HEARING VOICES MOVEMENT (HVM) TIMELINE
1984-1987: Psychiatrist Marius Romme treated patient Patsy Hage for voice-hearing and developed an “accepting voices” approach.
1986: Patsy Hage read The Origin of Consciousness in the Breakdown of the Bicameral Mind by Julian Jaynes. This lead her to view voice-hearing as normal, meaningful, and non-pathological.
1987: Romme and Hage appeared on Dutch television asking the public to respond to a survey about voice-hearing; 450 participants responded.
1987: Based on survey results, a national-level conference was held in Maastricht, Netherlands where the Hearing Voices Movement (HVM) was founded by Professor Marius Romme and Dr. Sandra Escher.
1988: The British Hearing Voices Network was founded in Manchester with Romme’s assistance.
1991: Ron Coleman attended the hearing voices group in Manchester for the first time.
1997: The International Hearing Voices Network (Intervoice) was founded to help provided structure and information exchange for the growing international movement.
2006: World Hearing Voices Day was established as September 14 by Intervoice.
2009: The first ever World Hearing Voices Congress was held and has been held annually since.
2010: Hearing Voices Network USA was founded.
Hearing the voice of the divine is central to the origins and mythologies of many of the world’s religious and philosophical movements. From Moses to Socrates, the Apostle Paul to Muhammad, the voice of God has been credited with introducing many new revelations and guiding the nascent stages of countless new spiritual pathways. Indeed, for many faiths (including the Vedic traditions, most of Christendom, Islam, and Sikhism) even their sacred texts are taken to be the “word” or “voice” of eternal truth. This privileging of the ear, of that which is heard, however, is given pride of place by the HVM in a somewhat different manner. Rather than necessarily positing a single external authoritative source for the voices heard, or a special message communicated by the voice for the collective, the HVM and its members have sacralized a narrative of self-empowerment in which hearing voices that no one else can hear is taken to be an usual, but non-pathological, source of meaning tied to the individual’s life story. In fact, although some members will understand their voices as spiritually significant, the movement’s cohesiveness is linked to its original emphasis on the validity and inclusivity of individual interpretation.
Indeed, the HVM was born from the paradigm-shifting encounter of Dutch psychiatrist Marius Romme [Image at right] with a single patient, Patsy Hage, in the mid-1980s. From 1984 to 1987, Romme met frequently with Hage, using various methods to attempt treatment of her persistent voices (auditory hallucinations). Eventually, it became apparent that Hage’s voice hearing intensified twice a year, coinciding with the dates of traumatic events of her past. Also around this time, Hage read Julian Jaynes’ 1976 The Origin of Consciousness in the Breakdown of the Bicameral Mind, a work of creative historical linguistic and psychological musings, which posits a pre-conscious period in human history during which thoughts and inner speech were perceived to be from external voices, often the gods. One of the notable implications of Jaynes’ book was that hearing voices was once commonplace, even inspiring. Struck by that possibility, and willing to connect her past trauma with her present voices, Hage convinced Romme to take her voices seriously, to begin seeking recovery (coping with the voices) rather than eradication (terminating the voices through medication) (Romme et al. 2009:48, 260-64).
Instead of treating the voices as symptoms of psychosis, most likely schizophrenia, Romme was challenged to accept the voices as significant phenomena in and of themselves. Perhaps, he and his patient began to think, the content and nature of the voices reflected something about or for Hage. They began to discuss the content, frequency, emotionality, and timing of the voices. By 1987, the evidence, or something like it, was there: Hage’s voices ceased to disturb her, and she got married shortly after participating in a television programme alongside Romme and the journalist/psychologist Sandra Escher. In fact, the television appearance led to a public survey of voice-hearers in the Netherlands, with 450 respondents claiming to hear voices and over 100 of those reporting that they were able to manage their voices without psychiatric help. Encouraged by the results of their national survey, Patsy Hage, Marius Romme and Sandra Escher organized the first national voice-hearing conference in Maastricht, Netherlands in 1987. With this event, the HVM was born, and both Romme and Escher (who later became Romme’s wife) became the de facto leaders. As medical humanities scholar Angela Woods notes, that story of Patsy Hage and the “accepting voices” approach began to “function as a foundation myth, told and retold in multiple contexts and on multiple occasions” (2013:264).
Although the HVM has remained, from the outset, a loosely woven patchwork of individuals, user-led organizations, and both local and global events, it was sufficiently large and cohesive enough by the mid-1990s that Romme and Escher founded the International Hearing Voices Network (or, Intervoice) in 1997 to provide central structure as well as a forum for information exchange and access to resources for the movement. Several smaller voice-hearing networks had been established earlier, including support groups in the Netherlands, Germany, and the United Kingdom. However, the development of Intervoice gave voice-hearers and their social networks access to stories of recovery and other resources across the world. Figures like Ron Coleman, a voice-hearer whose story has become emblematic of a sort of depatholigized anti-pharmaceutical account of voice-hearing recovery venerated by the movement, rose to notoriety during the late 1990s and early 2000s, thanks in large part to the work of Intervoice and the use of video, audio, and internet technology to build connections between voice-hearers, whether they identified as mental health service users or not (Powell 2017:121). With the origin myth in place, and charismatic leaders like Coleman holding seminars, selling videos, and offering self-guided courses, the anti-psychiatric and user-led message of the HVM continued to grow, illustrating a sacralising process that transformed one doctor-patient relationship into a worldwide phenomenon.
By 2009, the movement was large enough that the first World Hearing Voices Congress was organized and held in Maastricht to mark twenty-two years since the movement’s founding. The congress brought service users, voice-hearers, mental health clinicians, researchers, journalists, and others together. There has been an international congress annually ever since, with the event held across the globe in countries like England, Italy, France, Greece, Spain, and Australia. [Image at right] There are now over 20,000 members of the movement with hearing voices networks in more than thirty-one countries.
The HVM is largely held together by a brief set of assumptions regarding the experience of hearing voices that no one else can hear. Most fundamentally, they believe that voice-hearing (they prefer this term over auditory hallucinations or other stigmatizing alternatives) is a normal, if unusual, part of being human and not necessarily a symptom of poor mental health. Accordingly, it is held that learning to cope with distressing voices is often a matter of accepting the voices and addressing them as a significant part of one’s personal story. Two additional assumptions held by many, although not all, in the movement include that voice-hearing relates to past trauma and that bio-medical accounts of psychosis lead to increased stigma, distress, and societal misunderstanding rather than to recovery or resilience (Intervoice 2020).
Furthermore, Intervoice as well as Hearing-Voices.org (the website for the British network) and other affiliated sites have dedicated spaces for those who not only adhere to the above beliefs but also believe that their voices are of spiritual or religious significance. Indeed, the HVM is partly characterized by a commitment to individual interpretations of the significance of voices in the light of personal histories. This leaves open the possibility that voices are of supernatural origin.
The key values of HVM are as follows (Corstens et al. 2014:S286-S288):
Hearing voices is a natural part of the human experience.
Diverse explanations for voices are both accepted and valued, and the HVM respects that people may draw on a range of explanations to make sense of their voices.
Voice-hearers are encouraged to take ownership of their experiences and define it for themselves…A multiplicity of explanations [is] a key principle.
It is believed that in the majority of cases voice-hearing can be understood and interpreted in the context of life events and interpersonal narratives.
A process of accepting voices is generally regarded as more helpful than attempting to suppress or eliminate them…However, consistent with the diversity of opinion valued by the HVM, if voice-hearers choose to take antipsychotic medications to manage or eradicate voices, this too is respected.
Peer support is seen as a fruitful means of helping people to make sense of and cope with their voices.
In addition to a large annual conference, the HVM is sustained by hundreds of Hearing Voices Groups across the world. These small user-led groups meet frequently to exchange ideas and stories, providing resources and social support for voice-hearers. The primary activity at these gatherings is open and honest sharing of individual accounts of voice-hearing, including testimony-like narratives of improved coping resulting from one’s encounter with the HVM (and often following failed pharmaceutical/psychiatric treatments). There is much discussion of “owning one’s story” in this way (the theme for the 2016 international congress; see Hearing Voices Network 2016) as well as of the “hope” and “empowerment” gained by joining the HVM (Hearing Voices – Durham 2016).
What is more, these stories of coping and recovery frequently turn on novel or somewhat unconventional therapeutic practices that can be shared and adopted by members across the movement. One well-known figure of the movement, Jacqui Dillon, began implementing various self-help practices that she credits with finally giving her a “sense of order and structure in what often felt like a chaotic environment” (Romme et al. 2009:191). Other HVM members, like Eleanor Longden who has published on her experiences (2013), now describe their encounter with the movement as a conversion from “schizophrenic” to “voice-hearer” (Woods 2013:266). Still others explicitly identify the HVM and its practices with their “salvation” (Romme et al. 2009:170). Espousing alternatives to the antipsychotic medications offered by psychiatrists, such as therapies emphasizing communicative interaction with one’s voices (viz., “relating therapies” or “talking therapies”), these members of the HVM have been compared to the “indigenous healers” of Africa (James 2001). In both cases, marginalization and even persecution comes at the hands of more modern and powerful socio-political forces because of the practices being promoted. For the HVM, and crucial to the poignant stories ritually recounted at its many group meetings, the relevant practices involve speaking to the voices as one would any other social agent and searching for meaning in the statements the voices make. Such approaches differ fundamentally from the bio-medical perspective that would treat voices as symptoms to stamp out and set the HVM apart as a unique and active orientation to voice-hearing.
As journalist Adam James notes of the movement’s origins, it was ‘the postmodern era and [its notion of] cultural relativity which…cradled the HVM’ (2001:27). In fact, first-hand reports and other qualitative research suggests that members of the HVM tend to resist or to resent labels, discourses, and explanations regarding voice-hearing that are perceived to be imposed upon them by others, particularly the mental health establishment (Holt and Tickle 2015:259; Blackman 2001) Thus, although there is a sort of informal hierarchy (with Marius Romme and Sandra Escher at the top, followed by Ron Coleman and other public voice-hearers somewhere in the middle tiers), the HVM is mostly fueled by a concern for the empowerment of the voice-hearers themselves. Consequently, members of the movement have adopted the term “experts by experience” as a marker of their co-equality with so-called “experts by training.” The social-legitimation of the Patsy Hage myth has cemented the role of the “expert by experience” as the most important in the organization. After all, it was Romme’s patient who enlightened him rather than the other way around. With this important emphasis on power inversion and individualism, voice-hearers are directly involved in leadership and administration at all levels. The HVM is very rightly understood as a user-led socio-political movement, even as it exhibits many of the tell-tale signs of Max Weber’s “routinization of charisma” or Hans Mol’s “sacralization of identity” (Powell 2017).
Indeed, even with Romme’s psychiatric credentials lending authority and legitimacy to the movement, and with proselytizing figures like Coleman speaking to international audiences of the merits of “accepting voices,” the relatively fast growth of the HVM as well as the challenges brought on by rapid globalization and effective social media use has led to some concerns about the common viewpoints holding the movement together. In the twenty-first century, the HVM seeks to be inclusive and empowering but, as with any sacralizing institution, it must delimit the worldviews of its members to some degree to remain salient amidst competing alternatives. It is unclear whether, for instance, the emphasis on trauma-related voices will remain if/when this is perceived as a marginalizing influence on those whose voices are unrelated to past abuse. In contrast, the movement’s basic assumption that voice-hearing is a normal part of the human experience has been increasingly bolstered by a growing body of empirical evidence suggesting that hallucination-like experiences occur on a spectrum rather than as discrete symptoms of ill health.
Here, however, is a potential threat. Although the scientific evidence may increasingly support one of the group’s presuppositions (that hearing voices is a relatively common and benign component of human experience), much of the potency and cultural currency of the movement has come from its explicit criticisms of the psychiatric establishment. Nurturing identity in this tension between elitist science and “expertise by experience,” the HVM may face the struggles of accommodation and acceptance navigated by most new religious movements as they shift from sectarian outsiders to a more mainstream social position. Of course, this growing evidentiary support could mean that the HVM will adapt positively, claiming socio-political success for its members whilst continuing to provide them with a strong mythological origin, basic tenets, clear opposition in the form of traditional bio-medical models of psychosis, and a ritualized peer group space for embodying and reinforcing meaningful values.
Image #1: Professor Marius Romme.
Image #2: Seventh World Hearing Voices Congress.
Blackman, Lisa. 2001. Hearing Voices: Embodiment and Experience. New York: Free Association Books.
Corstens, Dirk, Longden, Eleanor, McCarthy-Jones, Simon, Waddingham, Rachel, & Thomas, Neil. 2014. “Emerging Perspectives From the Hearing Voices Movement: Implications for Research and Practice,” Schizophrenia Bulletin 40:S285-S294.
Hearing Voices – Durham. 2016. “What does the Hearing Voices Movement mean to you?” Accessed from http://hearingvoicesdu.org/what-does-hvm-mean-to-you on 29 November 2019.
Hearing Voices Network. 2016. “2016 World Hearing Voices Congress—Paris.” Accessed from http://www.hearing-voices.org/events/2016-congress on 29 November 2019.
Holt, Lucy and Tickle, Anna. 2015. “‘Opening the Curtains’: How Do Voice Hearers Make Sense of Their Voices?” Psychiatric Rehabilitation Journal 38:256-62.
Intervoice. 2020. “Values and Vision.” Accessed from https://www.intervoiceonline.org/about-intervoice/values-vision on 2 April 2019.
James, Adam. 2001. Raising Our Voices: An Account of the Hearing Voices Movement. Gloucester: Handsell Publishing.
Longden, Eleanor. 2013. Learning from the Voices in My Head. TED Books.
Powell, Adam. 2017. “The Hearing Voices Movement as Postmodern Religion-Making: Meaning, Power, Sacralisation, Identity.” Implicit Religion 20:105-26.
Romme, Marius, Escher, Sandra, Dillon, Jacqui, Corstens, Dirk, & Morris, Mervyn, eds. 2009. Living with Voices: 50 stories of recovery. Ross-on-Wye: PCCS Books.
Woods, Angela. 2013. “The Voice-Hearer,” Journal of Mental Health 22:263-70.
8 April 2020