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Deptford Hearing Voices Service (DHVS)

COPING WITH VOICES - Click on the links below for help and advice

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Introduction
 

1 Focussing
2 Distraction
3 Concentration
4 Social Activities
5 Mechanical
6 Thinking (Cognitive Techniques)
7 Medication
8 Other Strategies
9 Charts

INTRODUCTION TO THE COPING TECHNIQUES
 

The FAQs in this section of the website come from the experiences of many voice hearers themselves, researchers and other types of workers. This part of the website will take time to fill out. The worker in the mean time can answer questions logged onto the discussion board of this website. There are links from this site to other websites that will also describe coping strategies for voice hearers. It is important to cross check your own experiences with other voice hearers as well as to what is written by a variety of other sources from journals, books and the internet. You are however always your own best expert!
 

The meaning of coping

Use of the term ‘COPING’ (or managing) the voices should be taken as being any positive decision or action taken, with the purpose of bringing the ‘voice hearer’ relief from their voices. There are good or functional strategies and bad or dysfunctional strategies.
 

Good strategies will generally not produce any complications for the person, while bad strategies which offer short term relief from the voices may still impair the health of the person using them. For example some people may find short term relief in using alcohol or cannabis to bring relief from the voices but both these substances have been shown to produce long term health problems as well as becoming either totally ineffective or making the ‘voices’ worse. More will be said about these substances in the FAQs below.
 

Medications

It is respectful to acknowledge that some voices hearers may not always find medications given for their ‘voices’ to be effective or perhaps feel the side effects of the medication to be as bad or worse than the nuisance of their voices. In fact research shows that between 25 – 40% of people on medication still hear voices. This does not mean that the medications should be discontinued: rather a careful weighing of their other benefits or hazards should be taken into account before any decisions is taken to continue or discontinue them. Such benefits from the medication – even if ineffective with voices – such as those of increasing sleep, improving mood etc, may still be valuable enough to make them worth taking once the balance of risks are carefully discussed with the Doctor, other professional worker or advocate.
 

Research generally shows that most voice hearers have usually worked out some way of dealing with or coping with their voices; but the use of the same coping strategies by different people may not always work for all of them.
 

There are many different ways of dividing up or giving headings for the approaches people use to deal with their voices, different books or journal articles may use more technical medical or psychological terms. The main strategies listed here are the following (1) Focusing, (2) Distraction (3) Concentration (4) Social (5) Mechanical – includes - counter stimulation techniques, (6) Thinking (7) Medication. The categories under which various methods fall are a matter of choice for each author.
 

It is important to note that various techniques listed below are not by any means all: other people reading those mentioned in the FAQs below may know of coping techniques used by other voice hearers which are not yet listed. If this is the case do mention this to the discussion board of the DHVS website.
 

Also use click-on buttons for the COPING METHODS CHART which you can download to print, the chart provides a way of recording your successes or not with different coping methods suggest below. Please note focusing techniques for finding out the pattern of the voices also has its own click-on chart.
 

Both charts can easily be redesigned afresh if you have your own computer so that they be better suited to your needs.

 

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Notes on copyright: DHVS © www.dhvs.freeuk.com

Please note the copyright symbols for the FAQs or any part of the website are not to discourage people importing whatever they find useful from the dhvs website but just a reminder for people to appropriately reference that the source of this material if it comes from the DHVS, is from the DHVS: this is in respect of the author’s hard work as well that of the webmaster and provides a useful ad., for the site! I hope this makes sense.
 

All the material from the FAQs come from a huge variety of sources and experience obtained from the author’s clinical practice, much of it if not all of it is already well known to those in the trade! In this field there are a lot of ideas often adaptations from others! I always try to reference my sources, and when this doesn’t occur it is very likely an accidental omission or just that I got the item from a source that did not itself reference where it had obtained the item. The author of the website is always happy to take advice and to make corrections where this seems both appropriate and fair.
 

You will find a complete absence of references to this FAQ an omission which is simply done in recognition that the knowledge is widespread and also to keep the FAQs from being chopped around by the insertion of those references. Later on a list of authors will be attached to a section of this website as in the FAQs on voices.
 

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**FOCUSSING**

Focusing or working out if the voices have a pattern is a useful step to be taken at any time and will give you information about the behaviour of the voices. Knowing the pattern of the voices may give you ideas on how you might deal with them. One advantage of using focusing is that the method itself ENCOURAGES PEOPLE TO TAKE A STEP BACK FROM THEIR VOICES (that is being more objective) and is a way of using thinking about the voices in a more structured way. It is generally easier for people to talk about the behaviour of the voices rather than about what the voices actually say (which is often a more sensitive topic).
 

Most if not all ‘VOICES’ have a PATTERN of APPEARING and DISAPPEARING: or if not then of increasing or diminishing in loudness and frequency. This is often related to STRESS TRIGGERS; either a single big event (or a collection of lesser events) that produce, anxiety, fear, upset or worries. A way of working this pattern out is to keep a simply diary (or use a calendar) and mark out the days when your voices are worst.
 

A detailed way of recording the activity of the voices is to score them out of ten (10). Below 4 the voices are of low or negligible nuisance, scores of 4 – 6, means they are affecting concentration, at 7 upwards means they are a serious distraction. You could create your own simple hand drawn graph or use the graphs you get on fairly cheap arithmetic exercise books bought from your local stationers. The upwards (vertically drawn) scale is marked out at regular intervals from 0 – 10, the flat (or horizontal scale) is divided either into 7 days or more. On this kind of scale ‘0’ means no voices whatsoever, ‘10’ means voices are continuous from the time you’re awake to the time you have gone to sleep.
 

Recording or checking out the pattern of your voices can be regarded as a form of coping. You are using your time to check them out to see if they have a pattern of coming and going. Actually seeing that they do have a pattern of coming and going does two things: (1) the fact they have a pattern makes them a bit less mysterious; (2) if you are able to relate to their pattern of coming and going to (stress or worry making) events in your life (i.e. events that might trigger the voices), opens up the possibility of having some control over the voices. That is if you can see the stress triggers to your voices; it follows that it might be possible to work out ways in which you could either reduce the number of stress triggers affecting you or better still to reduce the way those triggers impact upon you.
 

An example of reducing a stress trigger:

Its’ difficult to give examples of this but crudely lets say you have a friend who is constantly phoning you up about one thing or another, taking your space and maybe ‘doing your head in’: how do you deal with this?
 

An extreme measure might be to terminate your friendship with them thus removing the source of the stress; of course this would be extreme and maybe cause you more distress at losing a friend who might be a nuisance but still a valued person. The next measure is that you might simply switch your phone on answer mode only, or pull the phone socket out during the times you need a break, but the problem is you cut off other people you might want to hear from. Another measure is that you have an assertive adult chat with them in which you spell out that their frequent calls are actually increasing your stress rather than relieving it, and to propose they reduce their calls to one a day, or one a week etc (this kind of situation can equally be applied to loving parents or siblings!).
 

In life there are things we have control over and things we don’t have any control over. We can sometimes move location to escape bad landlords, a bad environment, or a negative relationship. But what if we can’t do those things so easily, what then?

What we are faced with, is to consider whether we can adjust to a situation i.e. accept we have a bad landlord but that the other good things in our life give us an acceptable ‘trade-off’ for the bad things. The other action we can take is to change the relationship with the landlord (or with the partner) so that it becomes better (in other words bring about a change in them so they become nicer to us).
 

Another form of change is one that requires a change only in our attitude to a situation from something that is negative to something that is more positive to help us live with it (not always easy): that is we don’t change the people or the situation only our own attitude to them.
 

For example the weather in the UK is showery and windy for about 9 months of the year: it is pointless me getting annoyed with this because its’ not going to change, so unless I actually decide to move to a sunnier part of the world all I can do is to accept that the weather is part of the deal with living in the UK. In this situation I have taken a conscious decision to adjust my attitude not my location. The weather remains the same but I don’t get so bothered about it! We often do not make conscious decisions about many situations or unsatisfactory relationships which tend to just drag on without change, so they remain an unsolved irritation to ourselves and a repeating cause of stress.
 

There is a ‘saying’ by an ancient Greek philosopher called Epictectus, which has a certain truth to it "People are disturbed not by things but by the view …they take of them"
 

To summarise Focusing is one method of coping that aims to INCREASE KNOWLEDGE of the behaviour of the ‘voices’: at the same time such knowledge may also suggest ideas of how the TRIGGERS to the ‘voices’ could in some way be affected or reduced.
 

However ‘focusing’ is not in itself a quick fix for the nuisance of the ‘voices’. The value of such knowledge may be more helpful with coping with the voices in the long term: so any knowledge you get of their pattern is generally not wasted and can be used to experiment with how you reduce or simply deal with the stress events that form the trigger to your voices. People can use this technique on their own but it is often better to do this with a worker or someone who can stand outside of your situation but who nonetheless wanting to constructively help you.

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(2) **DISTRACTION**

By this I mean DOING SOMETHING THAT REMOVES OR DIVERTS YOUR ATTENTION AWAY FROM THE ‘VOICES’. That is the act of distraction just pushes the voices more into the background: they seem to become less loud or frequent because you are thinking of something else. Distraction activities don’t require a huge effort of concentration on something else. The impact of the voices becomes reduced because your mind is being gently occupied by other things or activities.
 

Common activities might include, going out for a walk, playing games like board games and video or computer games. Doing routine domestic chores at home, washing, ironing, cleaning or gardening etc.
 

There is also watching TV, listening to radio, a walkman or hi-fi (such methods not suitable for all voice hearers).
 

There are the distractions that require you to move out of your place if only temporarily. Going out for a walk, doing some shopping, travelling around on public transport as a form of diversion than without serious intent to travel to any particular place, going out for a drive or even visiting a transport hub like an airport or busy railway or station.
 

It might be a good exercise to create your own list of things that you particularly like to do as a reminder that you refer too when you having a particularly hard time with the voices.
 

N.B. Listening to music or watching TV does not generally require much effort to concentrate unless you already suffer a severe impairment to concentration by some other disability, such as medication, tinnitus, impaired eyesight etc.
 

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(3) **CONCENTRATION**

This means undertaking specific actions or tasks that REQUIRING YOU TO FOCUS on something specific or undertaking an activity that really requires a lot of thinking.
 

This could be reading, studying, writing a journal or diary, or undertaking creative writing such as for a story, play, some prose or a poem or maybe doing proof reading on someone else’s work. It might be doing art work or sculpting or something related.
 

N.B. Please note that studying is not recommended for those people who might for example get badly stressed by this activity due to past negative experiences. It’s a fact that some students can be tripped into an episode of mental distress or even illness just from the pressures of studying. The pressure of study may just act as the trigger for illness which may have had other contributory factors in that person’s background!
 

It could include putting together air-fix models, jigsaw puzzles, undertaking DIY (do-it-yourself activities) or repairing things at home or maybe at someone else’s place.
 

Play chess, shooting pool, going to a bowling alley, playing racket sports.
 

Or it could be playing a musical instrument e.g. guitar, drum, violin or keyboard instrument synthesiser: it could be things like singing specific tunes or songs, even attending a choir etc.
 

It might include certain types of physical exercises, like working out at the Gym, Yoga, or swimming.
 

Another form of concentration activity is what is termed SUBVOCALISATION. Essentially this means doing specific tasks in your head that you might otherwise use your mouth for. Examples of this method would be ‘counting’ (in your head up to 100 rather than aloud), or reciting a poem in your head or the words of a song that you like. You can use a special COPING METHODS CHART to record the DIFFERENT TYPES OF COPING THAT YOU USE. Using such chart helps you experiment or try out with the different coping methods so that the results of your success can be remembered more easily. You can then use the various charts to make a short list of the coping methods that work best for you.

N.B. MEDITATION as a technique for concentration is not generally recommended as both self reports of voice hearers and researchers suggest that such methods can appear to INCREASE the problems with ‘voices’ and or that of accompanying mental health symptoms.

Both distraction and concentration activities can include sports activities, some are gently recreational (water chutes), cycling, swimming for enjoyment as opposed to using more purposeful exercise; others require a real effort of concentration e.g. racket sports or table tennis. Some activities fall under both headings and physical activities could also be classified under the heading behavioural…
 

You may have worked out better headings to classify your activities or read other articles that put things in a better way for you.
 

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(4) ** SOCIAL ACTIVITIES**
 

This means undertaking activities that involve others either to distract or divert you from your voices.
 

You might take time to speak with a partner, a close friend, or even a sympathetic worker, if you for example live in some kind of formal residential setting.
 

Telephoning a friend/s
 

Visiting (fairly supportive) friends or relations who are fairly supportive to you even they may not necessarily understand your experience.
 

Attending groups, such as peer support groups such as one for voice hearers, or joining a hobby/activity groups.
 

Some people can find being amongst even loving or supportive friends or relationship does not always make them feel more at ease sometimes people can feel worse: this can be related their own personal feelings of low self esteem, or feeling they’ve let themselves or others down, it can also come from uncomfortable feelings produced by comparing of where one is, in relation to other peers you perceive as being more successful than yourself.
 

It is important to avoid gatherings where you may feel too watched or too crowded in. Equally important unless duty calls for this to avoid staying too long in the presence of people you ‘perceive’ as being negatively critical** as opposed to constructively critical at this can lead to an increase in both stress and by association the intensity of the voices.
 

People who hear voices can also experience the sense that other people can read their minds etc. Bear in mind the evidence for real telepathy suggest this is rather more limited in scope than people often imagine, that is limited to the passing information of shapes or pictures, rather than real mind reading in any detail!
 

N.B.** an interesting piece of research on people with mental illness histories discharged from hospitals into family homes, or homes with a carer were twice as likely to breakdown than those people who were discharged back to own flats (with on else around). It was found that many of those discharged home to relatives or a carer/partner were often returning to place in which a negatively critical atmosphere occurred.
 

Some people however do find being on their own is more comfortable than being in the company of others. That being in company of people particularly like public transport can bring on more stress or worsen the voices.
 

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(5) **MECHANICAL**

This means the use of specific items as a medium for dealing with or reducing the impact of the voices.
 

Use of EAR PLUGS in either the right or left ear: though it seems for many people using of a single ear plug in the right ear works best. The formal term describing this method is known as MONO-AURAL OCCLUSION (the word aural referring to the ear).
 

For some people cotton wool plugs work but from my experience WAX ear plugs that can be moulded to the inside of your ear (but don’t push to hard!) are generally the best. The wax ear plugs generally have cotton wool mixed in them so there is no danger of them melting into your ear! The advice is to try first the right ear for a period of time (say for two hours) and then again on the same ear later on for the same period of time. Later on you can try the same with the left ear but on a different day.
 

The main point is only use the earplugs for a limited period of time and only when the voices are at their worst or most loud.
 

You could use the COPING METHODS CHART to record your trials with this method as well as others. There are various charts at the end of this FAQ as those to record the pattern of your voices.
 

Part of the affect of the ear plug is that it does reduce the environmental noises which can often stimulate pseudo-hallucination (essentially the brain misinterpreting noise) or just make existing voices worse. But they do seem affective for other types of voices as well.

COUNTER STIMULATION TECHNIQUES (mechanical)
 

HUMMING A TUNE, GARGLING or swallowing can apparently be effective in stopping the voices.
 

READING OUT ALOUD, or talking out aloud all to be done in privacy of your own company!!
 

Having a good ARGUMENT with the voices even SHOUT at them but using something like a public phone (or mobile phone) so it looks more natural, it would look to any passing person that you were having an argument with someone. For some people a good shout can bring temporary relief from the voices.
 

Holding a pencil ACROSS the mouth lengthways (a long pencil held gently in between the teeth – so that it cannot be accidentally swallowed!): the theory behind this technique is that holding the mouth slightly open stops the vocal cords being used: this justification for this technique came from research suggesting that voices might use the vocal cords but below the level of obvious hearing.
 

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(6) **THINKING (cognitive approaches)**

Thinking (termed Cognitive) strategies means using your thoughts in a self aware way to challenge or in some way diminish the impact of the sense of the power that you may feel the voices have over you.

‘Reality testing’

The voices may be saying something about your friend or partner, and providing they are understanding and are not likely to take offence, you can check with those people to see if what the voices have said about what they may be thinking is true: take comfort from the fact that generally the ‘voices’ (I mean those of auditory hallucinations as opposed to the so called ‘clairaudient’ voices) have been found by the majority of voices hearers to be mostly unreliable, mischievous, or hazardous with regard to some of their proposals. You also have to be cautious about the content of what you wish to check out with person the voices are speaking about, as some of it may just be too intrusive or personal and may actually cause offence! And it may be the voices just want to get you into trouble or bring trouble in your friendships or with the people the voices are attacking.

Negotiating ‘TIME OUT’ with the voices or otherwise postponing (delaying) listening to the voices.
 

In exchange for giving the voices your positive attention say for a half hour or an hour you ask them to go away for half or a whole day. You may have to experiment with this awhile to get some effect. Its’ like saying I will reward you with positive attention for a while if you will then shut-up for the next four hours or so. Or you say if you go away now I will give positive attention towards the end of the day say 5pm etc.
 

Providing you don’t feel too frightened of the voices you could practise bringing them on than dismissing them: this can really work for some people and build up their confidence over controlling some of the voices.

Telling the voices to go away

Some people find that telling the voices to go away in firm manner can sometimes cause them to go for awhile.

‘Thought stopping’

A variation of the above method would be for you to just tell the voices to shut up and on doing so, IMMEDIATELY DIVERT YOURSELF onto to a distraction or concentration activity: even if the voices still stay around, continue to ignore them for a certain period of time before giving them any attention. Thought stopping as a technique is often listed and described in certain books on the subject of psychological therapies.

Ignoring the voices

Some people find actively ignoring the voices (somehow shutting them out of your mind) can be effective for getting them to go for a while. It is generally easier to do this though by doing some other activity.

Thinking positive thoughts of yourself

Thinking positive thoughts about yourself when the voice are around (voices are often negatively critical), perhaps writing something positive about yourself, your achievements or what you might want to do in the future etc. You may have a portfolio (or album) containing mementoes of things you achieved in the past, it can be helpful to look at these as a way of recalling positive aspects of you life.

Changing what we think about the voices

Changing the way we think about the voices may be more difficult to do on your own and it may be better to speak to someone possibly trained in some form of therapy like CBT to help with this. For example very religious people would find the idea that voices might come from some evil entity to be more distressing than say thinking that voices come from angels or even those of friends. What we think of the voices will be determined by the content of the voices, that is whether they are negatively critical or positive to us; equally our reactions will also be affected by our cultural and religious background.
 

Sometime the meaning we put on our belief of voices is termed ATTRIBUTION. Psychological therapies like CBT as previously mentioned can be used to help us to more objectively weigh the evidence for and against particular ideas about the voices: therefore help us REATTRIBUTE our ideas about the voices: that is changing our beliefs about the voices. This can be especially helpful if we find ourselves stuck with certain ideas about the voices which continually distress us and may not be true.
 

It is very natural for people to go for FIRST CONCLUSIONS when trying to find an explanation for what seems a mysterious happening like voices: we all do that. People do jump to conclusions not just about phenomena but about each other or particular situations: some of these conclusion have been found over time to be incorrect; sometimes amusingly and sometimes not so amusingly especially if the consequences of that understanding have led to damaging consequences. Situation comedies (so called bedroom farces) take advantage of that very human tendency to entertain us with plot lines where people are constantly misinterpreting situations.
 

There is not the space in the FAQ section nor would it be appropriate for the author of this website to explore this issue further but rather to advise that any voice hearer distressed by their voices should seek at least to TALK THROUGH THEIR IDEAS about their voices to someone who is a approachable and with a broad educational background and who will also not jump to conclusion! Professional counsellors, doctors, psychologists or perhaps someone who has actually gone through such an experience themselves would be a useful people to discuss such issues but all such people must be ideally bound to the rule of confidentiality. It is important not to see that any such person as being out to change your fundamental beliefs about religion or politics but just to help you take a more objective view of a very specific ideas related to the voices which may be distressing to you. It is also important never to simply rely on one person’s opinion but to check your ideas with different sources.
 

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(7) **MEDICATION**

Alcohol, Cannabis, Crack Cocaine and Amphetamines are complete ‘no, noes’. Even if these substances might not always start the problem (a debatable point), or maybe appear to bring short term relief: they most certainly, in the long term will always make the voices worse. Additionally such substances will often have other unpleasant effects (causing mood swings) which in the long term usually impair physical health. Use of these substances alongside the medication, either neutralises the beneficial effects of the medication or strengthens certain affects, for example like making people even more sleepy, depressed or worse more PARANOID and apt to misinterpret what might be going around them.

All medications prescribed by Doctors to help relieve the voices needs to be carefully supervised or monitored because of the very distressing side effects that might occur. Weight gain, depression, loss of libido or impotence, sensitivity to sun burn, occasionally breast enlargement in males, stiffness (Parkinson like symptoms), heavy salivation, or unpleasant involuntary twitching of muscles or worse dramatic involuntary movements of legs, mouth tongue muscles. Some medications may also effect the production of certain blood cells, so it is very important to try and read any leaflets on side effects or to get someone else to read it for you or to you especially if you suffer blurring of vision. There are also various books on this topic. Do remember such books do tend to GET OUT OF DATE fairly quickly as new medications hit the market while even more recent research on the previous ones comes out.
 

Beware of being OVER MEDICATED when you might find yourself just wanting to sleep all the time and that it is real effort to get up on account of the medication (rather than say from being depressed!). You may also find your thinking very slowed down. It is not unusual for one anti-psychotic medication to be prescribed along with a medication for dealing with the side effects and also one to deal with depression. Some people may be prescribed one antipsychotic oral medication and another anti-psychotic medication by injection, i.e. a slow release DEPOT injection.
 

No medication is without some side effects either in the short-term, and certainly in the long term. The main thing is your Doctor and or your worker should always explain what the benefits and disadvantages of the medication are likely to be, so that you can make INFORMED CHOICES about whether to take them, or not providing that is you are not a legally detained patient. Legally detained patients do still have right to QUESTION the medication being given even if they are obliged to take medication and to ask for a second opinion which if necessary can be requested through an independent advocate.
 

"REBOUND PSYCHOSIS"

This condition basically presents as if the person has gone back to becoming as ill as they were before and can occur in consequence of a sudden withdrawal of anti-psychotic medication particularly when someone has been on that medication for a long time. That is the return of the symptoms of mental illness might not always be because the person has not improved at all and needs medication restored to the full dose as before, but rather that the MEDICATION WAS WITHDRAWN too quickly for certain areas of the brain to adjust. The rule of thumb applied to those who have been on long term anti-psychotic medication is for that particular medication to be reduced very slowly to give the brain time to adjust or compensate for diminishing amounts of the medication. That is TO ALLOW TIME for the brain to secrete its own natural hormones (more accurately termed neuro-transmitters) in place of the medication withdrawn.
 

Beware of medications often used for dealing with physical illnesses which may have a PSYCHO-ACTIVE EFFECT on the brain. Some of these medicines may be listed by pharmacists, books or journal dealing with this topic. For example certain combination therapy medications prescribed to people who are HIV+ may alongside certain other medicines induce or produce depression or even strengthen suicidal thoughts. Some anti-depressants can also have some very negative effects on a person’s moods; an example would be that they could make a person very ANXIOUS.
 

Research indicates that DEPRESSION remains not only UNDER DIAGNOSED in the general population but also amongst people who have other mental illnesses other than depression itself.

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**OTHER STRATEGIES**

Some people try FOOLING OR TRICKING THE VOICES by for example changing their routes home or doing something contrary to the voices commands or suggestions. This sometimes works for some people at least some of the time. Actually it is difficult to place what category this form of coping would come under.
 

The strategies listed above are not by any means all there is but they are the ones that come to mind at this time. That’s about it for now, do let me know if there is anything here you found useful. You may of course, have found other strategies that you would like to suggest to others on the notice board.

See pages below for information on charts that can be used to help you with your coping.

DHVS: Voices Frequency/loudness grid or scale.

Explanatory notes:-

Below on the last page is a two week grid or scale for measuring the loudness of voices. Incidentally this chart can also be used to record the intensity of other experiences. A SAMPLE chart with instructions is also created below to how it can be filled in. A clean chart for printing can be found on page 3 of this section.
 

Sample Voices Chart A0

Write start date above day on grid you start your record of the voices. So the date 3^rd would be written above Monday if that is the actual day and date of the month you start the chart or say 5th is written above W for Wednesday etc…

Two weekly (record here start date): 5^th March 03
 

Sample voices chart A0

	Also insert start date directly below
	3rd	4th	5th	6	7
	M	T	W	T	F
10
9
8
7
6			X
5
4				x
3
2
1
0

The ‘X’ s are marked on the sample (Voices Chart A0) above, are marks you put to record the loudness or frequency of the ‘voices’ from a scale of 1 - 10, as each day goes by. This allows you to grade the worsening, or improvement in your voices. Doing this is the first step to seeing that ‘voices’ generally for most people, do have a pattern of intensity, or of coming and going which is often different if not always for each day then at least every few days or so.
 

The next stage is then to examine more closely the days when the voices were worse and the days when they are markedly better: and try to see what events were or were not occurring at those times. More importantly to see what the effect the various events were having on your stress levels. You can use chart A1 to record what was happening when your scores were very high. If you have lots of high scores but only a few low than record instead what was happening or not happening on the days your scores were unusually low.
 

The general pattern of association with voices is that they tend to get worse or more intense on bad days or weeks of high stress and are quieter or absent on days when people are feeling either more relaxed, or happier or doing something they enjoy or which took their mind off the voices.
 

Very often people can be so OVERWHELMED or bewildered by the voices so much so, that it can be hard for people to know where to start (understandably so): also the very idea that there may be some possibility of control over the voices will seem impossible.
 

Seeing that ‘voices’ have a PATTERN, even if the pattern may not at first make sense is the most important step in focusing; and is applicable to both good voices as well as bad voices.
 

When we see that things have a pattern than that also introduces the idea, that we might be able to make sense of that pattern and even better perhaps we be able to do something about changing that pattern.
 

For some people even if the ‘voices’ may seem like the weather, to be uncontrollable: if we take this to be a worse case situation, than actually knowing when the weather - or voices - are likely to be bad may still help us PREPARE (or ANTICIPATE) for it. We can’t control tornadoes but may we can find a strategy or do the equivalent of going into storm cellars, rather than just waiting for it to hit.
 

There might be COUNTER MEASURES that we can use; for some people this could involve increasing medication. However getting to KNOW the EVENTS that STRESS us may offer the possibility that we either try to avoid those events (not always practical) or deal with them in a way that might make it less stressful; so (a) either get help from other people or (b); or sometimes changing the way we might view an event.
 

For example any voice hearers find longs periods of being ALONE can set off the voices or make them worse; so it is a case of doing something to lessen the sense of loneliness be an effective of preventing the voices getting worse e.g. switching on a radio or phoning or seeing a friend (see FAQs on Coping with Voices for more details).
 

How to use the scores on the chart

Each time your score is high look back over the day (or week) and think of any events that might have been stressful to you. This could be caused by arguments with parents, friends; getting an unexpected bill, a sad anniversary, being ill or feeling depressed, anxiety over an interview or medical test; perhaps pressure of work from family duties, job, or academic studies: it may come from a sleepless night, fear, or high excitement. The whole point about this chart is that it gives you a way of looking at the variation of your voices and to see if this links with real events in your day to day life.
 

Record & date good days and really bad days and see if there is a positive or negative link with the way the voices behaved during the week. You can record these at the back of another designed sheet "Voices Chart A2" below, also printed from the website. Voices "chart A1" can be used to equally record the waxing and waning of other particular experiences such as that of super suspiciousness ("paranoia") or strong anxiety states, both can be equally distressing to some people.
 

If you do not understand using this chart simply ‘log’ your question onto the website and I will do my best to give you a better explanation. You could also expand the print size through Microsoft word to make it more readable for yourself. Make one without the words, once you are familiar with the intention of the chart.
 

Another thing you could do is to design your own chart with the same principles in mind but one that you feel makes better sense for you. The charts created on this website are adapted from others found elsewhere.
 

DHVS Voices Chart A1

Two weekly frequency and intensity chart which can be used for to examine pattern of voices or other special experiences or unusual perceptions (record here start date): …………………….
 

Please note 10/10 is the score for your voices at their worst (this will be different for each person) and 0 for total absence. 10/10 for some people will be hearing voices from dawn to dusk for others worst may be hearing them for a few hours each day. Each person will know in their mind what 10/10 is for them.

 

	Also insert start date directly below:- (week 1)							(week 2)
	M	T	W	T	F	S	Sn	M	T	W	T	F	S	Sn
10
9
8
7
6
5
4
3
2
1
0

Y Vertical scale X – Y line is to measure the intensity, loudness or frequency of voices

See page below for a four weekly chart made up of two 2 weekly charts, one below the other which can then be photocopied clean and with the minimum of instructions. The charts below are organised in that way to reduce on photocopies or printing needed when down loading.
 

DHVS Voices Chart A1

Two weekly frequency and intensity chart which can be used for to examine pattern of voices (Focusing) or other special experiences or unusual perceptions (record here start date): …………………….

(First two weeks)

	Also insert start date directly below:- (week 1)							(week 2)
	M	T	W	T	F	S	Sn	M	T	W	T	F	S	Sn
10
9
8
7
6
5
4
3
2
1
0

(Second 2 weeks)

	Also insert start date directly below:- (week 3)							(week 4)
	M	T	W	T	F	S	Sn	M	T	W	T	F	S	Sn
10
9
8
7
6
5
4
3
2
1
0

Voices Chart A2 to record either exceptionally high or low scores

This sheet can be used to accompanying the Voices Chart A2 or intensity scale to record what activities or events were happening around you that may have contributed to higher than normal scores out of 10 if these seem the more unusual or the days when very low scores out of 10 were recorded. This is to help you see if there is any kind of pattern between particular events and the activity levels of your voices or other types of unusual perceptions that you have decided to record on the A2 chart
 

Date	Location Where you were at the time	Activity What you were doing at the time

DHVS (2003) Coping methods success chart A3

The purpose of this chart is to record use of a particular coping method used to reduce or otherwise control the experience in question e.g. voices, intrusive images other. See sample chart below for explanation of how it can be used:
 

Name of experience on which coping technique tried: …..voices………………...
 

Name of actual coping techniques being tried: …counting in head

(subvocalisation)

 

Day & date	Location where technique tried: At home, elsewhere e.g. public transport	Length of time Technique used Minutes, hours etc	Record success of method as Either Yes, No or Unsure
Tues 04.03	Home (sitting)	5 min	yes
Tues 04.03	Home (lying down)	5 min	unsure

The sample chart immediately above can be used to record different coping techniques to deal with the voices or other nuisance or intrusive experiences. It is useful to try one coping method several times under different conditions or settings to see if it works before deciding if it is successful and useable for you.
 

For example the word ‘counting’ (see FAQs on coping) means counting not aloud in words, but in your head up to 100. The count should be done slowly and with concentration. If you find just counting with numbers difficult, you could use a visual image of what you are counting which might help you count better than just using numbers alone e.g. lamp posts or even sheep. It is helpful not to fall asleep unless of course this is your first intention! See FAQs on coping to find other methods you can try!
 

The whole point is to do the exercise WHEN THE VOICES are ACTIVE or at their WORST to see if this affects them in some way.

For some people using this exercise can actually shut out or dull the voices.
 

If you are have recorded ‘unsure’ on the chart, second check with another person if you got the method right or maybe used it in the most appropriate way. It may well be that the method really didn’t work for you at all. Lots of "yeses" means the coping method is a hit or SUCCESS for you. See page below for clean chart to print out.
 

DHVS Coping methods record chart A3 (adapted from other charts)

The purpose of this chart is to record the use of a particular coping method to reduce or otherwise control the nuisance experience in question e.g. voices, intrusive images other. See sample chart on page for explanation on how to use the chart.

Name of experience on which coping technique tried: ……………………………

Name of actual coping techniques being tried: ……………………………………

 

Date of day	Where method tried: At home, elsewhere e.g. public transport	When and length of time of coping method used Minutes, hours etc	Success or not of method tried: Record Yes, No or Unsure

The sample chart immediately above can be used to record different coping techniques to deal with the voices or other nuisance or intrusive experiences.
 

You try ear plugs for a 2 hour period in one ear. For other ideas on methods see FAQs on coping with voices.
 

The whole point is to do the exercise when the voices are active for a specific period of time to see if a particular coping method you try affects them in some way. The chart helps you remember what you found most helpful and when. You can then make your own priority list of coping methods that work for you to remember for the next time. The FAQs on coping with voices does not by any mean list all the coping methods that people have learned to use to bring relief from their voices.