edu here.)

 

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Out of Our Heads, Shoreditch Town Hall Basement, 13-29 June 2014

Shoreditch Town Hall Basement
13-29 June 2014, 10 am – 6 pm daily & weekends

Curated by James Putnam and Vassiliki Tzanakou, Out of Our Heads is a visual arts exhibition which explores one of the most fascinating human experiences – hallucinations – and its links with perception, illusions and mental health.

The exhibition will attempt to ‘provoke us to enter into the space where the human brain and mind construct the world, hovering between perception, imagination and belief’ and will feature the works of established and emerging artists in a variety of media including painting, sculpture, installation, video, sound and performance art.

Many of the artworks were developed with input from world leading hallucinations researchers and experts in the human brain and mind, including David Nutt (Psychiatrist and Neuropsycholpharmacologist), David O’Flynn (Psychiatrist), Dominic ffytch (Psychiatrist), Fiona Macpherson (Philosopher), Jill Peay (Lawyer), John Foot (Historian), Konstantinos Moutoussis (Neuroscientist) and Semir Zeki (Neurobiologist).

Alongside the exhibition, there will be a series of talks, film screenings, workshops, performances and events on the themes of perception, illusions, hallucinations and mental health, the aim of which is to engage the public in a dialogue about hallucinations and mental health, and to challenge the stigma that surrounds mental illness.

Out of Our Heads is the first art project of the newly established arts organisation ARTINTRA - an organisation committed to the production of multi-disciplinary arts projects.

10% of the proceeds will go to buy art supplies for the creative therapy departments of mental health institutions.

For more information on this exhibition and to book tickets, please see the Out of Our Heads website.

 

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