Hidden demons : A personal account of hearing voices 155
Article updated 20/10/2008
By Dr. Ben Gray
In this article, academic Dr. Benjamin Gray recalls his experiences of dealing with voices that other people could not hear, published with the kind permission of the author.
It is perhaps ironic that in over 10 years as an academic and researcher in the field of mental health, I never appreciated the suffering of people with schizophrenia and mental illness until I had a nervous breakdown that kept me under section in a psychiatric acute unit for 12 months.
Among the people I met during my time there was Rosemary. The last time I saw her she was waiting to be discharged from the hospital. She had no one to go home to, just an empty house.
Rosemary was an unassuming, quietly spoken woman, unremarkable apart from an air of sadness and loss. Rosemary had told me and many of the nurses that she would be better off dead than hearing any more of the terrible and taunting voices that kept her from sleeping. Better up there with her mother in heaven, she told me, then down here in the hell of the psychiatric ward with her voices.
Within a few days of being discharged, she was with her mother again. The nurses called a meeting in the communal lounge. There had been an accident. Rosemary had thrown herself in front of a train. The girl next to me at the meeting broke into tears.
Night after sleepless night and through the long, seemingly endless days on the ward, where smoking and TV stood in place of any attempt of therapy, I and my fellow patients experienced similar feelings to those of Rosemary, feelings of loss, isolation, pain, confusion and helplessness.
"You're alone," an insidious voice told me. "You're going to get what's coming to you."
Joy was different. She was a mother of two autistic boys and had a loving husband who would visit her every day and brought her cigarettes, the social currency of the ward. There was always a glimmer of hope in her eyes, despite the voices that urged her to set herself on fire and despite seeing people covered in snakes.
Then one evening, as the nurses dispensed medication while we lined up zombie-like, I found her in hysterical tears. She told me about the voices and the serpents. I held her for a moment, trying to comfort her, as the nurses were doing nothing to calm her down. I said it would all be all right and there was always hope.
"You're going down there," a voice that sounded like Joy's hissed at me. "You wait until you see what I'm going to do to you."
No one moved or looked startled. It was just me hearing the voice. I tried not to answer it. Better to ignore the voice, repress it and soldier on, I thought. I had seen others screaming back at their voices, and it had left me with feelings of consternation, pity and fear.
I didn't want to look mad, like them. Any symptoms of hearing voices would go on medical case notes, be raised as proof of insanity and keep me locked up in the hell of the ward away from family, friends and what seemed like a long-distant normal life.
I learned several important lessons: never admit you hear voices; certainly never answer them; do exactly as you're told by staff or concerned family or you'll be seen as ill; never question your diagnosis or disagree with your psychiatrist; be compliant and admit your mental illness or you'll never be discharged.
All the time the voices got worse. "Hot fire in your eyes!" shouted a voice to me in the ward.
There is little study of what schizophrenics' voices say to them, which would make people's experiences more valid and meaningful and also lend itself to a more human account of mental illness. People's experiences of hearing voices are silenced, which can only augment ignorance and fear, both in society and in the mental healthcare system.
To make matters worse, it is almost impossible to talk with other people and relate the pain that voices inflict when they are raging inside you and shouting you down.
John was a child of the 60s and hadn't seen his family for twenty years. Because of his voices they had disowned him. "Nobody cares," said a sad voice in John's intonation.
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Experiencing voices 1
Last updated 15/06/2007
Baker P.K (1990): I hear voices and I'm glad to! Critical Public Health, No. 4, 1990, pp 21 27
Baker P.K (1995): Accepting the Inner Voices, Nursing Times, Vol. 91, No 31, 1995, pp 59 61
Batty DM (1997): "I still hear the priest occasionally but he's only a minor voice now", The Independent, July 1
Bauer S (1970): The function of hallucinations: an enquiry into the relationship of hallucinatory experience to create thought, Origin and Mechanisms of Hallucinations, Keup W (ed), New York, Plenum
Bentall R.P and Slade P.D. (1995), Reliability of a scale for measuring disposition towards hallucinations: a brief report, Person. Individ. Diff. Vol 6, No. 4, pp. 527 529
M. Birchwood; A Meaden; P. Trower; P. Gilbert; J. Plaistow; (2000): The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine. Vol 30 (2), 337-344
Background. A preliminary report by the authors suggested that the range of affect generated by voices (anger, fear, elation) was linked not to the form, content or topography of voice activity, but to the beliefs patients held about them, in particular their supposed power and authority. We argued that this conformed to a cognitive model; that is, voice beliefs represent an attempt to understand the experience of voices, and cannot be understood by reference to the form/content of voices alone. This study puts this cognitive model to empirical test.
Methods. Sixty-two voice hearers conforming to ICD-10 schizophrenia or schizoaffective diagnoses were interviewed and completed standardized measures of voice activity; beliefs about voices and supporting evidence, coping behaviour; affect and depression.
M. Birchwood; A Meaden; P. Trower; P. Gilbert; J. Plaistow; (2000): The power and omnipotence of voices: subordination and entrapment by voices and significant others. Psychological Medicine. Vol 30 (2), 337-344
Background. A preliminary report by the authors suggested that the range of affect generated by voices (anger, fear, elation) was linked not to the form, content or topography of voice activity, but to the beliefs patients held about them, in particular their supposed power and authority. We argued that this conformed to a cognitive model; that is, voice beliefs represent an attempt to understand the experience of voices, and cannot be understood by reference to the form/content of voices alone. This study puts this cognitive model to empirical test.
Methods. Sixty-two voice hearers conforming to ICD-10 schizophrenia or schizoaffective diagnoses were interviewed and completed standardized measures of voice activity; beliefs about voices and supporting evidence, coping behaviour; affect and depression.
Results. Beliefs about the power and meaning of voices showed a close relationship with coping behaviour and affect (malevolent voices were associated with fear and anger and were resisted; benevolent voices were associated with positive effect and were engaged) and accounted for the high rate of depression in the sample (53%). Measures of voice form and topography did not show any link with behaviour or affect and in only one-quarter of cases did neutral observers rate voice beliefs as following directly from voice content.
Conclusion. The study found support for our cognitive model and therapeutic approach. Factors governing the genesis of these key beliefs remain unknown. A number of hypotheses are discussed, which centre around the possibility that voice beliefs develop as part of an adaptive process to the experience of voices, and are underpinned by core beliefs about the individuals self-worth and interpersonal schemata.
Lisa Blackman (2001): Hearing voices, embodiment and experience , Free Association Books, London, ISBN 1 85343 3
Paul Chadwick, Susan Lees and Max Birchwood (2000), The revised beliefs about voices questionnaire, British Journal Psychiatry no 177, pp 229-232
Chadwick PDJ, Birchwood MJ (1995): The omnipotence of voices II: the beliefs about voices questionnaire, British Journal of Psychiatry, no 166, pp 773-776
Graham Cockshutt (2004), Choices for voices: A voice hearer's perspective on hearing voices, Cognitive Neuropsychiatry, Volume 9, Issue 1 & 2 February 2004 , pages 9 - 11
Davies, Peggy; Thomas, Philip; Leudar, Ivan (1999): Dialogical engagement with voices: A single case study. British Journal of Medical Psychology, 72, 179-187
Julie Downs, (Ed), (2001), Coping with Voices And Visions, A guide to helping people who Experience hearing voices, seeing visions, tactile or other Sensations, Hearing Voices Network, Manchester, England
Johnson F.H. (1978): The Anatomy of Hallucinations, Nelson Hall, Chicago
Jung C. G. (1969): Memories, Dreams, Reflections, Pantheon Books, Random House, New York
Martin P. J. (2000): Hearing voices and listening to those that hear them. Journal of Psychiatric and Mental Health Nursing 7 (2), 135–141
Sanjuan J, Gonzalez JC, Aguilar EJ, Leal C and Os J; Pleasurable auditory hallucinations Acta Psychiatrica Scandinavica 2004; 110 (4); 273-278
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What is it like to hear voices? 1
Last updated 20/10/2008
It is difficult to explain what it is like to hear "voices", particularly if you have never heard voices yourself. However, the experience of hearing voices is not as alien an experience as it is generally thought to be.
Firstly, it may be the same as hearing a voice in the normal way through your ears, the difference being that the "voice" has no physical cause - but like normal voices, there is variety and every experience has its differences. You may think you have never experienced this, but are you sure? You may have had the experience of hearing someone call your name only to find that there is no one there. Indeed, research shows that especially for people recently bereaved, it is not an uncommon experience to hear the voice of the recently deceased person.
As well as hearing voices through the ears, people also hear voices as if they are thoughts entering the mind from somewhere outside themselves. This is not the same as a suddenly inspired idea, which people usually recognise as coming from themselves, rather the thoughts are not their own and would seem to come from outside their own consciousness, like telepathy.
A good example of this is the experience of recalling a rhyme or tune, which you find yourself repeating unconsciously under your breath and which keeps going through your head again and again. You can even find yourself humming it. You never took a decision to start thinking of it and it's difficult to stop thinking about it. The difference between the tune and "voice thought" which appears as words in your mind is that it may go on to speak coherently to you and even engage you in conversation. You, yourself are not responsible for it and you have no idea what this "voice" is going to say next.
There are many different ways to hear voices. Voices can be experienced in the head, from outside the head or even in the body. It may be one voice or many voices. The voice may talk to you or about you.
There are other ways to hear voices, some of them make the phrase "hearing voices" a poor description and perhaps one day we will have to come up with a better one - because it is never the same for everyone. Some people for instance, experience non verbal thoughts, images and visions, tastes, smells and touch. All with no physical cause and all sensations they didn't call into being themselves.
Voices can be like dreams, we all dream and experience words, images and even sensations. When we are bored we can drift off and have a short dream. When we dream all sorts of strange things can happen to us, but we still believe they're really happening to us. Hearing voices can be like that - a waking dream - but something that is experienced as real.
For voice hearers, the voices might be present all day and have the effect of preventing them from doing things in their daily life. Voices might also punish the voice hearer if they don't do what the voice wants them to do. For example; leaving a party on their say so; not being able to talk about the voices; becoming silent and as a result isolated from other people.
There can be a pleasant side to hearing voices. Sometimes the apparent wisdom is real and the voices or some of them can seem intelligent. Voice hearers report that they have been told things they didn't know or couldn't work out for themselves and the voices have been of real assistance. For some people this experience is considered a gift, something that is like a valuable insight or even extra sensory perception (ESP.) and the voices can be trusted. Voices can be intelligent, witty, funny and incisive.
Voices can in themselves be a coping mechanism. What the voices say corresponds with the effect that the social and emotional world is having on the voice hearer. The voices will often comment on how the voice hearer is experiencing the world and in this way the voices can be a defence mechanism against overwhelming or forbidden feelings. Voices are often related to life history, such as recent or childhood trauma and the voices speak of powerlessness and injustice. This is complex and personal experience and the voices can respond either as positive guides or as chiding critics.
Can you gain control of the voices? What do you do about voices, which are not on your side, which denigrate you and insult you, or interrupt your thoughts, or pander detrimental advice and tell you to do stupid things? The first thing to realise is that although the voice may be intruding on your consciousness, that doesn't mean that you should blindly do what it says. Would you rush off and commit murder if someone told you to? - absolutely not.
People who hear voices have the same right to self-determination as anyone else and you can tell the voices exactly that. If some of the voices are pleasant and friendly, then clearly you chat to them, and not to the ones who are not. You can tell the unpleasant voices that you find them neither pleasant nor useful, and that you have no reason to tolerate them unless they are both. What about malevolent voices that can cause acute mental pain and can order you to do things (like staying in and avoiding people)? One solution is to remove as much stress from your life as possible. Not only does stress increase the voices but also it makes them say more unpleasant things. Secondly, don't ignore the voices as they tend to get more aggressive, however at the same time don't let them get away with running your life without your permission.
Further reading and references on experiencing voices
Research and related articles on the experience of hearing voices
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As well as leaving a comment on this page, you may wish to discuss your experiences and get feedback and responses from other INTERVOICE supporters, if so you can join our the online discussion forum home pageclick on Register, follow the instructions and you will be joined up straight away.
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