There’s a t-shirt–you may have seen it– that says, “I do whatever the voices in my head tell me to do.” My guess is that the person who decided that particular expression should be screen printed on cotton had never experienced auditory hallucinations, just as the person who came up with the “Kiss me, I’m Irish” t-shirt was probably Latvian.
We quip about hearing voices because we don’t think it’s normal. You’ll never see a t-shirt that says, “I respond when asked a question,” or “I sleep laying down.” If we’ve never heard voices, though, then who are we to deem it (and damn it) as abnormal?
In my last mental health post, I wrote about empowering the mental health consumer by engaging them and their families more meaningfully in decisions around their treatment protocol. When working with those who deal with psychosis, however, if we pathologize the experience of hearing voices, we’ve instantly set boundaries on the discussion–and attached a certain stigma–as we dive into contemplation of ways to eradicate the voices.
A different philosophy bears consideration. Started 26 years ago as the Hearing Voices Movement and now operating as INTERVOICE, it holds that voice hearers can develop their own personal narrative around the experience, including tools for accepting and coping with the voices. Instead of labeling voice hearing as abnormal, it applies recognition of voices as meaningful and related to the hearers’ lives, possibly even linked to unresolved trauma or a difficult event. Thus, an environment is created where voice hearers are encouraged to talk about their experiences without shame and stigma.
The approach is supportive and respectful. The result is empowerment.
While many voice hearers are leading the way in changing perceptions around voice hearing (take the wonderful Eleanor Longden, for example), I’m also thinking about this with a more all-encompassing mental health shift in mind. Movement toward more meaningful mental health care, for any symptoms and illnesses, require that we approach with an open mind and suspension of some of our usual labels for what’s normal and what’s not. Stay human-focused. Try new things. Engage in deep dialogue with mental health consumers to come up with new policies. And then, one happy day, the t-shirt designers will have to respond to a savvy market and retire some of their classics.
What do you think about this philosophy? And are there any risks or other considerations that I’ve missed?
Ken Kailing says
Strange, I’ve always considered my voices to be a kind of coping mechanism, telling me how to deal with things. And, sometimes they are strong and sometimes they are weak. But they are always rational; never unnatural.
Laura Zera says
A coping mechanism seems a good way to think of them, Ken, and you’re extra lucky that they’re always rational.
Jodi from Heal Now and Forever says
I love the Hearing Voices Network. They were influenced, I think by narrative therapy and my teachers, Michael White and David Epston. Very cool. So human focused. When I take this approach, you’d be surprised at the backlash I get sometimes. Especially from psychiatrists who chose to be scared of liability. I just don’t choose it.
Laura Zera says
Wow, I didn’t even think of liability as being an obstacle to wider spread acceptance in practice. I always love the practical considerations that you bring to the conversation (and I’m glad you work around this particular one!). Thanks, Jodi.
Jo-Anne Teal says
I think the sentence: “The approach is supportive and respectful. The result is empowerment.” says it all.
Any and all ways that stigma can be reduced, or ultimately eliminated, is positive.
Laura Zera says
Well, the other half of stigma is shame, and so yes please, let’s get rid of that! Glad you stopped by, Jo-Anne.
Jeri says
Hmmm, the voices are there so why not listen to them and learn to work with them? So long as the voices aren’t causing the hearer to do really horrible things, the more compassionate approach is the human-focused one. When my mom would get paranoid, she heard things. A lot of the time I was the only one home. You should have seen that… a middle-schooler asking her mom about the logic of what she was being told by “voices.” Ahhh, childhood memories.
Laura Zera says
Ah, the memories. If we weren’t writers, we could have been country singers. We’ve got an arsenal of song lyrics between us.
Jagoda says
I like this humane approach. Perhaps someday, mental health treatments will have the same respect as treatments–both ‘western’ and ‘alternative’–for other illnesses. Sometimes I wonder whether we’ve come very far at all from the days when the mentally ill were locked up behind bars although I know there are many compassionate and competent psychologists and psychiatrists out there. Keep on educating folks with your articles–it is so important.
Laura Zera says
Thank you, Jagoda. I especially think that this philosophy has a role to play because many people who take medication report that the voices still don’t go away, and sometimes get worse. And I see a future where there’s more respect and acceptance for a variety of mental health treatments. Remember back when chiropractic medicine was considered quackery?
Chris James says
Thank you, Laura, for another informative post. I don’t read about this kind of thing anywhere else, and I find it all very interesting. Your analogy at the beginning is very good.
Laura Zera says
Why, thank you, Chris! So glad you find these posts informative.
Aniruddha says
Wonderful post, Laura.
Laura Zera says
Thank you so much, Aniruddha! And thank you for reading.
Jagoda says
Hi…for something completely unrelated to your post. I came across this site and thought you might be interested in contributing articles there based on your adventure travel: http://www.vagabundomagazine.com/want-to-contribute/
Cheers, Jagoda