Breaking the Stigma - Hearing Voices
The experience of hearing voices is often stigmatised, particularly in Western cultures. However, hearing voices is more common than you might think and not solely part of mental health pathology. In fact, we all have the capacity to hear voices under the right conditions - such as severe stress, isolation, bereavement, extreme physical demands, sleep deprivation and when we are falling asleep or waking. Statistics vary, but it’s generally accepted that between 3 and 10% of the population hear voices that other people don’t. If you include one-off experiences (like hearing someone call your name when you’re out shopping, or hearing your phone vibrate in your pocket) this figure goes up to 75%.
The stigma and distress that can be caused by hearing voices is partially informed by cultural background. In some cultures, hearing voices is viewed as a positive and useful experience (and is subsequently experienced with less distress). For this reason, it is important that we understand the explanatory model from our patient’s perspective beyond just that of a medical or Western perspective. People’s distress from hearing voices is also mediated by their perception of the voice’s omnipotence and malevolence.
Approximately 1/3 of voice hearers have never been in contact with mental health services. Of those who seek support this may be through a peer led hearing voices group (such as the one run through Footprints Brisbane) or more formal pharmacological or psychological treatments.
Cognitive Behaviour Therapy has been customised for people who hear voices and who are seeking talk-therapy. This treatment is matched to the phase of the hearing voices experience - the startling, organisation or stabilisation phase. People who are new to hearing voices are often distressed and distracted by the experience – even if the voice content is positive. This is defined as the startling phase. Within this phase, treatment will focus on creating a sense of safety through rapport building, psychoeducation, normalisation and coping skills enhancement. The next phase is defined as the organisation phase - when people can start focusing on their voices and making sense of their experience. Treatment focuses on weakening the attribution of power and malevolence given to voices, changing the relationship between the patient and their voices, and looking for patterns in the content and onset of the voices. The stabilisation phase is the final stage of treatment and is reached when the patient views their voice hearing experience as meaningful. Treatment in this phase supports patients to connect with other valued life areas.
If you would like to access further information on voice hearing resources can be found at the following websites:
· Intervoice: http://www.intervoiceonline.org/
· Hearing Voices Network: http://www.hearing-voices.org/