Considering coping techniques, we have distinguished three types, each of which are relevant to one or more of the three phases that voice hearers go through:
- Short-Term Techniques (Phase One): Focus on extending control over the voices by agreeing new behaviours with the voice hearer.
- Medium-Term Techniques (Phase Two): Tackle specific interactions between hearer and voices, such as triggers, underlying belief systems and problems, etc.
- Long-Term Techniques (Phase Three): Aims at a new way of dealing with hearing voices. This is when the underlying problems are dealt with. This cannot happen until the hearers have gained some control over the voices.
The short-term techniques described here have mainly been proposed by voice hearers featured in our case studies, who have used them with success in their lives to increase their control over the voices. People deal with voice hearing in different ways. Here we have listed the 10 most commonly used methods of coping, that will be further on explained along the Post:
- Replying to the voices.
- Designating a set time and duration for the voices,
- Dismissing the voices and duration for the voices.
- Writing down what the voices say and want.
- Checking whether what the voices say is true.
- Creating boundaries.
- Postponing orders.
- Substituting different orders and learning to express anger.
- Anticipating the voices.
- Talking to somebody about the voices.
1. Replying to the Voices
This consists on giving short responses to the Voices one hears, such as, “yes, you are right” or “no, you are wrong”. This is suitable when the Voices either reflect what the Hearer is doing, or comment on it. For instance, a Hearer, in this case Marieke, might be standing at the front door waiting to go out, when the voices say: “Marieke is going out”. It is likely that she secretly feels the Voice’s statement is a criticism that would usually make her question her decision. That is, she could be thinking “Shall I go out, or is there something more useful I should be doing?”. For this reason, Marieke should then just reply: “Yes, I’m going out”, which will infuse her with confidence and make things easier.
This is the simplest technique. As we can see, it is not about arguing with the voice, but about answering honestly without causing problems. The Voice might be right, in which case the answer is “Yes”, or wrong, in which case it is “No”. This can also be effective in the case of perceiving criticism or insinuation from the Voices. The Hearer should stay and answer to the superficial message, the one stating “the facts”, and ignore the possibility of there being a hidden or subtle intention to their words. It is important not to get involved in discussion with them. This technique is about defining your position and learning to stand up for your own choices in a simple direct fashion.
2. Designating a set Time and Duration
This requires discipline, and works better when Hearers are less afraid of their voices. It is ideal for when Voices are disrupting one’s activities, to be able to make more time for ordinary living. In these cases, the Hearer should make an appointment with his Voices to listen to them for a restricted amount of time, that can last from 5 to 30 minutes, at a time of the day that suits him. Any other time outside of this frame, the Hearer should reject the Voices by saying, “Not now, later, at such and such time”.
It is a good idea to be systematic and constant about the timings and durations of the appointment each day, lasting these for minimum 5 minutes and maximum one hour. In addition, it could be helpful, especially at the beginning, for Hearers to have a daily schedule of activities. This will make it easier for them to defer the Voices into a slot that does not disturb what they had planned to do. Activities can be anything, i.e. cooking, walking, reading, working, etc. The key is to concentrate on the activity, and ensure that the Voices are only allowed to make comments on these at their designated time.
Suppressing Voices is not easy. Hearers must remain strong and consistent with the agreement, and not let them skip it. Any agreement will depend on:
- Having a set time and duration.
- Paying proper attention to the voices in their assigned time.
- Sticking to the agreement, even if it does not work at first.
- Creating a reasonable balance between paying attention and ignoring the Voices.
- Writing down the agreement to have an unambiguous physical reference of the conditions of the arrangements, which could also be read out loud. This will help the Hearer combat the Voices when these are not willing to comply.
3. Dismissing the Voices for a certain period
When the Voices are continuous, the previous technique will not work. However, it may be possible to send the Voices away for half-an-hour, while the Hearer occupies him- or herself with some absorbing activity. At the end of the agreed period, the voices must be allowed to return.
There is a variation to this technique if the Voices don’t come often, but appear at very inconvenient moments. Then the Hearer can make an excuse to leave the room or activity, going for example to the toilet, and talks and listens to the voices for two minutes in there. Once settled, the Hearer would return to what he or she was doing.
4. Writing down what the Voices say and want
Some people are so intimidated, that they cannot listen properly to the Voices. Hearers can help themselves by writing down what the Voices say, to based on this, later make a decision on what to do. If the Voice has said something useful, they can hang on to the piece of paper. However, if the advice is bad, Hearers can either put the paper to one side, throw it away or even post it without address. Even if the Voices seem to be talking nonsense, it is worth writing it down. This can later be taken to the therapy group or self-help group, or to anyone else the Hearer can talk things over with.
5. Checking whether what the Voices say are true
This technique stimulates opinion-forming and counteracts the Voices by checking whether what they are saying is true or not. For instance, a Voice may say “You are Lying”. There is more than one way to respond to this statement. You may become angry, or ashamed, or can even reply “You are right, but I’ve got good reasons”, or “You are wrong. What you are saying is simply not true because I didn’t say anything at all.”
For anyone who feels insecure about what they are doing, what they look like or what they want to say, this is an excellent technique to adopt, and one we all employ in our everyday life when we have a look at ourselves in the mirror. If a Voice is critical of someone’s appearance, standing in front of a mirror for a minute is all that is needed to check if what has been said is true or not. The Hearer can then, depending on whether they agree or not with the Voice, to make some changes. Not checking when this happens tends to make the Hearer feel more insecure, and the relationship with the Voice stays the same.
Checking builds a sense of security. Furthermore, it encourages decision-making, and obliges both Hearer and Voices to pay more attention to the reality of a situation.
6. Creating Boundaries
This is slightly more difficult to do. It implies that, as soon as the Voices say anything that is unacceptable, the Hearer must send them away. In this way, the Voices would only be able to stay on the Hearer’s terms. These rules are imparted in the same way as when bringing up young children, by setting limits on their bad behaviour. People who tend to put up with too much from their Voices or other people, should benefit from this method.
7. Postponing Orders
Voices can be at times very demanding and impatient, making Hearers feel forced to respond or do what they want straight away. Finding a way to reduce the pressure and release the emotions brought by the Voices can be helpful. Most of the emotions tend to disappear quickly, within approximately an hour. Nevertheless, they are important to bear in mind and time them.
The object of the technique is to learn, to wait and see what happens when the Hearer doesn’t try to counteract nor comply to the Voices. In this role of interested observers, Hearers will discover that if they don’t do anything, it will be the Voices who get wound up. When the Voices are issuing orders, the longer the Hearer can wait the better. They should start by waiting one minute before doing what the Voices want and seeing what happens. Then, if nothing happens, start increasing the time lapse next time.
8. Substituting different orders and learning to express anger
This technique is similar to “Postponing Orders”, but it is especially useful when the Voice’s orders are very threatening or disturbing, urging Hearers to kill or hurt someone. This is normally related to the Hearer’s inability to express anger, which is then expressed by the Voices but with much more intensity. Psychology tells us that when we cannot express anger, this only increases and comes back at us like a boomerang. Thus, finding a way of expressing anger is vital. This can be done in many different ways, such as hitting a cushion, punching a ball hard, buying a set of drums to beat, or choosing a sport that is utterly exhausting. Everyone has to find out what suits them best if they are to put it into use.
Later on, it would be a matter of learning to think why they are so angry, discussing where that anger should be directed to, then owning up to having a problem with anger, and exploring what this is about. The last part is the hardest of all, as it often requires an intermediate stage of hitting punch balls, etc.
Hearers who want to follow this technique, should take the following steps:
- Listen carefully to what the Voice says.
- Wait a few minutes to make sure the Voice has been heard right.
- Write down what the Voice said.
- Think and write down 10 alternative ways of expressing anger.
9. Anticipating the Voices
This technique focuses on finding solutions to situations before they arise. For example, Janet goes to a party with her boyfriend. At midnight, the Voices tell her to go home. This causes an argument with her boyfriend, who wants to stay longer. But if Janet stays, the Voices will create a lot of extra noise inside her head. However, Janet has learned to anticipate these kind of situations by striking an agreement before going to the party on the time they would be going home. By doing this, she is not troubled by the Voices, nor does she get into an argument with her boyfriend. Anticipating situations successfully means becoming aware of potential triggers and finding a solution to them.
10. Talking to somebody about the voices
By talking about the Voices, Hearers can overcome feelings of shame and anxiety. This works best if the other person is also a Voice Hearer, as there is a greater feeling of recognition and relief in discovering that other people also experience similar problems. It can also provide individuals with more insight into how other people address their Voices, changing as a result the relationship with their own.
For more information about this topic, read Chapter 15 of Making Sense of Voices, by Marius Romme, 1999.