Table Of ContentPsychosis as a Personal Crisis
Psychosis as a Personal Crisis seeks to challenge the way people who hear
voices are both viewed and treated. This book emphasises the individual
variation between people who suffer from psychosis and puts forward the
idea that hearing voices is not in itself a sign of mental illness.
In this book the editors bring together an international range of expert
contributors, who in their daily work, their research or their personal
acquaintance, focus on the personal experience of psychosis.
Further topics of discussion include:
• accepting and making sense of hearing voices
• the relation between trauma and paranoia
• the limitations of contemporary psychiatry
• the process of recovery.
This book will be essential reading for all mental health professionals, in
particular those wanting to learn more about the development of the
hearing voices movement and applying these ideas to better understanding
those in the voice hearing community.
Marius Romme is Professor of Psychiatry at the University of Maastricht.
He is Visiting Professor at Birmingham City University and Founder and
former Chair of Intervoice the International Association for Voice Hearers,
which has networks and support groups around the world.
Sandra Escher is a former journalist and senior staff member at the Com-
munity Mental Health Centre in Maastricht. She is an honorary research
fellow at Birmingham City University and Co Founder of Intervoice the
International Association for Voice Hearers.
The International Society for the Psychological Treatments of
Schizophrenias and other Psychoses book series
Series editor: Brian Martindale
The ISPS (the International Society for the Psychological Treatments of the
Schizophrenias and other Psychoses) has a history stretching back more
than fifty years during which it has witnessed the relentless pursuit of
biological explanations for psychosis. The tide is now turning again. There is
a welcome international resurgence of interest in a range of psychological
factors in psychosis that have considerable explanatory power and also
distinct therapeutic possibilities. Governments, professional groups, users
and carers are increasingly expecting interventions that involve more talking
and listening. Many now regard skilled practitioners in the main psycho-
therapeutic modalities as important components of the care of the seriously
mentally ill.
The ISPS is a global society. It is composed of an increasing number of
groups of professionals, family members, those with vulnerability to psy-
chosis and others, who are organised at national, regional and more local
levels around the world. Such persons recognise the potential humanitarian
and therapeutic potential of skilled psychological understanding and therapy
in the field of psychosis. Our members cover a wide spectrum of approaches
from psychodynamic, systemic, cognitive, and arts therapies to the need-
adaptive approaches, group therapies and therapeutic institutions. We are
most interested in establishing meaningful dialogue with those practitioners
and researchers who are more familiar with biological-based approaches.
Our activities include regular international and national conferences, news-
letters and email discussion groups in many countries across the world.
One of our activities is in the field of publication. Routledge has recog-
nised the importance of our field, publishing the ISPS journal, Psychosis:
Psychological, Social and Integrative Approaches (www.isps.org/journal.
shtml). The journal complements Routledge’s publishing of the ISPS book
series, which started in 2004. The books aim to cover many topics within the
spectrum of the psychological therapies of psychosis and their application in
a variety of settings. The series is intended to inform and further educate a
wide range of mental health professionals as well as those developing and
implementing policy.
Some of the books will also promote the ideas of clinicians and researchers
well known in some countries but not familiar in others. Our overall
intention is to encourage the dissemination of existing knowledge and ideas,
promote healthy debate, and encourage more research in a most important
field whose secrets almost certainly do not all reside in the neurosciences.
For more information about the ISPS, email
Psychosis as a Personal Crisis
An Experience-Based Approach
Edited by Marius Romme and
Sandra Escher
First published 2012
by Routledge
27 Church Road, Hove, East Sussex BN3 2FA
Simultaneously published in the USA and Canada
by Routledge
711 Third Avenue, New York NY10017
Routledge is an imprint of the Taylor & Francis Group, an Informa business
Copyright � 2012 Selection and editorial matter, Marius Romme & Sandra
Escher; individual chapters, the Contributors
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in
any information storage or retrieval system, without permission in writing
from the publishers.
Trademark notice: Product or corporate names may be trademarks or
registered trademarks, and are used only for identification and explanation
without intent to infringe.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging-in-Publication Data
Psychosis as a personal crisis : an experience-based approach / edited by
Marius Romme & Sandra Escher.
p. ; cm. – (International society for the psychological treatments of the
schizophrenias and other psychoses)
Includes bibliographical references.
ISBN: 978-0-415-67331-0 (hardback) – ISBN: 978-0-415-67330-3 (pbk)
1. Hallucinations and illusions. 2. Psychoses. I. Romme, M. A. J. II. Escher,
Sandra. III. Series: ISPS book series.
[DNLM: 1. Hallucinations–etiology. 2. Psychotic Disorders–therapy.
WM 204]
RC553.H3P79 2012
616.89–dc23
2011015854
ISBN: 978-0-415-67331-0 (hbk)
ISBN: 978-0-415-67330-3 (pbk)
ISBN: 978-0-203-14765-8 (ebk)
Typeset in Times by Garfield Morgan, Swansea, West Glamorgan
Paperback cover design by Hybert Design
Printed and bound in Great Britain by TJ International Ltd, Padstow, Cornwall
Contents
List of figures and tables x
List of contributors xi
Foreword xiii
1 Introduction 1
MARIUS ROMME AND SANDRA ESCHER
PART I
Changes in attitude 5
2 Psychiatry at the crossroads: The limitations of contemporary
psychiatry in validating subjective experiences 7
BRIAN MARTINDALE
3 Changing attitudes in clinical settings: From auditory
hallucinations to hearing voices 17
MONIKA HOFFMANN
4 Voice hearers are people with problems, not patients with
illnesses 27
LUCY JOHNSTONE
5 The process of recovery and the implications for working
with psychosis 37
RON COLEMAN AND KAREN TAYLOR
6 Useful instruments for exploring hearing voices and paranoia 45
SANDRA ESCHER
viii Contents
PART II
Relationship with trauma or other life
experiences 59
7 Childhood trauma and psychosis: Revisiting the evidence 61
WARREN LARKIN AND JOHN READ
8 The relationship between trauma and paranoia: Managing
paranoia 74
PETER BULLIMORE
9 Personal links between traumatic experiences and distorted
emotions in those who hear voices 86
MARIUS ROMME
PART III
Recovery-oriented approaches 101
10 Hearing voices in children: The message of the voices 103
SANDRA ESCHER
11 Open dialogues with patients with psychosis and their families 116
JAAKKO SEIKKULA AND BIRGITTA ALAKARE
12 Hearing voices groups: Creating safe spaces to share taboo
experiences 129
JACQUI DILLON AND ELEANOR LONGDEN
13 Relating to alternative realities 140
RUFUS MAY
14 Accepting and making sense of voices: A recovery-focused
therapy plan 153
MARIUS ROMME
15 Talking with voices 166
DIRK CORSTENS, RUFUS MAY AND ELEANOR LONGDEN
16 Understanding psychosis and cognitive therapy 179
DAVID KINGDON
17 A psychoanalytic framework for psychotic experiences 185
DAVID GARFIELD AND GABRIELA IAGARU
Contents ix
18 Using medication wisely in treating psychosis 199
JOHN WATKINS
Index 212
Figures and tables
Figures
8.1 Making sense of paranoia 79
8.2 The vicious circle 80
8.3 Help break the cycle 81
Tables
4.1 Psychiatric versus hearing voices assumptions 29
4.2 Diagnosis versus formulation 32
5.1 Aids to recovery 39
6.1 Example of a record identifying voice characteristics 48
