Current Projects

A common misperception of people who hear voices when no one is speaking is that they are suffering from psychosis, which affects 1% of the population yet costs the NHS more than £10 billion per year. However, it is now clear that healthy individuals can also hear voices with a sound quality and frequency similar to those heard by patients with psychosis, but these individuals do not require any psychiatric diagnosis or care. Indeed, it is often the distress and lack of control rather than the presence or absence of voices that lead to impairment. One potential explanation is that people’s intrinsic ‘sense of self’ and their ability to differentiate internally and externally generated thoughts and sensations can modulate the damaging effects caused by voice-hearing in patients and people who do not find their voices distressing may experience their self differently. Novel brain stimulation techniques enable us to briefly change brain activities involved in the sense of self and temporarily break down the boundaries between self and other – a condition reported by many patients with psychosis. Not everyone experiences such disruption in the same way and this project will allow us to better understand why some individuals who hear voices are more resilient to this kind of confusion. This knowledge will help us to study the brain mechanisms that support a healthy sense of self and, in the long term, may lead to targeted treatments in people who find their voices troublesome and improve their quality of life.

Auditory verbal hallucinations are conceptualised as hearing voices or sense of being communicated to without any external speaker present. Historically viewed as hallmarks of psychosis and other serious mental illnesses, we now know that nonclinical voices can occur with varying intensities and frequencies in the general population too. However, clinical voices such as those of a commanding nature often contribute to severe levels of distress and dysfunction, especially when the voices command the voice-hearer to carry out harmful actions against their will. Related phenomena, called delusions of (thought) interference, include thought insertion and delusion of control, defined as the feeling that someone external is sending or forcing thoughts into a person's mind and being under the influence of an external power, respectively. Command hallucinations, delusion of control and thought insertion breach if not erase the boundary between one's self and other, thus leading to a confusion between internal and external events which can make the commands exceedingly difficult to resist. Sometimes both the distress caused by and the coercive nature of such experiences can lead to suicidal feelings and behaviours including acts of self-harm. This project aims to investigate the relationships between such command hallucinations, inserted thoughts and suicidal behaviours by studying their trajectories, how they develop and change over time, as well as clarifying the impact of these experiences on individuals' mental wellbeing versus diagnoses of mental illness.

At least one in three people with psychosis experience distressing visual hallucinations, also known as visions – seeing things that others cannot. When visions occur, they can have a detrimental impact on people’s lives, such as more frequent and prolonged hospital admissions, and greater likelihood of suicide.

Our previous research has found that the way in which people make sense of their visions are one of the keys factors driving distress. For example, when people thought visions were negative or threatening, they found them to be more distressing and this had a bigger impact on their lives. The next step is therefore to explore this on a larger scale to understand more about people’s appraisals of their visions. Then this can be used to validate a scale of visions appraisals and develop targeted treatments for these.

To do so, this study will develop a questionnaire focused on people’s beliefs about visions. It will also explore the relationships between these appraisals and other difficulties which people may experience, such as poor sleep or high worry.

By developing a new measure and our knowledge of causal mechanisms of visions, it will be the next important steps to developing better treatments for these