Hearing Voices

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Hearing Voices

• Dirk Corstens
• The School of Social- and Health
• Fynen
• 2007 March 6

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Content

• Attitude towards voices
• Making sense of voices
• The hearing voices interview
• Optional
• Construct
• Voice Dialogue

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Hearing voices

• The first encounter

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What kind of reactions can voices evoke ?

• A story of a man hearing a voice

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Jonathan

• 28 year old American man
• A voice told him to jump out of the window
• He did, from the first floor, and broke his back
• He never did hear a voice before

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What do you want to know?

• What happened with you when you heared the voice?
• What did the voice literally say?
• Whose voice was it?
• Why did you obey?
• Do you still hear that voice?
• Did you hear voices before?
• Do you have any idea why the voice came?
• What happened before you heared the voice?
• What is your own explanation?
• What does the voice solve?
• What are going to do when the voice comes back?

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Voices can evoke

• Astonishment
• Powerlessness
• Fear
• Extreme behavior
• In the voice hearer
• and (!)
• the professional
• Parallel processes

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• Voice hearers ask you to stop the voices
• And we want to save people
• But
• Take a close look at the background

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Background

• His congregation demanded him to go back to the
  US
• He was married to a Dutch woman and had one child
• The dilemma
• He was scared to go back
• He didnt want to resist the demand of his
  congregation
• The voice gave a solution to his dilemma
• He could stay in Europe
• (Before he never told about the voice)

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Content

• Countertransference
• Attitude
• General advice
• Short term interventions
• Some conclusions

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Countertransference

• Powerless - Silence
• I must do something, act, protect - The voices
  must stop (medication)
• Labelling
• Rejecting the experience / the person

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Countertransference

• Take too much or less responsibility
• Being afraid of the voices or the forces they can
  provoke
• Too afraid to evoke psychosis and/or dissociation
• I am not specialised in it

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Countertransference

• It is not bad
• Be aware of your reactions
• And the implications of it
• There are other options

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Attitude

• POSITIVE TOWARDS THE EXPERIENCE
• Hearing voices is a normal phenomenon
• Voice hearers can become ill due to their voices
• Voice hearing itself is not an illness
• Voices have a meaning
• Voices use a methaphoric and subjective language

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Attitude

• ACCEPTING DIFFERENT REALITIES
• Shared and personal reality
• About dilemmas
• It is about conflicts/problems in life
• Relation with life history
• About methaphorical and subjective reality

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General advice

• Most voicehearers are not allowed to talk about
  their voices (threat) - communicate that
• Voices know you dont like them
• Make clear that you are not the enemy
• It is as if you talk to a group of people
• Make clear to who you are talking

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General advice

• Accept even negative voices
• Try to make a bond
• Also with the voices, in a neutral way
• Voices have their own characteristics
• State that it is important for you that the
  person stays in charge

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General advice

• When you are afraid, dont make a secret of it
• Voices can be protective
• Voices have intentions
• Separate treatment of voices and the daily
  supportive work

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What to do?

• Start to listen and ask questions
• Use the hearing voices interview
• Show the voicehearer that you are curious about
  their voices world
• Learn how people already cope with their voices,
  validate that

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Short term interventions

• Anxiety reduction
• Positive information
• Restoring hope
• Medication

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Short term interventions

• Setting time for the voices
• (Consulting room)
• Listening to the voices
• (non-judgemental)
• Ask them questions
• Talk back to the voices and staying firm
• De-escalating
• (voices want to be heard)

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Short term interventions

• Neglecting the voices
• Setting limits not everything has to be obeyed
• Planning finding strategies
• Writing (diary)

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Short term interventions

• Avoid powerless making labels (there is time
  enough to sell them later)
• Restore the relation with the life history
• Restore his or her dignity by acknowledging their
  real pain and trauma

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What can be the effects ?

• Anxiety reduction
• Reduction of depression
• Finding ways to cope better with the voices
• A working relationship
• Give a meaning to the voices
• Use the voices

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Conclusions

• Keep an open mind when working with voices
• Voices can be dealt with
• It is the demoralization that is the enemy, not
  the voices themselves
• Voices point at emotional issues in life