HEARING VOICES:

A SOCIAL CONSTRUCTIONI

STPERSPECTIVE

15TH June 2012

sally.mcmanus@commlinks.co.uk

PERCEPTIONPOWER

PERSPECTIVES

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

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

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

WHAT IS IT LIKE TO HEAR VOICES?

Discussion

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

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

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

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.”

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?

DISCOURSES AND POWER Psychiatry Psychology Media Government (MHA) Religion/spiritual Dominant social constructions Multiple perspectives necessary: choice

ROMME AND ESCHER Voices as inner commentator to alert us

to problems Voices not problem Coping research Construct/Formulation

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

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

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)

PERSPECTIVES Medical Psychological Social Spiritual Other

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

PSYCHOLOGICAL PERSPECTIVE Problem in psychology of individual and

result of life events?

Therapy as a means of social control?

Definitions of “normality” and acceptability

SOCIAL MODEL OF DISABILITY Voice hearing as a disability? Adaption to society (medication) Society adapting to voices hearing

experience? (acceptance) Anti-stigma campaigns

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)

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?

CONCLUSION

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

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

QUESTIONS

Click icon to add picture

DISCUSSION You meet someone who tells you they

hear voices What would you say/do/ask in order to

show ACCEPTANCEUNDERSTANDINGACKNOWLEDGEMENTVALIDATION

REFERENCES Berger and Luckmann “ The Social

Construction of reality” McManus (unpublished) MSC

Dissertation Foucault INTERVOICE website/ HVN website Romme and Escher Ron Coleman