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Published: Tuesday, 18 January 2011 07:32

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My first recollection of voice hearing was when I was very young, around six years old. I would hear a very soothing maternal voice telling me that everything was all right they would “protect me” and “not to be afraid”.  This voice remained during my early years and was always a great comfort and frequently lulled me into sleep which so often eluded me at night.

As I approached adolescence the range of voices increased and I was visited by four or five voices of differing gender and age.  My previous experience of voices had been positive and comforting but now the voices took on a much more critical tone and made disparaging comments regarding my actions. They would find fault or berate me for doing things wrong, being stupid, and never being able to get things right. Still the maternal voice remained to soothe and mitigate the negative impact those voices were having on me.

Upon completing my schooling the voices became more active and far more intrusive, they invaded all parts of my life and I felt I had no privacy and was constantly being observed and scrutinized. I lived in fear of the barrage of abuse that would follow any of my actions and became increasing anxious about mixing with others as I felt sure others could also hear the voices and were aware of just what a terrible and useless person I was.

I retreated into a solitary world as I endeavored to make sense of what was happening to me. A complex and mystical explanation developed, in which I believed that I had been chosen to receive a message from God.  This message would relieve mankind of war and conflict and peace would prevail. What I had to do was stay home and be ready to receive this message.

In the meantime I was being tested by demons and the devil (the voices) to prove I was a worthy recipient of the message.  I stayed in my house for eighteen years not leaving except in the most exceptional circumstances waiting dutifully for this message.  Voices filled my day and kept my mind occupied as I engaged in deep conversations with them.

They exposed secrets to me that only I was privy to. That I had been chosen, I was special, I was important, I was entitled to be here.  Soon all the world would know of me and it was I who would hold the key to eternal peace for the world.  I began to study the bible looking for references to myself, and my beliefs became more entrenched and even more fanciful.

I was seduced by the notion that my suffering and miserable existence had some purpose and meaning to it. It made the isolation, loneliness and lack of human touch tolerable.  My ability to endure was sustained by my belief that there was an extraordinary gift for all mankind to receive and the responsibility of that gift sat with me. 

Constantly I failed. I was unable to demonstrate the qualities required of me. The battle was becoming more and more difficult and I started to doubt that I would ever measure up.  I was too weak, too feeble-minded, too selfish, too flawed. I spoke to no-one about this as the voices made it clear that if I shared any of what was happening I would be betraying a sacred oath and I would be a complete failure. Keeping the secret was the one thing I could do.

I reached a point when I felt I could no longer continue the quest.  I had no option but to kill myself. Surely God would grant me peace, then I would no longer be tormented; I would be free.  Whilst the desire to gain peace was overwhelming the will to live was stronger, and still within the recesses of my mind was a flicker of hope. Hope that I would overcome and have the life I secretly craved.  With the help and assistance of a friend I decided I was going to have one last crack at getting the voices under control and if that failed I knew I had done all I could.

I had been under mental health services for several years and although I was heavily medicated the voices persisted and my body was lethargic and yet agitated all at the same time.  I had not told my nurse of my beliefs as I was sworn to secrecy therefore she was unaware and unable to assist me adequately.

I decided that everything I was doing so far was not working for me so doing the exact opposite made sense to me.  I began to reflect and critically analyze what was happening and I concluded that the demons had made a mistake in choosing me. I was not up to the task and if they had made a mistake in picking me then perhaps they were not as infallible or as powerful as what I initially believed.

I decided to test this out. One of the first things I did was change my attitude towards them, so instead of being fearful of them and bowing to their every whim I embraced them as friends and welcomed their intrusions, greeting them with kindness and respect.

As a consequence my fear reduced which in turn alleviated the distress I felt, now when I heard a voice my anxiety level didn’t increase. This enabled me, with some confidence, to tackle the voices and their apparent power more readily.  I decided that I would set the demons some tasks to do as they had threatened to manifest all sorts of mayhem if I didn’t do as they asked. So I decided to test out these ‘masters of the universe’. 

I gave them a simple task to wash the dishes unaided. They were unable to achieve this, and so the seed of doubt as to their actual power was sown and with it the dawning of a thought which was to prove incredibly useful to me and sustained me during trying periods.  I realized that the only power the voices had was the power I gave them. 

They needed me to perform tasks and speak to certain people; without me they were impotent. It was me that held the power. This was a moment of enlightenment and the beginning of my own journey of taking back control.  The battle lines were drawn and I was ready for them. We would continue this relationship on my terms and on my terms only. 

It was never my intention to get rid of the voices. They had been such a large part of my life that the idea of living in a silent world scared me. I still had a few that were positive and comforting. I decided that they could stay, but the ones that caused so much distress would have to learn some manners if we were going to co-exist. Now I began the process of reclaiming my life. 

I approached the voices as I would approach any relationship and began to put parameters around how and when they could contact me.  I also began exploring other areas of my life.  I thought of the role the voices played in my life and discovered they fulfilled a need in me, a need to feel connected to someone, a need for a friend, a need to belong.  As unkind as they were they were I believed only telling me the truth about myself.  

The voices kept me so busy I had no time for any other relationships and they also spared me the pain and hurt I had experienced by numerous rejections from people in the past.  At least they did not desert me, they were there all the time; they never left me as other people did. As the voices receded the feelings of loss and grief filled the void and I decided I needed to take the risk of inviting real people into my world and cautiously and clumsily this became my new quest. 

This proved to be pivotal to my recovery. Developing relationships and being exposed to people who showed they could be kind, caring and flawed just like me, freed me from the need for voices. As I put more time and energy into these relationships the negative voices receded further and further back.

I devoted my time to just getting my voices under control and it took approximately nine months before I felt completely confident that I had mastered them.  I eventually got to the stage where I began to venture out from my home I continued my education, went to university made friends and gained employment.  Instead of having a life totally consumed by voices now I began to devour my ordinary life.

It was several years later that I decided to work in the field of mental health as an advisor and educator. It was while working in this role that the opportunity was presented to me to work specifically in the area of voice-hearing.  I was approached by a clinician who wanted to start up therapy groups for voice-hearers. She discussed her ideas and I talked of my own understanding of the process, and the key points I learnt from my own process of dealing with voices. 

On reflection these key points were as follows: the voices have something important to say but they only know how to communicate in a negative, clunky way. For me to make sense of the voices I needed to interpret what it is that they are truly trying to tell me.  I need to deal with the voices immediately and if I try to ignore them they become more persistent and louder. I realized that what they have to say is important, so they won’t let you ignore them.

There is a strong relationship between voices and stress. Often they are trying to tell me I’m stressed or worried about something and I need to do something about it. Arguing with them doesn’t help they always win. They can’t always be trusted to tell the truth so I need to evaluate what they are saying and see if there are other possible explanations for what they have said to me.

The only power they have is the power I give them.  I’m in charge here.  I will decide what I do as it is only I who must face the consequences not the voices. The mind is a powerful tool and I identified my personal strengths and worked with them.  I found it almost impossible to change my emotions but I could change the way I thought about things I could change my attitude to the voices, which influences the way I think, feel and respond to them.  

Therefore drawing from my own experience of getting voices under control together we extracted the skills and knowledge I had acquired, and converted that understanding into the basic content for the group sessions. We then refined these after feedback from the participants. These are the same skills and approach I still use today so I can function and thrive.

We piloted the groups within our District Health Board and it proved very successful. Briefly the methodology is as follows. The groups are lead by a voice-hearer and co-facilitated by a clinician.  The philosophy of the groups is based on the view that clients are extremely resilient, want to improve and are willing to take responsibility for their own lives therefore they are the best ones to drive the process of healing and recovery. The role of the clinician within the group is to be an active participant and deal with any distressed clients who may need to leave the group setting.  They also provide feedback and offer any information that may be useful to clients. Clinicians also bring their own expertise of evidence-based practices, and sometimes their own voice hearing experiences.

The groups are based on the idea that hearing voices is part of the continuum of normal human experience. There is a strong emphasis on normalizing and validating, and participants feedback indicates that this strategy has up to 80% efficacy and reduction in distress. A normalising approach affirms that it is the impact of the voice hearing experiences that causes distress. For instance, those who experience helpful voices do not tend to present to services but those with negative, critical voices seek help. However, because of the content, the majority of voice hearer’s will never present to services.

Encouraged by the results the DHB decided to adopt the methodology service wide, and all clinicians are now taught the guiding principles and the techniques to use either individually with clients, or make appropriate referrals to the group. The groups are now considered core business, and have led to the wider approach of psychological strategies for those with psychosis.

In keeping with the philosophy of consumer-led recovery I was appointed as Project Manager of the Psychological Strategies for Enduring Mental Illness project. I run groups and train and coach clients and clinicians as facilitators. I also teach clinicians the methodology to enhance their skill base so they can work individually with people.

The approach is also being taught to nursing students within the nursing curriculum at the University of Auckland. Currently this is the only consumer clinician alliance using psychological interventions being offered within a public mental health service in Australasia.

Ultimately the goal is to increase the opportunities for voice-hearers or others who have had similar experiences, to join the mental health workforce to provide expertise. What voices hearers can offer is the wisdom obtained from first hand experience that cannot be convincingly articulated by scientific knowledge alone. This could lead to the delivery of a totally consumer-run service. 

I have had the privilege of working with extraordinary people, clinicians, consumers and some who identify as both.  They demonstrate the most incredible resilience and ability to overcome life events that could destroy the human psyche and spirit.  I gain an enormous satisfaction from the work I am involved in. 

I have found my niche. I have had the opportunity to take what was a catastrophic event and turn it into a positive life affirming vocation.  I am surrounded by people who are as passionate and committed to working with people to enhance their well-being and lives as I am.  I have found where I belong.  I might have misinterpreted the voices all those years ago in terms of freeing the world of tyranny but in some ways they were right.  My time now is devoted to working with clinicians and clients so they can acquire some peace from their voices and hopefully, be able to flourish and would say they have a life worth living.

Compiled 10th January 2007 by:

Debra Lampshire 

Experienced Based Expert & Educator