Fortunately, it is not always necessary to eliminate the voices completely to decrease the discomfort they cause. Most people who experience acoustic hallucinations attribute a purpose to their voices. How they view their voices—wellmeaning or out to destroy them—is almost always a function of what they hear. In 2003 Mark van der Gaag, now at the Free University Amsterdam in the Netherlands, found that only two of 43 patients evaluated their hallucinations differently from what researchers expected. Some patients are convinced that critical voices are actually well-meaning. “As therapists, we need to pay more attention to how a person explains the phenomenon,” Bock concludes. Therapists who immediately talk in terms of severe mental illness often only make the problem worse, risking that the patient will withdraw. The sooner a patient begins to talk about the voices, the less power those voices tend to have.
|Quiet! Some voices|
who hear voices
often live extremely
in turn, fuel
Frequently, it is enough to reframe the voices. Even if they are overwhelmingly negative, other intentions or characteristics may be attributed to them through therapy. According to guidelines developed by Netzwerk Stimmenhoeren, a German organization dedicated to founding self-help groups and supporting the affected, their families and the psychiatric community, the main goal is to make sufferers “masters in their own house” again. Patients can sometimes regain this control not only by listening to the voices but by answering them, concentrating on positive messages and agreeing to specifi c, limited talking times.
Another mainstay of treatment involves changing a patient’s social interactions. Often a person’s relationship with his or her voices mirrors those with real people, as Mark Hayward, now at the University of Surrey in England, demonstrated in 2003. If, for example, a person usually subordinates herself to someone else, she will tend to hear dominant voices. The net effect is that the hallucinations become increasingly real. Networks of fellow sufferers may help people reduce the isolation they feel and make strides in recovery. “I got to the point where I couldn’t take it anymore,” Laurie says, explaining why she dared to “come out.” Laurie agreed to make time for her voices in the morning, and, in exchange, they agreed to leave her alone the rest of the day. The approach may seem odd, but it worked. Now, she says, “My voices simply don’t scare me anymore.
BETTINA THRAENHARDT is a psychologist and science journalist in Bonn, Germany.