6. Discussion
In Hong Kong, schizophrenia has constituted a longrecognized
mental disorder and accounted for the largest
number of persons receiving psychiatric recovery services
[35, 36]. As auditory hallucination is a major psychotic
symptom of schizophrenia, it has salient impacts on the lives
of the sufferers. The experiences shared by the participants
in this study highlighted the day-to-day struggles of persons
with auditory hallucinations in the Chinese cultural context
of Hong Kong. Results from this study showed that not
only did the participants struggle with the voices, but they
also had to bear the negative consequences in isolation. In
general, the voice hearers were psychologically burdened,
prone to odd behavior, financially disadvantaged as a result
of poor employability, and socially isolated from family
members and friends. They suffered great emotional strain
with limited social support.
Hearing voices that no one else can hear can be disturbing
and frightening for the hearers and for those around
them. Family members and friends may have difficulty in
accepting that the persons they care about are experiencing
voice-hearing problems. No one really knew why people
had auditory hallucinations. However, the participants in
this study made use of some effective lay coping strategies,
including (a) changing social contacts through ignoring and
justifying the voices, (b) manipulating and regulating the
voices, and (c) changing perception and meaning towards
the voices. Moreover, the effectiveness of the strategies was
related to the respective individuals’ characteristics and
might vary according to different phases of the problems. The
results of this study have provided an initial understanding
of coping strategies of people with auditory hallucinations in
Hong Kong.
6.1. Limitations of the Study. Each research method has its
limitations and strengths. The great strength of the qualitative
method used in this study is the rich abundance of data
on the subjective experiences of the participants obtained
from in-depth interviews. However, in spite of the potential
advantages of qualitative methods, there are situations that
could undermine the validity of the study. Most pertinent in
this regard is the fact that its qualitative nature meant that
only 20 participants were interviewed. A small sample is
unlikely to be representative of the population of the voice
hearers inHong Kong. Thus, the findings of this study cannot
provide the basis for conclusions supported by statistical
analysis, as with quantitative methods.
Because of the impact of schizophrenia, the side-effects of
drugs and perceived secrets of the voices, some participants
might not be totally open to disclosing their hallucinations.
Understandably, it was not easy for some of them to disclose
freely the private contents of their hallucinations in the
interviews. Owing to the nature of their illness, the answers
given by some voice hearers were short and not necessarily
relevant to the study. Again, the researcher had to rely on
some follow-up questions in the interviews. It is therefore
possible that some participants might not have been able to
tell their story in their own terms, and this might well have
affected the effectiveness of the study.