Term Paper on "How Individuals That Hear Voices and Therapists Relate With the Experience of Hearing"

Term Paper 15 pages (4695 words) Sources: 1+

[EXCERPT] . . . .

Hearing Voices, Patients/Therapists

In an issue that aimed to reconsider the contributions that phenomenology offers to the practice of clinical psychology, Davidson outlined the ways in which transcendental psychology reconceptualized both research and clinical practice. One of the things he attempted to do in his investigation was to bring 'suspicious' events, such as hearing voices (auditory hallucinations) into a more mainstream setting, one in which a "phenomenology of respect" held the high ground. Davidson was not attempting to convince anyone that the heard voices were real; rather, "by virtue of the phenomenological reduction, to suggest that people who hallucinate actually ("really") do have experiences of hallucinations. Hearing a voice when no one else is around is an actual experience just like any other" (2004, p. 149+). Using the language of pop psychologists, Davidson suggested that the experiences of hearing voices "are what they are" and that "The question for us is how this changes our approach to psychological research and treatment" (Davidson, 2004, p. 149+).

Davidson traced phenomenology into clinical psychological and psychiatric practice through Karl Jaspers, a follower of the philosopher Heidegger's work. He notes, too, that while the existential and empirical approaches to clinical practice that were based on this work were nonetheless heavily influenced by Freud, with various schools regarding phenomenology having been developed by Freud's students (Davidson, 2004, p. 149+).

It is by way of this path that Davidson legitimizes phenomenology as an appropriate means of dealing with auditory hallucinations. While Davidson is a purist regarding phenomenology, he also posits the fact that Jung, Ferenzi and Erickson also offered views of events such as auditory hallucination that were seductive to phenomenologists. "In this respect, phenomenology and psychoanalysis make, at best, curious bedfellows" (Davidson, 2004, p. 149+). Still, the insistence on articulation of the obvious would clearly have something to impart to a clinician dealing with 'voices,' if only in the fact that the therapist would necessarily need, then, to determine the 'reality' of the issue, perhaps indeed lending respect to the work with the patient.

Freud, of course, would have been "highly skeptical" of any such approach both because of the nature of subjectivity (which is clearly what the therapist would be dealing with, from any angle) and because of what he considered the latent content of experience that could not be drawn forth by reflection alone: The vast majority of psychic life is considered by psychoanalysis to lie outside of the person's awareness, at various levels of the unconscious. And even for Freud, the only access to this unconscious was through the (further) indirect means of interpretation" (Davidson, 2004, p. 149+). Clearly, then, to Freud and his followers, a phenomenological approach to auditory hallucination would be anathema.

Davidson does, however, offer a cogent way for therapists to look at the experience of auditory hallucinations. He asks what it means for phenomenologists to insist that auditory hallucinations are legitimate experiences. He suggests it is similar to asthma; not everyone who gasps for breath under various circumstances is asthmatic; likewise, he suggests, not everyone who hears voices from time to time is experiencing psychosis. He argues, finally, that auditory hallucinations mean nothing in themselves, just as gasping for breath means nothing, until it is viewed in a constellation of other events/behaviors that, in the aggregate, add up to a problematical issue (Davidson, 2004, p. 149+).

Earlier work by Davidson (2002) noted " Through an exploration of the constitution of sense of self in the experiences of two people with schizophrenia, we see how cognitive disruptions, auditory hallucinations, and delusional ideation may be related to funda- mental peculiarities in a person's experiences of intentionality and his/her resulting sense of agency and identity" (p. 39+). While he did not claim phenomenology could provide complete explanations of psychosis, he asserted that it can shed light on that transcend single disciplines, such as auditory hallucinations, which are of interest to therapists, anthropologists, and even clergy.

Thalbourne & Delin tried even harder to make auditory hallucination fit into the parameters of recognized psychosis, contending that religious luminaries such as Theresa of Avila and St. John of the Cross may have been, as they put it, 'manic depressives,' manifesting various abnormal states such as the hearing of voices (1994, p. 3+).

Moreover, they note:

To anticipate our results, we believe that we have serendipitously made something of a breakthrough in our understanding of the findings in this area by discovering significant linkages between the topic of paranormal belief and other psychological phenomena, including mystical experience, creative personality, and a number of variables of psychiatric interest (Thalbourne & Delin, 1994, p. 3+).

Thalbourne (1991) had examined the psychological aspects of mystical experience and had concluded that understanding the phenomena involved, including auditory hallucination, would require reports by normal individuals rather than by manic-depressives and schizophrenics. "Because mystical experience is usually considered a benign and even valuable phenomenon, it was of great theoretical interest to see whether in a statistical study -- as opposed to case study ... --there would be any association with mental illness, especially mania, which involves a type of elation that seems to have much in common with religious ecstasy" and often includes hearing voices (Thalbourne & Delin, 1994, p. 3+).

One of their most interesting conclusions, particularly for therapists, is the correlation they found between creativity and mystical experienced. They noted that Auerbach (1987) had also found that "the voices and visions of mystics are often an artistic expression of a creative mind. One also of such persons as William Blake, in whom there were combined the talents of poet, painter, and mystic, and closer to our time, the poet Anne Sexton, whose final opus was deeply mystical (Shurr, 1985)" (Thalbourne & Delin, 1994, p. 3+).

Thalbourne & Delin studied "transliminal" people -- those who are prone to transcending the thresholds of consciousness in more significant ways than most (Thalbourne & Delin, 1994, p. 3+) -- and found that they:

.Tend to a greater extent to be willing to undertake psychological experimentation, to regard dreams as meaningful and containing guidance, to report experiences of ESP (of the present and of the future), visions of the dead, healing powers, and contact from the Divinity. They report hearing voices and seeing more hallucinations; they experience more paranoid ideation, and are probably more likely to have consulted a psychiatrist (Thalbourne & Delin, 1994, p. 3+).

While the Thalbourne & Delin work may be at the outer edge of credible scientific investigation, work by Bemak & Epp concerning the mind-body dichotomy in schizophrenia is much closer to being a standard medical study. Indeed, they propose that, voices or no voices, psychotherapeutic interventions are "indispensable to the treatment of schizophrenia" (Bemak & Epp, 2002, p. 14+).

Some of their report, however, seems to echo some of the thoughts of the phenomenologists; they note that others who have observed schizophrenia describe the "glass wall" effect, which is characterized by flat affect, glazed eyes and agitation form stimuli only the schizophrenic individual is experiencing. All this, they say, seems to indicate a "private psychological experience more magnetic and absorbing than the questions of the clinical interviewer attempting to unravel the meaning of the visions and voices reported by these clients" (Bemak & Epp, 2002, p. 14+).

(One effort to provide information that provides nothing but a medical rubric, in the form of clozepine, a psychoactive drug costing almost $10,000 per year to administer to schizophrenics, also cited auditory hallucinations as one of the symptoms it would stop (Higgins, 1995, p. 124+).)

Laing also had theories concerning the voices heard by schizophrenics. Laing, too, seems to acknowledge some truth to the phenomenologists' viewpoint, noting that in addition to seeing illusions and hearing voices, the schizophrenic can also be 'real' "Among these (normal) attributes are the ability to see and think clearly, to experience inner tranquility, to relate to others meaningfully, to approach the world with trust, and to love others without deluding the true nature of their character (Laing, 1969).

Bemak & Epp, again acknowledging phenomenology as important to states in which hallucinations are present, wrote that "The phenomenology of schizophrenia may be compared to living within the imagery of Salvador Dali's surrealistic painting ...." (2002, p. 14+).

Bemak & Epp, despite providing a wealth of medical/scientific information geared toward the therapists' understanding of how to manage schizophrenics, conclude by agreeing more than disagreeing with the phenomenologists about the character of the condition that produces auditory hallucinations. They admit that "The prevalence of schizophrenia in creative individuals is a troubling thorn in psychiatry's disease model" (2002, p. 14+). And they also provide a 'laundry list' of those historical figures believed to have heard voices and yet who were not only considered normal (if eccentric or brilliant), but made major contributions to human knowledge. Their list includes "Kant, Swift, Shelley, Faraday, Newton, Copernicus, Linnaeus, Pascal, Socrates, Mozart, Beethoven, Handel, Kafka, Michelangelo, Poe, Da Vinci, Rembrandt, Schopenhauer, Spinoza, Dostoyevsky, Tolstoy, and Van Gogh ...." (Bemak & Epp, 2002, 0-. 14+).… READ MORE

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