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Two thirds of people who experience auditory hallucinations will hear voices which criticise or threaten them. New research seeks to learn from people who hear nasty voices about what it’s like to be around other people. This new in-depth interview study offers a unique insight into the factors that lead to social isolation.

Illustrated picture of a person standing in the middle of clouds and a star shape. © Image produced by Scriberia

What is it like to be around people whilst also hearing voices?

Hearing voices can come in many forms. Some people hear voices that are friendly, helpful, insightful or inspiring.  Indeed, these kinds of voices can be very enriching experiences. However, others hear voices that are scary or critical. These can have very disruptive effects on day-to-day life. Whilst voices differ substantially, what unites all voice hearing experiences is that they are rarely talked about. 

The voices can seem incredibly real, and are often described as being very believable and difficult to ignore (Sheaves et al., 2020). Understandably they have a powerful impact on the individual.

One participant from the study explains:

“It’s a scary, scary, scary, scary situation, I’ve had more fear in the last two years than anywhere in my life.”

What factors lead to social isolation?

The study uncovered the following as factors that lead to social isolation for people who hear voices:

  • Difficulties during conversations, for example, concentrating on someone talking whilst also hearing voices is hard and tiring
  • Negative expectations of interactions, for example, fearing stigma and negative judgement
  • Difficulties sharing experiences of voices, for example, a selfless concern that talking about voices will leave others feeling upset 

Consequently, at a time in people’s lives when they most needed the support of loved ones, many voice hearers described efforts to manage the difficult experience on their own.  Being isolated wasn’t a long term solution, as another participant explains, “Not talking to people just made myself worse."

Several interviews revealed that social support was a crucial step in the process of recovery. 

 

“The more I could open up, the more I let my mates know, the more everything has settled down really.  

Is connecting with people important in helping people manage hearing nasty voices?

Speaking to people helped provide distraction from the abusive comments made by voices, it provided an opportunity to gather other information in an effort to question the nasty things the voices said and some actually described hearing nasty voices less often when they were around others.  The research suggests that connecting with people could well be an important vehicle in helping people to manage nasty voices, but this requires testing in future research.

 

Through my work in the NHS I have met many people who struggle with voices saying really nasty and abusive things to them. I am frequently left feeling inspired by people’s resourcefulness and strength for managing these really difficult experiences. Our hope is that this project inspires more conversations about voices, because nobody should be hearing nasty voices alone. - Lead author, Dr Bryony Sheaves, Department of Psychiatry, University of Oxford.

  

To read the full paper, The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis

To read an article in The Conversation, Hearing voices can be frightening and isolating - but talking can help.

Watch an inspiring animation, produced in collaboration with the Department of Psychiatry at the University of Oxford and the McPin Hearing Voices Lived Experience Advisory Panel. The animation shares the stories of people who hear one type of voices: those which threaten them or criticise them.