Hearing voices: A phenomenological-hermeneutic approach

The word "phenomenology" has a number of meanings. In this paper we briefly contrast the different meanings of the word in psychiatry and philosophy. We then consider the work of the philosophers Heidegger and Merleau-Ponty, as examples of what Hubert Dreyfus calls ontological phenomenology, in contrast to an epistemological approach. We present a brief outline of Merleau-Ponty's theory of embodiment, and contrast this with the dominant, epistemological (or Cartesian) view of experience. Through the example of a woman who experienced bereavement hallucinations, we try to show how this approach can open up a hermeneutic approach to the experience of hearing voices. An understanding of embodiment can help to counter reductionism, whether biological or social, and dualism (body/mind and mind/society). It is only when we consider the totality of human experience that we can understand its meaning. This has two main benefits. First, it legitimates the claims made by those who hear voices that their experiences are intrinsically meaningful. Second, it can provide a framework for those who work with voice hearers and who are interested in understanding these experiences. In this sense, phenomenology can become a valuable clinical tool.