Self-help – Coping with Voices

"What this research shows is that we must accept that the voices exist.
We must also accept that we cannot change the voices. They are not
curable, just as you cannot cure left-handedness - human variations are
not open to cure - only to coping….It takes time for people to accept that
hearing voices is something that belongs to them”
Professor Marius Romme

Voice hearing is not an uncommon experience.

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Up to 1 in 10 people hear voices so hearing voices is a very common
experience. Research shows that many people hear voices and is not
always a sign of being unwell. It is also common for people from different
cultures to experience hearing voices differently. Some people may also
have spiritual or religious reasons to explain the voices they hear.

Nobody knows exactly what causes people to hear voices nor why some
people hear voices and others don’t. It’s thought that many people hear
voices because of life experiences which are largely out of our control.

Voice is there for a reason

You may hear voices for different reasons
 It is to protect and keep us safe
 Protect us from future harm
 Drawing our attention to past distress and memories of threat that
have not yet been resolved
 Passed away relative
 Difficult life
 To be critical

Voices and Compassion:

Research shows having compassion towards self is the first steps
towards learning to live with voices and understand the purpose of them.

The more you push away the voice the more they get louder.

Take a deep breath, calm down and try to be curious of the voice so you
can live together more in harmony and experience peace.

It might be helpful to develop a part of you that is compassionate and

confident to counterbalance a critical voice. This is not about getting into
an argument with a critical voice but rather developing a part of us that
can be kind and supportive to ourselves about the things the critical voice
is focussing on.

We may need help to do this from supportive people around us. Some
people find that they can better dialogue with their voices if they first
build this compassionate part and come from that compassionate self or
part when they do this.

Self-inquiry – Questions on the voices:

How do the voices speak to you?

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What does it say?

How does it work for you?

What does it help you do?

What is the voiced concerned about?

What does the voice think would happen if you did _____ and how
would the voice feel after?

Are there times where they are more intense?

Are there times where they are less intense?

Are there times where they are comforting?

Voices and symbolic language

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Sometimes voices don’t mean what they say literally. It may that they are
using metaphorical or symbolic language, like we can experience when we
dream or in some art. ‘You need bigger shoes’ could mean that people are
walking all over you. ‘You need to die’ may mean you need to make a
change and develop new ways of being in the world. Or it may mean you
need to find ways to feel a greater level of safety and power in your life. It
may be helpful to write down what the voice is saying and to look at it
later to try and find some meaning in what it is saying. If you find a voice
is difficult to understand you can also ask the voice to say more about
what it means and this may give you more to go on.

Understanding the voices

Type Relationship style Possible function

with voice-hearer

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 Suspicious Voice Protecting me from further
harm by scanning for
‘Danger’ threats and potential
Don’t trust them’ dangers
‘They are going to
hurt you’

Threatening / Protecting me from further

abusive voice harm by:
- Creating an internal guide
‘I am going to hurt of what a dangerous person
you/punish you/kill is like
you’ - Creating a powerful
protective response in me
Voices with a mind that can match the extreme
and opinion of their level of potential harm from
own another person.

Blaming / shaming Protecting me from

voices unbearable feelings of
helplessness and defeat by
‘It’s your fault’ providing me with a sense
‘you deserved it’ of control and choice (sense
that there is something I
can actually do about this
to avoid further harm)

Commanding voices Protecting me from

overwhelming feelings and
‘Do this job the way I memories by focusing my
tell you’ attention on rules and
‘You should always tasks. This gives me a
listen to my advice’ sense of control that I can
do something to stay safe –
that I can avoid harm
through specific actions.

Voices that create Protecting me from further

responses that are – harm by:
submissive,
compliant, - Feeling withdrawn and
appeasing. undeserving of other
‘Always put your people’s attention.
friends needs before - Keeping my head down
your own’ don’t event - Avoiding
contradict your boss’ conflict/confrontation
- Keeping others happy

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Voices that are linked Can be any of the Drawing my attention to a
to memories above but more like a threat-based memory from
tape recorded on the past that has not yet
repeat been processed. My mind is
still trying to make sense of
it, because the memory is
stored in a fragmented way
and needs to resolved as a
‘complete’ memory so I can
better protect myself in the
future.

What ifs?

What if I find the voices too controlling?

It is not uncommon that the voices are demanding you carry out actions.
They may make threats or try to bully you into doing things, promising
they will be nice to you or go away if you do what they say. The first thing
you might want to learn to do is to assertively set boundaries. You can
practice standing up to your voices with a friend or supporter.
If a voice says: “cut yourself”, you can practice saying something like “no
I want to find another way to cope with my distress” If a voice says:
“kill yourself”, you can practice saying back “I want to live” or “I
choose life”. If a voice says: “don’t go out”, practice saying “I want to go
out because I need/want… (fresh air/to see my friends/exercise/do the
shopping etc.)” Practice saying back things clearly and confidently. Look
at the kind of things the voices you hear usually say and think of things
you can say back. Practising with yourself or a friend is good because you
may feel overwhelmed when the voices come along and then it is easy to
forget what you had planned to do. When you have practised it, it can be
easier to do. Like practising sport or playing an instrument – when we
rehearse things, they come more easily to us when we are under
pressure.

What if the voices are too offensive?

If your voices are being insulting, you can try saying: ‘when you say
….... (example of the words the voice uses) I feel hurt or sad
because I need respect to feel safe. So please can you talk to me
in a more kind / respectful way’.
If a voice continues to be disrespectful and you feel upset you can
terminate the conversation and let the voice know that you need to be
talked to respectfully to engage in a conversation.

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What if I hear many voices?
It can be useful to map out the different voices you hear according to
their different characteristics. You can also try dividing voices into
different groups if that is helpful. It can also be productive to explain to a
voice or a group of voices that you can only hear one at a time. You can
introduce the idea of a talking stick and only the voice ‘holding’ the
talking stick can speak. Or ask the voices to organise it so they have a
rota for who gets to talk to you. Some people have found it useful to start
with the strongest voices, others have found it helpful to start with the
voice most willing to dialogue.

What if I hear voices that are crying?

You can dedicate a soothing activity (such as a face massage or a
breathing exercise) to the voice or soothing music or read the voice a
children’s story. Some voices appreciate it if you help them create a safe
place they can go to for refuge. This can be done by drawing a safe place
or using your imagination collaboratively with the voice.

What if a voice tells me to kill myself?

This can be a very distressing to hear. You might want to get support from
others in dealing with this. There are all sorts of reasons why voices might
say this. Voices may be feeling hopeless and distressed themselves. They
maybe reliving difficult memories. Another reason could be they might be
trying to get your attention. They may be angry with you and want to feel
powerful and intimidating. If you feel confident enough to you can ask the
voice about its reasons for saying this. A voice that talks about killing
yourself may reflect that part of you is feeling suicidal. It may be helpful
for you to focus on what your motivations are for living before you engage
in a dialogue or let your voice know that you have decided to live. To do
this you can practise (by yourself or with someone you trust) saying “I
want to live” or “I choose life”. You can try and make a list for yourself
for reason you choose to live, like ‘I like listening to music’, ‘my
family/friends are important to me’, ‘I enjoy food’, ‘I want to
experience getting old’, ‘I have goals I want to try and achieve’ or
something else personal to you.
They can be big or small and they may change over time.
What if a voice tells me not to go out?
This is very common. It may be that going out feels frightening to the
voice, because the outside world is scary to it and unpredictable. It may
be useful to try and ask the voice what would make it feel safer when you
go out. For example, many voices relax more when they are informed
about the person’s plans for the day. You can also explain to the voice
why you want to go out. E.g. “I want to go out because I need/want...”

What if the voice uses a lot of swear words?

Voices might be aggressive when they are angry or confused. Or it might
be because they know it will make you pay attention to them. You can try

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and ask a voice that swears, whether he/she feels angry or upset about
something. You can also tell the voice that you will pay attention properly
to what he/she has to say for 5 or 10 minutes but only if he/she stops
swearing. Alternatively, if you are comfortable with it you can join the
voice in doing a bit of swearing. A lot of people find if they start being
aggressive back at the voice the argument escalates. However, some
voices respect the person if they firmly set a boundary even if this
involves a swear word. Some voices enjoy banter. The important thing is
to try to stay relaxed and choose a way of relating you are comfortable
with.

What if the voice does not seem to make any

sense?
You could try writing down what the voice is saying and look at it later
with somebody to see if you can find some meaning in what it is saying.
You can ask the voice to clarify or you can ask it questions for it to answer
with a ‘yes’ or ‘no’. You can try and ask the voice why it is talking the way
it is; maybe it likes to be mysterious, maybe it has its own language or is
speaking a language you don’t know or maybe the voice is feeling very
confused and overwhelmed. Sometimes building a relationship means you
have to try and find a common language that you can speak to each
other. It’s the same with people – like some professions have their own
jargon or some areas have their own dialect. Some people like to talk
using abstract and philosophical words and other people have a very
down to earth way of talking. Sometimes we have to ask each other what
we mean when we say certain things or use certain words. Maybe you and
the voice you hear need to negotiate a way of talking that you are both
okay with.

Other practical things to do:

- Breathing activity (boxed breathing)

- Toxic sweets

- Sitting up straight

- Ask for staff support

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- Future focussed goals – motivation

- Keeping in touch with family members

- Stress ball – Help to cope.

Relaxed breathing
When we are anxious or threatened our breathing speeds up in order to
get our body ready for danger. Relaxed breathing tells the body it is
safe to relax.
It is slower and deeper than normal breathing and happens lower in the
body (in the belly rather than the chest).

How to do it
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 Get comfortable by sitting
or lying down.
 Close your eyes if you are
comfortable in doing so.
 Breathe in to count of four,
pause for a moment, then
breathe out to a count of
four.
 Make sure your breathing
is smooth, steady and
continuous.
 Counting to four isn’t an
absolute rule. Try three or
five.
 It can feel unusual or
uncomfortable at first this
passes with practice.

Am I doing it right?

 Breathing should be low in

How long and how often? the belly and not high in
the chest.
 You can check by putting
 Try breathing in a relaxed
one hand on your stomach
way for at least a few
and one on your chest. Try
minutes at a time – it
to keep the top hand still.
might take a few minutes
Your breathing should
to notice an effect.
move only the bottom
 If you are comfortable, aim
hand.
for 5-10 minutes each
 Focus on your breath –
session.
some people find it helpful
 Try to practice regularly
to count in their head or
when you can.
you can use your fingers.

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