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The phenomenology of auditory verbal hallucinations in emotionally unstable personality disorder and post-traumatic stress disorder

Published online by Cambridge University Press:  06 August 2020

S. Wallis ,
P. Denno ,
J. Ives ,
P. Mallikarjun ,
S. J. Wood ,
F. Oyebode ,
M. Broome  and
R. Upthegrove
S. Wallis
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
P. Denno
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England
J. Ives
Affiliation:
Population and Health Science Institute, Bristol Medical School, University of Bristol, Bristol, UK
P. Mallikarjun
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England
S. J. Wood
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England Orygen, The National Centre of Excellence for Youth Mental Health, Melbourne, Australia
F. Oyebode
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England Birmingham and Solihull Mental Health Foundation Trust, Birmingham, England
M. Broome
Affiliation:
Institute for Mental Health, University of Birmingham, Birmingham, England
R. Upthegrove*
Affiliation:
College of Medical and Dental Sciences, University of Birmingham, Birmingham, England Institute for Mental Health, University of Birmingham, Birmingham, England
*
*Address for correspondence: R. Upthegrove, Institute for Mental Health, University of Birmingham, IMH, 52 Prichatts Road, Edgbaston, BirminghamB152TT, (Email: [email protected])
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Abstract

Objective:

To explore the phenomenology of auditory verbal hallucinations (AVHs) in a clinical sample of young people who have a ‘non-psychotic’ diagnosis.

Methods:

Ten participants aged 17–31 years with presentation of emotionally unstable personality disorder or post-traumatic stress disorder and frequent AVHs were recruited and participated in a qualitative study exploring their subjective experience of hearing voices. Photo-elicitation and ethnographic diaries were used to stimulate discussion in an otherwise unstructured walking interview.

Results:

‘Non-psychotic’ voices comprised auditory qualities such as volume and clarity. Participants commonly personified their voices, viewing them as distinct characters with which they could interact and form relationships. There appeared to be an intimate and unstable relationship between participant and voice, whereby voices changed according to the participants’ mood, insecurities, distress and circumstance. Equally, participants reacted to provocation by the voice, leading to changes in mood and circumstance through emotional and physical disturbances. In contrast to our previous qualitative work in psychosis, voice hearing was not experienced with a sense of imposition or control.

Conclusions:

This phenomenological research yielded in-depth and novel accounts of ‘non-psychotic’ voices which were intimately linked to emotional experience. In contrast to standard reports of voices in disorders such as schizophrenia, participants described a complex and bi-directional relationship with their voices. Many other features were in common with voice hearing in psychosis. Knowledge of the phenomenology of hallucinations in non-psychotic disorders has the potential to inform future more successful management strategies. This report gives preliminary evidence for future research.

Keywords

Auditory hallucinationvoicepersonality disorderpost-traumatic stress disorderinterview
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 39 , Issue 2: Themed Issue: Psychiatric Anthropology , June 2022 , pp. 196 - 206
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of The College of Psychiatrists of Ireland

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Footnotes

†

These authors contributed equally to this work.

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