Voice-hearing: lived realities and meaning making
Susanne Ådahl is a Post-doctoral researcher in medical anthropology who has conducted ethnographic research on lay perceptions of cancer among Finnish farmers (see Ådahl 2007) and patient experiences of organ transplantation in Finland (see Ådahl 2012 a and b). Her contribution to the Mind and the Other project deals with the phenomenon of voice hearing as a subjective, lived experience.
A starting point in her research project is to investigate the manner in which people frame, situate and learn to experience voice hearing and how it in turn shapes voice hearing experiences themselves. The pivotal focus of the research is investigating the phenomenon of voice hearing void from preconceived labels. Ådahl is interested in the intersubjective nature of the experience and the contemporary beliefs and explanatory models (Kleinman 1980) surrounding it. In the study she asks how voice hearers interact with voices and how they negotiate the agency that exists between them and the voices. How do people’s explanatory models illuminate the cultural values attributed to the sensory experience of voice hearing? In what ways do the voices and the people hearing them shape social identity and subjectivity within the voice-hearers’ community? What does this tell us about perceptions of the human mind in Finnish society? Her theoretical focus is on agency, practice and interpretations of the illness experience.
The hearing of voices that others cannot hear (also called auditory hallucinations) is a global phenomenon that, accoording to conservative estimates, affects around 2-4% of the population. Only 1/3 of those experiencing this phenomenon need psychiatric care and many voice hearers are never in touch with psychiatric services. People who hear voices do not necessarily define themselves as suffering from an illness, although auditory hallucinations are one of the symptoms of a psychotic state and of schizophrenia (see Blackman 2000, 2007). In many cultural contexts the hearing of voices is linked to religious beliefs, as verbally answered prayer and voice hearers may be viewed as individuals in possession of special, valued abilities (Dein & Littlewood 2007). There are also other channels through which voice hearers can give meaning to this experience through networks and organisations working to support the rights and needs of people who hear voices. The global Hearing Voices Network, together with its member organisations, such as the national level voice hearing association Suomen Moniääniset ry, provide a platform for sharing experiences, extending social and peer support and giving voice hearers tools for coping with and responding to their voices. The association has existed since 1996 and is dedicated to doing advocacy work and extending support to voice hearers. The profile of the association is to view voice hearing as a human trait, rather than as an illness; it is believed that communicating about the experience in a peer support context will aid recovery and coping of voice hearers (Suomen Moniääniset 2014).
Within psychiatry auditory hallucinations are pathologised and persons suffering from this condition are induced to accept this state of mind as a condition in need of a biomedical intervention (Dumit 2005). The pathology of auditory hallucinations is, however also within psychiatry a contested field – some practitioners see it as a reaction to traumatic life events, rather than a symptom of schizophrenia. Biomedical explanatory models of auditory hallucinations are inadequate in explaining the complexity of this phenomenon. Of equal relevance to how auditory hallucinations are received in society and within biomedicine is what type of theory of mind is prevalent in that society, of how perception, intention and inference are culturally imagined. There are cultural differences seen in the sensory modes of hallucination experience (Luhrmann 2011, 2012).
In present day society we still know fairly little about how people suffering from this phenomenon experience it, live with it and seek to explain it in everyday life and how they act to come to grips with this condition. This is a gap that can and needs to be filled by qualitative research. A phenomenologically informed understanding of voice hearing is needed in order to establish the vital link between voice-hearing and people’s life experiences (Woods et al. 2013).
In spite of the potentially high number of individuals that have experienced the phenomenon of voice hearing it has received fairly little attention and visibility in Finland. The strong stigma and fear of being labeled crazy makes people conceal their experiences. It is clear that a vast number of Finns who have the experience of voice hearing either conceal it or have found alternative means of dealing with this trait. Through the research Ådahl wants to gain a holistic view of voice hearing experiences and phenomenological interpretations of the phenomenon from a wide group of individuals. Giving voice to individuals that have experienced this phenomenon is a way of providing a more nuanced picture of what goes on in the human mind, how alternative realities are explained and made meaningful by these persons, helping them to live with this phenomenon.
Using an ethnographic approach Susanne Ådahl has been observing the activities of a national level patient organisation (Suomen Moniääniset ry) and soliciting members to be interviewed. To date altogether 18 ethnographic have been conducted with a sample of individuals mainly recruited through Suomen Moniääniset ry, resulting in a total of 25 hours of taped and transcribed interview material, with interviews lasting between 30 minutes to two and a half hours. Additional empirical material has been collected in the form of notes taken during participant observation of two peer support group meetings in the capital city area for a period of 1 year. Three respondents have written voice diaries during a one month period.
Bibliography
Blackman, Lisa 2000. Ethics, Embodiment and the Voice-Hearing Experience. Theory, Culture and Society, 17(55): 55-74.
Blackman, Lisa 2007. Psychiatric Culture and Bodies of Resistance. Body & Society 13 (1): 1-22.
Dein, Simon and Littlewood, Roland 2007. The Voice of God. Anthropology and Medicine 14: 213-228.
Dumit, Joseph 2005. The De-psychiatrisation of Mental Illness. Journal of Public Mental Health 4(3): 8-13.
Kleinman, Arthur 1980. Patients and healers in the context of culture: an exploration of the borderland between anthropology, medicine, and psychiatry. Berkeley: University of California Press.
Luhrmann, Tanya 2011. Hallucinations and Sensory Overrides. Annual Review of Anthropology 40: 71-85.
Luhrmann, Tanya 2012. A Hyperreal God and Modern Belief: Toward an Anthropological Theory of Mind. Current Anthropology 53 (4): 371-395.
Woods, Angela; Romme, Marius ; McCarthy-Jones, Simon ; Escher, Sandra Sandra & Jacqui Dillon (2013) Special edition: Voices in a Positive Light, Psychosis: Psychological, Social and Integrative Approaches.
Ådahl, Susanne 2007. Good Lives, Hidden Miseries. An ethnography of uncertainty in a Finnish village. Research Reports no. 250, Department of Sociology, University of Helsinki. Helsinki: Helsinki University Printing Press.
Ådahl, Susanne 2012a. ‘I was a model student’: Illness Knowledge Seeking and Self‐care Among Finnish Kidney Recipients. Culture unbound: journal of current cultural research 4: 443-463.
Ådahl, Susanne 2012b. The Freedom Machine: Home-based dialysis and caring for the Self. Suomen antropologi, Journal of the Finnish Anthropological Society 37(3): 24-41.
Presentations in seminars and conferences
“Äänten kuuleminen mystisenä kokemuksena – kulttuuriset selitysmallit”, Suomen Moniäänisten Pyhimyksiä vai mielipuolia –näyttelyn avajaisseminaari, Lahden pääkirjasto, 2.9.2015.
“From global emancipation to local practices: Strategies of control in the everyday life of voice hearers as presented in peer group discussions”, NNHSH conference on Encounters between Nordic health, welfare and the global: Challenges and possibilities, UIB Global, University of Bergen, Norway, 4-5 May, 2015.
”Alien Voices: Using the phenomenology of Bernhard Waldenfels to understand alterity in voice hearing”, Seminar on the Limits of Mimesis, University of Helsinki, 29 April, 2015.
“The inaccessibility of words in the head: Experimenting with the ontographic approach”, International workshop on Alterity as a Theoretical and Methodological Challenge in Fieldwork, Sirkkala Campus, University of Turku, 20 February, 2015.
“Aistimellisuus ja kummat kokemukset”, Kirjaseminaari Nykypäivän kummat kokemukset, Sirkkala Campus, University of Turku, 2 February, 2015.
“Cultural soundscapes and voice hearing”, International symposium on Minding the Sound, Sounding the Mind, Halmstad University, November 27-28, 2014.
”Äänten kuulemisen fenomenologia”, Mielen kulttuuri. Kerrottu, koettu ja kuvitettu hulluus, Maailman mielenterveyspäivän seminaari 10.10.2014, Jyväskylä.
”Miten ymmärtää äänten kuulemisen kokemusta kulttuurin muovaamana ilmiönä?” Annetaan äänemme kuulua – seminaari äänien kuulemisen kokemuksesta, Turku, 8.10.2014.
“Magical Consciousness – Transgressing the boundaries between mind, body and nature”, Play the Rite Ritual Festival, Kiila, Kemiö 26-28.9, 2014.
“Negotiating Agency with Voices”, Ambiguity of Action symposium, University of Helsinki, 10-11.6, 2014.
“Hearing voices, Hearing Self”, Conference of the Medical Anthropology at Home Network on Assemblages, Transformations, and the Politics of Care, 29.5-1.6, 2014, Bertinoro-Bologna, Italy
“Creating a new self: the potential of cognitive self-therapy among voice hearers”, Conference of the Nordic Network for Health Research within Social Sciences and the Humanities on Creative and Able Citizens: dealing with health and illness during the life course, University of Helsinki, 22-23.5, 2014
“Disciplining the mind: transforming auditory hallucinations in Finland”, Panel on Sensory Experience of Suffering and Healing, IUAES (International Union of Anthropological and Ethnological Societies) conference Japan 15-18.5, 2014
“Mind Labour: working in/with the concealed world of voice hearing”, workshop on Limits of and Beyond Experience, Turun yliopisto, 9-11.4, 2014
“Patients Helping Patients: Caregiving among Voice Hearers and Kidney recipients”, Panel on Caregiving and Communities: Challenging and Transforming Health Care American Anthropological Associations Annual Meeting, Chicago, November 24, 2013
“The Experience of Voice Hearing in Finland”, Human Flourishing: A Postgraduate Medical Humanities Conference, Centre for Medical Humanities, University of Durham, Great Britain, May 16-17, 2013.