![]() ![]() Giving meaning to voices, making sense of voices, became a new paradigm, constructively creating new treatment roads and ways of recovery.Įpidemiologic data reveals that hearing voices is a common human experience ( 2 - 6 % of the population Tien 1991, Eaton 1991 ). Gradually it emerged that many voice hearing patients suffered from trauma, a neglected aspect of psychosis in general and the voice hearing experience in particular (Romme & Escher 1989 Read & Ross, 2003 Read et al., 2005 ). ![]() Some time later, cognitive behaviour therapy research showed that even people with the diagnosis of schizophrenia could change their attitude towards their voices (Chadwick, 1994 ). Yearly conferences in these countries spread the old (but forgotten) news that people can learn to live with their voices, and hearing voices was widely covered by the media. The foundation of hearing voices networks in the UK, Germany and The Netherlands have created possibilities for acknowledging and supporting VH and those around them. All kinds of explanatory models were welcome. The stories of VH who had extensive experience with the psychiatric system and who (despite this) learned to cope with their voices were widely presented in conferences and network meetings. Presenting the information of the non-patients and patients who learned to cope successfully generated hope for voice hearing patients. We found that bringing together patient and non-patient VH showed the relative lack of difference between the experiences of these two groups. The alternative approach is based on helping people make sense of their voices and learning to cope with them. Voice hearers who come to the attention of psychiatric services are often stuck in destructive communication patterns with their voices. However, from our perspective, rejecting the meaning of voices is the same as rejecting the person. As such, their only goal is the elimination of the voices (voices that, in our opinion, harbour meaning in reference to peoples’ lives) they have nothing to offer VH who seek their help other than medication. ![]() In contrast, Western clinical psychiatry sees voices as symptoms of an illness, a meaningless pathological phenomenon. The alternative model that Romme and Escher developed, in close collaboration with VH, was based on the premise that hearing voices is a normal human experience that has a personal meaning in relation with life history, which they seek to understand. These activities led to and became embedded in what we can call ‘the hearing voices movement’. ![]() Many other countries also now have networks of voice hearers organised outside of the mental health system. Especially in the UK, this led to the development of a nationwide network of VH who found and elaborated ways of supporting each other. Starting from one patient who insisted that her voice hearing experiences be taken seriously, Romme and Escher conducted several research projects and organised meetings and networks for VH and professionals in the Netherlands and other countries. The history of the Maastricht approach and of the Hearing Voices Movement In addition to emphasising understanding the purpose or meaning of the voices, a specific treatment model for working directly with a person’s voices – emphasising their dissociative nature – has been developed by adapting the Voice Dialogue method (Stone & Stone, 1989 ) for working with VH. It is based on three central tenets, that the phenomena of hearing voices is: a) more prevalent in the general population than was previously believed, b) a personal reaction to life stresses, whose meaning or purpose can be deciphered and, c) best considered a dissociative experience and not a psychotic symptom (though it can sometimes occur in the context of psychotic symptoms, such as delusions Moskowitz & Corstens, 2007 ). This approach contends that people hearing voices (hereafter referred to as ‘VH’ for ‘Voice Hearers’) can learn to cope with their voices and benefit from psychological and social interventions. This approach has become progressively more influential, in Europe, Australia, New Zealand, and elsewhere, and has led to voice hearers organising themselves into networks, empowering themselves and working towards recovery in their own ways. In Maastricht, the Netherlands, over the past twenty years psychiatrist Marius Romme and researcher Sandra Escher have developed a new approach to hearing voices, which we will call the ‘Maastricht’ approach, that emphasises accepting and making sense of voices. Moskowitz (ed) (2008) Psychosis, trauma and dissociation: Emerging perspectives on severe psychopathology, Wiley & Sons. Accepting and working with voices: The Maastricht approachĭirk Corstens, Sandra Escher and Marius Romme ![]()
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