Voice hearers' explanations of trauma‐related voices and processes of change throughout imagery rescripting: A qualitative exploration

Author:

Strachan Laura P.1ORCID,Paulik Georgie234,Roberts Lynne1,McEvoy Peter M.15

Affiliation:

1. Discipline of Psychology, Curtin School of Population Health & enAble Institute Curtin University Perth Western Australia Australia

2. School of Psychology Murdoch University Perth Western Australia Australia

3. Perth Voices Clinic Perth Western Australia Australia

4. School of Psychological Science University of Western Australia Perth Western Australia Australia

5. Centre for Clinical Interventions Perth Western Australia Australia

Abstract

AbstractObjectivesPost‐traumatic stress is common among people who hear voices (auditory verbal hallucinations), many of whom hear trauma‐related voices, whereby voice content is related to past trauma. Preliminary evidence suggests that imagery rescripting (ImRs) may more effectively reduce post‐traumatic stress and voices compared to treatments that are based on existing models of PTSD or positive symptoms. No known studies have explored the potential maintaining factors of trauma‐related voices in relation to ImRs. We aimed to uncover insights into the factors that maintain trauma‐related voices and how ImRs may influence such factors by exploring voice hearers' explanations of voices and experiences of change throughout ImRs.DesignThematic analytical methodology was used due to the study's critical epistemological framework.MethodsSemi‐structured interviews explored relationships between trauma and voices, and experiences of change and stability throughout ImRs in a transdiagnostic sample (N = 10) who underwent 10–18 weekly ImRs sessions. Thematic analysis was used to develop themes.ResultsTwo themes captured explanations of voices, which suggested voices may have counterproductive protective functions. Three themes captured psychological experiences during ImRs, which reflected concepts such as freedom to experience emotions, and experiences of justice, closure and grieving. Three themes described the outcomes of ImRs, reflecting concepts such as increased confidence, coping, perceived safety and voices becoming less powerful.ConclusionsTrauma‐related voices may have underlying protective functions and ImRs may support emotional expression, adaptive trauma re‐appraisals and improve self‐worth and coping self‐efficacy. These change processes may have clinical implications in ImRs and other treatments for trauma‐affected voice hearers.

Publisher

Wiley

Subject

Psychiatry and Mental health,Arts and Humanities (miscellaneous),Clinical Psychology,Developmental and Educational Psychology

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