The more we can understand about voices we are hearing and the issues they represent the easier they will be to deal with. By finding out more about them we make them less mysterious and therefore less scary. This hand-out looks at how to get to know the voices, how to strengthen your awareness and how to understand and work with the deeper issues the voices are indicating.
1. Getting to know your voices
We can get to know our voices better by studying them. Answering the following questions may help:
· What are the voices like?
· How many are there?
· Are they male or female?
· How old are they?
· What do they say and how?
· Do they have names, can we give them a name?
· Can you see them, if you can, what do they look like?
- If they are judgemental, do they focus on appearances, morality, achievements, competency, trustworthiness, relationships?
- Can you learn from this? What needs to be strengthened, e.g. self confidence, self acceptance, self appreciation or self kindness)?
- What is the voice's relationship with the person?
- What is the voice's relationship with the other voices?
- When did they start, what was happening at this time?
- Are there any particular events or emotions that trigger them?
- How do you cope with your voices?
- What are significant life events in your life?
- Are the voices in any way like people you have known?
At first it can be frightening to find out more about the voices. But if you persevere it leads to the voices being more understandable and therefore less frightening and more manageable. For more similar questions see the work-book 'Working with Voices ' by Ron Coleman and Mike Smith and also the Maastricht Interview by Marius Romme and Sandra Escher.
2. Mind strengthening exercises
There are many ways to strengthen our will and our awareness. Doing purposeful activity is a good way to strengthen our will and our awareness of the 'here and now'. Different activities will suit different people. Some examples are drawing, painting, walking, sport, jogging, cooking, gardening, an exercise routine, yoga, breathing exercises, singing, drumming, video games, puzzles, maths, Sudoku, guided visualisations, meditation, prayer. See the video section at www.rufusmay.com for some good mind body awareness strengthening exercises
The following mindful activity steps are good for strengthening our will and awareness. We can practice this single minded activity with washing up or walking in the park or any singular activity. It may be useful, at first, to just try this for ten minute periods each day.
1. Decide what is the most important thing to be doing and then do it.
2. Do one thing at a time
3. Focus fully on it
4. When you get distracted bring your mind back to what you were doing.
5. Repeat step 4 several hundred thousand times (i.e. distraction is normal, just gently bring your attention back when you notice you have become distracted).
6. If you keep getting distracted by thoughts or voices you may need to pay them some attention, they may be trying to tell you something. You can choose to do this immediately if it is convenient, or if not you can make an appointment with your thoughts or voices when it is possible.
Mindful Breathing can be helpful you can count your breath as it comes and goes. In our mind we can say: ’In... out, one’; ‘in... out, 2’ and try to get to ten, go back to one if you lose count. Another more visual breathing exercise is to imagine breathing in a healing white light and to imagine breathing out black smoke of negativity. If the voices seem jealous and try to distract you, it may be helpful to try inviting the voices to join in or dedicate the relaxation exercise to them as well as you.
Another way to strengthen our concentration and awareness of the present moment is to notice 5 things you can see, 5 things you can hear, 5 things you can feel; then to notice 4 things you can see, 4 things you can hear, 4 things you can feel; then three things you can see, three things you can hear, three things you feel; then notice 2 things you can see, 2 things you hear, 2 things you can feel and finally notice 1 thing you can see, one thing you can hear, one thing you can feel. This exercise can make us more aware of the world around us and less pre-occupied by thoughts feelings and voices.
3. Listening to your voices
If you have voices that are distracting you at inconvenient times you may need to develop a structured way of paying attention to them. Many voice hearers who hear voices every day find it useful to listen to their voices at a set time each day. Make an appointment with your voices for a set period of time for example half an hour or an hour. Keep to the arranged time. Try to make it a welcoming atmosphere. So create a space where you feel comfortable. Some people have found it helpful to make a cup of tea and have some cake or a candle lit to help make the atmosphere hospitable. Some Buddhists even offer voices some cake to eat! If the content is difficult to listen to or is complicated, try writing it down. Keep a record of the opinions and claims of the voices.
Deep listening: listening to the symbolic meanings of the voices
Stressful voices say difficult things. It can be helpful to not take them literally but to look at the deeper meanings they are pointing to. For example a voice telling you ‘you are useless’ the deeper meaning might be find ways to value yourself. With critical voices it can be helpful to think of what is the opposite of what they are saying. For example if a voice says ‘everyone hates you’… the opposite might be ‘some people like me’. If we make these opposite statements to ourselves it can provide a valuable positive alternative to the critical voices.
It is also helpful to think what the symbolic meanings could be. For example a voice telling you to harm yourself the deeper meaning might be find a way to express your hurtful feelings and your needs.
If you can keep a record of what your voices say, later you can discuss this with people you trust. They can then help you think about how to understand the meanings of the voices and ways to respond to them.
Domineering voices are often messages about relationships in which we don’t feel we have much say. If this is the case we can practice being more assertive and standing up for our needs. Its worth also asking if there is some 'unfinished business' with past relationships the voices are pointing to that you need to talk about and address in some way. One way to address 'unfinished business' is to write a letter to the person concerned. You don't have to send it. It may also help to read it out loud. We can also use role-play and imagine the person we want to address is sitting in an empty chair. Such activities as the letter writing and role play can release pent up energy and help us become more confident in the future as we have found a way to speak up for ourselves and negotiate our needs with others. It’s a good warm-up for future relationships.
4.Talking (dialoguing) with your voices
Many people find it helpful to negotiate with their voices through talking with them. This needs to be done in a way that does not bother other people and does not dominate your life. However timely dialogue can be an important way to change the power relationship from disempowering to empowerment. When you talk to your voices try to be friendly and acknowledging but assertive too. Try welcoming voices, sitting upright with an open posture. Don't give up be persistent in inviting them to be constructive or acknowledging some small way they have been helpful.
However if the voices are continuously critical, try saying “You are welcome to your opinion but I disagree”. Also ask the voice why it holds its opinion.
Try not to get into aggressive arguments with the voice. At the same time it may help to be dynamically assertive and you can practice this with a friend or supporter.
Thank them for their symbolic meanings.
e.g. to a critical voice: “Thank you, you are reminding me I need to send myself love and kindness.”
Voices that are trying to stop us doing things may be trying to protect us from painful feelings of failure. We can therefore say to the voice “thanks for your advice, that may have helped me in the past but now I have got other ways to look after myself, so you can step back a bit and give other parts of me the opportunity to support me” .
A voice that tells you to kill yourself can be very frightening. The way to deal with this is to generate a number of significant reasons why you wan to live. Writing down for example 10 reasons why you want to live can help this process. Once you are clear about these you can say with determination to your voice "I have decided I want to live."
Manipulative voices need to be handled carefully. They may make claims to be more powerful than they are. Take a good look at the evidence (preferably with trusted others) - are they claiming responsibility for random social events? e.g. 'I made your dog die” and are they using such claims to blackmail you? e.g. “unless you do what we say your cat will die too.” Thinking of the opposite of what they say can be helpful. For example “we are going to make your life hell” we can think the opposite, ‘I am going to grow in confidence and not let you effect me’ or ‘I am going to find ways to be strong and calm.”.
If voices are acting in a possessive or controlling way, sometimes it is helpful to reassure voices that they can join in an activity or enjoy a sunset or a breathing exercise with you as long as they are respectful of you, you will respect them.
Voices often calm down if we show we are less afraid of them. We can rehearse talking to them more confidently. A very helpful exercise is for someone else to role-play being the voice and for us to practice assertively responding. We can then swap roles so the other person plays us and we play the critical voice. This role-playing helps us understand the tactics of the voice and be more confident at dealing with it.
If voices are using certain words that are frightening to us, we may find it helpful to repeat them out loud many times, so we become less afraid of them.
If we practice being friendly to our voices saying welcome or thanks in a confident way they will often calm down when we say this to them. Often if supporters and or the voice hearer make it clear they are not trying to get rid of the voices, the voices calm down. When I am helping someone I usually ask the voice hearer to explain to the voices that my aim is to help understand why the voices are there and increase understanding between the voice here and the voices and that I am not seeking to get rid of the voices. If a voice is angry maybe it is showing that I am secretly angry. Try expressive activities, such as shadow boxing or hitting a pillow (other examples are singing, talking about your feelings, journaling, exercise, creative expression etc) and see if this helps.
5. Working with the emotional issues the voices bring up.
Fearful memories: Find ways to express what happened in a trusting relationship. Use different mediums e.g. talking, drawing, singing, acting and writing. Develop calming activities such as relaxation, massage, yoga, being in nature, meditation etc.
Shame and Guilt – Find ways to be compassionate to self and fairly account for what happened. We need to develop a truth and reconciliation process so we can be more understanding to wards ourselves.
Thoughts of self -blame – Try to break cycle of self punishment and replace with constructive thoughts and actions. Find different ways to look at what happened (e.g. by drawing, writing poetry reading other’s accounts of similar experiences) so that we can become less punitive or judging of our behaviour. We may need to take responsibility for mistakes we made but be compassionate to ourselves too
Also we can rehearse with a friend or supporter resisting accusations we are to blame.
For example one person says ‘You are to blame’, the other person says with determination ‘I am not to blame’ we repeat this 25 – 40 times. Swapping roles can also be helpful to get to know the emotions better around guilt tripping and resisting guilt tripping.
Dealing with self criticism
Develop statements of self acceptance, that we can we can repeat to ourselves:
e.g ‘even though I have these problems I am O.K. just as I am’. Rehearsing self acceptance may be important saying affirmations such as ‘I accept myself deeply and completely’ this can be done using Emotional Freedom Technique (see www.eftfree.net).
With critical voices we could develop a rhyming response, for example:
'your words are unkind
but I don't mind,
self respect and self kindness, I am determined to find'
Practice self soothing activities, and activities that give you a sense of well-being.
Self appreciation: Research stories others or you have of qualities and strengths you have. Keep a list of the strengths, the stories and the people who know this about you. Learn self confidence through new activities, e.g. dance, singing, chanting, self defence, assertiveness, role play, drawing, painting yoga, relaxation, tension release exercises (see video section on www.rufusmay.com)
For Self doubt it can be helpful to generate the energy of trust towards oneself. Try saying with increasing conviction ‘I trust myself’ – repeat this 50 – 100 times (see the ‘handbook for the urban warrior’ by The Barefoot Doctor.
Anger – There are many ways to deal with our angry feelings. It can be helpful to learn non-violent ways to channel hurt feelings (see the writings on Non Violent Communication by Marshall Rosenberg), we can write letters to people we have unresolved feelings with. We don’t have to send this letter. Sometimes it is helpful to structure the letter in the following way; what you appreciated about the person, what you regret, what you felt hurt by and how you would like to have been treated, what you would like them to learn from what happened, also we can imagine someone we feel hurt by or angry with is in an empty chair and confront the empty chair as a drama exercise that helps us release emotion and psychologically stand up for ourselves. We can channel anger about injustice into campaigning and activism to help address injustice either we or others have experienced. It is good to do this work with others rather than in isolation. It is also important to balancing with nourishing activities e.g. mindfulness and compassion work (see the books ‘The Compassionate Mind’ by Paul Gilbert and ‘Anger: Buddhist wisdom for cooling the flames’ by Thich Nhat Hanh).
Distrust -check out fears with others and be open to different perspectives. Be aware that some feelings of distrust maybe a memory from the past if you suspect this try saying out loud “this is just a memory it is not happening now”.
Changing the power relationship with challenging voices so they are not dominating your life is possible but it takes time. We have to study how they are and look at the emotional conflicts they are rooted in. There are many ways for us to rebuild our confidence and to address the themes the voices focus on. Its about finding activities and exercises that you find helpful, being willing to try new things and carefully reflecting to see if it was helpful.
By facing the fears that the voices revolve around we reduce their power over us. Voices often reflect difficulties in our social relationships so if we can become more assertive and able to negotiate our needs with the people around us; this will strengthen us mentally and calm down our mind. Dialoguing in a managed way with voices can reduce their intimidatory power. Speaking with others in self help groups or who have knowledge of self help strategies is also going to be very helpful. Finally reading other people’s recovery stories can be very helpful (e.g. Living with Voices, 50 Stories of Recovery by Marius Romme et al.).
Acknowledgement I am very grateful to the work of Ron Coleman who originally introduced me to the hearing voices approach and the work of Marius Romme, Sandra Escher, Dirk Coerstens and colleagues. I am also grateful to Sophie Ashton for help with presentation and imagery.