Hearing voices is not new. Nor, as McCarthy-Jones makes clear, as rare, as pathological or as ominous as may be commonly believed.

McCarthy-Jones himself has had the experience, as have luminaries such as the writers Samuel Johnson, his friend William Cowper, and Virginia Woolf, the mountaineer Joe Simpson, the mathematician Francoise Chatelin and the musician Brian Wilson – and all of them, as does everyone, have had a deeply personal relationship with it.

The underlying purpose of this sensitive, engaging, compassionate and enlightening book is to challenge the dominant and somewhat pessimistic interpretations of hearing voices – that they are a prime indicator of severe mental illness or perhaps some neurological disease. Perhaps, he argues, hearing voices can be understood in other ways, and particularly if the meaning attributed by the hearer in ways that can sometimes be comforting, reassuring or spiritual. And he suggests that a historical review may show that there are many ways of understanding and responding to them.

The book may be seen to develop four main perspectives: a historical arc, phenomenologies (what the experience is like, particularly when described in the first person), causes (from divine communication to advanced neuroscience) and meanings (for both those who experience them and the wider scientific community).

He considers what the experience of hearing voices might be like if viewed from different perspectives or through different prisms. If, for example, it is seen as a religious experience both the individual as well as those around him or her may see this as powerful and privileged – it doesn’t happen to everyone, and perhaps some are specially chosen. But he also describes how fashions or conventions of religious voices come and go, and while in Judaism it was not uncommon at one point to hear the voice of God it stopped with the prophet Malachi, 2500 years ago, but in Christianity it may still have some currency.

Warming to his second theme, causes, he begins to link the different perspectives. Certainly there is no shortage of explanatory models; again there are religious models, moral explanations or psychoanalytic paradigms, and more recent ones such as the schizogenic parent, all of which seemed persuasive in their time, but that time has largely passed. It may be hugely significant to learn through sophisticated techniques, advanced technology and contemporary neuroscience what may be happening on a micro-neurological level, and he devotes a substantial part of the book to a detailed and clear account of recent developments. There are, he suggests, both static and dynamic voices, and that changes the experience and even then we are still faced with the questions of making sense of and making meaning out of that experience.

It is at this point that McCarthy-Jones hits his stride. Integrating the emergence of the Hearing Voices Movement, and the work of Marius Romme in particular, he argues eloquently and movingly that few experiences are as intense or as personal, and what may be called a trans-disciplinary understanding is required if the personal and clinical are to be satisfied.

Because he is able to mesh a lighter tone and clear scholarship the book is a welcome addition to the literature, although an inevitable drawback of the colloquial style is that it can easily date (we can only hope that readers in 20 years’ time will not understand the reference to I’m a Celebrity – Get Me Out of Here! (p.184)). It could be said that the book normalizes the experience of hearing voices and could dissuade some from seeking treatment but that seems to be unduly skeptical. However, throughout it demonstrates a deep compassion and a commitment to a humanely-driven care model, and puts the individual at the center. It is written with wit as well as rigor, and is accessible and valuable to professionals, both those who are experienced and those who may be students, the general public – and, of course, voice-hearers. The personal stories that are threaded through the book will stay with the reader, and McCarthy-Jones is realistic enough to recognize that these experiences do not always end well; there is Ken who speaks of his recovery and relationship with his voices, and there is Mel who fear of her voices made her jump out a window and break her pelvis and eventually to hang herself. And partly because of these very human and personal aspects the book will bear re-reading, especially for those who are in a caring relationship and need to take a moment to think about what is really going on.

© 2017 Mark Welch

Mark Welch, Vancouver, BC