Eleanor Longden

• BSc, MSc, PhD
• PostDoc Position at Greater Manchester West Mental Health NHS Foundation Trust

Background Symptoms of complex post-traumatic stress disorder (cPTSD) may play a role in the maintenance of psychotic symptoms. Network analyses have shown interrelationships between post-traumatic sequelae and psychosis, but the temporal dynamics of these relationships in people with psychosis and a history of trauma remain unclear. We aimed to ex...

Background User-led hearing voices groups (HVGs) have existed for the past 40 years, but little research has been conducted into if and how this approach can be implemented in statutory mental health settings, and whether they can be delivered effectively when held online. The aim of this study was to conduct a feasibility and acceptability trial o...

Background Post-traumatic stress disorder (PTSD) has been shown to predict psychotic symptomology. However, few studies have examined the relative contribution of PTSD compared to broader post-traumatic sequelae in maintaining psychosis. Complex PTSD (cPTSD), operationalized using ICD-11 criteria, includes core PTSD (intrusions, avoidance, hyperaro...

Auditory hallucinations are common in people with histories of adversity, possibly indicating a causal relationship. However, hallucinations occur in multiple sensory modalities and the relationship between trauma and hallucinations in other sensory domains is less explored. We examined the occurrence of hallucinatory experiences in different senso...

Background People with serious mental health problems (SMHP) are more likely to be admitted to psychiatric hospital following contact with crisis services. Admissions can have significant personal costs, be traumatic and are the most expensive form of mental health care. There is an urgent need for treatments to reduce suicidal thoughts and behavio...

Background Face-to-face hearing voices peer support groups (HVGs), a survivor-led initiative that enables individuals who hear voices to engage with the support of peers, have a long-standing history in community settings. HVGs are premised on the notion that forming authentic, mutual relationships enables the exploration of one’s voice hearing exp...

Background Traumatic events, particularly childhood interpersonal victimisation, have been found to play a causal role in the occurrence of psychosis and shape the phenomenology of psychotic experiences. Higher rates of post‐traumatic stress disorder (PTSD) and other trauma‐related mental health problems are also found in people with psychosis diag...

BACKGROUND Face-to-face hearing voices peer support groups (HVGs), a survivor-led initiative which enables individuals who hear voices to engage with the support of peers, have a longstanding history in community settings. HVGs are premised on the notion that forming authentic, mutual relationships enables the exploration of one’s voice hearing exp...

Objectives: Compassion-focused therapy (CFT) is an evolution-informed biopsychosocial approach that seeks to cultivate attachment and care motivational systems and their psychophysiological regulators. These can counteract some of the harmful effects of social threat, inferiority, shame, self-criticism and depression, which are common in people wi...

Purpose: The purpose of the study was to investigate service-users' experiences of a therapist engaging with their voices (auditory hallucinations) using psychological formulation and direct dialogue. Method: A nested qualitative study was conducted within a randomised controlled trial of a novel intervention for supporting voice hearers with a...

Objectives To establish a James Lind Alliance (JLA) Priority Setting Partnership (PSP) to identify research priorities relevant to the health and social care needs of adults with lived experience of recent and/or historical sexual violence/abuse. Participants Adults (aged 18+ years) with lived experience of sexual violence/abuse (ie, ‘survivors’)...

[This corrects the article DOI: 10.3389/fpsyt.2022.946615.].

There is growing clinical interest in addressing relationship dynamics between service-users and their voices. The Talking With Voices (TwV) trial aimed to establish feasibility and acceptability of a novel dialogical intervention to reduce distress associated with voices amongst adults diagnosed with schizophrenia spectrum disorders. The single-si...

Although it is recognized that voice-hearers often report a large number and variety of voices there have been few investigations of this multiplicity. Understanding the phenomenology of voice-hearing can provide a firm foundation for theorizing about its causes. In this international online survey of voice-hearers, details were elicited of the con...

Background Emerging evidence supports the safety, acceptability, and efficacy of trauma therapies for people experiencing post-traumatic stress and psychosis, despite common concerns about iatrogenic harm when processing trauma memories for this population. However, to date there have been no mixed-method studies examining whether trauma-focused th...

Background People with psychosis have high rates of trauma, with a post-traumatic stress disorder (PTSD) prevalence rate of approximately 15%, which exacerbates psychotic symptoms such as delusions and hallucinations. Pilot studies have shown that trauma-focused (TF) psychological therapies can be safe and effective in such individuals. This trial,...

Purpose: To investigate the clinical perspectives and experiences of therapists when engaging in direct dialogue with auditory hallucinations. Method: Therapist accounts were explored via a qualitative study nested within a pilot randomized controlled trial of a novel intervention for supporting distressed voice-hearers (Talking with Voices). Fi...

Introduction Aggregate data meta-analyses have shown heterogeneous treatment effects for cognitive–behavioural therapy (CBT) for patients with schizophrenia spectrum diagnoses. This heterogeneity could stem from specific intervention or patient characteristics that could influence the clinical effectiveness of CBT, termed treatment effect modifiers...

Aims: The Talking With Voices pilot trial assesses feasibility and acceptability of a novel dialogical intervention to ameliorate distress associated with auditory hallucinations. The results will inform a definitive randomised trial to assess clinical and cost-effectiveness of the intervention. Method: The trial is single-site with a single-blind...

Purpose: To present a treatment protocol for delivering Talking With Voices, a novel intervention for people with psychosis that involves dialogical engagement with auditory hallucinations. Method: This paper presents a manualized approach to therapy employed in the Talking With Voices trial, a feasibility and acceptability randomized control tr...

Theoretical models and qualitative research suggest that dissociation can be functional in some circumstances, despite being a cause of concern for many. This is the first study that evaluates a novel questionnaire on positive appraisals of dissociation (the Positive Beliefs about Dissociation Questionnaire; PBD-Q), and its link with dissociation f...

Background: Collections of lived experience narratives are increasingly used in health research and medical practice. However, there is limited research with respect to the decision-making processes involved in curating narrative collections and the work that curators do as they build and publish collections. Objective: This study aims to develo...

Background Evidence for the effectiveness of treatments in early-onset psychosis is sparse. Current guidance for the treatment of early-onset psychosis is mostly extrapolated from trials in adult populations. The UK National Institute for Health and Care Excellence has recommended evaluation of the clinical effectiveness and cost-effectiveness of a...

Evidence suggests that dissociation is associated with psychotic experiences, particularly hallucinations, but also other symptoms. However, until now, symptom-specific relationships with dissociation have not been comprehensively synthesized. This is the first prospectively registered (CRD42017058214) meta-analysis to quantify the magnitude of ass...

The ‘Making Sense of Voices’ (MsV), or ‘Maastricht’ approach has become established within large sections of the voice hearing community, as well as being adopted by some professional mental health workers. However, there has been limited research to assess this intervention. A recent case series using the MsV approach reported promising results ac...

BACKGROUND Collections of lived experience narratives are increasingly used in health research and medical practice. However, there is limited research with respect to the decision-making processes involved in curating narrative collections and the work that curators do as they build and publish collections. OBJECTIVE This study aims to develop a...

Background Adolescent-onset psychosis is associated with more severe symptoms and poorer outcomes than adult-onset psychosis. The National Institute for Clinical Excellence (NICE) recommend that adolescents with first episode psychosis (FEP) should be offered a combination of antipsychotic medication (APs), cognitive behavioural therapy (CBT) and f...

This paper presents an outline of voice-hearing phenomenology in the context of evolutionary mechanisms for self- and social- monitoring. Special attention is given to evolved systems for monitoring dominant-subordinate social roles and relationships. These provide information relating to the interpersonal motivation of others, such as neutral, fri...

The current evidence-base for the psychological treatment of distressing voices indicates the need for further clinical development. The Maastricht approach (also known as Making Sense of Voices) is popular within sections of the Hearing Voices Movement, but its clinical effectiveness has not been systematically evaluated. The aim of the approach i...

The project group reflects on the responses to the Power Threat Meaning Framework (PTMF) one year after publication. The group welcomes the interest shown in the document, and takes this opportunity to clarify some points, reflect on and learn from others, and suggest areas for future development.

Hearing voices that other people do not hear has long been considered a cardinal sign of madness. This chapter reviews the research supporting the argument that voice hearing is a dissociative phenomenon. It begins with a brief review of population studies, followed by studies of voice hearing in various clinical and nonclinical groups. The chapter...

Over the past three decades in Maastricht, the Netherlands, psychiatrist Marius Romme and researcher Sandra Escher have developed a new approach to hearing voices which emphasizes accepting and making sense of the experience. Since Romme and Escher's initial work, substantial empirical support has been provided for the Maastricht approach's key pro...

Diagnostic nomenclatures have been central to mental health research and practice since the turn of the 20th century. In recent years, an increasing number of mental health professionals have proposed that a paradigm shift in diagnosis is inevitable. The Standards and Guidelines for the Development of Diagnostic Nomenclatures and Alternatives in Me...

Clinicians are often sceptical about offering cognitive behavioural therapy (CBT) to individuals experiencing thought disorder. This view may result from perceived difficulties in clients being able to learn and better understand their experiences through verbal dialogue. However, it may also partly be due to the lack of clear guidance on how to ad...

Introduction: Hearing distressing voices can be a significant mental health challenge, potentially disrupting working lives. Yet few studies have explored voice-hearing in relation to employment. This study aimed to understand the work-related experiences of voice-hearers, including the impacts on their working lives and their corresponding self-ma...

The Hearing Voices Network (HVN) is an influential service-user led organisation that promotes self-help as an important aspect of recovery. This study presents the first systematic assessment of the impact and effectiveness of HVN self-help groups. A customized 45-item questionnaire, the Hearing Voices Groups Survey, was sent to 62 groups affiliat...

Traumatic life events (TLEs) have been associated with multiple psychiatric diagnoses, including anxiety disorders, major depression, PTSD, and psychosis. To advance our understanding of the complex interactions between forms of adversity as they manifest across the lifespan, psychosis, and symptom content, we undertook a mixed-methods investigatio...

Despite the long association between auditory verbal hallucinations (AVH) or voice hearing and schizophrenia, recent research has demonstrated AVH's presence in other disorders and in persons without a diagnosis, particularly amongst those with a history of traumatization. But are there differences in the type of voices between these populations?

While voice hearing (auditory verbal hallucinations) is closely allied with psychosis/schizophrenia, it is well-established that the experience is reported by individuals with nonpsychotic diagnoses, as well as those with no history of psychiatric contact. The phenomenological similarities in voice hearing within these different populations, as wel...

Purpose The purpose of this paper is to investigate whether Shared Reading (SR), a specific literature-based intervention, is transposable to a prison context and whether mental health benefits identified in other custodial and non-custodial settings were reported by women prisoners. Design/methodology/approach In all, 35 participants were recru...

Cognitive behavioural therapy for psychosis (CBTp) is, at times, perceived as a technical therapy that undervalues the importance of human relationships and the fundamental principles on which CBTp itself is based (such as collaboration, validation, optimism and recovery-orientated practice). As such, it can be dismissed by service users or practit...

Background: It is now over half a century since community care was introduced in the wake of the closure of the old asylum system. This paper considers whether mental health services, regardless of location, can be genuinely effective and humane without a fundamental paradigm shift. Data: A summary of research on the validity and effectiveness o...

Purpose – Although there is a growing evidence base for the value of psychosocial and arts-based strategies for enhancing well-being amongst adults living with dementia, relatively little attention has been paid to literature-based interventions. The purpose of this paper is to assess the impact of shared reading (SR) groups, a programme developed...

Although repeated associations have been found between adversity exposure (particularly exposure to childhood sexual abuse), dissociation, and auditory hallucinations in the context of psychosis, there is little comparable research examining hallucinations in other modalities. This study aimed to determine whether cumulative adversity exposure infl...

Objective: Adverse effects (AEs) of antipsychotic medication have important implications for patients and prescribers in terms of well-being, treatment adherence, and quality of life. This review summarizes strategies for collecting and reporting AE data across a representative literature sample to ascertain their rigor and comprehensiveness. Met...

Despite increasing evidence for the role of psychosocial factors in the onset and continuance of psychosis, the experiences involved are still largely considered the result of a biogenetic anomaly for which medication is the first-line treatment response. This review summarizes the extensive literature demonstrating that adverse events involving tr...

Background: Two discourses exist in mental health research and practice. The first focuses on the limitations associated with disability arising from mental disorder. The second focuses on the possibilities for living well with mental health problems. Discussion: This article was prompted by a review to inform disability policy. We identify seve...

childhood adversity, existentialism, hearing voices, hermeneutics, narrative, phenomenology, recovery Henriksen et al. (2015) use phenomenology as a tool to clarify the status of what they regard as the abnormal experiences of the condition called schizophrenia. This reveals phenomenology as a method of detailed scrutiny of these experiences to est...

Auditory verbal hallucinations (AVH: ‘hearing voices’) are found in both schizophrenia and post-traumatic stress disorder (PTSD). In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumati...

This study examines relationships between childhood adversity and the presence of characteristic symptoms of schizophrenia. It was hypothesised that total adversity exposures would be significantly higher in individuals exhibiting these symptoms relative to patients without. Recent proposals that differential associations exist between specific psy...

Public health strategies have placed increasing emphasis on psychosocial and arts-based strategies for promoting well-being. This study presents preliminary findings for a specific literary-based intervention, Shared Reading, which provides community-based spaces in which individuals can relate with both literature and one another. A 12-week crosso...

The international Hearing Voices Movement (HVM) is a prominent mental health service-user/survivor movement that promotes the needs and perspectives of experts by experience in the phenomenon of hearing voices (auditory verbal hallucinations). The main tenet of the HVM is the notion that hearing voices is a meaningful human experience, and in this...

Auditory verbal hallucinations (AVH) are complex experiences that occur in the context of various clinical disorders. AVH also occur in individuals from the general population who have no identifiable psychiatric or neurological diagnoses. This article reviews research on AVH in nonclinical individuals and provides a cross-disciplinary view of the...

A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualize human suffering across the whole spectrum of mental health difficulties. It is a strongly evidence-based synthesis of findings from trauma studies, attachment theory and neu...

A data synthesis is presented from 100 clinical cases, 80% with a diagnosis of schizophrenia or other psychotic disorder, in which Romme and Escher’s “con- struct” method was used to formulate voice-hearing content and characteristics in relation to life events. Across the sample, most participants heard between two and five voices and the average...

The biological disease conception of auditory verbal hallucination holds that their causes and treatment are directed by biology alone, that their discussion is detrimental and their content arbitrary. An alternative view sees voice-hearing as a widespread and meaningful human experience, encouraging a dialogue with the voices in order to discover...

We comment on a recently published article in Schizophrenia Bulletin: 'The treatment of hallucinations in schizophrenia spectrum disorders' (Sommer et al., 2012). Contrary to the recommendations made in this piece, we suggest that, on the basis of available evidence, psychological therapies (including, but not limited to cognitive behavioural thera...

The dominance of technological paradigms within psychiatry creates moral and ethical tensions over how to engage with the interpersonal narratives of those experiencing mental distress. This paper argues that such paradigms are poorly suited for fostering principled responses to human suffering, and proposes an alternative approach that considers a...

Growing evidence suggests a meaningful association between life experience, particularly trauma and loss, and subsequent psychotic symptomatology. This paper describes a method of psychological formulation to analyse the relation- ship between the content and characteristics of voices (“auditory hallucinations”) and experienced adversity in the lif...

Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue (Stone & Stone, 198930. Stone , H. and Stone , S. 1989 . Embracing our selves: T...

In this paper, reasons reported by people who self-injure to explain this behaviour are presented. Traditional service responses are examined and it is suggested that these may exacerbate the reasons why people self-injure and are likely to create vulnerability to further harm. A rationale is presented which suggests that service-providers should a...

Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue (Stone & Stone, 1989: Embracing our selves: The voice dialogue training manual,...

Although people who hear voices may dialogue with them, they are regularly caught in destructive communication patterns that disturb social functioning. This article presents an approach called Talking With Voices, derived from the theory and practice of Voice Dialogue (Stone & Stone, 1989: Embracing our selves: The voice dialogue training manual,...

A synthesis of literature from developmental psychology, traumatology and cognitive neuroscience is presented in order to suggest that psychosis and many other forms of mental distress can be most appropriately understood as a meaningful psychological response to trauma and loss. Clinical and theoretical implications of this holistic, integrated pa...

Voice hearing (VH) is often regarded as pathognomic for schizophrenia. The purpose of this article is to review and integrate historical, clinical, epidemiological, and phenomenological evidence in order to suggest that VH may be more appropriately understood as a dissociative rather than a psychotic phenomenon. First, we discuss the lifetime preva...

Because of their autonomous nature and resistance to traditional measures of evaluation and outcome, hearing voices self-help groups have not been systematically evaluated. However, hearing voices groups and the ‘hearing voices approach’ have now become more commonplace and accepted within mainstream mental health services (e.g., Wykes, Parr, & Lan...