People who hear voices commonly want to get rid of the voices, and the mental health system, that sees voices as a sign of illness, pretty universally wants to get rid of voices as well. Yet, there is a lot of evidence that shows that trying to get rid of mental events is often likely to make them more frequent. And there is also evidence that voices are a dissociative experience, which means that they actually represent part of a person’s mind that is not well integrated. That is, they carry important meaning, even if what they say taken literally is very wrong.
Those who have recovered from psychological crisis, yet who continue to hear voices, commonly talk about the way voices are valuable as a sign of something, for example, they often indicate that a certain kind of stress is present. But if voices are actually potentially useful as a sign of an underlying reality, then they cannot be truly seen as “psychotic” or out of touch with reality. In fact, it would be completely ignoring them that could contribute to “psychosis” since it would leave the person in a position of ignoring a clue about reality.
One way of getting in better touch with what might be behind the voices is to dialog with them, and to actually work at developing empathy for the voice’s perspective. For example, consider the example of a voice that calls the voice hearer an “idiot.” How did the voice come to believe that the voice hearer was an idiot? If this belief is the result of life events, how did the voice feel about those events, what was it like for the voice to see those events happening? What feelings did the voice go through? What is the voice hoping to accomplish by calling the voice hearer an idiot now?
Developing empathy for the voice does not mean that one cannot also set limits with the voice. In fact, developing empathy and setting limits often are best done together. An example of this is the way that good parents combine empathy with discipline: see the book “Unleashing Parental Love” as an example of this.
Incidentally, the same approach is useful for all of us, even those of us who don’t hear voices, in dealing with unwanted thoughts and emotions. For example, even those of us who don’t hear voices that call ourselves “idiot” will typically have thoughts at times that call us “stupid” or various sorts of criticisms. The best way to deal with these is to combine setting limits on how much we believe them, while being interested in exploring the thoughts and feelings that underly the criticisms, in other words, working on empathy for the critical part of ourselves.
A problem though is that this typically breaks down when dealing with extreme or vehement condemnations of ourselves. Then the condemnation seems so extreme we can’t deal with it, it seems like it comes from a completely different person or being or spirit, and we can think of nothing to do but try to get rid of it. Empathy seems impossible. We lose track of how to dialog with ourselves about what is going on behind it. The mental health system jumps on the bandwagon, agrees that the voice is just an illness, it won’t talk with the person about it and tries to get rid of the voice by any means necessary. Voices are talked about only in the context of trying to get rid of them.
It’s very different to turn around and face the voice, and become curious about it, and wonder what led to it’s vehement and extreme expressions, such as “you must kill yourself right now.” What is the voice feeling, and how did those feelings come about? This doesn’t mean giving in to the voice or seeing its views as 100% correct, just seeing it as having something to say. Often the voice had a perception of traumatic events that was different than that held by the conscious self, but really listening to the perspective of the voice can help the voice hearer develop a broader understanding of the impact of the trauma and assist in healing. And as the person understands the feelings and perceptions behind the voice, the voice itself becomes less essential to the person and may integrate in a way that makes it no longer stand out or distract.
Even if a voice does not seem to directly respond to efforts to dialog with it, the voice hearer can reflect on what might be going on for the voice, attempting to be as empathetic as possible. (A similar strategy can also be helpful in trying to heal relationships with actual people with whom one has been having conflict.) Often as the result of seeing such genuine reflection or attempts at understanding, real communication begins to open up.
Interested readers might want to look more into the voice dialog way of working with voices. Also, for more on the key role played by accepting that voices have a meaning, see this recent article on voices by Rufus May and Eleanor Longden.