How the Light Gets in is a philosophy and music festival which takes place annually at Hay-on-Wye. This May was the seventh festival with over 650 philosophy, comedy and music events over a 9 day period.
On the 24th May I attended a workshop run by Richard Bentall (pictured above) about hallucinations – in particular AVHs (auditory verbal hallucinations) also known as ‘voice hearing’. In this workshop Bentall gave us a ‘whistle stop tour’ of the research and literature on ‘voice hearing’. He drew on his own research and the research of others on signal detection analysis (eg: Bentall & Slade, 1985; Badcock et. al.,2013), the research of Chris Frith and others (eg Frith, 1987; Ford & Mathalon, 2005) on the neuroscience behind the experience and on research from Marius Romme who has investigated aspects such as history, background and onset (including childhood trauma) to understand how ‘voice hearing’ might be conceptualised (Romme et. al., 2009).
There are a significant number of people in the population who experience ‘voices’ who do not consider themselves to be ill and do not seek psychiatric help (ibid). Secondary symptoms, such as stress relating to the experience of mis-attribution of one’s own internal voice to external others can be ameliorated by conceptualising the experience in ways that are meaningful to the person experiencing the phenomenon. Marius Romme is not in the business of ‘curing’ those who experience voice hearing. He is more interested in understanding the meaning that the experience holds for those facing the phenomenon.
Bentall referred to the oft-cited example (Romme, 1993) of a voice hearer who read The Origin of Consciousness in the Breakdown of the Bicameral Mind by Julian Jaynes – a book that argues that consciousness as we now understand it is a recent phenomenon (Jaynes, 1976). The ‘voice hearer’ saw that there was hope for her predicament - perhaps she had the pre-conscious mind of an ancient Greek person and this was why her mind seemed to be in dialogue with gods or others. This gave her some relief regarding the tension and stress associated with the experience and changed the way she (and her psychiatrist, Romme) conceptualised voice hearing. Bentall's presentation was followed by a lively discussion with a diverse audience about the nature of hallucination.
I also attended a workshop run by Dinesh Bhugra (pictured below) on global mental health. He referred to Geert Hofstede’s research on aspects of culture and their impact on mental health. He also highlighted how a culture can define a mental illness and someone moving from one culture to another can find themselves mentally ill in the new environment (eg: certain cultural beliefs can be seen as delusional outside that culture). He also discussed aspects such as metaphor and behaviour which might be very diverse between cultures and how these might constitute explanations or manifestations of mental illness. He asks us to make ourselves culturally aware in order to recognise these different manifestations.
Bhugra gives an example of research undertaken in India which, at first pass, identified that 47% of Indian girls had some kind of eating disorder. On analysis of the cultural context it was understood that, for example, when asked to rate on a scale how much ‘food controls my life’ the question has an entirely different meaning in the affluent West than in poorer countries when food is scarce and (usually) women are expected to feed the family. In other countries some illnesses are seen as spiritual problems. For example, in Arabic countries and in the Punjab there is no word for depression and a person with typical symptoms of depression might seek help from a spiritual leader. Again, a lively discussion took place at the end of the workshop which included speculation on the decline of spiritual leadership in the UK coupled with the increase of depression and the use of anti-depressants.