LEAH ROKEACH LCSW
Ms. S. is 31 years old and has been hearing voices for the past 10 years. The voices come almost every day and they tell her that she is a failure, will never amount to anything, no one likes her or respects her. Ms. S. was diagnosed with schizophrenia. At the age of 21 she was told she has a disease of the brain and will need to take medication for the rest of her life. She was a senior in college, studying psychology and hoping to go to graduate school and earn a PhD. She also dreamed of marrying and having her own family. With the diagnosis of schizophrenia her dreams were shattered.
She left school and went back home to live with her parents. Over the past ten years, she was hospitalized a few times, especially when the voices commanded that she kill herself. She described the voices as powerful; they have control over her life and as a result she cannot function, cannot have friends, cannot work, nor go back to school. She reports: “the voices are tormenting me.” She is taking medications, but nothing has changed. Yes, there are times when she feels calmer, but she continues to hear voices. She expressed feelings of loneliness and sham – shame at having been diagnosed with schizophrenia and shame at hearing voices. She has watched her younger siblings move on with their lives and this has reinforced her hopelessness and distress.
Most people who hear voices feel the way Ms. S. does: they are in distress, they feel hopeless and believe the voices control their lives. People diagnosed with schizophrenia are told what Ms. S. was told, that this is a disease of the brain and as in the case of diabetes, they will have to take medication for the rest of their lives. Some are also told that they cannot go back to school, work or get married, or do anything that might cause stress. This is a message that causes helplessness and despair.
Fortunately for Ms. S. and others like her, new methods on how to cope with the voices are emerging, for the most part because of the efforts of the Hearing Voices Movement. This is the organization founded in 1987 by Marius Romme, a psychiatrist in the Netherlands, and his wife Sandra Escher, a psychologist. The organization’s membership includes voice hearers who have recovered and lead meaningful lives - while continuing to hear voices. Countless voice hearers have gained ascendancy over the negative impact of their voice hearing experience. The organization has branches in many European countries, Australia, and more recently, here in the United States.
The Hearing Voices Movement espouses the theory that the voices people hear are real and should be treated like people. According to this theory the voices themselves may not be the problem, rather it’s the relationship with them, the power and influence that the voices have in the person’s life. The voice hearer is taught to talk directly with the voices and negotiate with them, asking questions such as: who they are, what do they want, offering a set a time for talking with them. The voice hearer is taught to listen attentively and also to respond, and to talk to the voices in a respectful manner. This approach is about changing the relationship with the challenging voices so they do not dominate a person’s life. It does not banish the voices from the person’s life. The point is that by talking with the voices one can reduce their power, and calm them down so that they become quieter and even become friendly.
Initially, Ms. S. was not interested in therapy. “What is the point of therapy? My past life disappeared and I have no future, I am a schizophrenic,” she said. However, after hearing about the Hearing Voices Movement and reading stories of recovery, she had this to say: “This is the first time someone told me about recovery, about the possibility of leading a better quality life.”
Confronting and talking to the voices in a respectful manner seemed utterly novel for Ms. S. Over the past ten years she has been doing everything she could to escape them. She screamed at them, she pulled her hair until she lost most of it, and hit her head all in the hope that the voices would disappear.
Working hard, and being surrounded by supportive family members and professionals, helped Ms. S. to start the journey of recovery. She is starting to accept her voices as real and talk with them. She is learning how to listen to them and trying to understand what they mean. It has taken her a long time to get to the point where she is hopeful about her future, more motivated and in general feels more positive about her life.
Today she is less frightened by the voices and has started to take some control over them. Her psychiatrist, who was impressed with her progress and is not opposed to the methods of the Hearing Voices Movement, reduced some of her medications, so she is able to focus better and is more alert. As part of learning to live with the voices, she also started to take responsibility for her physical health, and with the help of a nutritionist is eating healthier foods and exercises on a regular basis. She has joined a voice-hearing group so that she is able to share her experiences with others while getting peer support and exchanging coping strategies. Ms. S. is finally coming closer to returning to school and pursuing her dream of obtaining a PhD in psychology.
People who are given a diagnosis of a psychiatric disability due to hearing voices, should also be given a message of hope - that recovery from the distress of hearing voices is possible. Medications play an important role, but in addition, it is most important for mental health professionals to be open to new approaches.
The Hearing Voices proponents believe that if we do not see schizophrenia as a life sentence, we will all increase the chance that people with this diagnosis will be able to discover their own resilience. This is a profound insight, and it offers hope to those who face the horrors of hearing voices
Leah Rokeach, LCSW has a private practice in Brooklyn, NY. She specializes in working with people who are diagnosed with a psychiatric disability. She uses the following psychological methods to help adults who have a psychiatric disability start the journey to recovery: Psychiatric Rehabilitation and Recovery Oriented Approaches, Cognitive Behavior Therapy for Psychosis. She has been trained in working with people who hear voices. She started a group in Boro Park for men who hear voices. Anyone interested in joining the group may contact her. She can be reached by email [email protected] and by phone 1-917-670-7148.