Beyond the omnipotence of voices: further developing a relational approach to auditory hallucinations

Auditory hallucinations ("voices") can be understood within a cognitive model whereby the beliefs an individual holds about their voices influences their level of distress and how they respond to them. Despite contributing greatly to interventions for voices, the cognitive model appears to have limitations due to its focus on dimensions of voice power and the relative neglect of beliefs about malevolence. In enhancing the impact of psychological intervention for voices, a potential direction is to seek the roots of beliefs about voices in developmental frameworks, such as attachment and interpersonal theories. In this theoretical and conceptual paper we will examine how a relational approach to conceptualising the interaction between a voice-hearer and their voice may be beneficial, how developmental factors such as attachment patterns may influence the type of relation a person has with their voices, and how either altering or attenuating one's relationships with voices, as well as other people in one's social word, may be clinically useful.