The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis

<p><strong>Objectives:</strong>&nbsp;Relationships with other people are important determinants of the course of psychosis, yet social isolation is common. This study sought to learn about the patient experience of being around other people when hearing derogatory and threateni...

Full description

Bibliographic Details
Main Authors: Sheaves, B, Johns, L, Cernis, E, Griffith, L, The McPin Hearing Voices Lived Experience Advisory Panel, Freeman, D
Format: Journal article
Language:English
Published: Wiley 2020
_version_ 1797110749893492736
author Sheaves, B
Johns, L
Cernis, E
Griffith, L
The McPin Hearing Voices Lived Experience Advisory Panel
Freeman, D
author_facet Sheaves, B
Johns, L
Cernis, E
Griffith, L
The McPin Hearing Voices Lived Experience Advisory Panel
Freeman, D
author_sort Sheaves, B
collection OXFORD
description <p><strong>Objectives:</strong>&nbsp;Relationships with other people are important determinants of the course of psychosis, yet social isolation is common. This study sought to learn about the patient experience of being around other people when hearing derogatory and threatening voices (DTVs).</p> <p><strong>Design:</strong>&nbsp;A qualitative interview study.</p> <p><strong>Methods:</strong>&nbsp;Fifteen participants with experience of hearing DTVs in the context of non‐affective psychosis were recruited from NHS services. Data were obtained by semi‐structured interviews and analysed using thematic analysis.</p> <p><strong>Results:</strong>&nbsp;Three themes were identified: (1) reasons why interacting with people is difficult when hearing DTVs; (2) the relationship between social connection and DTVs; and (3) factors which enable voice hearers to connect with others. A further ten sub‐themes are outlined as reasons why hearing DTVs led to lower social connection, including difficulties during conversations (e.g.,&nbsp;<em>the</em>&nbsp;<em>concentration required is hard</em>), negative expectations of interactions (e.g.,&nbsp;<em>fearing negative judgement from others</em>), and difficulties sharing experiences of voices (e.g.,&nbsp;<em>people will be hurt or upset if I tell them about the voices</em>). Isolation was a common response to hearing DTVs but also a time of vulnerability for hearing voices. Managing the challenges of interacting with people led to some improvements in DTVs.</p> <p><strong>Conclusions:</strong>&nbsp;There are understandable reasons why hearing DTVs leads to lower social connection. Yet isolating oneself can also be a time of vulnerability for DTVs. Social connection might be one vehicle for disengaging from and disputing derogatory and threatening voice content. The effect on voice hearing of social recovery interventions warrants further investigation.</p> <p><strong>Practitioner points:</strong></p> <ul> <li>Participants shared 10 reasons why being around people is challenging when hearing derogatory and threatening voices. These typically affected both daily social experiences and contact with clinicians.</li> <li>Common initial responses to hearing DTVs were to reduce contact with people, experience difficulties connecting during conversations and to avoid sharing the experience of voice hearing.</li> <li>However, social isolation was a time of vulnerability to DTVs, and hence, increasing social connection might be a target for interventions.</li> <li>A range of factors enabled voice hearers to manage social situations, for example: the fostering of trust, self‐acceptance, learning when it is better to stay at home, and developing a narrative to explain voice hearing to others.</li> <li>Addressing the barriers to connecting with others might have an important role in personal recovery from voice hearing.</li> </ul>
first_indexed 2024-03-07T08:00:43Z
format Journal article
id oxford-uuid:925962c5-38b9-4f1f-90f4-56d9d4f59096
institution University of Oxford
language English
last_indexed 2024-03-07T08:00:43Z
publishDate 2020
publisher Wiley
record_format dspace
spelling oxford-uuid:925962c5-38b9-4f1f-90f4-56d9d4f590962023-09-19T13:02:41ZThe challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:925962c5-38b9-4f1f-90f4-56d9d4f59096EnglishSymplectic ElementsWiley2020Sheaves, BJohns, LCernis, EGriffith, LThe McPin Hearing Voices Lived Experience Advisory PanelFreeman, D<p><strong>Objectives:</strong>&nbsp;Relationships with other people are important determinants of the course of psychosis, yet social isolation is common. This study sought to learn about the patient experience of being around other people when hearing derogatory and threatening voices (DTVs).</p> <p><strong>Design:</strong>&nbsp;A qualitative interview study.</p> <p><strong>Methods:</strong>&nbsp;Fifteen participants with experience of hearing DTVs in the context of non‐affective psychosis were recruited from NHS services. Data were obtained by semi‐structured interviews and analysed using thematic analysis.</p> <p><strong>Results:</strong>&nbsp;Three themes were identified: (1) reasons why interacting with people is difficult when hearing DTVs; (2) the relationship between social connection and DTVs; and (3) factors which enable voice hearers to connect with others. A further ten sub‐themes are outlined as reasons why hearing DTVs led to lower social connection, including difficulties during conversations (e.g.,&nbsp;<em>the</em>&nbsp;<em>concentration required is hard</em>), negative expectations of interactions (e.g.,&nbsp;<em>fearing negative judgement from others</em>), and difficulties sharing experiences of voices (e.g.,&nbsp;<em>people will be hurt or upset if I tell them about the voices</em>). Isolation was a common response to hearing DTVs but also a time of vulnerability for hearing voices. Managing the challenges of interacting with people led to some improvements in DTVs.</p> <p><strong>Conclusions:</strong>&nbsp;There are understandable reasons why hearing DTVs leads to lower social connection. Yet isolating oneself can also be a time of vulnerability for DTVs. Social connection might be one vehicle for disengaging from and disputing derogatory and threatening voice content. The effect on voice hearing of social recovery interventions warrants further investigation.</p> <p><strong>Practitioner points:</strong></p> <ul> <li>Participants shared 10 reasons why being around people is challenging when hearing derogatory and threatening voices. These typically affected both daily social experiences and contact with clinicians.</li> <li>Common initial responses to hearing DTVs were to reduce contact with people, experience difficulties connecting during conversations and to avoid sharing the experience of voice hearing.</li> <li>However, social isolation was a time of vulnerability to DTVs, and hence, increasing social connection might be a target for interventions.</li> <li>A range of factors enabled voice hearers to manage social situations, for example: the fostering of trust, self‐acceptance, learning when it is better to stay at home, and developing a narrative to explain voice hearing to others.</li> <li>Addressing the barriers to connecting with others might have an important role in personal recovery from voice hearing.</li> </ul>
spellingShingle Sheaves, B
Johns, L
Cernis, E
Griffith, L
The McPin Hearing Voices Lived Experience Advisory Panel
Freeman, D
The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title_full The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title_fullStr The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title_full_unstemmed The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title_short The challenges and opportunities of social connection when hearing derogatory and threatening voices: A thematic analysis with patients experiencing psychosis
title_sort challenges and opportunities of social connection when hearing derogatory and threatening voices a thematic analysis with patients experiencing psychosis
work_keys_str_mv AT sheavesb thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT johnsl thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT cernise thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT griffithl thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT themcpinhearingvoiceslivedexperienceadvisorypanel thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT freemand thechallengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT sheavesb challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT johnsl challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT cernise challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT griffithl challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT themcpinhearingvoiceslivedexperienceadvisorypanel challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis
AT freemand challengesandopportunitiesofsocialconnectionwhenhearingderogatoryandthreateningvoicesathematicanalysiswithpatientsexperiencingpsychosis