Monday, 19 May 2008

Redefining hearing voices

"If you talk to God, you are praying; If God talks to you, you have schizophrenia.If the dead talk to you, you are a spiritualist; If God talks to you, you are a schizophrenic."

--The Second Sin, by Thomas Szasz,

If it was not for social psychiatrist Professor Marius Romme, visiting professor of the University of Central England, the Hearing Voices Network may never have been founded. He describes why he believes hearing voices – or auditory hallucinations – is not necessarily symptomatic of an illness.- based on a speech given at the launch of The Hearing Voices Network, in the summer of 2000.

"Hearing voices in itself is not a symptom of an illness, but is apparent in 2 - 3 % of the population. One in three becomes a psychiatric patient - but two in three can cope well and are in no need of psychiatric care and no diagnosis can be given because 2/3 are quite healthy and well functioning.
There are in our society more people hearing voices who never became psychiatric patients than there are people who hear voices and become psychiatric patients.
The difference between patients hearing voices, and non-patients hearing voices, is their relationship with the voices. Those who never became patients accepted their voices and use them as advisers.
In patients, however, voices are not accepted and seen as evil-messengers.

Don’t kill the messenger

They are messengers and they have a message. They are related to sincere problems that occurred in the person’s life and they tell us about those problems. Therefore it is not wise to kill the messenger. Instead of not-listening to the message we should look how to help and sustain the person in solving their problems. (It is like it has been in many wars and conflicts in ancient times already, where the messengers were killed when a message was not welcome).
Research shows also that hearing voices in itself is not related to the illness of schizophrenia. In population research only 16% of the whole group of voice hearers can be diagnosed with schizophrenia.
Also, therefore, it is not right to identify hearing voices as an illness. Psychiatry in our western culture, however, tends unjustly to identify hearing voices with schizophrenia. Going to a psychiatrist with hearing voices gives you an 80% chance of getting a diagnosis of schizophrenia.
However, when you identify hearing voices with illness and try to kill the voices with neuroleptic medication, you just miss the personal problems that lay at the roots of hearing voices - and you will not help the person solving those problems. You just make a chronic patient.


Many patients rightly realize that their experience of hearing voices is wrongly interpreted as a symptom of an illness of schizophrenia. Many patients also rightly feel that it is a handicap that they are not allowed to talk about their voices in psychiatry on fully unjustified grounds.
Many patients also are unjustly treated with high doses of neuroleptics which becomes a drawback to their development and their possibility to take their lives in their own hands.
Therefore many voice hearers are glad that there is an opportunity created by the National Hearing Voices Network, where their experience is recognized and accepted as real. Where the possibilities are available to talk about this experience and be appreciated for it.


In these groups of voice hearers people can learn form each-other about coping with their voices and they can support each other in their battle to stop being discriminated against. I do not deny that there exists a pattern of behaviour and experience that can be categorized as "schizophrenia.
The question, however, is how this pattern of behaviour and experience has developed in the diagnosed individual. We know quite a few people who, when they first heard voices, were not able to cope with their voices and developed a range of secondary reactions that mimic the whole range of schizophrenic behaviour and therefore were diagnosed as such.
But when they started to listen to their voices and recognise their problems and were able to learn to cope with their problems they were also able to cope with their voices and the full range of reactions diminished or vanished.


Therefore everyone who hears voices and has troubles with them, should be given the opportunity to assess the relationship of the voices. Their life experiences should be assessed for the reasons for hearing voices, before they become diagnosed and are treated for an illness instead of being helped with their problems.
The negative attitude of our society and our psychiatric services towards hearing voices and schizophrenia should be scrutinized. As long as that is not the case HVN offers a unique opportunity for voice hearers to scrutinize their own victim status and help each other to overcome the negative attitude of the society the consequences of discrimination related to it.


The prognosis of hearing voices is more positive than generally is perceived. In Sandra Escher's research with children hearing voices she followed 82 children over a period of four years. In that period 64% of the children’s voices disappeared congruently with learning to cope with emotions and becoming less stressed.
In children with whom the voices were psychiatrised and made a part of an illness and not given proper attention, voices did not vanish, but became worse, the development of those children was delayed.
Normalising the experience within the family was of help to children and parents who became able to support the child with existing problems. While the illness concept estranges parents and children, makes them afraid and introduces a fatal outlook on the future of a life-time illness.
Therefore the HVN is of such importance and should expand its activities in training professionals to react differently with voices and voice hearers to support each-other instead of deny their experience and try to kill it. To develop actions that will end the social taboo.
As long as there exist a social taboo against voices psychiatry will keep up his role as custodian of this taboo. Because that is what psychiatry is set up for, to watch over societies interests in mental health affairs. In itself this is an adequate role when it is done rightly and effectively, which is at the moment not the case as far as voice hearing is concerned.
Taken from psychminded

Helping children who hear voices

hearing voices can be triggered by stressful events, such as child abuse

Hearing voices when you are a child may be a temporary condition whose symptoms lessen with age if they are sensitively handled, according to new research.
Dutch researchers studying 80 children over a four-year period found that if hearing voices was treated as relatively "normal" and not strange or frightening, symptoms were likely to lessen.
The researchers Sandra Escher, Marius Romme and Alex Buiks are half-way through their study and will present their findings at mental health charity Mind's annual conference on Tuesday.
There have been few previous studies of children who hear voices, but only one has looked at the condition over a period of time.
It suggested that the severity of the disturbance caused by hearing voices worsened as the child got older.
However, the Dutch study says children in the second year of the research were more likely to have fewer symptoms and to need less psychiatric treatment.
The children are aged eight to 18.


The researchers said many of the voice-hearing experiences were triggered by stressful circumstances, such as sexual abuse, moving home or bereavement.
They believe that understanding the cause of the condition and dealing with it sensitively can reduce the symptoms dramatically.
They say the key to reducing symptoms appears to lie in whether the child and his or her parents try to "normalise" the condition and not make it seem frightening or strange.
According to Mind, 2% of children in all age groups hear voices, although there is very little research on the subject.

Accepting voices

It has traditionally been thought that hearing voices was a symptom of schizophrenia. Patients are usually prescribed tranquillisers.
However, Marius Romme, professor of social psychiatry at the University of Limburg, Maastricht, says: "We must accept that the voices exist. We must also accept that we cannot change the voices. They are not curable, just as you cannot cure left-handedness or homosexuality - human variations are not open to cure - only to coping.
"Therefore to assist people to cope we should not give them therapy that does not work. We should let people decide for themselves what helps or not. It takes time for people to accept that hearing voices is something that belongs to them."
He believes people who hear voices need to understand their condition and see it in a positive way.
Taken From BBC News on line

More For Voice Hearers;
Hearing Voices Network
Hearing Voices Network USA

Accepting voices is By Marius Romme, Sandra Escher
MIND Publications, pp 258 ISBN 1-874690-13-8

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