Time changes everything? A qualitative investigation of the experience of auditory verbal hallucinations over time

Although phenomenological surveys have established the typical properties of auditory verbal hallucinations, little research has examined the key issues associated with hearing voices over time. To explore this, interviews with six young adults with psychosis who heard voices were conducted and analysed using Interpretative Phenomenological Analysis. Six themes emerged, and an experiential journey through voices was discerned. Voices typically emerged after negative life events ("Negative Trigger"), and were at first rejected as being part of the self ("The Rejection Phase"). Crisis events ("Crisis-induced Change") could then lead to either positive changes (e.g., the voice-hearer opening up to talking to their friends and services about their voices) or negative ones (e.g., voices becoming more critical/abusive). Voice-hearers could enter a phase involving "Discovering, Adjusting and Trying to Cope" with the voices, based on three key resources: themselves, others, and services. Finally, a "New Understanding" phase could be reached where participants changed from simply rejecting their voices to different understandings, such as that their voices were a part of them, and were potentially there for the long-term. However, many struggled with these potential new understandings. Implications for clinical practice and the direction of future research are examined.