'What is it like?': The Hearing Voices Movement & Respectfully Curious Questions

In the 1980s, patient Patsy Hage collaborated with her psychiatrist, Marius Romme, on understandings of voice hearing. In 1987, they appeared together on Dutch TV sharing their work and launching a hotline for people who heard voices to call in and talk about their experiences.

That same year, the first congress was held for people who hear voices. It led to the launch of Foundation Resonance in Utrecht, the first ever National Hearing Voices Network. There are now numerous similar networks across the world.

Whilst I am not a voice hearer, I am someone who experiences mental states that others don’t always understand.

The way I relate to my experiences has been significantly influenced by The Hearing Voices Movement (HVM), the international grassroots movement promoting understanding of voice hearing as a meaningful human experience— one that deserves respect and exploration.

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It all began during my Master’s degree in Medical Humanities at King’s College London when I researched and wrote an essay entitled: ‘Respectful Curiosity: Hearing Voices: Phenomenological & Narrative Approaches to Voice Hearing’.

I spent nights delving into the research on the often multi-sensory and embodied experience of voice hearing. I discovered that numerous individuals experience voices as far more than auditory phenomena.

It struck me then that the term ‘hearing voices’ may, for some people, be insufficient or even misleading.

I learnt that some individuals’ voices may have tone, volume, pitch and/or a sonic texture, such as vibration. I found out that voices can be experienced with spatial or proprioceptive properties; for example voices that come closer, whisper in ears, call out from other rooms or across a distance.

I discovered that voices can have social characteristics, including personality, character or a sense of agency. Some could relate to people from long ago, non-human entities and more. Voices could be scolding, humiliating, frightening or kind, generous and loving.

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I’ve been interested in subjective perception and the textures of people’s inner landscape ever since I could speak. I was a child who tested my family’s patience with questions such as ‘what if I see red and you see blue, but I call it red blue and you call blue red?’

I could get caught up in the sensation of my hands or feet and how heavy they felt on the ends of my arms and legs. I told people I thought rice tasted like the letter x. I was really fun to hang out with at school.

As I got older, what I was really asking though was: How does it feel to be inside someone else’s mind? And: how abnormal am I?

The other question on the tip of the tongue I was always trying to bite:

Was there anyone out there like me?

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I found out what phenomenology was during my English Literature degree.

I was knee deep in reading the so-called Modernist writers, like James Joyce, Virginia Woolf, Katherine Mansfield, T.S.Eliot. My heart was skipping beats over their attempts to render something like a consciousness on the page.

Something else I was knee deep in was my own unravelling mental health crisis. And my confused attempts to render that decipherable to someone, anyone.

When I wasn’t crying in the library toilets or overdoing it with coffee, I was crushing over Virginia Woolf’s writing.

I wrote a dissertation on how she used architectural spaces, furniture and objects to try to represent states of mind. ‘The centre of that great cathedral space which was childhood’, she wrote in her essay ‘A Sketch of the Past’.

I knew exactly how that felt. That sense of enormousness, if only I could reach up and grab the great ceiling of my childhood.

In The Waves, Woolf's characters obsess over the solidity of objects, such as coffee cups, cutlery and tables, in contrast to the flowing sea.

‘I am rooted, but I flow’, expresses one of the characters. I was having panic attacks that made me feel like I was losing the edges of my body. Even my bed felt too unstable, I needed to lie on floor.

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In 2018, the year I wrote ‘Respectful Curiosity’ (also the year I fell in love with the guy who never stopped being kind, two years before my very close friend decided to delete me from her life) there were sixteen matches for the words ‘phenomenology’ or ‘phenomenological’ in the bibliography for the Hearing The Voice project.

Based at Durham University, this interdisciplinary research project explores ‘the subjective experience of voice hearing’ and examines how this phenomenon has been understood across time, place and culture.

In Medieval Europe, voice hearing was nearly always understood through a religious lens, for example. In 2018, anthropologist Tanya Luhrmann and colleagues R. Padmavati, H. Tharoor and A. Osei published research on voice hearing in the USA, India and Ghana.

They found that 'participants in the USA were more likely to use diagnostic labels and to report violent commands than those in India and Ghana, who were more likely than the Americans to report rich relationships with their voices and less likely to describe the voices as the sign of a violated mind.'

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For a self-confessed phenomenology fangirl like me, phenomenological approaches to human experiences offer something that traditional, medical approaches often miss when exploring mental states.

Firstly, a phenomenological approach is an inherently curious one. Its questions lead to more questions, many of which are notoriously difficult (impossible?!) to answer. Secondly, I believe it is respectful. It’s an antidote to testimonial smothering and epistemic injustice because it centres first person knowledge as it is lived and breathed.

A phenomenological approach leaves no stone unturned in a person’s inner landscape. It asks about temporality. Does time seem to contract or expand when you think or feel in a certain way?

It asks about spatiality and how mental events or memories are structured or seem to sit in relation to one another. Importantly, it also respects the embodied nature of psychological states.

In Phenomenology of Perception (1945), French philosopher Maurice Merleau-Ponty argued that ‘the redness of red’ cannot be adequately described because it is a lived, bodily experience.

Ultimately though, a phenomenological approach has the courage to ask intimate questions such as: ‘what is it like when you hear a voice?’.

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The Maastricht Voice Interview, a tool for understanding the nature of an individual’s voices and their relationship with them, includes questions like ‘[A]re you able to carry on a dialogue with the voices?’ and asks whether the voices may be connected to known people, life events or stresses that may have felt overwhelming.

For some people, voices can be containers of memories or events that felt too painful or unsafe to process at that time.

I relate and I am asking what my mental states might contain, or what messages they have for me. I'm asking what do I need to learn, what needs to be held onto and what needs to be let go. It is complex.

In the article ‘Don’t Pity Me: Psychosis Gave Me Mad Skills’, Rai Waddingham, International mental health trainer and chair of the Hearing Voices Network, writes: ‘I’ve learnt, through the Hearing Voices Movement, to relate to my voices with a firm kind of compassion. I listen to what the voices are saying (when I feel solid enough to do so) and try to remain curious about possible stories hidden beneath the words themselves.’

I try to remain curious too.

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I’ve always dabbled in metaphor as a kind of magic.

As a bid to communicate, as a bid to connect, as a bid to transmute something untranslatable. This might have been through recursive drawings in my twenties of crows and women with their mouths sewn shut and written imagery of birds with broken beaks and jellyfish chopped in half by spades.

I’ve always been interested in fiction blended with reality. I don’t see one as having more validity than the other. Also, I’m not always interested in the question: ‘what is true?’

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For me, creativity is my most dependable, most robust, form of resilience. It never lets me down. Every time I sit with my daughter at the kitchen table with the paints, the crayons and the glue, I try to give this to her.

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In "What Is It Like to Be a Bat?" (1974), philosopher Thomas Nagel argues that it’s impossible for a human to know what it’s like to be a bat. For a start, their primary mode of perception is echolocation which is about as alien and unrelatable as it gets for us humans.

And that’s okay.

I don’t think I expect, or ask for, understanding.

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Living with Voices: 50 Stories of Recovery (2009) states ‘voices say something and what they tell is where the interest should be focused’. ‘Being asked about voices seems to be one of the most powerful things to kickstart recovery’.

Not only does The Hearing Voices Movement advocate for speaking about voices, but conversing with them as well.

More traditional, medical approaches to distress too often prioritise silence and the act of silencing. A question though, asked with respectful curiosity, offered with compassion, opens up the space for something different.

What is it like…

What is it like to…

‘On the outskirts of every agony sits some observant fellow who points’, says the 'phrase-maker' character, Bernard, in The Waves.

A question opens up so many possibilities.

Rosie x

Luhrmann TM, Padmavati R, Tharoor H, Osei A. Differences in voice-hearing experiences of people withpsychosis in the USA, India and Ghana: Interview-based study. British Journal of Psychiatry. 2015;206(1):41-44. doi:10.1192/bjp.bp.113.139048

The Maastricht Voice Interview, developed by Sandra Escher, Patsy Hage, and Marius Romme, https://improvingmipractices.org/application/files/9615/6924/4250/Maastricht.Mine.pdf

Merleau-Ponty, Maurice. Phenomenology of Perception. Translated by Colin Smith, Routledge & Kegan Paul, 1962.

Nagel, Thomas. "What Is It Like to Be a Bat?" The Philosophical Review, vol. 83, no. 4, 1974, pp. 435–50.

Romme, Marius, and Sandra Escher, editors. Living with Voices: 50 Stories of Recovery. PCCS Books, 2009.

Waddingham, Rai. "Don’t Pity Me: Psychosis Gave Me Mad Skills.", Medium https://raiwaddingham.medium.com/dont-pity-me-psychosis-gave-me-mad-skills-60c0d5084a17 2017

Woods, Angela, et al. "Interdisciplinary Approaches to the Phenomenology of Auditory Verbal Hallucinations." Schizophrenia Bulletin, vol. 40, no. suppl_4, 2014, pp. S246–54.

Woolf, Virginia. "A Sketch of the Past." Moments of Being, edited by Jeanne Schulkind, Harcourt Brace Jovanovich, 1985, pp. 64–159.

Woolf, Virginia. The Waves. Hogarth Press, 1931.