By Kate Hilpern

Published: The Independent, 06 March 2007

Eleanor Longden, 25, started hearing voices when she was a teenager. But, contrary to the usual perception of inner voices, Longden says hers weren't destructive: "It was rather mundane, simply giving me a narration of some of the day-to-day things I was doing. In many ways, the voice was companionate because it was reminding me that I was carrying on with my responsibilities despite feeling so sad inside. There was something constructive about it."

People like Longden who admit to hearing inner voices can generally expect two outcomes: a diagnosis of insanity, and potent medication. But a group of psychiatrists and psychologists believe it's time we reconsidered labels such as schizophrenia and the drugs used as treatment. In fact, they believe we should get people to listen to, and actually engage with, the voices inside their heads.

Longden believes her biggest mistake was in telling a friend she was at university with about her experiences. "I explained that the voices were actually quite positive, but she was horrified and insisted I see a psychiatrist, who ignored my unhappiness and homed in on the voice, assuming it meant I had no sense of normality. For example, I was quite involved with the university television station, and the psychiatrist stated in her notes that I had delusions of being a broadcaster. The second time I saw her, she suggested that I admit myself to hospital for three days for tests."

Three days turned into three months, during which time Longden was told that if she left, she'd be sectioned and forced back. The drugs she was coerced into taking did little except cause weight gain, and the terrifying label of schizophrenia she was given was, Longden believes, directly responsible for the arrival of 12 very hostile inner voices.

Like most multiple-voice hearers, Longden says one voice was dominant. "He was demonic, and had a visual manifestation of a huge grotesque figure swathed in black. His threats were graphic and violent. The other voices, which were less clear, would back him up."

As if this wasn't enough, back at university Longden found herself the victim of a bullying campaign. "People had heard about where I'd been and within a week, my door in the halls of residence had been defaced, and I was spat at. I started to self-harm. The worst instance was in the student bar when a group of people asked me to stub a cigarette out on my forearm. When I did it, they cheered."

Longden became suicidal and was sectioned. After seven weeks back in hospital, she went to stay with her parents in Bradford, where she continued to self-harm and her voices were louder than ever. Her psychiatrist told her it would almost have been better if she'd had cancer because it would be easier to cure.

Finally, the breakthrough came. "Everyone had treated me with this total lack of hope, and as completely passive. But then I was put in touch with a psychiatrist who asked me what I thought would help me. When I said I felt I could deal with the voices better when my mind was clear, he supported me to reduce the medication. Better still, he suggested that I engage with the voices because they probably had a symbolic meaning that might help me recover."

Longden began to recognise her voices as a representation of unconscious feelings of self-loathing. This helped her to fear them less. "If they were metaphorical, it stood to reason they couldn't have any control in the external world," she says.

The psychiatrist encouraged her to talk back to them. "I began to question them, and their replies gave me great insight into my subconscious feelings - enormously helpful in my therapy - and then I started negotiating with them. Sometimes I'd say to the dominant one, 'I'll only talk to you after EastEnders,' and he'd agree!"

Three years on, Longden is off medication. She says she's happy, and is studying for a doctorate in clinical psychology. Although her voices sometimes return, she feels in complete control of them. "I see them as useful - almost like a stress barometer. My mum's clue to feeling stressed is a migraine; mine is the voices."

Dr Rufus May, a clinical psychologist, says the aim of getting people to connect with their voices is to enable them to incorporate them into their daily lives so they are not distressing. "Voices themselves are not a problem; it's people's relationship with them that's important. So, rather than voices being something that we should avoid at all costs - the traditional psychiatric view - we should be trying to get people to face them, understand them and work with them."

May says negative voices can be turned into a positive experience. "If a voice is telling someone to kill themselves, that could be signifying rage. So the voice-hearer could say, 'Thanks for flagging this up. I'm not going to take you literally, but you've shown me there are things I need to change about me.'"

He even talks to his patients' voices himself. "I ask the person to tell me verbatim what each voice is saying. I'll ask questions such as, 'How long have you been in Mary's life?" and 'Why did you come along?' Sometimes, they'll tell me something about the person they themselves are unaware of. After all, we're dealing with the subconscious here."

May recalls one man, Edward, whose voice told him to build a time machine. "I asked this voice - via Edward - why. It transpired that Edward felt responsible for his brother's death and wanted to go back and change it. We were able to address that and Edward began to realise he wasn't responsible."

Such responses may even be life-saving opportunities. May cites the case of John Barrett who, having walked out of a secure hospital unit, stabbed a retired banker in 2004 after hearing voices in his head. "It seems to me that people didn't work meaningfully with his voices. He'd had a violent childhood, so his voice could have represented his father."

May is now involved in training mental health professionals in helping people who hear voices. "Conventional training goes deep, but it helps that I have a high profile," he says. In fact, he doesn't advocate that all voice-hearers take this route. "But if you catch people early, or other approaches haven't worked, it can work very well."

Some professionals - such as Richard Bentall, professor of experimental clinical psychology at Manchester University - go further, stating that medications should be avoided wherever possible. "They have high costs in terms of side-effects, some life-threatening. Antipsychotic drugs, in particular, can produce stiffness, tremors, involuntary movements, massive weight gain and increased risk of heart attacks and diabetes," he says.

What's more, research estimates that about half of patients given drugs don't get an adequate therapeutic response. "Add to this the fact that they are given a label like schizophrenia - which has no scientific meaning, and is deeply stigmatising - and it's little wonder that voice-hearers are given such little hope. The bottom line is that we need to stop trying to cure people, and liberate them instead."

Professor Marius Romme, a psychiatrist, adds that many inner voices can be unthreatening and even positive. "They may try to comfort, congratulate, guide or reassure. It's wrong to turn this into a shameful problem that people either feel they have to deny or to take medication to suppress."

Romme's work was instrumental in the formation of the Hearing Voices Network, an education and self-help registered charity for voice-hearers. Jacqui Dillon, who chairs the network, says:"We call inner voices - or indeed visions - messengers, because they give strong signals into people's mindsets."

The network has a growing professional following, Dillon says. "We get a lot of referrals from psychiatrists nowadays, although there's still a long way to go."

Talking heads

* Studies have found that between four and 10 per cent of Britons hear voices.

* Between 70 and 90 cent of people who hear voices do so following traumatic events.

* Voices can be male, female, without gender, child, adult, human or non-human.

* People may hear one voice or many. Some people report hearing hundreds, although in almost all reported cases, one dominates above the others.

* Voices can be experienced in the head, in the ears, outside the head, in some other part of the body, or in the environment.

* Voices often reflect important aspects of the hearer's emotional state - emotions that are often unexpressed by the hearer.

* The "hearing voices movement" has spread across the world. There are groups in countries as far afield as Australia, Finland, Japan and Palestine.

* Well-known voice hearers include Plato, Sigmund Freud, Beethoven, Byron, Charles Dickens, Virginia Woolf, Sylvia Plath, Isaac Newton and Winston Churchill.