Hearing voices, dissociation and the self: a functional-analytic perspective

Item does not contain fulltextIn the current paper, we review existing models of the aetiology of voice hearing. We summarise the argument and evidence that voice hearing is primarily a dissociative process, involving critical aspects of self. We propose a complementary perspective on these phenomena that is based on a modern behavioural account of complex behaviour, known as Relational Frame Theory (RFT). This type of approach to voice hearing concerns itself with: the functions served for the individual by this voice hearing; the necessary history, such as trauma, that establishes these functions; and the relevant dissociative processes involving self and others. In short, we propose a trauma-dissociation developmental trajectory in which trauma impacts negatively on the development of self, through the process of dissociation. Using the RFT concept of relations of perspective-taking, our dissociation model purports that trauma gives rise to more co-ordination than distinction relations between self and others, thus weaking an individual's sense of a distinct self. Voice hearing experiences, therefore, reflect an individual's perceptions of self and others, and may indicate impairments in the natural psychological boundaries between these critical related concepts. One clinical implication suggested by this model is that therapeutic 'intervention' should understand the behaviours associated with a sense of self that is fragile and threatened by others. Relations with self and others should be a key focus of therapy, as well as interventions designed to enhance a coherent distinct sense of self.20 p

A pilot study of the relations within which hearing voices participates : towards a functional distinction between voice hearers and controls

The current research used the Implicit Relational Assessment Procedure (IRAP) as a preliminary step toward bringing a broad, functional approach to understanding psychosis, by focusing on the specific phenomenon of auditory hallucinations of voices and sounds (often referred to as hearing voices). On this path, we created a taxonomy of some critical features of voice hearing based on the existing literature (i.e., perceived normality of voices, appraisals of self and other people hearing voices, and fear of voices) as a focus of our experimental manipulations. It was our hope that our findings would add to the broad literature that has used explicit measures to study these phenomena, and that the use of an 'implicit' measure might assist toward a functional analytic understanding. Three pilot studies were conducted to assess the relations within which hearing voices participates in non-clinical voice hearers (i.e., individuals who hear voices but have no clinical diagnosis or distress) and compared to non-voice hearing control participants. The IRAP effects demonstrated both positive and negative relational responses across the three studies, and these effects varied according to explicit levels of delusional ideation. Furthermore, these IRAP effects also predicted explicit aspects of voice hearing and well-being. The current set of pilot studies demonstrate the utility and precision of the IRAP in this domain, and we propose that this type of experimental analysis may hold potential for future bottom-up functional analyses of voice hearing

Using the IRAP to explore natural language statements

This study explored a modification to the typical presentation of label and target stimuli on Implicit Relational Assessment Procedure (IRAP) effects. We asked whether combining the labels and targets into a single phrase would influence performances. The key purpose of the study was to determine the feasibility of altering the way in which stimuli are presented within the IRAP, so as to potentially employ more complex natural language-like statements in future research. In the Typical IRAP employed here, labels and targets were presented as separate words, while in the Natural Language IRAP they were combined to form a single statement. The results demonstrated no substantive differences in the effects recorded on both types of IRAP, thus supporting the future use of a Natural Language version

Narrative : its importance in modern behavior analysis and therapy

The current article considers how the analysis of language and cognition in RFT may be conceptualized as a multi-dimensional multi-level framework (MDML) for understanding how simple units of analysis specified in RFT connect to more complex units, such as the relating of relational networks, which is seen as critical to narrative and story-telling. A brief outline of the framework is used to illustrate the importance of narrative in the treatment of human psychological suffering. In addition, the development of the concepts of verbal functional analysis and the drill-down are presented as examples of how the therapeutic relationship itself can be understood through the lens of the MDML and RFT more generally

Exploring the potential impact of relational coherence on persistent rule-following : the first study

Rule-governed behavior and derived relational responding have both been identified as important variables in human learning. Recent developments in the relational frame theory (RFT) have outlined a number of key variables of potential importance when analyzing the dynamics involved in derived relational responding. Recent research has explored the impact of one of these variables, level of derivation, on persistent rule-following and implicated another, coherence, as possibly important. However, no research to date has examined the impact of coherence on persistent rule-following directly. Across two experiments, coherence was manipulated through the systematic use of performance feedback, and its impact was examined on persistent rule-following. A training procedure based on the implicit relational assessment procedure (IRAP) was used to establish novel combinatorially entailed relations that manipulated the feedback provided on the trained relations (A-B and B-C) in Experiment 1, and on the untrained, derived relations (A-C) in Experiment 2. One of these relations was then inserted into the rule for responding on a subsequent contingency-switching match-to-sample (MTS) task to assess rule persistence. While no significant differences were found in Experiment 1, the provision or non-provision of feedback had a significant differential impact on rule-persistence in Experiment 2. Specifically, participants in the Feedback group resurged back to the original rule for significantly more responses after demonstrating contingency-sensitive responding than did the No-Feedback group, after the contingency reversal. The results highlight the subtle complexities that appear to be involved in persistent rule-following in the face of reversed reinforcement contingencies