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Hearing voices that are distressing: Self-help resources and strategies

By Patricia Deegan, Ph.D.

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This article is available in Spanish and Icelandic.  See follow-up Article (English)

The National Empowerment Center has a complete curriculum where participants have a simulated experience of what people who hear voices go through on a daily basis.

I have been a voice hearer since childhood, but it was not until my adolescence that I was hospitalized for hearing voices that were distressing. For many years I felt isolated and stigmatized for carrying a label of mental illness and for hearing voices that continued to be distressing for me. Psychiatric drugs did not make my voices "go away" although there were times when I was so drugged I didn't care about anything, including what the voices had to say. Therapists showed little interest in my voice hearing experiences. In fact, during the seventeen years that I was labeled and treated for schizophrenia, my therapists called my voice hearing experiences "auditory hallucinations". They seemed to view my voice hearing experience as nothing but the random fluctuation of neurotransmitters in my brain. In essence they viewed my "auditory hallucinations" as evidence of some sort of "neurotransmitter meltdown".

This attitude of ignoring voice hearers' experience is quite prevalent in the helping professions. For instance, when I consult to programs that provide services to people who hear voices that are distressing, I find it remarkable that staff know so little about the individual's experience. For example, I recently consulted with staff that work in a residential program with a man who hears distressing voices for approximately 80% of his waking hours. This man has been hearing distressing voices for over ten years. Yet if you look at his record all it says is: "Has auditory hallucinations that sometimes command him to hurt himself". In ten years of treatment no one has explored the voice hearing experience with this individual. No staff person has thought to inquire if the voices are male or female. Do they speak English? Are there helpful voices as well as distressing voices? How do you understand the existence of these voices? Are there one or many voices? When do the voices come and when don't they come? Do you have any personal power in relation to the voices-i.e., can you communicate with them, can you reason or bargain with them, can you turn your attention away from them and get involved with another activity, can you tell them you will talk with them later in the evening, etc.?

Indeed, hearing voices seems to be stigmatized not only in the wider Western culture, but also within the mental health community as well. It seems that as a general rule, most mental health staff feel it is taboo to inquire into the voice hearing experience of the people they work with. Of course such stigma and taboo only serve to further isolate those of us who hear voices that are distressing.

The good news is that voice hearers themselves have begun to organize and speak out about the voice hearing experience. Two excellent books:

Hearing Voices: A Self-Help Guide and Reference Book (1993) by John Watkins, Melbourne, Australia. Available online.

Accepting Voices (1998) by Marius Romme and Sandra Escher, MIND Publications, London. These authors have done pioneering work in the areas of listening to the experiences of voice hearers and helping to bring them together to share life strategies. Available online.

There are self-help groups run by and for voice hearers in Europe and now the United States. These groups hold regular meetings to share experiences, publish newsletters, hold conferences, share information and educate professionals and the general public. Hearing Voices groups do not pathologize the experience of hearing voices or experiencing other altered/extreme states, instead they ask what does the experience mean to you?

Intervoice: The International community for hearing voices www.intervoiceonline.org

New USA hearing voices network: Support groups for voice hearers and also trainings for leaders of support groups. www.hearingvoicesusa.org

Hearing Voices Network, Manchester, UK (has links to other hearing voices networks and online groups): www.hearing-voices.org

Voice-Hearers Support Group: http://groups.yahoo.com/group/voice-hearers

Hearing Voices Movement: http://en.wikipedia.org/wiki/Hearing_Voices_Movement

Hearing Voices Info Booklet: http://hvna.net.au/upfile/HVNA_Info_Booklet.pdf

Through these resources and networks voice hearers are beginning to let the world know that not all experiences of hearing voices are pathological or indicative of mental illness. Many people in Western Judeo/Christian culture have heard voices, including St. Paul, Joan of Arc, St. Francis, Socrates, William Blake, George Fox (founder of the Quakers), the classical music composer Robert Schumann and the psychiatrist Carl Jung. Hearing voices does not automatically mean you are "sick". However, there are clearly voice hearing experiences that can be very distressing and can disrupt our lives and ability to work, make friends, reach our personal goals, etc. Voice hearers are beginning to learn from each other how to creatively cope with and/or eliminate distressing voices. We are learning that we do no have to be victims of our distressing voices. Some self help strategies include these:

  • Don't isolate. Find people you can talk with about your voice hearing experience. Perhaps start a Hearing Voices Network in your area!
  • Some research suggests that if you put a rubber band around your wrist and snap it each time the distressing voices start, they will decrease in intensity and/or frequency.
  • Some people have found it particularly helpful to use "I statements".  For instance, if a voice begins to tell me I am a whore, worthless, no good, etc. I can say out loud, "Right now I feel worthless, I feel like I am not good, I feel I am a whore", etc. This is very different than saying "the voices say I'm no good, a whore, worthless" etc. In this strategy I say what I am hearing and own it as my thought and when I do this the voices don't have to keep reminding me of it and they quiet down.
  • Keep a record. Some people have found it helpful to keep a record of the time, place, day and what they were doing just before the voices start up. By keeping a record for a few weeks you may begin to see a pattern. For instance you may begin to notice that your voices start up after visits to your family, after being in crowds, just before work, only when you use alcohol, etc. Once you notice a pattern you can avoid those situations and thereby eliminate the voices related to those situations.
  • Try some music. Research has shown that for some people using a Walkman™ and listening to your favorite music can help diminish the intensity of voices. Interestingly, it's not that loud volume "drowns out the voices". Rather, what seems important is that your attention is focused on music you like. Thus, if you really like Metallica but only have a Brahms concerto to play on your walkman, no matter how loud you listen to Brahms it probably won't diminish your voices. So make sure you are listening to music that engages your attention and that you really like!
  • Don't forget that physical factors can effect the voice hearing experience. For instance, some people find that they hear voices that are particularly distressing when they have a fever or when they are pre-menstrual. Others find voice hearing gets worse after using alcohol, street drugs or over-the-counter drugs such as caffeine, sugar, antihistamines (cold medicines that cause drowsiness, such as Contact, Drixoral), etc. Knowing your body's reaction to fever, PMS, over-the-counter drugs, street drugs and other physical conditions can help you both predict when voices may be most distressing and help you eliminate these factors or at least be able to predict the length of time you will feel acutely distressed. For instance you could say "each time I drink alcohol my voices get worse, so I will stop drinking alcohol" or you might say "each time I am pre-menstrual my voices get worse so I know this will only last for several days and I will arrange for extra support from my friends each month during this time".

There are many, many other self-help techniques for helping to control or eliminate distressing voices. Perhaps you have found some things that work for you. If so, please feel free to write to me and let me know what works for you. I'll keep publishing self help ideas as they come in. Just write your ideas to: our contact form located at www.power2u.org/contact.html.

The National Empowerment Center has a complete curriculum where participants have a simulated experience of what people who hear voices go through on a daily basis. [Click to view the Hearing Voices Curriculum]