Sometimes, I think mental health providers and psychiatric services have got themselves stuck between a rock and hard place when it comes to hearing voices. Making more than a marginal difference to outcomes for individuals seems beyond our abilties and we settle for lower recovery rates as a result. Of course, this has implications and consequences for individuals seeking help.
If the long established belief system within medical services is that schizophrenia is a life long condition with poor outcomes, then what can we expect other than a focus on symptom reduction and some hope for functional recovery improvements at best? And that is what we, by and large, get. The lowest expectations for recovery and the longest dependency levels on the use of neuroleptic medication, with all the attendant benefits and risks.
Above, a fairly typical medical model map and you can see that the picture it paints is not an optimistic one!
Look at the language. used. Does this inspire a recovery focussed response from nursing and health professionals? Hard to imagine so.
This would explain why so many nurses I spoke to in psychiatric settings over twenty years held out very little optimism for folk diagnosed with schizophrenia when it came to discussions of recovery and qualitiy of life expectations. They were victims of their own training and restrictive beliefs in these matters. Recovery is not really possible for folk with this diagnosis. This was the unspoken and tacit "truth" in psychiatric circles and has been for too long.
It also fails to recognise that many of the "symptoms" it lists are direct effects of powerful and sedating medications given to reduce symptoms and bring relief to people undergoing sometimes extremely difficult experiences.
Health professionals would benefit greatly by reading these books by Professor Marius Romme. .Frustrated with poor recovery rates, he began to create opportunities for voice hearers to speak with one another and to share their stories with health workers.
This was very liberating for nurses and support workers as it encouraged engagement with the individual and not just treating symptoms, which can seem a bit impersonal. After all, if the doctor is focussed entirely on treating your symptoms, it is easy to overlook the story or narrative that is behind your admission to hospital or your request for help.
Consequently. this story is rarely heard, something patients used to tell me they found very frustrating as it mattered to them, and they were often keen to tell it, but doctors and nurses were often too busy to hear it. They wanted to be heard, a very important step in the healing ritual and a vital part of the process. But, too often, no space was available for this to happen.
When Marius Romme began to research and listen to his own clients he discovered quite a lot about their beliefs around hearing voices, that their relationship with the content of the voices and how they felt about the experience played a significant role in determining outcomes, levels of distress and coping abilities etc. This knowledge has been put to good use in " Coping with Voices" guide books and also helped in setting up many hundreds of support groups for voice hearers globally.
When U.K. Nurse of the year Mike Smith asked women who heard voices in English prison settings about their voice hearing experiences, he was the first to show an interest in their voices and their individual explanations. In many cases the voices talked directly to previous painful experiences that remained untreated or unhealed and yet, despite multiple admissions and long histories of involvement with mental health and prison services, no one had ever bothered to ask or listen before. I find this rather sad and also shocking as it borders on neglect. It leaves individuals stuck between a rock and a hard place, being treated for "symptoms" but with no real attempt to deal with the underlying issues or problems that lead to a person breaking down in the first place, It is a sticking plaster approach to mental health distress.
And now, with the belief that the problem is all about brain chenistry imbalances, why waste valuable time talking to patients? Finding their story? Helping them make sense of their lived experiences? Something old school psych professionals used to enjoy doing and now seen, sadly, as too time consuming and energy depleting. Who wants to actually listen to all that madness? That chaos? That distress and pain when you can just prescribe a pill?
Well guess what? The benefitsof listening outweigh the costs. All it needs is a little bravery from managers of health and psych recovery services and some local reinvention and creative thinking and we can adopt a better model of working WITH voice hearers and their voices and not against them.
Was there ever a group of people more trapped in service dependency and snared by the meagre expectations of others? I doubt it. If those who "support" you do not believe you have much of a future, even if they do not transmit this directly and openly to you, that limited thinking and restricted belief in genuine recovery will have a direct effect on you, your treatment, your hopes and expectations, even if silently and implicitly.
People deserve better from mental health services then to be labelled and written off because of erroneous beliefs in the minds of the medics.
People can and do recover from metal ill health and this includes those diagnosed with schizophrenia. Some learn to live with their voices and manage their experiences effectively, others struggle. Some are now voice free.
And some people manage to be free of reliance and dependency on psychiatric meds too. Although this takes time and proper planning and support to achieve, it has and is being done by many. Contact me for details of safely withdrawing off psych medications.
Activist/ Health worker/ 20 years. Specific interests : wellness/ voice hearing/ coping/ exploring/ sharing/ stigma reduction.