Jacqui took to the little platform stage and talked ad hoc for an hour to a full house on a snowy January night in East London. It’s hard to summarise the pindrop atmosphere and attentive audience at her feet.
Starting by name-checking the great Judith Hermann and those Dutch pioneers of the HVN, Marius Romme and Sandra Escher, she took us straight to the heart – voice-hearing makes complete sense.
In the wider world voices are seen as ‘symptoms’ with an 80% chance of a ‘schizophrenia’ diagnosis, and those hearing voices who visit a psychiatrist will be given neuroleptics to eradicate them. It’s said this ‘works’ for 33% of these people, and 67% ‘benefit’. Before psychiatry voice hearing was seen very differently. It’s a common experience with up to 10% of people hearing voices. 2/3 of these never see psychiatrists. Jacqui explained that hearing voices is a reaction to extreme things happening, (PM - or which have happened), in people’s lives. The HVN is the polar opposite of the traditional approach; they understand and listen and enable survival. They support people to listen and understand the voices. Voices are on a continuum of human experience. This supportive and person-centred approach has spread to 26 countries with a US network kicking off – on a continent dominated by profit-driven big pharma & the stranglehold of the insurance companies. Different cultural backgrounds are much more accepting of voice-hearing and hearers, far from the taboo culture which equate voices with mad to bad to dangerous to unpredictable.
The 180 or so groups in England provide, above all, a safe space to share experiences. Voice-hearers talk about their voices ‘knowing their Achilles Heel’ and their personal taboos. Theses groups give expertise and share expertise. ‘You are the expert in your own experience’. It is a process of empowerment – divorced from the dominant ‘expert’ doctor and passive patient model. Those who are labeled ‘psychotic’ are frequently those who are overwhelmed by distressing life experiences, which are uncomfortable for people to hear, often abuse, racism and/or poverty. People need to be asked ‘what’s your story?’ ‘What’s happened to you?’
HVN is not pointing the finger at the psychiatric profession but creating alternatives and moving beyond the status quo. Jacqui’s own experience of voices has led her to feel they are ‘communications from the unconscious’ – they talk to each other and even dictate what she needs to write. She hears many voices: women, children, different accents. That begs to question: what is the difference between a voice and a thought?
Psychiatrists are quick to dub voices ‘misattributed inner speech’ and pathologies the experience. This does voices a disservice. The whole ‘thought’ and ‘voice’ area is a knotty one – which is a thought, which is a voice? She has heard voices telling her to kill, but does not act on them; one is responsible for one’s actions. Treatment reduces risk.
Threatening voices need to be heard more about and engaged with. The hearer must be kept safe.
Her definition of a good psychiatrist is one not subscribing to DSM, someone who does not pathologies and recognizes distress as an ordinary human reaction. Someone who listens, is humble and curious. They are more existential – concerned with the meaning of life. Jacqui’s voices used to tell her to cut herself; through therapy she could untangle the cutting. It was a shame, anger and rage release.
At the HVN meetings all explanations for hearing voices are accepted. There is a respect for all in the group – whether they say their voices are aliens or neighbours or anything. She has developed a working relationship with her voices and renegotiated power, and punctured their omnipotence.
Where do ideas come from and what does it mean metaphorically? She feels that those on drugs who develop a psychosis ‘reveal’ through drugs rather than have the psychosis ‘induced’. There are other things going on that lead someone to take drugs – there are reasons. Recovery is finding one’s own knowledge and power.
So much has been done: creating safe spaces, training professionals, allying with academics and professionals, writing, speaking, talking, tweeting. There is no need to prove anything; she believes the evidence is before our eyes. The evidence that someone has recovered. The qualitative evidence is the most important. ‘The Masters tools will not dismantle the Masters House’. The system is out of date and the training of psychiatrists out of date. Everything needs to be more humane.
This was such an inspiring evening and questions could have flown here and there for hours. I greatly admire Jacqui and the work she is doing. Here’s hoping HVN will go from strength to strength.