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The listening book

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VOL: 98, ISSUE: 05, PAGE NO: 42

Mike Smith

For many years nurses have discussed the meaning in the voices that some people hear. Perceived wisdom in psychiatry is that it is the form and frequency of the voices rather than the content that is critical.

For many years nurses have discussed the meaning in the voices that some people hear. Perceived wisdom in psychiatry is that it is the form and frequency of the voices rather than the content that is critical.

This belief (which is not evidence-based) has led to nurses developing a practise of only recording the frequency of voices and sometimes the detail of their form, such as command hallucinations and commentary voices. This also applies to delusions, where form is concentrated on - such as nihilistic, somatic, or paranoid delusions - rather than what they mean in the person's life.

Many nurses and people who hear voices have challenged this approach. They believe the form of voices is less important than their identity, characteristics and influence on the hearer's life. Those who work with voice-hearers soon realise that the voices are full of meaning for the hearers and may be a direct communication, or a symbol of underlying and often undisclosed problems.

Intervoice is an international collaboration of experts in the profession that aims to increase awareness of, and research into, the phenomenon of voice-hearing. Intervoice promotes acceptance of and engagement with the voices rather than denial and retreat. According to Intervoice, the problem is not the hearing of voices, but the hearer's relationship with them and the influence the voices have over that person's life. Intervoice's approach allows people the opportunity to change their relationship with their voices if they wish, in order to regain control over their lives.

To develop this work further, Intervoice intends to collect the stories of voice hearers' lives and their success with living with voices. The organisation is particularly interested in how hearers have learned to live with their voices using this emerging methodology rather than denying or running from them or waiting for psychiatry to cure them.

Intervoice has requested the help of Nursing Times readers to gather anecdotal evidence. This is an ideal opportunity for nurses to encourage voice-hearers to be positive about their successes in living with voices and so help others in the process.

Using the evidence collected, Intervoice will compile a book of 50 examples of people who have heard voices and benefited from the 'accepting voices' approach pioneered by Romme and Escher (1993). The aim is that the book will contribute to the evidence-base and provide positive examples and motivation for other voice hearers and health care professionals.

Intervoice requires personal accounts from voice-hearers, or from health care professionals in collaboration with a consenting voice-hearer. Guidelines on entries will be provided on request. Entrants do not need to complete all parts of the entry form if they feel certain details are private. They should feel free to tell their story in their own way. Assistance with entries is available from Intervoice members in the UK and Europe.

- The guidance pack, which includes example entries, a framework for writing your own, and consent and contact information, is available from Mike Smith on 0121 623 5520 or via e-mail on or

Entries should be no more than 3,000 words long. Entrants will be asked permission if any changes are proposed during editing.

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