The Hearing Voices Movement (HVM) is an international grassroots initiative composed of individuals and organizations who promote the hearing voices approach—a framework for understanding the experience of hearing voices. While mainstream psychiatry typically refers to such experiences as auditory verbal hallucinations, the movement uses the term hearing voices, which it argues is more accurate and respectful.
The movement originated in the Netherlands in the late 1980s through the collaboration between voice-hearer Patsy Hage, psychiatrist Marius Romme and researcher Sandra Escher.
HVM regards hearing voices as a meaningful, though sometimes distressing, human experience that can be explored and understood. It supports the creation of hearing voices groups, peer-led spaces where individuals can share and make sense of their experiences.
Rather than treating voice-hearing as a symptom of mental illness, HVM emphasizes approaches grounded in human rights, social justice, diversity and collective empowerment. It challenges the dominance of the medical model in psychiatry and questions the validity of diagnostic categories such as schizophrenia.
History The Hearing Voices Movement originated in the Netherlands in the late 1980s through the collaboration of voice-hearer Patsy Hage, psychiatrist Marius Romme, and researcher Sandra Escher.Escher S. Romme M. The Hearing Voices Movement, Chapter 28 page 385 in "Hallucinations" by Jan Dirk Blom and Iris E.C. Sommer, Editors Springer, New York; Dordrecht; Heidelberg; London (2012). HVM was formally established in 1987 with the founding of the first national Hearing Voices Network in the Netherlands, Stichting Weerklank, following a meeting organized by Escher and Romme. In 1988, a group was formed in Manchester by voice-hearer Louise Pembroke and community worker Paul Baker.Adam James (201) Raising Our Voices: An Account of the Hearing Voices Movement, Handsell Publishing (2001) After receiving media attention in 1990, this developed into a national UK network.
Following this, more national networks were formed, including in Austria (1992), Finland and Japan (1996), Germany (1998), Palestine (2001), US (2010), and Uganda (2012). In 1997, the organisation Intervoice was established to support and connect hearing voices networks and initiatives worldwide. In 2009, the first World Hearing Voices Congress was held in Maastricht, Netherlands.
The Melbourne Hearing Voices Declaration was launched at the World Hearing Voices Congress in 2013. It promotes the hearing voices approach as a rights-based alternative within mental health care. This was followed by the Thessaloniki Declaration in 2014.
Tenets At its core, the Hearing Voices Movement proposes that hearing voices is a meaningful human experience. Rather than seeking to eliminate voices, the movement emphasizes the importance of allowing individuals to make sense of their voices on their own terms.
HVM uses hearing voices as an umbrella term that also includes seeing visions and other sensory experiences such as touch, taste, and smell. The movement views these experiences as an aspect of human difference, rather than a mental health problem.
The principles of the movement closely align with the recovery model, emphasizing empowerment and human rights, and promoting holistic approaches to address problematic and overwhelming voices.
Since many people live successfully with their voices, voices themselves are not viewed as the problem. Instead, the relationship between a person and their voices is considered a central issue. Research has found that people who hear voices can be helped using methods such as mindfulness-based interventions, voice dialoguing cognitive behaviour therapy (CBT) and self-help methods. HVM offers guidance to mental health practitioners to assist people who hear voices and may feel overwhelmed by the experience.
HVM takes a critical stance toward the medical model of disability and expresses concern about an exclusive reliance on medication as treatment. They highlight that service users are sometimes discouraged from talking about their voices as these are seen solely as symptoms of psychiatric illness.Heard but not seen (1990). Romme, M.A.J. & Escher, A.D.M.A.C. Open Mind No 49, 16-18'You don't talk about the voices': voice hearers and community mental health nurses talk about responding to voice hearing experiences. Coffey M, Hewitt J. J Clin Nurs. 2008 Jun;17(12):1591-600.Jones M, Coffey M. Voice hearing: a secondary analysis of talk by people who hear voices. Int J Ment Health Nurs. 2012 Feb;21(1):50-9.England M. Accuracy of nurses' perceptions of voice hearing and psychiatric symptoms. J Adv Nurs. 2007 Apr;58(2):130-9. Historical and anthropological critiques are referenced to illustrate how experiences like voice-hearing have been culturally devalued. In Voices of Reason, Voices of Insanity, Leudar and Thomas review nearly 3,000 years of voice-hearing history.The anatomy of hallucinations. Johnson, Fred H. Oxford, England: Nelson-Hall. (1978). xvi 239 pp. They argue that the western world has moved the experience of hearing voices from a socially valued context to a pathologised and denigrated one. Foucault has argued that this process can arise when a minority perspective is at odds with dominant social norms and beliefs.M. Foucault, Madness and Civilization: A History of Insanity in the Age of Reason trans. by R. Howard, (London: Tavistock, 1965) - abridged; History of Madness ed. Jean Khalfa, trans. Jonathan Murphy and Jean Khalfa, (London: Routledge, 2006)
The position of the hearing voices movement can be summarised as: Hearing voices is not in itself a sign of mental illness. Hearing voices is part of the diversity of being a human, it is a faculty that is common (3-10% of the population will hear a voice or voices in their lifetime) and significant. Hearing voices is experienced by many people who do not have symptoms that would lead to diagnosis of mental illness. If hearing voices causes distress, the person who hears the voices can learn strategies to cope with the experience. Coping is often achieved by confronting past problems that lie behind the experience.
Theoretical overview The work of Marius Romme, Sandra Escher and other researchers provides a theoretical framework for the movement. They find that:
Not everyone who hears voices becomes a patient. Over a third of 400 voice hearers in the Netherlands they studied had not had any contact with psychiatric services. These people either described themselves as being able to cope with their voices and/or described their voices as life enhancing. Demographic (epidemiological) research provides evidence that there are people who hear voices in the general population (2%-6%) who are not necessarily troubled by them. Only a small minority fulfill the criteria for a psychiatric diagnosis and, of those, only a few seek psychiatric aid indicating that hearing voices in itself is not necessarily a symptom of an illness.Jardri, Thomas, Cachia & Pins|title=The Neuroscience of hallucinations|year=2013 Even more (about 8%) have peculiar delusions and do so without being ill. People who cope well with their voices and those who did not, show clear differences in terms of the nature of the relationship they had with their voices.Sorrell E, Hayward M, Meddings, Interpersonal processes and hearing voices: a study of the association between relating to voices and distress in clinical and non-clinical hearers. S. Behav Cogn Psychother. 2010 Mar;38(2) People who live well with their voice experience use different strategies to manage their voices than those voice hearers who are overwhelmed by them.The accepting and making sense of hearing voices approach. (2006) Romme Marius and Escher Sandra 70% of voice hearers reported that their voices had begun after a severe traumatic or intensely emotional eventRomme, Marius AJ, and Sandra DM Escher. "Trauma and hearing voices." Trauma and psychosis: New directions for theory and therapy (2006): 162-191. such as an accident, divorce or bereavement, sexual or physical abuse, love affairs, or pregnancy.Personal links between trauma, distorted emotions and hearing voices (2011) Romme Marius, Psychosis as a personal crisis: an experienced based approach Romme and Escher eds. Routledge Romme and colleagues found that the onset of voice hearing amongst a patient group was often preceded by either a traumatic event or an event that activated the memory of an earlier trauma.Personal history and Hearing voices (2010) Romme Marius and Escher Sandra, Hallucinations: A quide to treatment and management. Frank Leroi and Andre Aleman (eds) Oxford University press Oxford Specifically, there is a high correlation between voice hearing and abuse. These findings are being substantiated further in on-going studies with voice hearing amongst children. Some people who hear voices have a deep need to construct a personal understanding for their experiences and to talk to others about it without being designated as mad.
Intervoice Intervoice (The International Network for Training, Education and Research into Hearing Voices) is an international organization that coordinates and supports initiatives within the global Hearing Voices Movement. It supports and connects "experts by experience" (voice hearers) and "experts by profession" (mental health workers, academics, activists).
Intervoice was founded in 1997 during a meeting in Maastricht, Netherlands. In 2007, it was incorporated under UK law as a non-profit organisation and charity, operating under the name International Hearing Voices Projects Ltd. Its governing body includes both voice hearers and mental health practitioners.
Activities
Hearing voices groups Hearing voices groups are based on an ethos of self-help, mutual respect and empathy. They provide a safe space for people to share their experiences and to support one another. They are peer support groups, involving social support and belonging, not necessarily therapy or treatment. Groups offer an opportunity for people to accept and live with their experiences in a way that helps them regain some power over their lives. There are hundreds of hearing voices groups and networks across the world. In 2014 there were more than 180 groups in the UK. These include groups for young people, people in prison, women and people from Black and Minority Ethnic communities.Anna Ruddlea, Oliver Mason, Til Wykes, A review of hearing voices groups: Evidence and mechanisms of change, Clinical Psychology Review Volume 31, Issue 5, July 2011, Pages 757–766, 2011)
World Hearing Voices Congress Intervoice hosts the annual World Hearing Voices Congress. In 2015 the 7th Congress was held in Madrid, Spain, the 2016 Congress will be held in Paris, France. Previous conferences have been held in Maastricht, Netherlands, (2009); Nottingham, England (2010), Savona, Italy (2011), Cardiff, Wales (2012); Melbourne, Australia (2013); Thessaloniki, Greece (2014); Madrid, Spain (2015).
Annual World Hearing Voices Day This is held on 14 September and celebrates hearing voices as part of the diversity of human experience, It seeks to increase awareness of the fact that you can hear voices and be healthy. It also challenges the negative attitudes towards people who hear voices and the assumption that hearing voices, in itself, is a sign of mental illness.
Research Intervoice has an international research committee, that commissions research, encourages and supports exchanges and visits between member countries, the translation and publication of books and other literature on the subject of hearing voices and other related extraordinary experiences.
Relationship to psychiatry