Self, Voices and Embodiment: A Phenomenological Analysis.
OBJECTIVE
The primary aim of this study was to examine first-person phenomenological descriptions of the relationship between the self and Auditory Verbal Hallucinations (AVHs). Complex AVHs are frequently described as entities with clear interpersonal characteristics. Strikingly, investigations of first-person (subjective) descriptions of the phenomenology of the relationship are virtually absent from the literature.


METHODS
Twenty participants with psychosis and actively experiencing AVHs were recruited from the University of Illinois at Chicago. A mixed-methods design involving qualitative and quantitative components was utilized. Following a priority-sequence model of complementarity, quantitative analyses were used to test elements of emergent qualitative themes.


RESULTS
The qualitative analysis identified three foundational constructs in the relationship between self and voices: 'understanding of origin,' 'distinct interpersonal identities,' and 'locus of control.' Quantitative analyses further supported identified links of these constructs. Subjects experienced their AVHs as having identities distinct from self and actively engaged with their AVHs experienced a greater sense of autonomy and control over AVHs.


CONCLUSIONS
Given the clinical importance of AVHs and emerging strategies targeting the relationship between the hearer and voices, our findings highlight the importance of these relational constructs in improvement and innovation of clinical interventions. Our analyses also underscore the value of detailed voice assessments such as those provided by the Maastricht Interview are needed in the evaluation process. Subjects narratives shows that the relational phenomena between hearer and AVH(s) is dynamic, and can be influenced and changed through the hearers' engagement, conversation, and negotiation with their voices.
University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA.
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C
Rosen
Stanford University, Department of Anthropology, 450 Serra Mall, Stanford, USA.
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N
Jones
University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA.
K A
KA
Chase
University of Illinois at Chicago, Neuropsychiatric Institute, Department of Psychiatry, USA.
L S
LS
Grossman
University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA.
H
H
Gin
University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, USA; Jesse Brown Veterans Affairs Medical Center, USA.
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RP
Sharma
Auditory Verbal Hallucinations; Phenomenology; Psychosis