We won´t pretend it was easy. Making changes to the way you relate to voice hearing experiences and their impact on your life can be a challenge for sure.
Importantly, Katy wanted change. She was fed up being stuck in a cycle of service dependancy and personal despair and feeling that her life ahead was already predestined as a patient.
Initially, she didn´t have any real expectations of recovery and had a label of schizophrenia that even health professionals believe holds little prospect for improvement. It seems that managing symptoms via medication for life is the best "we" can do and this requires acceptance of a reality that, in my opinion, minimises options for any real and lasting improvements in the quality of a person´s life.
But, Katy took her time and thought about what she wanted. She read the books I had recommended on managing voices and looked at the coping ideas that have already worked for others. She grew her gentle determination little by little.
Making a voice profile and keeping a voices diary gave her some insights into her experiences and allowed her some power and autonomy to make decisions that no one had ever suggested were possible before.
She began to select times in the day when she told herself and her voices that she would not be available to listen. And during these windows, she booked herself into a yoga group and a mindfulness meditation class. When her voices spoke at any point during these times she asked them to go away, reminding them that she would make herself available at the designated time. And when that time came, she kept her part of the bargain.
If they persisted, she instructed them to leave her alone, and, if they still persisted, she ordered them away. In her mind she visualised the voices and even got a notepad in order to sketch out their faces. Then she could imagine them more easily and was able to visualise herself holding a ray gun that emitted a beam of light and she "zapped" them.
She also set herself some useful boundaries and determined to not pay attention to voices at specific places or when doing certain activities. And with this in mind, she began to take a little more control of her experiences, in turn growing her autonomy and self confidence. Katy still used her medication as directed but expressed a wish to reduce her dependency on drugs over time. She suggested a six month period of slow and subtle reductions and agreed she would discuss this with her doctor. She would self moniter her moods, thoughts and feelings and have regular contact with him to report in any difficulties.
The next step was to identify first an ally, someone outside the medical circle, and secondly, someone who might be available for an agreed weekly phone chat especially if there were moments of high anxiety. Katy had to think hard as she was somewhat isolated socially and hadn´t been in regular contact with family members but, she sent an email to her cousin in Prague, setting out her objectives and bringing her up to speed with events in her life and how she was determined to make improvements. She asked for some support.
She sent a guide to coping with voices and some useful links to websites and asked if her cousin thought she would be able to provide a little moral support in the coming weeks if it was structured as laid out above. Katy described her ambitions to have a fuller life and to be more in control of her experiences and she knew that this was likely more possible with some support. Her cousin was delighted to hear from her again and after so long and yes, she was happy to do this. They agreed to talk on Skype and it went well. She had an ally!
Negotiating and instructing voices came with challenges too. The voices did not like and were not used to being asked or instructed to go away, even with a promise of Katy being available at another time of the day to be present and to listen. Sometimes the cruel taunts and insults from her two negative voices simply got worse. One voice, named "John" constantly taunted her and belittled her efforts to assume more control. He used foul and sarcastic language and in this early part of her experience, he became angrier.
I advised the Three Ps : Patience, Persistence and Power.
If Katy could hear this voice and be patient in the knowledge that her lived experience and situation might change for the better. If she persisted, rather than surrender under pressure, we agreed she would have a better chance of success, however that might be defined. Finally, she recognised that she was growing slowly into a place of increased power.
By taking actions and putting together a tool kit of responses, by researching ideas that have helped other critical voice hearers and by tapping into her own reservoirs of determination and desire for change, she was letting the voices know that something was about to change and that this were definitely happening!
And this was the stimulus for the hostile reactions of her voices. It was a sign of progress and a recognition of a shift taking place in the power relationship that Katy had with her voice hearing experiences and by extention, with herself.
Let´s take a quick look at her most dominating and negative voice, "John". This was the most damaging and influential voice, the voice that had driven Katy to hide within her rooms and within herself.
When we looked at Johns comments and criticisms, I asked Katy where in her life history did this voice come from?
He was highly critical and sometimes very angry, often telling her how useless she was.
Katy once had a boyfriend who had been very manipulative and controlling and often used her emotions to make himself seem necessary and vital in running her life.
He used to read her phone records and emails and hacked himself into her facebook and bank accounts. It turned out that these were traits he had learned, partly, from his own father, who had found out that his wife had been seeing another man secretly for many years. He was always suspicious of women in general and intrusive from that point on to the point of paranoia.
But this was a trait that the father took on after he became divorced with other potential partners. When it became too much for them to cope with, Johns father would recall being badly hurt emotionally and get very angry, often saying that men "should never trust women" and that " they will always leave you".
And John, on growing from a boyhood without a mother, had absorbed this painful psychological energy filled with feelings of loss and themes of betrayal.
Getting the real John out of her life had proven very difficult. He was emotionally volatile and reacted to suggestions that they should think of splitting up by hardening his attitude, using verbal threats of aggression and turning up unexpectedy at social events and even at her house when she had guests, often sitting outside in his car and watching the house, who came and who went.
Sometimes her friends reported that they had seen him driving slowly around the neighbourhood and this made Katy feel very nervous and quite afraid. She began to recieve texts and messages describing her actions, where she had been and who she had been with. Friends advised that she consider calling the police. But she found this very hard to do and simply hoped the whole thing would somehow stop. Eventually, it took a court action and several police warnings to keep John from contacting her any more.
So, "John" was a voice like an echo from the past. We identified a healing opportunity and Katy did some reading on forgiveness and self-forgiveness too. She started using meditation and mindfulness practices and read several books on self-esteem and personal development. She switched from sugar filled drinks complete with artificial chemical flavours to a healthier diet of fresh fruit and more vegetables and started cleaning the kitchen so she could cook again. The microwave was placed in a cupboard, out of sight.
Katy was determined to regulate her life a little more, so with this in mind, she walked more during the day and bought herself a track suit. Within a week she had jogged in the park and consequently began to lose a little weight. She went to bed earlier, awoke earlier, treated herself regularly to a warm soak in a bath filled with relaxing herbal oils, listened to relaxing music videos and talks on Zen and spirituality. She bought a smoothie maker and her skin began to shine a little. She felt more positive and more powerful, so much so that, after six weeks on this regime, her doctor agreed to support a small and gradual reduction in medication use. To his mind, the visible changes were due to the effectiveness of the prescribed medication. Of course, this also may have been true. Katy didnt think so.
Katy was surprised that the lesser negative voices sometimes stopped on first request. Even if she had to reiterate her instructions to go away at times. And she always kept her part of the agreement to allow some time for listening but, we agreed she would reduce the listening time and expand the "no voice times" over the coming weeks and months.
When the voice of John kept nagging away one day and laughing at her efforts to make improvements she told me that she had finally had enough, that this voice always tried to ruin everything and saying she would amount to nothing and that she really ought to end it now and go kill herself.
"So I got really angry as I saw that everything else was starting to go really well in my life, and in my house while I was getting ready to go to meditation I shouted at him :
"Listen...Are you stupid or something?
If you want to be able to talk to me it means you must need me. You cannot talk to me if I am not here any more. If I look after myself and keep myself fit I will live longer and you will have your companion for longer so...I am going to my class and then to coffee with a friend afterwards so...SHUT UP!"
"And what happened next? I asked her. A pause. "He was silent. Just a deafening silence. I was elated and surprised because, you know, this voice is all the time chattering and moaning, calling me names. I could not believe I had made him quiet. I was a little shocked to be honest."
We agreed that this was a breakthough of sorts and worthy of celebration! Katy decided to go dancing for the evening and I poured a small glass of cold German beer.
I wonder how the weeks to follow will be....stay tuned!
Activist/ Health worker/ 20 years. Specific interests : wellness/ voice hearing/ coping/ exploring/ sharing/ stigma reduction.