Department of Anthropology, Stanford University, Stanford, CA, USA.
Department of Psychology, Durham University, Durham, UK.
Schizophr Bull. 2023 Feb 24;49(12 Suppl 2):S3-S12. doi: 10.1093/schbul/sbac005.
There are communities in which hearing voices frequently is common and expected, and in which participants are not expected to have a need for care. This paper compares the ideas and practices of these communities. We observe that these communities utilize cultural models to identify and to explain voice-like events-and that there are some common features to these models across communities. All communities teach participants to "discern," or identify accurately, the legitimate voice of the spirit or being who speaks. We also observe that there are roughly two methods taught to participants to enable them to experience spirits (or other invisible beings): trained attention to inner experience, and repeated speech to the invisible other. We also observe that all of these communities model a learning process in which the ability to hear spirit (or invisible others) becomes more skilled with practice, and in which what they hear becomes clearer over time. Practice-including the practice of discernment-is presumed to change experience. We also note that despite these shared cultural ideas and practices, there is considerable individual variation in experience-some of which may reflect psychotic process, and some perhaps not. We suggest that voice-like events in this context may be shaped by cognitive expectation and trained practice as well as an experiential pathway. We also suggest that researchers could explore these common features both as a way to help those struggling with psychosis, and to consider the possibility that expectations and practice may affect the voice-hearing experience.
在一些社区中，经常听到声音是很常见且被期望的，并且参与者并不需要得到照顾。本文比较了这些社区的想法和做法。我们观察到，这些社区利用文化模型来识别和解释类似声音的事件——而且这些模型在不同社区之间存在一些共同特征。所有社区都教导参与者“辨别”或准确识别说话的精神或存在的合法声音。我们还观察到，有大约两种方法被教授给参与者，使他们能够体验精神（或其他无形的存在）：对内经验的训练关注，以及对无形的他人的重复言语。我们还观察到，所有这些社区都模拟了一个学习过程，在这个过程中，随着实践的进行，听到精神（或无形他人）的能力变得更加熟练，而且随着时间的推移，他们听到的内容变得更加清晰。实践——包括辨别实践——被认为会改变经验。我们还注意到，尽管存在这些共同的文化观念和实践，但在经验方面存在相当大的个体差异，其中一些可能反映出精神病过程，而另一些则可能并非如此。我们认为，在这种情况下，类似声音的事件可能是由认知期望和训练实践以及经验途径共同塑造的。我们还建议，研究人员可以探索这些共同特征，不仅可以帮助那些与精神病作斗争的人，还可以考虑期望和实践可能会影响声音体验的可能性。
