Roz Oates, a doctoral student in Durham’s Centre for Medical Humanities and Department of Geography, who is also part of the ‘Hearing the Voice’ research team, recently attended the 6th World Hearing Voices Congress in Greece. In this post, she gives an account of keynote presentations at the Congress which can be viewed here. Views are the speakers’ own.
When I saw this year’s World Hearing Voices Congress advertised, I was intrigued by its title, ‘Odysseying with the Sirens’. Its location was the culturally diverse city of Thessaloniki in Greece. Given the current economic crisis in Greece, it was highly relevant that the theme of the Congress explores “struggling towards recovery in times of crisis”. I was curious as to how individual stories of recovery would be described, and if these would be linked to crises that occur on either interpersonal or societal levels. Next year I am planning to help set up an Unusual Experiences Group in Oxford, for people who experience voices, visions and/or unusual thoughts. So I was hoping that the Congress would give me the opportunity to speak to voice-hearers and mental health professionals who currently facilitate hearing voices groups, and to learn from them strategies for running a helpful group for people who have unusual experiences. I did discover from a lady who facilitates a hearing voices group in Ireland that my story, ‘Behind the wall’, which is included in Hearing the Voice’s Voicewalks magazine, has been read by her group and this prompted a discussion about voices.
I was excited by the varied programme of presentations and workshops at the Congress. Speakers included Will Hall, an American counsellor and activist who would be speaking about “suicidal feelings and social justice”; Rachel Waddingham, the Manager of the London Hearing Voices Network, who would be presenting about the hearing voices groups that she facilitates in prisons; and Rufus May, a clinical psychologist, whose workshop would be exploring difficult situations that might be resolved in creative ways. I hoped to be able to attend as wide a range of workshops as possible, and to use this experience to reflect on my own journey of recovery in learning to live with voices. I appreciated the respectful space that the Congress created for people from many different countries to tell their stories of living with voices.
This 6th World Hearing Voices Congress was the first non-English speaking Congress, and each attendee wore a headset, so that they could hear a translated version of each presentation. This emphasized that this was an international Congress, with voice-hearers from many different cultures sharing stories of their voices. One of the keynote speeches was being given by Professor Marius Romme, a psychiatrist from the Netherlands, who is one of the founders of the Hearing Voices Movement. The title of Romme’s speech was “How to solve the schizophrenia problem”. (A podcast of Romme’s presentation is available here.) He considers that mental health professionals should not give a diagnosis, and that service-users should not accept a diagnosis. Romme argued that there is a lack of empirical scientific evidence for the diagnosis of schizophrenia. With schizophrenia, the symptoms are used to construct the illness, and, at present, there are no biomarkers or tests for determining this.
Romme explained that 4% of the general population has had a voice-hearing experience. There are many more people who hear voices than become a patient with this experience. Yet, “the illness concept discriminates millions of people who hear voices, because generally it is seen as a symptom of an illness”. Romme pointed out that there are links between the characteristics of voices and the problems that a voice-hearer has faced in their past. Romme believes that calling hearing voices “a psychotic experience” suggests that this is a meaningless experience, when, in fact, voices often have meaning for the voice-hearer. Romme added that “people don’t just hear voices. They hear different voices. Therefore, the voices need to be analyzed and discussed”. Overall, I found Romme’s presentation with its emphasis on abandoning the practice of using diagnostic labels to be thought-provoking and powerful, particularly given that there can be so much stigma attached to receiving a psychiatric diagnosis.
In another presentation, the researcher Sandra Escher, discussed the experiences of young people who hear voices. (A podcast of Escher’s presentation is available (Part 1) here and (Part 2) here.) Escher has worked with children who hear voices since 1995, and has interviewed three hundred voice-hearers. She said that only recently has it been accepted that some voice-hearers can be non-patients. Escher pointed out that the characteristics of the voices experienced by both groups are the same, in terms of the location of the voices, the loudness and reality of the voices, the number of voices, and their personification. However, she noted that the patient group usually has a lower level of education. The patient group is also likely to hear the voices more frequently, to be more distressed by these voices, and feel that they have less control over them. The patients are also likely to report more emotional triggers and greater adversity. The patients also used specific coping strategies, such as passive problem solving.
Escher’s research has found that for young people the onset of the voices is often linked to trauma. Traumas included their confrontation with a death, problems around the home situation, and problems around the school situation. Interestingly 67% of the children lost the voices during the period that Escher was researching their voices. Escher recommended that the child be interviewed with their parents present. In this way the parents could learn more about the voices that the child experiences. Escher suggested that the child needs space to work out their relationship to the voices, and one way is for them to keep a diary recording their voices. Escher said that “the child does not need to be frightened – the voices are mostly messengers”. She recommended that the young person “find out the message”. Escher argued that “the voices are not an illness, but a relation with the life history”. Escher suggested that the voices give information about the abusers and the problem. For example, she said that “if the voices are triggered at school – the problem is mostly with the school”. Escher added that “you don’t need medication to learn to cope with emotions. You need wise people”.
Rufus May, a clinical psychologist, gave a presentation on how dialogue can be used to understand voices that come out of crisis. (A podcast of May’s presentation is available here.) May pointed out that the acceptance of voice-hearing within the Hearing Voices Movement has led to a growing interest in dialoguing with voices. This is demonstrated by the Institute of Psychiatry’s Avatar Therapy trial, in which a computer-based avatar enables a psychiatrist to synchronize what a voice says to the patient, and the patient is encouraged to dialogue with this. May pointed out that a variety of approaches may be taken for dialoguing with voices, and these include cheaper alternatives, such as using finger puppets or art work and drawing. He suggested that in order to dialogue with voices, it is important to build trusting relationships, and to strengthen the person’s sense of self. It might also be helpful to honor the occasion of dialoguing with voices with flowers or making a cake. May suggested that “distressing voices are beings who are in distress”. He considered that this approach may help a voice-hearer to feel less scared by voices. However, as he pointed out, it is important to find safe ways to express powerful emotions.
May linked voices to dissociation, and suggested that voices that sound like an abuser may have their own secret stories. He suggested that “in a difficult situation most of the parts flee, and one part is left. This part is shaped by the abuser. It may even sound like the abuser.” May then told us a story about healing in post-civil war Gorongosa, Mozambique, where gamba spirits emerged in women who had experienced sexual violence. May said that these women felt possessed by the spirits of men who had died in the war. These men had experienced trauma, and their gamba spirits threatened to make the family sick if the family did not talk about their trauma. The gamba spirits then demanded to be married to the women, and this ceremony took place. May suggested that just as the gamba spirit helped the person to acknowledge abuse, the person’s voices made it possible for the voice-hearer to be in touch with many parts of themselves. However, May acknowledged that “listening to voices that are in crisis can be very difficult”. He recommended that voice-hearers look after themselves, and in doing so build compassionate relationships, and a community that supports them.
As someone who lives with voices myself, I was excited during the Congress hearing about these new psychological approaches that are being taken in dialoguing with voices. The rest of the Congress led to interesting conversations with other voice-hearers and mental health professionals from all over the world. If you would like to listen to other presentations from the Congress, these are available here. Next year the World Hearing Voices Congress will be taking place in Madrid, and it will be very interesting to hear about what new developments have taken place in both the practice of helping voice-hearers to live well with their voices, and in research into voice-hearing.