Coping with Hearing Voices: a Repertory Grid Study
Marshall, Catherine Ruth
Hearing voices is a well researched experience, found in both schizophrenia and the general population. Previous research investigating the unusual experience has reinforced cognitive psychology concepts such as beliefs, power, core beliefs about the self, intent and identity. It has been suggested that these factors all mediate individual coping with the experience. Coping with voices is a clinically significant area of research pioneered by Romme and Escher and requires careful consideration. Kelly‘s Personal Construct Psychology and the repertory grid technique were used in the study to compare two ways of coping with voices: engaging and resisting coping. The groups were compared on the repertory grid measures of construed distance between the self and the voice, salience of the self and voice, and tightness of the overall construct system. In a sample of 18 voice hearers, the Beliefs about Voices Questionnaire- Revised (BAVQ-R), a measure of psychological distress (OQ45.2) and Kelly‘s repertory grid were administered. The study also used three case examples and content analysis of construct poles applied to the dominant voice and the self as coper to supplement the quantitative analysis with a more in-depth exploration. Resisting coping was found to be associated with a greater construed distance between the self and the voice, a more salient view of the voice, and a tighter construct system. However, neither resisting nor engaging coping was associated with psychological distress. In addition, voice malevolence was associated with distancing oneself from the voice, suggesting that distancing was an adaptive coping strategy used, possibly as a way to preserve selfhood. The study therefore added to the list of mediating factors between the voice hearing experience and the coping strategy adopted. As a result, the repertory grid showed some scope in assessing the three areas of interest. The findings suggest that clinically, voice hearers can best be supported by adopting the appropriate relational approach with the voice (closeness or distance), reducing the salience of the voice and moving through Kelly‘s Creativity and Experience Cycle.