Thursday, May 26, 2022

Hearing Voices


Finally, the powers-to-be are acknowledging what lowly counselors and social workers have long understood. The World Health Organization(WHO) recently unleashed a scathing report, castigating psychiatry for how it treats severe psychiatric disorders. For these conditions, the report dismisses the effectiveness of most psychotropic drugs, the mainstay of the profession; it also calls for an end to all involuntary or coercive inpatient care. All of this was recently detailed in  NYT Magazine.⁠1

The article follows the life of Caroline Mazel-Carlton who has heard voices since childhood. She was prescribed every conceivable medication, but the voices persisted; she lived a troubled life into her twenties, including being arrested and institutionalized on multiple occasions. Finally, after being locked up again  in her twenties, it became clear to her the toll the meds were taking on her, “the futility and harm.” She stopped taking all of them cold turkey. Rather than falling apart, her voices became more subdued, and the hair she had been pulling out grew back.


Caroline did work at low-end jobs until landing a position leading support groups for the Hearing Voices Network (HVN). These groups are similar to Alcoholics Anonymous meetings but for folks with auditory and visual hallucinations. There are no clinicians in the room, or if they are, they remain transparent. These groups are voluntary, and self-disclosure is optional. They have been so effective that they are blossoming all around the country, including NH, which I will get back to.

What psychiatry refers to as psychosis, the Hearing Voice Movement calls “non-consensus realities.” The group facilitator’s role is never to dispute the reality of what a group member self-discloses. Instead, their job is to pay close attention to the content of those voices and to show curiosity by asking the member to say more about their experience. Talking about their voices helps defuse the stigma that society has placed on them. Furthermore, exploring what the voices are saying can lead to deeper meanings.  

Non-ordinary states of consciousness can cover a broad spectrum, as I discovered in my psychotherapy practice; they can range from purely spiritual states without any pathological features to clearly biological conditions that require medical treatment. Many are the result of early trauma or abuse.

I am reminded of a client that fit this profile; he was a gentle, awkward man who had been institutionalized on several occasions after being given a medical discharge from the Army after serving in Vietnam. He was symptom-free most of the time, but he would hear voices telling him he was God whenever he encountered specific stressors. He would then hole up in his room, decompensate, sometimes being remanded to a psychiatric hospital.

Because of my eclectic background, I took naturally to what appears to be the HVN position: The most important thing I did was listen to him deeply without judging him or disputing how he saw the world. Being accepted by a fellow vet as an equal, not as a crazy person, broke through his defenses: he was able to relax and, over time, tell his story. Through that process, we were able to unearth underlying conditions, helping him make sense of his voices.

Here’s the story the veteran told: He had always been extremely anxious and, by all accounts, a poor choice to be assigned to a frontline combat unit, but that’s where he found himself. Soon after his arrival, his base camp was battered by an intense mortar attack. The other soldiers immediately took cover, but my client panicked, running frantically this way and that, attempting to avoid the explosions, landing all around him. Finally, he collapsed from exhaustion, fervently praying to God to save him. Like a miracle, at that exact moment, the mortar barrage stopped.

Afterward, he appeared lost, walking around in a daze repeating the voices telling him he was God. He was given a medical discharge and sent home. After returning to civilian life, he coped pretty well. It turned out he only heard voices when triggered by a particular sound or smell that caused him to flashback to the mortar attack. After therapy and with greater self-knowledge, he no longer fell apart when he heard these voices; as a result, he was able to get on with his life without being recommitted.

Now back to the Hearing Voice Network(HVN). I did a little research and found that NH has at least one HVN group at Monadnock Peer Support in Keene: Jude Grophear, a voice hearer herself, has been facilitating this group since 2015. She will also be co-facilitating a 3 day HVN Group Facilitator Training in August.

I’m pleased that NH is on the vanguard of this movement to provide innovative new strategies to de-stigmatize people who hear voices, helping to bring psychiatry into the 21st century.




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