Hearing Voices. On the Anthropology, Psychology and Politics of the Unspeakable

This working paper examines the experience of hearing voices at the intersection of anthropology, psychology, and transcultural psychiatry. Beginning with the Rosenhan experiment and its lasting implications for diagnostic practice, it traces how cross-cultural research, particularly the work of Luhrmann and colleagues, shows that culturally mediated cognitive frameworks significantly shape whether voice-hearing is experienced as distressing or benign. It reviews therapeutic approaches for distressed voice-hearers grounded in compassion-focused therapy, including avatar therapy as a digital dialogue-based approach, and relates these to the Hearing Voices Movement's advocacy for an experience- and person-centred, de-pathologizing approach. Drawing on McCarthy-Jones and Longden's work on trauma, shame and memory and on Byron Good's work on political subjectivity, it considers how biographical experience and political context may also shape the content of distressing voices. Originally written in 2019, this working paper includes a 2026 postscript that updates the evidence base. The studies show a deepening of relational and culturally informed approaches in voice-hearing research as well as an attempt to provide further evidence-based digital care offerings for the empowerment of voice-hearers in distress. The working paper concludes that this body of research points to compassion-focused, culturally sensitive and trauma-informed digital approaches as a particularly promising direction for sustainably supporting the recovery and empowerment of voice-hearers in distress. Their development and study require interdisciplinary collaboration at the intersection of anthropology, psychology, and the practical design and delivery of mental health care.