• Sam Vaughan and David Fowler.
• Clinical Psychology and Psychotherapy Service, Bedford Hospital North Wing, Bedford, UKSchool of Health Policy and Practice, University of East Anglia, Norwich, UK.
• Br J Clin Psychol. 2004 Jun 1; 43 (Pt 2): 143-153.

ObjectivesTo explore the relationship between distress and the perceptions that voice hearers have of their relationship with the voice they hear. We predicted that a dominant style of relating by the voice and a submissive and distancing style of relating by the voice hearer would be linked with distress.MethodThirty people who were hearing voices took part in the study. Information was gathered about the characteristics of the voice-hearing experience, the level of distress experienced in relation to the voice, the relationship between the voice hearer and the voice, and level of depression.ResultsThe tendency for the voice to relate in a dominating, insulting manner and the tendency of individuals to react with suspicion and lack of communication with the voice were uniquely associated with distress.ConclusionsAppraisals of the relationship between the voice and voice hearer made by voice hearers are associated with differing emotional responses to voices. Clinical assessments of people who have distressing voices may be enhanced by a detailed consideration of the sort of relationship that exists between the client and their voice.

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