Hearing Voices: A SOCIAL CONSTRUCTIONist perspective

1. Hearing Voices:A SOCIAL CONSTRUCTIONistperspective 15TH June 2012 sally.mcmanus@commlinks.co.uk

2. POWER PERCEPTION PERSPECTIVES

3. Sally McManus • MSc Mental Health Leeds Metropolitan University 2011(Supervisor : B.Penson) • BSc (Hons) Social Science (Sociology and Social Psychology) University of Bradford 1996 • Care Coordinator at aspire, Leeds Early Intervention in psychosis service (3 years) • Previous diagnosis of psychosis • Ex-voice hearer

4. Values • Honesty, openness, straightforwardness, clarity, individuality, respect, equality, equilibrium • Voice hearing as normal and everyday • Voice hearing as amazing, serving a purpose, not necessarily terrifying • White British, female, middle class upbringing, late 30’s, single, no dependants • Sympathetic to psychiatry and psychology • Use of Critical Psychiatry and Critical Psychology perspectives

5. AIMS • Definitions of voices/social constructionism • Use theory to explore how voices are constructed in West • Discuss dominant discourses (psychiatry and psychology) • Power, perceptions and perspectives • Ideas for practice • Research potential

6. Discussion WHAT IS IT LIKE TO HEAR VOICES?

7. Voice Hearing • Voices, sounds, music, noises • External or unknown source/mind of hearer • Psychiatry: auditory hallucination/symptom • Magical, terrifying, empowering, destructive, wonderful, annoying, incredible, hateful, personal • Continuum, normal, everyday experience

8. Social Constructionism • Beliefs developed about the world, objects, phenomena and people • That are not defined by nature (Berger and Luckmann (1966, 1991) • “Nothing is real unless we agree that it is” (Gergen and Gergen 2004) • Nature has no life of its own (Searle 1995) • Creates doubt and encourages reflection on assumptions/beliefs and ideologies

9. Voice hearing and social constructionism • Berger and Luckmann : voice hearing as unnatural phenomena. Voices use language: language is socially constructed • Searle: everything socially constructed • Potential for both social constructionist perspectives to theorize voice hearing • Assumption that voice hearing is socially constructed in society

10. Berger and Luckmann “Man is biologically predestined to construct and inhabit a world with others. This world becomes for him the dominant and definite reality. Its limits are set by nature, but, once constructed this world acts back upon nature. In the dialectic between nature and the socially constructed world the human organism is itself transformed. In this same dialectic man produces reality and thereby produces himself.”

11. Berger and Luckmann • Object becomes apparent with different discourses around it • No ultimate truth • Communication with others, and voices • Omnipotence: why? • Construct clashes: with whom?

12. Discourses and power • Psychiatry • Psychology • Media • Government (MHA) • Religion/spiritual • Dominant social constructions • Multiple perspectives necessary: choice

13. Romme and Escher • Voices as inner commentator to alert us to problems • Voices not problem • Coping research • Construct/Formulation

14. Foucault • Writing at a similar time to Berger and Luckmann • French philosopher/historian/sociologist • Geneological approach • Post-structuralist school (not soc construct) • Looks at “madness” (not voices specifically) • Looks at notions of “truth” and “power” • Political/moral/cultural/time/space/place

15. Perception “If illusion can appear as true as perception, perception in its turn can become the visible, unchallengeable truth of illusion.” (Foucault) • Imagination, perception and reality? • Voice hearer is subject where truth is sought and power overlooks and operates upon • Ultimate truth out of reach

16. Power • Historical approach • Foucault and social constructionism • Means whereby truth constructed and inconsequential whether factually correct • Foucault as empiricist – flawed? • Medicine as dominant perspective • Law as overarching controlling body (Government)

17. PERSPECTIVES • Medical • Psychological • Social • Spiritual • Other

18. Medical perspective • Us and them • Language • Medication • Treatments in history • Concept of mental illness/diagnosis • Suppression of symptoms • Continnuum perspective • Many truths and realities around voices

19. PSYCHOLOGICAL PERSPECTIVE • Problem in psychology of individual and result of life events? • Therapy as a means of social control? • Definitions of “normality” and acceptability

20. Social model of disability • Voice hearing as a disability? • Adaption to society (medication) • Society adapting to voices hearing experience? (acceptance) • Anti-stigma campaigns

21. In practice • Accepting • Understanding • Normalising • Talking about voices • CBT approach/Romme and Escher Maastricht Interview • Hearing Voices groups via HVN • Providing choice about how to make sense (perspectives) • Allowing people to reach own conclusions about voices • Helping people cope with voices (strategies)

22. RESEARCH QUESTIONS • Are relationships that people have with their voices similar to the relationships that people have with people they know? • What is the relationship between voices and self esteem/low mood? • Why are voices omnipotent?

23. Conclusion Voice hearing is constructed socially, within and without a complex set of power dynamics, diversely, across time, culture and space.

24. Conclusions • Many ways of constructing voices within society currently • Psychiatry holds dominant discourse • Continuum perhaps more valuable discourse • Acceptance and non-stigmatising • Campaigns and research • Social constructionism as refuting itself

25. QUESTIONS

26. DISCUSSION • You meet someone who tells you they hear voices • What would you say/do/ask in order to show ACCEPTANCE UNDERSTANDING ACKNOWLEDGEMENT VALIDATION

27. REFERENCES • Berger and Luckmann “ The Social Construction of reality” • McManus (unpublished) MSC Dissertation • Foucault • INTERVOICE website/ HVN website • Romme and Escher • Ron Coleman