Voice-Hearing Across The Continuum: A Phenomenology of Spiritual Voices.
Peter Moseley, Adam Powell, Angela Woods, Charles Fernyhough, Ben Alderson-day
Schizophrenia bulletin September 1, 2022 Peer reviewed DOI: 10.1093/schbul/sbac054 via PubMed
Summary
Nonclinical voice-hearers exhibit important similarities and differences compared to those with psychosis. In a study of 26 nonclinical individuals from spiritualist communities and 40 patients with psychosis, findings confirmed that nonclinical voice-hearing is associated with reduced distress and increased control. Nonclinical participants often integrated multiple modalities into one entity and experienced high levels of visual imagery. Most reported voices prior to engaging in spiritualism, indicating that their experiences were not solely due to deliberate practices.
Study at a glance
| Design | comparative phenomenology |
|---|---|
| Sample size | 66 |
| Population | nonclinical voice-hearers from spiritualist communities and patients with psychosis |
| Key finding | Nonclinical voice-hearing is characterized by reduced distress and increased control compared to clinical voice-hearing. |
Abstract
Voice-hearing in clinical and nonclinical groups has previously been compared using standardized assessments of psychotic experiences. Findings from several studies suggest that nonclinical voice-hearing is distinguished by reduced distress and increased control. However, symptom-rating scales developed for clinical populations may be limited in their ability to elucidate subtle aspects of nonclinical voices. Moreover, such experiences often occur within specific contexts and belief systems, such as spiritualism. We investigated similarities and differences in the phenomenology of clinical voice-hearing and nonclinical voice-hearer (NCVH). We conducted a comparative interdisciplinary study which administered a semi-structured interview to NCVH individuals (N = 26) and psychosis patients (N = 40). The nonclinical group was recruited from spiritualist communities. We used content analysis and inductive thematic analysis to create a coding frame which was used across both spiritual and patient groups to compare phenomenological features of voice-hearing. The findings were consistent with previous results regarding distress and control. Additionally, in the NCVH group, multiple modalities were often integrated into 1 entity, and there were high levels of associated visual imagery, and subtle differences in the location of voices relating to perceptual boundaries. Most NCVHs reported voices before encountering spiritualism, suggesting that their onset was not solely due to deliberate practice. Nonclinical spiritual voice-hearing has important similarities and differences to voices in psychosis. Future research should aim to understand how spiritual voice-hearers cultivate and control voice-hearing after its onset, which may inform interventions for people with psychosis with distressing voices.