SELF-HELP GUIDE TO VOICES

August 2002 Edition 1.0

Index   Explanatory Notes   FAQ 1     Are ‘voices’ real or not?   FAQ 2     Types of Voices   FAQ 3     Where do the voices come from?   FAQ 4     Are there special tests for Voices?   FAQ 5     Does hearing voices mean you are mentally ill or mad?

Please take time to read the cautionary note on the frequently answered questions in this section, otherwise known as FAQs.

Explanatory Notes The FAQs are intended to present fairly brief and handy answers to the most likely asked questions on the topic of ‘voices’. They are added to the Website because it is recognized that obtaining answers to the type of questions voice hearers need may not always be so available particularly to those people who cannot gain easy access to libraries and particularly libraries that are well resourced. The FAQs will be few in number at first but are expected to increase as more people put their questions to this website. Please note the order in which the FAQs are placed may also be changed as more are added.

Cautionary note: the notes written on this website reflects information from a number of sources; (a) from the author’s direct experience from his work (as nurse and counsellor) with people who hear ‘voices’ otherwise termed auditory hallucinations and; (b) information collected from the work of other people with backgrounds that may or may not include professional training. It also needs noted that there is a ‘trade off’ between simplicity, complexity and accuracy of answer in this difficult area of human experience.

Where possible the authors will do their best to identify sources of information whether as websites, books, pamphlets or journal articles. No referencing of an author, may indicate that author’s direct experience or knowledge is simply widely shared information with others; it may also represent a simple mistake in not referencing, this can come from accident or simply not knowing. There are times when sources of information used are second hand may not have a named author or else be inaccurately referenced by other authors.

To save on unnecessary repetition of references as well as on space, there will be a section at the end of the FAQs for referenced books, articles and journals used as sources of information. Suggestions for better or more recent sources of references will be welcomed and researched by the author/s for the FAQs though not all of these may be included as additional references.

There are increasing numbers of people working and doing research on ‘voices’ so knowledge in this area is always increasing and changing. Over time some of the information from this website may become out of date, irrelevant or downright wrong: the author or authors will do their best to keep the site reasonably up to date, realistically within a 10 year period. Many of the journal articles referenced in this area will be much, much older but that is because the author judges what they have to say, as still being useful today.

The author strongly advises that the information read from the FAQs (frequently answered questions) is always cross checked with other sources of information and also people knowledgeable in this area. Such people will include, other voice hearers themselves, workers who may have direct experiences of working with voice hearers, many of these may have a medical, psychiatric, psychology, nursing, social or other care training background.

The caution also applies to any approaches the author might make in coping with the voices or for example on issues concerning medication. Suggestions given in the FAQs should not be taken as a direct prescription for action, but ideas which people need to check out with other sources before trying out.

Finally the author cannot be held legally responsible for inaccuracies in the information presented. Such inaccuracies are not intentional, the author will be glad for any of these inaccuracies to be pointed out providing those making those suggestions also clearly take into account the wide range of opinions on these matters.

If the hearing of ‘voices’ are real to you than accept them as being real.

The main reason you identify the ‘voices’ as the experience of ‘voices’ auditory hallucinations) is that they come and go mostly as if they had a life of their own AND when they come no one else hears them even when sat next to you. This means that the ‘voices’ are an ‘unshared perception’, this is another way of saying people around you are not perceiving (or not receiving) the experience of the ‘voice’ or ‘voices’ as you are.

It does not matter much if the ‘voices’ seem to come outside of yourself or from within.

It does not matter if the ‘voices’ seem to come from people you know in the present or from the past, what matters is that you hear them and you generally see them as not yourself (as self talk or thinking out aloud in your mind) even if you might agree with people who say they come from within yourself.

A few people can voluntarily bring on the ‘voices’ and also make them go away when they want; this form of control of the ‘voices’ while not common can be learned.

A number of people can sometimes in their own way, get rid of the voices at least for a while, or somehow put them to the back of their mind by concentrating on something else, or doing some activity.

N.B. See other FAQs on ‘Type of Voices’ and on various techniques to that can help people cope (somehow deal) with the voices i.e. ‘Coping with voices’.

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Voices can take on many forms.

They can sound like real people.

Be male or female or seem or neither

Even after many years people may not be able to tell if they are male or female

Voices may seem to come from people

May sound like machine type (robotic) voices

The voices can seem more like whispering

They can just be humming

The can be ‘fuzzy’ or blurred but distinct from background noise (Bauman 99).

Voices can sound like the sounds that come from a seashell put next to your ear (Casino & Adam 1986).

The voices can be like mechanical noises: example a ticking clock or the clicking of switches.

They can sound like a radio turned down to very low volume.

The voices can be in the form of music which may seem to be coming from else where, the music can sometimes be very recognizable tunes or not at all (Sacks 1985).

Voices can come in the form of what would be considered bodily sounds.

Authors on other websites report voices being described as like a ‘marching band’ (Bauman 99).

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Voices can seem to come from many sources: birds or other animals, the rustling of leaves, traffic noise, banging hot water pipes, crowd noise, machinery noise, even air conditioning. You may be able to add to this list from your own experience.

Voices are spirits: of dead people/demons/angels/telepathy/deities/entities from other dimensions or planets/ and finally from the brain because of some malfunction.

Voices come from the brain: from the tricks of the mind when it is bored or under influence of suggestion, when the brain is going into sleep, or when it is waking up.

Voices may come from physical causes such as age changes affecting ears of people who are becoming deaf, also from ringing sounds in the ear i.e. tinnitus (Bauman 99). Voices may come from certain and rare malfunctions of the brain; such as a special form of epilepsy affecting one or two small areas of the brain, this is called temporal lobe epilepsy. The Temporal lobes are particular zones of each side of the brain containing specialized cells called the ‘hearing centres’.

Voices can occur in people who have had car accidents or a falling accident causing head injury: sometimes these injuries may have taken place in childhood and have been forgotten. More rarely it might occur because of changes in the brain caused by small areas of damage from minor strokes (more common in older people) or from very rare conditions: example some of the people who suffer a form of dementia.

Voices (as well as other hallucinatory experiences affecting smell, touch) can also be caused by various substances, including cannabis and other recreational drugs like such crack cocaine and amphetamines, long term abuse of alcohol, more rarely substance like penicillin (Cumming and other 196-7).

If you do go to anyone professional like a Doctor or other Specialist they will probably take details of your history. In the UK, USA and some other countries a Psychiatrist will probably undertake a PSE otherwise known as psychiatric state examination. This is a special or formal interview which will ask you particular questions that enables the doctor to see if your replies fall under certain categories of mental or sometimes physical illness.

In the West (this also used by many other non Western countries), the diagnosis (the illness label) the doctor makes from your replies will be based on either the Diagnostic and Statistical Manual (DSM), which comes from the USA, or ICM International Classification Manual (a United Nation Manual of agreed mental illness definitions), each of these diagnostic manuals (a kind of Doctor’s dictionary of illness) will have numbers attached to them like DSM IV, such number changes indicate to the worker how up to date these books are. It is important to note that the doctor or other worker you are seeing would also take into account your social situation, where you are living, job, family support and friends and put that together with circumstances before coming to a conclusion about your diagnosis.

The doctor depending on your replies (and disclosed history) will then decide on a course of treatment which should be fully discussed with you. This may include a wait and see approach, to see if things improve or get worse; it may include some form medication to treat the ‘voices’. Or the doctor may send you to a psychologist or specialist counsellor who may also be a nurse specialist. Some doctors may want to send you for other types of tests especially if they are unsure whether your ‘voices’ come from a mental health or physical condition.

There are physical examinations or tests which can help identify if there are special problems with the brain. You would need to see a doctor who may arrange for you to go to certain types of specialists doing different types of examinations of the brain, or tests of brain function.

There different kinds of tests which internationally may have different names. There are special X-rays, C-T Scan, PET Scan, MRI Scans. These tests are often very expensive so your doctor is more likely to ask you to have an Electro-Encephalogram (EEG) which while being much cheaper, can be very good at times for spotting if there are things that are not right in the brain.

Research on ‘voices’ using some of these tests (i.e. MRI) have found that when the voices are present or in action, certain areas of the brain associated with hearing are actually working even if nothing is being actually heard by those present with the ‘voice’ hearer under examination. Such tests have seemed to reveal at least the part of the brain working when the ‘voices’ are in action. But researches who have many ideas still don’t actually know exactly what causes them.

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The simplest answer is No.

The hearing of ‘voices’ alone does not make you mentally ill.

Mental illness behaviour includes a lot of things not just one single thing.

Many professionals (doctors included) would disagree with the first two answers.

But there is today a wider range of opinion on this matter than existed 40 years ago.

A good way of looking at this is to understand that there are people who hear ‘voices’ and do not otherwise have other problems that suggest any form of mental illness.

There are also people who have mental illness but do not hear voices including many who have been given a psychiatric diagnosis of mental illness (Romme & Escher 1993 & 2000).

There are also people with other mental health problems who are not diagnosed with schizophrenia but who also hear ‘voices’. For example people who have had a history of either heavy alcohol or recreational drug consumption (Crack, Cocaine) may sometimes also start hearing ‘voices’. Other people who may experience ‘voices’ can be those suffering Manic Depression and what is called ‘Dissociative disorders’ (an example being what is termed PTSD or Post Traumatic Stress Disorder).

Look at FAQ on causes of voices.

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All references placed here have been or will be used as sources of information for the FAQs. Some of these references may well be placed in advance of the launch of the some of the FAQs which will gradually be increased in number, so not all the references below recorded may be quoted in the currently list of FAQs at this time. It is intended for duplicate of the references to be located beneath but with the addition of the personal commentary of author’s opinion on their content, usefulness and pricing.

The ISBN numbers and authors full names are recorded to make it easier for people who wish to order the se books (all paperback unless stated) through their local book store or library.

Please note that some books listed in the references may be out of print, however they may be available through national inter library loan schemes i.e. where your local library may be able to obtain the book on temporary loan from the National or state library services. Journal articles from journals published as well may also be obtained through the library system.

References will be listed in alphabetical order using the author’s surnames. Asterisks or stars * will be placed by those books whose style making them easier to read or which even if not well written have important material. Three stars means relevant and readable, two stars relevant but not always that readable, finally one star useful reading but not essential, no star means excess material used by the author for the FAQs but which has no particular recommendation one way or the other. Of course these ratings are based on the author’s personal judgement with which not all people are expected to be in agreement. You could email the author or log your comments on the noticeboard.

There will be a separate notice board where people can list relevant and useful material to read on the topic of voices. Please note that the author does reserve the right to remove material that they do not consider to be relevant, useful or safe allowing for the broad range of opinion on this matter.

Bentall, R.P. (1990) The Illusion of Reality: A Review and Integration of Psychological Research on Hallucination, Psychological Bulletin, Vol. 107(1): 82 – 95

Bauman, Neil (1999) You were asking…, publisher: obtained through Google Search Engine www.saywhatclub.com

Dr. Peter Chadwick (1995) Understanding Paranoia: what causes it, how it feels and what to do about it, Publisher Thorson ISBN 0 7225 3023 4 ***

Casino GD & Adams, D. (1986) Brainstem auditory hallucinosis, Neurology 36: p 1042 – 1047

Cummings, JL., Barrit, CF., & Horan, M. (1986-7) Delusions Induced by Procaine Penicillin: Case Report and Review of the Syndrome, International Journal of Psychiatry in Medicine, Vol.16(2): 163 – 4. (just one example)

Haddock, G. (1995) Stress and Hearing Voices, Hearing Voices Network Journal (Winter edition) N.B. this particular ref. may be inaccurately placed

Ivan Leudar & Philip Thomas (2000) Voices of Reason, Voices of Insanity, Published Routledge, London Philadelphia, ISBN 0-415-14787-5

Prof., Marius Romme & Sandra Escher (1993) Accepting Voices, Mind Publications UK, ISBN 1 874690 13 8 ***

Marius Romme & Sandra Escher (2000) Making Sense of the Voices, Mind Publications UK, ISBN 1 874690 86 3

Sacks, O. (1985) The man who mistook his wife for a hat, publisher Picador

ISBN number 0 330 29491 1

Smith, S. (1997) Addict, ISBN 0-952-921502 (an account of the books author’s personal experiences).

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