Holt, Lucy
(2013)
How do mental health service users explain the origins and maintenance of their voice hearing: a grounded theory approach.
DClinPsy thesis, University of Nottingham.
Abstract
The current study sought to explore how, if at all, people construct an understanding of the origin and maintenance of their experience of hearing voices. An exploratory qualitative method, social constructionist grounded theory, was adopted throughout the research process. Theoretical sampling was utilised and eight participants who hear voices, or previously heard voices, and were distressed by this experience, were recruited through adult mental health teams. Each participant engaged in one digitally recorded interview.
A cyclical process of data collection and analysis was undertaken, utilising Charmaz’s (2006) guidelines throughout. Three overarching descriptive categories were constructed regarding participants understanding of the development and maintenance of hearing voices which included; ‘Search for meaning’, ‘View of self’ and ‘Explanations for voices.
A sentence summary of the ‘essence’ of the developing grounded theory constructed is stated below:
Participants attempted to construct an understanding of their voices through drawing on three main frameworks (inter, intra and para-personal), but the relative ‘success’ of this pursuit, and potential usefulness of an understanding, is effected by the sense of agency, stigma and hope(lessness) perceived by the individual.
This study highlighted participants’ attempts to search for meaning of their voices, but the utility of this was often linked to the hopelessness they experienced, and relatively few participants held an explicit theory of the development and maintenance of their voices.
This research offers a unique and distinct contribution to the current literature through illustrating how voice hearers actively searched for meaning in relation to their voice-hearing experience. This highlights the importance of helping people engage in meaning-making processes to help individuals understand the experience of hearing voices. Furthermore, the implications of imposing one theoretical framework, which may be incongruent to the voice-hearers own understanding, to the experience of hearing voices are discussed.
The study identified a number of clinical implications, such as the role of psychological formulation in generating a shared understanding of the voices. A number of methodological difficulties were encountered during the research process and are discussed. Future research is warranted to explore voice-hearers from a wider range of cultural, religious and spiritual backgrounds and to explore whether the experience of developing a shared framework to understand their voice hearing is valued.
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