Prepare to engage with voices

Identify and nurture the compassionate self and engage with voices from that perspective

Change the power balance with voices

Identify the function of voices

Work with voices that don’t seem to want to engage

Map out voices

Engage constructively with voices that sound like an abusive person from the past

Martial arts exercises that can help in work with voices

When people have problems with voices, the most common recommendation they are given is to try to avoid them — to take drugs to make them stop, to simply ignore them, to use distraction, or similar approaches. But these strategies often don’t work. Or even if they do seem to work, they may themselves cause other kinds of problems that may not be acceptable. So what else can people try? One possibility is to try the opposite of avoidance: to deliberately engage with the voices! But this sounds scary or wrong to some people. Won’t engaging with the voices make people take them too seriously or see them as more real than they are? Might that lead to people getting even more lost in the world of voices, and so more distressed? While the mind is tricky and things can always go wrong, we now know that it is possible for people to engage with voices in ways that make things better. Specifically, when the engagement is done with creativity and compassion, the result can be a positive change in the relationship with voices, leading to much greater peace of mind. But how can people learn how to facilitate this sort of constructive engagement? Fortunately, Charlie Heriot-Maitland (known for producing the Compassion for Voices video), Rufus May, and Elisabeth Svanholmer have just made available a free series of videos, in which they offer practical ideas about how to do just that. These videos cover topics such as how to:This is the first video in the series:You can access the rest of the series here . I spoke to Rufus May, one of those involved in making these videos, and asked him what inspired him and his colleagues to do this. He answered that:

“We know there is a growing interest in this approach and we wanted to make some accessible resources. In the Bradford Hearing Voices group I volunteer with, I might facilitate a dialogue with a group member’s voice and then encourage them to regularly engage with their voice or voices. In this way group members have found they have been able to improve the relationship they have with their voices.

People ask me, how can you talk with someone’s voice? I sometimes joke ‘I‘ve got a special microphone!’ But the truth is we ask someone to ask their voice questions and then report the answers the voice is giving them. We have found if we use good communication skills such as empathy and non-judgemental questions the voice sometimes begins to respond in a different way.”

I asked Rufus for an example of this:

“Through a facilitated dialogue with a person’s voice that was being quite harsh and critical towards the person, we established the voice wanted the person to be more assertive with people in their social network. The person went on to consult with the voice on who to be more assertive with, and when she became more assertive the voice seemed to relax and become more constructive.

We have also found if people compromise with their voices the voices often behave in a less controlling way. So finding out if the voices like certain types of music or food or drink and listening to the music the voice likes or consuming the food the voice likes can role model to the voices a more respectful collaborative relationship.”

He then explained where these engaging approaches have come from:

“In many traditional cultures, consulting with voices is something that has been done for hundreds of years. The original Hearing Voices research carried out by Romme and Escher in the 80s in Holland found that many voice hearers who had never used mental health services negotiated and engaged with their voices.

The challenge is how to talk with voices that are hostile and controlling. This means we as communities need to support voice hearers to become more confident in being assertive with their voices and then learning how to engage in a power with style of relationship, rather than power over.

Hearing Voices groups can be good spaces to learn this ‘living with voices’ approach. We have also found tools like Nonviolent Communication and mindfulness and compassionate mind exercises helpful in supporting this process.

We have tried to make short films that demonstrate how you can engage voices and find ways to learn from them. The three of us — myself, Elisabeth and Charlie — have used both role-play and some demonstrations of mapping out and talking with Elisabeth’s voices.

We don’t want engaging with voices to become a therapy that only highly trained professionals can use. While we welcome therapists using these approaches, we also want people who hear voices, and their friends and family, to know about dialoguing and creative ways to understand and engage with voices.”

*** Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

I think that last point Rufus makes is really important! It’s helpful when mental health professionals can offer certain kinds of assistance, but it can be even better when people learn how to help themselves and each other. That’s what really creates a healthy society. So I hope lots of you take an interest in this approach and do check out the video series.