Voice-hearing has traditionally been understood as a symptom of psychiatric illness, being most closely associated with schizophrenia. It has been referred to as a “symptom of brain disease just like blindness” and is typically treated with medication, which can indeed help.
So what has led to a different approach to hearing voices? First, there has been the rediscovery that many people hear voices without distress or impairment, and we are now able to pinpoint what can make voice-hearing problematic. There is an 88% probability of correctly guessing whether a voice-hearer is a patient or not from simply knowing one thing: whether the voices are nasty. Studies, including some with “psychics”, have also found that hearing voices frequently, and lacking control over them, is associated with it being a problem.
In addition, trauma has been found to be associated with hearing voices. In fact, suffering multiple childhood traumas is associated with later voice-hearing to approximately the same extent that smoking is with lung cancer. Not only does trauma increase the probability of voice-hearing, but the characteristics of the voices are often related to such events. However, the role of trauma in voice-hearing has historically been minimised, with hearers advised to chemically eliminate their voices, not to carefully explore them.
Understanding voices
But working closely with his partner, Dr Sandra Escher, and many other voice-hearers, Romme co-developed the interview. Speaking of it today, Romme said:
We had never interviewed a voice hearer about their experience as that was forbidden in the profession. Still most psychiatrists don’t know what to ask.
The purpose of the interview is to find the answers to two key questions: “Who do the voices represent?” and “What problems do the voices represent?” The voice-hearer and the interviewer then work together to “break the code” of the voices, uncovering the meaning of the voice in relation to the person’s life history, which may not be readily apparent.