Impact in Qualitative Research: Rachel Rowan Olive on multilingual voice-hearing

Rachel Rowan Olive is a research assistant with the QUAHRC and a survivor researcher using her experience of psychiatric systems to inform her work. She has an MA in Applied Linguistics and Communication and in October she will start a LISS-DTP funded PhD programme exploring suicide bereavement in communities of mental health service users in the UK.

It’s been three years since I completed my MA dissertation exploring experiences of voice-hearing with bilingual and multilingual people. Multilingualism in general, and specifically in relation to voice-hearing, is hugely under-researched in the psy-professions – although globally, speaking only one language is the exception rather than the rule. Linguists have tried to unpick the complexities of how multiple languages co-exist in one mind, but have rarely been familiar with complex power relations in mental health, or with psychiatric survivor and lived experience movements. A research review found one recent reference (Hadden et al, 2020), with older research typically relying on psychiatrists’ brief and at times alarmingly racist second-hand reports on their patients: one frequently-cited 1960s psychiatrist wrote about his non-European patients as primitive people driven to insanity by the speed of modern life (Lukianowicz 1962).

In October I presented a version of my findings to the SLaM Recovery College’s research club, a monthly open meeting largely attended by SLaM service users and sometimes clinicians. I have a complicated relationship with Recovery Colleges: in my area, the opening of a new Recovery College accompanied cuts to more intensive community services that I and my friends badly needed. So it felt a bit like a psychoeducational sticking plaster over wounds that needed relational care to heal. But it also feels important not to keep the knowledge interviewees shared with me locked in academic publications and presentations.

A university might frame this kind of presentation in terms of “real-world research impact”, but I’m uncomfortable with the idea. For me, it’s more that this knowledge doesn’t really belong to us. It belongs to the people and communities who trust us with their experiences. Not only did presenting mean that I could share what I found beyond the academy, but because the presentation was online, I could invite the people I had interviewed and share the recording with them afterwards. I will also share this blog with them.

So what did I actually present?

I interviewed ten voice-hearers who spoke more than one language using an adaptation of the Maastricht interview (HVN New Zealand), which focuses on the relationship between hearer and voice(s). I was also influenced by training from Rai Waddingham, who chairs the English Hearing Voices Network, on relational approaches to voice-hearing. Below is a whistlestop tours of my findings:

A surprising number of people do not understand some or all of their voices.

There was a full spectrum of experience: one person heard voices they didn’t understand, but which felt similar to languages they had heard in multilingual working environments. Three people didn’t mention any difficulty understanding any of their voices. Most people were somewhere in the middle: for instance, one person heard a mostly unintelligible but French-sounding muttering scattered with occasional words they understood, as well as voices in languages they did understand.

These experiences were associated with an enormous range of emotions, from comfort at hearing a language they heard in childhood but had lost, to a deep sense of unease. Word-for-word understanding is not required for emotional meaning, and the experience of not understanding could itself provoke strong feelings. For instance, the French-sounding muttering felt like an ominous power play on the part of the voice, withholding information to make the voice-hearer feel small.

Where people felt their voices had independent agency, they could hear them code-switch – move between languages – to highlight particularly strong emotion, for instance using grammatical constructions for emphasis which don’t exist in English.

Voices’ languages can reflect people’s life experiences – but it’s complicated.

Some people’s voices spoke a language mix which roughly reflected the mix of languages in their everyday life. For others it was more complicated. One person heard voices associated with visions of people who had bullied them at work. Those people spoke English, but their visions/voices spoke Gujarati and Hindi, making the whole experience more unnerving. Another heard a voice that was identifiably their dead grandmother – but speaking Scottish Gaelic, a language she had never spoken in life.

I discussed this using the metaphor of refraction: where light, rather than reflecting clearly off a smooth surface, is bent moving from one medium to another, such as air into water. This leads to an image which is distorted in a similar way to the slightly uncanny shifts that took place in the transition from language experience to voice-hearing.

Multilingual voice-hearing experiences affect how people feel about their languages.

Our languages are part of our identities, memories, emotions, and politics. The way we feel about languages is often tied up with what we experience through them. One person, whose first language was not English, felt inspired by their voice’s English-language confidence; another felt real grief that their Gaelic-learning hobby had been hijacked by their voices, as they heard Gaelic voices offering vicious criticism.

Mental health services and peer support networks tend to avoid talking about multilingualism.

Of the interviewees who had discussed their voice-hearing with clinicians or peers, only one had ever been asked about languages. Some felt they had bigger issues in accessing support: institutional racism; fear of social services removing their children if they mentioned psychosis. But others said that being asked about their voices’ languages would have opened up conversations they would have liked to have had.

What next?

This research skimmed the surface of the range and depth of experiences of multilingual voice-hearing. I’d love to explore what different methodologies such as diaries, experience sampling, or creative linguistic methods such as language portraits (Kasap 2021), could bring out about the topic.

You can read more about some of the findings described above in this paper: Rowan Olive, R., & Dewaele, J.-M. (2022). An Exploration of Multilinguals’ Voice-Hearing Experiences. Language and Psychoanalysis, 11(1), 16-40. https://doi.org/10.7565/landp.v11i1.6611