Advancing Understanding of Compassionate Relationships with Voices

Leach, Hannah and Parry, Sarah and Kelly, James (2024) Advancing Understanding of Compassionate Relationships with Voices. PhD thesis, Lancaster University.

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Abstract

This thesis focuses on people’s experiences of hearing voices that others do not. It approaches this phenomenon from a non-diagnostic perspective, prioritising social, psychological and relational frameworks for understanding voices. The concept of compassion for voices, and the role of relational therapies, is explored. Chapter One is a systematic review of the qualitative literature on relational aspects of voice-hearing. Through thematic synthesis, it explores the question, “how do people experience relationships with the voices they hear?”. The review synthesised findings from 25 studies, resulting in four themes which were found across studies with clinical and non- clinical samples. Clinical implications are discussed in the context of existing and potential interventions to help voice-hearers change their relationships with voices, themselves and with others in the social world. Strengths and limitations of the review are discussed. Chapter two presents an empirical research study, which focused on young people’s experiences of hearing voices. The concept of compassion was used, with participants being invited to reflect on their experiences of self-compassion and compassion in their interactions with voices. Qualitative data was gathered from 17 participants, and narrative analysis resulted in the development of four narrative chapters. Quantitative measures of self-compassion, and fears of compassion, enabled tentative links to be made between participants’ experiences with voices and their broader experiences of compassion. Further discussion is presented around the nuances in how young people conceptualise compassion in relation to the voices they hear. Recommendations for practice and future research are made, highlighting the need for de-stigmatisation of voice-hearing, and for individualised, flexible interventions for voice-hearers. In Chapter three, a further critical appraisal is offered, with practical and personal reflections on the empirical research undertaken.