Voice Dialogue. 31st March, 2nd and 3rd of April.
I was recently invited to do some training involving around auditory hallucinations, which took an approach didn’t take an almost, “Frankenstein monster.” View to the voices. Ok, you reading this might be thinking but we don’t chase down those who have Hallucinations with pitch forks and torches.
Think about how much you know about mental health
Rethink how people view those who experience those things that are viewed to be, “Not there.”
Sure, we have got past the stage where those who hear voices are not accused of witchcraft and shunned permanently from society. However, most theories and ways of, “Coping,” With hearing voices are based around getting rid of them. It’s not the person who gets shunned from society, but the voice. If you are a patient that hears voices, chances are you will be put on medication which could block the voice, it’s not exactly a permanent solution, if the medication does block the voice it’s basically like sweeping dust under a rug, no one can see it but if you take off the rug it still will be there and it will get into the room. We got a manual with the training, which also stated, “Medication in the long term reduces emotionality… it can diminish recovery prospects in the long term.”
Voice Dialogue training, ran by York University, does the opposite of what most therapies do. The training doesn’t involve trying to get rid of the voice/voices but work with them. Along with medication someone who experiences auditory hallucinations may also be taught distraction techniques, which in a way, is getting the voice hearer to ignore the voice/sound.
Voice dialogue, sort of gets you to see the voice as a real person, one of the main things brought up again and again though out the three days training was, “The voices are real,” voice hearer’s were told to look back into their histories to work out when the voices start, the training goes by there is some trauma/overwhelming experience that triggered the voice/voices, this was part of a, “Voice Profile,”- Well if others (A.K.A the Psychiatric nurses etc,) who were there, were going to treat these voices like real people they needed to know things about them, also it built up a relationship. It also got the voice hearer to open up more about the voice, as conditions such as schizophrenia and psychosis are often associated with a, “Mad,” Label, voices aren’t often talked about in the outside world because it is believed that, “Voices are a meaningless symptom of mental illness.” It is important to get details of when the voices started and details of the voice as the training is based on research done by Romme and Escher who acknowledged there is a connection between someone’s life story and the voices.
The training and also Romme and Escher’s research also tells what the voices are saying may not be what they mean, there may be a case a violent voice may just be protecting the person or to say something else.
As an example of this, a children’s story (amusingly it was actually one of the speakers children who told him the story and he put it together and told us)- The Selfish Crocodile by Faustin Charles- was told, we all had different interpretations of it.
The story told of a grumpy crocodile who no one would approach, as he wouldn’t let anyone near the river. However, one day the crocodile was in pain due to a bad tooth and no one helped him because they were scared of him. A mouse was brave enough and went inside the mouth of the crocodile and took out his bad tooth, helping the crocodile. The crocodile then started to realise how mean he had been and began to get along. The story told to some people that maybe if the voice was a bad one maybe it just needed some kindness, maybe it is hurt or it just needs to be acknowledged and helped for it to change. Consider how you would feel and how you would view things if you were constantly ignored. The voices for some people started off as a good thing but some change and this might be because voice hearers are told to in non-specific ways to ignore the voices.
The theory of voice dialogue takes into consideration that the voices mean something and are connected to the trauma that people have suppressed. The theory that, “Every individual consists of different selves each with its own history and opinions.” In a way, it’s kind of like Darwin’s theory of evolution; each species has physical characteristics that they have disowned in order to survive. The voice dialogue model takes a similar approach to personalities such as an independent person may have disowned the part of them what wants to rely fully on others. As the brain is a complicated thing these traits don’t disappear f
ully, it’s not like physical evolution where that part has just dropped off or grown, the traits, which are often opposite to the ones we show, get hidden in the subconscious unable to appear.
In the training we were told to write down characteristics in the people we hate. The theory brought up the characteristics we hate in others are actually because they are opposite to the ones we have, or there was even a case where someone realised they had some of the traits what they hated in that person. In relation to the hallucinations, voice dialogue brought out the idea that it is these traits we have disowned talking, some discovered that the voice held the characteristics of traits they hated or even traits they wished they had. This built up more of a profile, which turned out to be really effective, to help both the listener and the worker, when it came to later in the training. Take into consideration the Selfish Crocodile- the idea that the voices just want attention and help and take into consideration the traits you have disowned. If you have disowned a angry pessimistic trait the trauma could speak using your disowned traits, but the voice may say something like, “It’s not worth it, there is no point, just kill yourself,” But it is actually the pessimistic personality trait telling you that and in truth it probably means the opposite, well your conscious personality would have told you different. Not all hated or disowned personality traits will appear in the voice/voices but often the voice may appear angry because the voice has been repressed. Voice Dialogue training goes about helping people talk to their voices, or getting others to help the hearers talk to the voices to relieve that anger.
Details of the voices were written down, workers soon got to know the age/ages of the voices and the age and circumstances of when the voice appeared for the voice hearer, if the voice were male, female, mixed or just a sound, if the voice appears in a specific mood or situation- angry mood/stressful situation, how the voices makes the voice hearer feel- do they feel afraid of the voice? Do they trust him/her/it?
Although these three days were intensive it was important each person took breaks and took things slowly, as some of the voices may find the situation hostile as they are being talked about, in detail, which ok they may be angry that the voice hearer doesn’t really acknowledge them but it puts them in a whole new situation when you have two/more people situation acknowledging them. In the end the voice hearer can’t get away from the voice, so at the end of the days it was asked what everyone was doing, it was recognised the voices may not like what the hearers were doing the hearer could be listening to threats or complaints about the actions.
When it came to talking to the voices, it was important to get the voices permission before anyone started asking questions. The hearer had answered about details about the voice, but for some to could be a different thing asking the voice something directly, especially if the voice is hostile, it can be distressing for the hearer and provoke the voice. It could be a new experience for the worker and the hearer if the voice has never openly talked before, the voice could talk through the hearer, “The voice says…” Or directly to the worker, (The person just repeats or says with the voice what it’s saying.) It gave a chance for the voice to really talk about what he/she thought, say their side of the story. Yes, they may answer angrily but it is an important thing for the worker to remember they should not answer in a similar tone, it may be human nature, “Fight or flight,” that someone fights against you, you may get the urge to fight or run away, but in this case it is important for the worker attempt to end the dialogue on a calm note.
Overall, I feel like this method actually has a chance of working if the people are trained properly and if of course the patient and the voice is willing. Like any method the voice may feel threatened, they don’t want to be gotten rid of. There has been good feedback on patients who have had voice dialogue.
The method not only distinguishes a relationship between the hearer and the voice, it explores the voice’s underlying motives and almosts get’s the hearer to see the voice as an actual person, seperate from them.
For some patients it can set up a schedule, if the voice particually isn’t ready to work towards change yet, e.g. change of attitude, but it still continues talking. The method puts in the patient as an individual, they have the ability to control these voices, so they can say, “I’ll try to talk to them for about 30 minutes a day only.” Therefore, a relationship still is in progress but the patient may feel less stressed and more in control. It also helps the voice gradually know who is in control, with voice dialoge (talking to the voice) It is hoped we will find out why the voice is there so change can be initiated. Almost like the voice will get therapy not the hearer.
It also helps improve the stigma of mental health. It promotes to people that these voices aren’t a symptom of, “Crazyness,” And also can help take away the, “Murderous psychopath in where the voices told them to do it.” I think it’s also important that if voice dialouge does work the person will become less dependant on medication, I know from experiance it’s a hassle remembering to take my mood stabilisers once a day, hence they put me on longer lasting ones so the medication stops in my system longer. But not all medications have a longer lasting edition, in some cases it just takes one or two forgotten tablets and things start to effect you more.
I’ve tried to keep people’s names out of this for confidentialty reasons, but in the training there was evidence that this method would work. However, this method isn’t as popular as methods such as Cognitive Behahavioural Therapy or Biological methods- medication, so it isn’t readily avaliable in most places.
Training given by The University Of York Department of Health Science
Anita Savage Grainge