Voices Work using Maastricht Approach

Did you know that around 9 ½ percent of the world’s population experience voices or sounds that others can’t hear, commonly called Auditory Verbal Hallucinations?

More respectfully known as Voice Hearing, these experiences can be distressing, or they can feel normal. It generally depends on the voice hearer’s culture and background as to how they experience it. 

In Western culture, such as in Australia, the dominant biomedical system sees this phenomenon as a symptom of genetically based mental disorders that require diagnosis and pharmacological treatment. Medications can play a role, but this alone rarely leads to a satisfactory life for the person.

Additionally, not everyone knows how to relate respectfully to someone who hears voices. Typically, this leads to confrontation and results in either rejection or silence. In the past, and sadly sometimes even now, the aim is to silence the voices, with communication about the voices and their content generally discouraged. Voice hearers who come to the attention of psychiatric services are often stuck in destructive communication patterns with their voices. The alternative approach is based on helping people make sense of their voices and learning to cope with them. 

Current research has implicated childhood traumatic stress in the development of voices, and this can render people more vulnerable to hearing disturbing voices. These traumatic experiences made the person feel powerless as they couldn’t be solved by him or her. The voices initially came about to protect the person. However, there are many people in our society who hear voices and do not come to the attention of mental health services. This indicates that there are certain reasons that some people become ‘mentally-ill’ and others not. We believe that hearing voices in itself is not pathological, but the inability to cope with the voices produces illness and illness behaviour.

Because hearing voices is a very strange experience at the beginning, people easily become overwhelmed and ashamed by it. In our society, hearing voices is often associated with madness. Because of this societal ideology, a number of voice hearers don’t relate their voices to their life history at all.

About Voices Work

Voices work is a compassion-focussed approach that accepts voice hearing as a meaningful response to life experiences. It emphasises accepting and making sense of voices. It begins with the Maastricht Interview, a structured approach that supports individuals to understand the meaning of the voices and other realities they experience. It aims to arouse curiosity in the person and enables them to explore their own experience while creating some emotional distance from the voices. Through the process, a person often discovers a re-authoring of the narratives of their experience in understanding the origin of the voices.

On completing the interview, the facilitator and voice hearer are then able to build a construct of the experience so that they can “break the code of defence”. Voices speak in metaphors, they rarely speak literally. It is infused in a destructive way of communicating which leads the person to express their emotional needs in negative ways. Initially, the voices were there to perform a protective function in the person’s life, so we aim to get back to that initial purpose in order to assist the person to improve their relationship with the voices, and adopt alternative coping mechanisms for dealing with emotions.


Working with voices is offered on an individual basis once per week or fortnight. Individual sessions via telehealth are 50 mins for $170 or 75 mins for $244.

One or two family sessions can also be arranged, which helps families to gain a basic understanding of the experience of hearing voices. This fosters greater understanding and helps family members build a better relationship with their voice-hearing relatives. Family sessions are $250 for 50 mins via telehealth for up to 3 people on separate devices.

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Learn more about Voices Work and the Maastrict Approach at the following resources:

The Voices in My Head

To all appearances, Eleanor Longden was just like every other student, heading to college full of promise and without a care in the world. That was until the voices in her head started talking. Initially innocuous, these internal narrators became increasingly antagonistic and dictatorial, turning her life into a living nightmare. Diagnosed with schizophrenia, hospitalized, drugged, Longden was discarded by a system that didn’t know how to help her. Longden tells the moving tale of her years-long journey back to mental health, and makes the case that it was through learning to listen to her voices that she was able to survive.