Voice hearing over time: A qualitative study of a woman without a psychiatric diagnosis


Voice hearing, a complex perceptual phenomenon, is reportedly common in the general population yet understudied in nursing. Nurses meet voice hearers from diverse cultures; their understandings influence assessment. The aim was to explore voice hearing in everyday life in a non-patient population, revealing insights for assessing voice hearing. Method: Interview data was transcribed, translated into English and analyzed by qualitative content analysis. Outcome measures are thematic descriptions. Results: Voice hearing over time involved past (about year 2000) and recent (2009) time periods. Four main themes were: “Transitioning from not-being-at home when home alone to being at-home”, “Shifting overtime from frequent, repetitive voice hearing to inferquent intermittent voice hearing overtime”, “Changing from being disempowered to being empowered” and “Progressing from absence of significant others to presence of significant others”. Study Limitations: Interviewing a single participant residing in Scandinavia produced in-depth descriptions consistent with the study’s aim. The participant had no known psychiatric diagnosis and had not received mental health care when recruited and interviewed. However, we cannot be certain that her voice hearing was or was not non-pathological which raises issues concerning truth value of the study. Conclusions: The results reflect life world existential themes of lived time, lived space, lived body and lived human relation, and offers a framework for guiding and challenging nurses’ assessments of voice hearing. Voice hearing can be understood as a bereavement-grief response. Further research is needed in western and non-western cultures and non-patient populations.

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Talseth, A. , Gilje, F. and Kalhovde, A. (2012) Voice hearing over time: A qualitative study of a woman without a psychiatric diagnosis. Open Journal of Nursing, 2, 396-405. doi: 10.4236/ojn.2012.24058.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Fenekou, V. and Georgaca, E. (2010) Exploring the experience of hearing voices: A qualitative study. Psychosis, 2, 134-143. doi:10.1080/17522430903191783
[2] Lakeman, R. (2001) Making sense of the voices. International Journal of Nursing Studies, 38, 523-531. doi:10.1016/S0020-7489(00)00101-2
[3] Al-Issa, I. (1977) Social and cultural aspects of hallucinations. Psychological Bulletin, 3, 570-587. doi:10.1037/0033-2909.84.3.570
[4] De Jong, J.T.V.M. (1987) Decent into African psychiatry. Royal Tropical Institute, Amsterdam.
[5] Lukoff, D. (2007) Visionary spiritual experiences. Southern Medical Journal, 6, 635-641. doi:10.1097/SMJ.0b013e318060072f
[6] Deegan, P. (2011) Hearing voices that are distressing: Self-help resources and strategies. http://www.power2u.org/articles/selfhelp/voices.html.
[7] England, M. (2007) Accuracy of nurses’ perceptions of voice hearing and psychiatric symptoms. Journal of Advanced Nursing, 58, 130-139. doi:10.1111/j.1365-2648.2006.04162.x
[8] Blom, J.D. and Sommer, I.E. (2010) Auditory hallucinations: Nomenclature and classification. Journal of Cognitive and Behavioral Neurology, 23, 55-62. doi:10.1097/WNN.0b013e3181b2791e
[9] Serper, M., Dill, C.A., Chang, N., Kot, T. and Elliot, J. (2000) Factorial structure of the hallucinatory experience: Continuity of experience in psychotic and normal individuals. Journal of Nervous and Mental Disease, 193, 265-272. doi:10.1097/01.nmd.0000158374.54513.a0
[10] Beavan, V., Read, J. and Cartwright, C. (2000) The prevalence of voice-hearers in the general population: A literature review. Journal of Mental Health, 20, 281-292. doi:10.3109/09638237.2011.562262
[11] Coffey, M. and Higgon, J. (2001) Auditory hallucinations. Journal of Psychiatric and Mental Health Nursing, 21, 18-22.
[12] Hoffman, R.E. and Varanko, M. (2006) “Seeing voices”: fused visual/auditory verbal hallucinations reported by three persons with schizophrenia-spectrum disorder. Acta Psychiatrica Scandinavia, 14, 290-293. doi:10.1111/j.1600-0447.2006.00791.x
[13] Neckelmann, G., Specht, K., Lund, A., Ersland, L., Smievoll, A.I., Neckelmann, D. and Hugdahl, K. (2006) Morphometry analysis of grey matter volume reduction in schizophrenia: Association with hallucinations. International Journal of Neuroscience, 116, 9-23. doi:10.1080/00207450690962244
[14] Davies, M.F., Griffin, M. and Vice, S. (2001) Affective reactions to auditory hallucinations in psychotic, evangelical and control group. British Journal Clinical Psychology, 40, 361-370. doi:10.1348/014466501163850
[15] Hardy, A., Fowler, D., Freeman, D., Smith, B., Steel, C., Evans, J., Garety, P.A., Kuipers, E., Bebbington, P.E. and Dunn G. (2005) Trauma and hallucinatory experience in psychosis. Journal of Nervous and Mental Disease, 193, 501-507. doi:10.1097/01.nmd.0000172480.56308.21
[16] Boksa, P. (2009) On the neurobiology of hallucinations. Journal of Psychiatry Neuoscience, 34, 260-262.
[17] Romme, M. and Escher, S. (1994) Hearing voices. British Medical Journal, 309, 670. doi:10.1136/bmj.309.6955.670a
[18] Romme, M. and Escher, S. (2000) Making sense of voices: A guide for professionals who work with voice hearers. MIND Publications, London.
[19] Gray, B. (2008) Hidden demons: A personal account of hearing voices and the alternative of the hearing voices movement. Schizophrenia Bulletin, 34, 1006-1007. doi:10.1093/schbul/sbn099
[20] Slade, P.D. and Bental, P.R. (1988) Sensory deception: A scientific of hallucination. Johns Hopkins University Press, Baltimore.
[21] Watkins, J. (1998) Hearing voices: A common human experience. Hill of Content Publishers, Melbourn.
[22] Honing, A., Romme, M., Bernardine, E., Sandea, E., Monique, P. and Marten D. (1998) Auditory hallucinations: A comparison between patients and non-patients. Journal of Nervous and Mental Disease, 186, 646-651. doi:10.1097/00005053-199810000-00009
[23] Morrison, A.P., Wells, A. and Nothard, S. (2002) Cognitive and emotional predictors of predisposition to hallucinations in non-patients. British Journal of Clinical Psychology, 41, 259-270. doi:10.1348/014466502760379127
[24] Rees, W.D. (1971) The hallucinations of widowhood. British Medical Journal, 4, 37-41.
[25] Olson, P.R., Suddeth, J.A., Peterson, P.J. and Egelhoff, C. (1985) Hallucinations of Widowhood. Journal of American Geriatric Society, 33, 543-547.
[26] Hornstein, G. and Dillon, J. (2012) Hearing voices network USA. http://www.hearingvoicesusa.org
[27] Romme, M. (2012) International network for training, education and research into hearing voices. http://intervoiceonline.org
[28] Coffey, M. and Hewitt, J. (2008) “You don’ talk about the voices”: Voice hearers and community mental health nurses talk about responding to voice hearing experiences. Journal of Clinical Nursing, 17, 1591-1600. doi:10.1111/j.1365-2702.2007.02185.x
[29] Coffey, M., Higgon, J. and Kinnear, J. (2004) Therapy as well as the tablets. An exploratory study of service users “views of community mental health nurses” (CMHNs) responses to hearing voices. Journal Psychiatric and Mental Health Nursing, 11, 435-444. doi:10.1111/j.1365-2850.2004.00740.x
[30] England, M., Rubenstein, T. and Tripp-Reimer, L. (2003) Relevance of cues for assessing hallucinated voice experiences. International Journal of Nursing Terminology Classifications, 14, 77-95. doi:10.1111/j.1744-618X.2003.tb00067.x
[31] England, M. (2005) Mediation of the relationship of inner voice experiences to health-related quality of life. Perspectives in Psychiatric Care, 41, 1-13. doi:10.1111/j.0031-5990.2005.00006.x
[32] Meehan, D.B. (2012) Phenomenal space and the unity of conscious experience. http://psyche.cs.monash.edu.au/v9/psyche-9-12-meehan.html
[33] Mishler, E.G. (1986) Research interviewing: Context and narrative. Harvard University Press, London.
[34] Granheim, U.H. and Lundman, B. (2004) Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105-112. doi:10.1016/j.nedt.2003.10.001
[35] Hem, M.H. and Heggen, K. (2003) Being professional and being human: One nurse’s relationship with a psychiatric patient. Journal of Advanced Nursing, 43, 101-108. doi:10.1046/j.1365-2648.2003.02677.x
[36] Folstein, M.F. (1983) The mini-mental state examination. In: Crook, T., Ferris, S. and Bartus, R., Eds., Assessment in Geriatric Psychopharmacology, Mark Powley, New Canaan, 50-51.
[37] Van Manen, M. (2007) Researching lived experience. Human science for an action sensitive pedagogy. The Althouse Press, Ontario.
[38] Zingmark, K., Norberg, A. and Sandman P.O. (1995) The experience of being at home throughout the life span. Investigation of persons aged from 2 - 102. International Journal of Aging and Human Development, 41, 47-62. doi:10.2190/N08L-42J5-31D2-JUQA
[39] Romme, M., Escher, S., Dillon, J., Morris, M. and Corstens, D. (2009) Living with voices: 50 stories of recovery. Person Centered Counseling Services Books, Herefordshire.
[40] Beavan, V. and Read, J. (2010) Hearing voices and listening to what they say: The importance of voice content in understanding and working with distressing voices. Journal of Nervous and Mental Disease, 198, 201-205. doi:10.1097/NMD.0b013e3181d14612
[41] Barrett, T.R. and Caylor, M.R. (1998) Verbal hallucinations in normals, V: Perceived reality characteristics. Personality and Individual Differences, 25, 209-221. doi:10.1016/S0191-8869(98)00014-2
[42] Freeman, D., Garety, P.A., Fowler, D., Kuipers, E., Bebbington, P.E. and Dunn, G. (2004) Why do people with delusions fail to choose more realistic explanations for their experiences? An empirical investigation. Journal of Consulting and Clinical Psychology, 72, 671-680. doi:10.1037/0022-006X.72.4.671
[43] Martin, P.J. (2000) Hearing voices and listening to those that hear them. Journal of Psychiatric and Mental Health Nursing, 7, 135-141. doi:10.1046/j.1365-2850.2000.00276.x
[44] Smith, M.J., Thirthalli, J., Abdallah, A.B., Murray, R.M. and Cottler, L.B. (2009) Prevalence of psychotic symptoms in substance users: A comparison across substances. Comprehensive Psychiatry, 50, 245-250. doi:10.1016/j.comppsych.2008.07.009
[45] Kiekkas, P., Theodorakopoulou, G., Spyratos, F. and Baltopoulos, G.I. (2010) Psychological distress and delusional memories after critical care: A literature review. International Nursing Review, 57, 288-296. doi:10.1111/j.1466-7657.2010.00809.x
[46] Friedman, J.H. (2010) Parkinson’s disease psychosis 2010: A review article. Parkinsonism and Related Disorders, 16, 553-560. doi:10.1016/j.parkreldis.2010.05.004
[47] Parse, R.R. (1998) The human becoming school of thought. Sage, Thousand Oaks.
[48] Coleman, R. (1999) Recovery: An alien concept. Handsell Publishing, Gloucester.
[49] Millham, A. and Easton, S. (1998) Prevalence of auditory hallucinations in nurses in mental health. Journal of Psychiatric Mental Health Nursing, 5, 95-99. doi:10.1046/j.1365-2850.1998.00098.x
[50] Adam, R., Tilley, S. and Pollock, L. (2003) Person first: What people with enduring mental disorders value about community psychiatric nursing and CPN services. Journal of Psychiatric Mental Health Nursing, 10, 203-212. doi:10.1046/j.1365-2850.2003.00560.x
[51] Carlsson, M.E. and Nilsson, I.M. (2007) Bereaved spouses’ adjustment after the patients’ death in palliative care. Palliative and Supportive Care, 5, 397-404. doi:10.1017/S1478951507000594
[52] Baethge, C. (2002) Grief hallucinations: True or pseudo? Serious or not? Psychopathology, 35, 296-302. doi:10.1159/000067067
[53] Kersting, A. (2004) The psychodynamics of grief hallucinations—A psychopathological phenomenon of normal and pathological grief. Psychopathology, 37, 50-51. doi:10.1159/000077020
[54] Simon, N.M., Wall, M.M., Keshaviah, A., Dryman, M.T., LeBlanc, N.J. and Shear, M.K. (2011) Informing the symptom profile of complicated grief. Depression and Anxiety, 28, 118-126. doi:10.1002/da.20775
[55] Thomas, P. and Bracken, P. (2004) Hearing voices: A phenomenological-hermeneutic approach. Cognitive Neuropsychiatry, 9, 13-23. doi:10.1080/13546800344000138
[56] Guba, E.G. (1981) Criteria for assessing the trustworthiness of naturalistic inquiries. Educational Technology Research and Development, 29, 75-91.
[57] Diederen, K.M.J., van Lutterveid, R. and Sommer, E.C. (2012) Neuorimaging of voice hearing in non-psychotic individuals: A min-review. Frontiers of Neuroscience, 6, 111. doi:10.3389/fnhum.2012.00111

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