AUTHOR: Redaspie DATE: Monday, June 19, 2006 ----- BODY:

Currently typing this while watching a programme I recorded last night on Channel 4 on people who hear voices, which posited the idea that people who here voices are not necessarily suffering from mental illness, but experiencing something perfectly normal and natural. I won't bore you with all the psychological theory, but the central thesis being advanced is that voices are not the meaningless product of a mentally ill mind, but the byproduct of the building up in the mind of 'models' of the world around us, of people, objects and concepts, that then take on a life of their own and speak to us, sometimes even telling us things that we were consciously unaware of. At its simplest of course, this is simply a reiteration of the idea that voices are representations of our subconscious, hardly an original idea. However, that does not mean that this idea is not worth considering.

The idea that the voices are not a symptom of disfunctionality leads directly to questions of how to deal with people who are experiencing such phenomena. Traditionally, psychiatry has resorted to its usual pattern of behaviour and medicalised voice-hearing, treating those who hear voices as 'suffering' from a 'psychosis' and sticking them in institutions where they get pumped full of drugs and told that they're ill. The experience of such individuals as Ron Coleman, who was interviewed in the programme, are telling. He was institutionalised for a decade, an experience which did him no good at all, and it was only when he got involved with a group called the Hearing Voices Network, a self-help organisation for voice hearers who told him that the correct starting point was to accept that the voices were 'real', that he finally started to recover. The Network helped Coleman to come to terms with the voices, and to trace them back to the sexual abuse he experienced as a child. Now chief exec of a mental health training consultancy, he still hears voices which he 'consults' on important decisions, and labels himself as 'psychotic and proud' (go to this article here for more on Ron Coleman).

I am not going to go all the way and argue that institutionalising and drug therapy never works, or that all institutions should be abolished. Such radical ideas, which appear to be advanced by some in the 'mad pride' movement, need a lot of consideration before being supported, and I have not been able to give them such consideration. However, what this issue highlights is that conventional psychiatic methods are insufficient, and even sometimes oppressive. In the case of voice-hearers, the assumption is made that anyone who hears voices is ill. As with autism, abnormal behaviour or reactions to the world are medicalised and seen as 'wrong', yet the programme highlighted the experiences of artists, musicians and others whose voice-hearing experiences have been positively helpful.

Fortunately, the programme seems to suggest that attitudes are starting to shift. Following ground-breaking research in Holland, increasing numbers in the medical profession are starting to consider such ideas. The article linked to above, written over three years ago, shows how the Hearing Voices Network has been influential in the psychological profession, for instance in a report by the British Psychological Society which acknowledged and drew from the Network's ideas. Unfortunately, the psychiatrists, who are after all the ones manning the hospital wards, up until now show little sign of catching on.

-------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:6:48 PM COMMENT-BODY:Wish I had seen the programme, it sounds interesting.

I accept that for many hearing voices could be positive, such as artists. There is a danger in romantacising it. I have met many people who have been tortured by voices , voices criticisng them and very hostile. They have tied often to 'self medicate ' to stop it e.g cannabis or playing loud music.

The answer is not to drug people up and leave them in hospital. People should live in the community. It is important to help someone understand the voices, they can be linked to past experiences. but I do believe that for many drugs can help to control the voices and the distress. Drugs are improving but still are not great. But I have seen to many people tortured by voices to say no drugs, they are juts different. Different is good, unless it distresses that person.

Good mental health services listen to people and offer a variety of approaches such as medication but also therapy and support to live outside hospitals. -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:7:14 PM COMMENT-BODY:Sorry for all the typos !

Just re read comment. Im not saying we have good mental health services, but what good services would look like.

There of course is the much bigger debate about what is mental illness . -------- COMMENT-AUTHOR: Louisefeminista COMMENT-DATE:8:38 AM COMMENT-BODY:Ron Coleman has been around for years. Hearing Voices was set up in the mid-80s and they have done some extremely good work to highlight hearing voices and to campaign against the stereotypical view of the voice hearer. I worked with them (and I know Ron) as I was active in the mental health user movement and there are some great activists.

There have been articles and books written by Marius Romme, Sandra Escher, Phil Thomas and Pat Bracken on voice hearing. The traditional and psychiatric orthodoxy is to try and stem the voices (faulty biochemistry) by giving people medication. This medical model approach is popular. Psychiatrists dismiss the voices as part and parcel of that dysfunction. Phil Thomas and Marius Romme, for instance, very good lefty psychiatrists see voice hearing not as some biological entity but as a reaction against traumatic experince(s) and that people internalise their own oppression.

Phil will ask the client to listen to voice, does it sound familiar, when do you get the voice and so on and asks people to keep a diary. I know for Ron, his voices can be traced back to the sexual abuse he faced as a kid and similar with other people.

What Hearing Voices and psychiatrists like Phil Thomas and Pat Bracken argue is loathed by the Royal College of Psychiatrists where they are dismissed as giving too much say to the user!!!!. Heaven forbid, showing respect and understanding to a mental health user!!

Yet Pat and Phil who are based in Bradford have an extremely good and well developed mental health team. They win "good practice" awards from the DoH, which is ironic. -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:9:13 AM COMMENT-BODY:Louise I agree that its important not to just medicate out the voices . I do also know from my work experience of people being so very distressed by their voices they did want them to stop and could not cope with trying to understand them . I think medication used properly (and I accept there are lots of problems with it and better meds are needed) can help the person to have some control over their lives and some peace from the voices. It may be that they can them decide to try to understand them if they want to.
I have worked with people whose voices told them to harm themselves and have acted on it. I have seen real distress and torture . I am though open to the idea that voices can be worked with, but sometimes people do just want them to stop and stop now.
Involving people with mental health problems is something that always challenges psychiatrists, but they will have to get used to it ! -------- COMMENT-AUTHOR: Redaspie COMMENT-DATE:2:58 PM COMMENT-BODY:Stroppybird - I agree that medications can be useful. I think the argument to be had is that it should be up to the individual concerned to decide whether they take drugs or not, whether in cases of mental illness the standard response seems to remove the individuals' right & ability to make decisions about their treatment.

(I actually put this post yesterday but version 1 seems to have been swallowed whole by something). -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:3:21 PM COMMENT-BODY:Choice is a very difficult area . I have seen people who are very distressed and have made attempts on their life. They have been at that point very out of touch with reality. I know someone will come back and say reality is relative. I am talking abut someone who is holding views and ideas that are very far from what is really happening and as a consequence are very distressed and at risk to themselves. |The voices may be telling them how worthless they are and to kill themselves.Again there could be a debate about the 'right' to harm oneself. I do believe though ,at the extreme end of distress and delusions there is a responsibility to stop that person harming themselves and trying to create some calm for the person with medication.
I have worked with people, who once calmer, and with some relief from the voices ,are glad they were stopped and are glad the medication has stopped the voices. Many people are able to survive in this world with medication to stop the voices.
Most people are more likely toharm themselves, but there are some who have voices telling them to harm others. The media of course focuses on that, its a small minoirty , but it has to be considered.

There is a need for a place of safety. Hopsitals are not the best places as they are set up at the moment, still very dominated by the medical model. There are more moves to support people in their homes but no real fundamental rethink of the system that has come up with radical alternatives. -------- COMMENT-AUTHOR: Louisefeminista COMMENT-DATE:5:54 PM COMMENT-BODY:I do think it is about choice and the fact when you refuse medication it is forcibly given to you (myself and others have experienced that and it destroys trust completely and your self-worth etc.)No discussion whatsoever.
That's the issue with the m.h. user movement, that we are sick of having things done against our will and that we aren't listened to. Containment and coercion helps nobody. Crisis cards for instance were put forward as an idea when someone gets into extremely badly distressed state they have a "living will" i.e. crisis card to fall back on. This would explain what to do in the situation. It also gave a kind of empowerment to users as we campaigned for various psychiatrists to take these seriously. When i lived in Bristol we were successful and Crisis cards were given out to users. It wasn't revolutionary but it was damn well better than nothing.

Phil Thomas and Pat Bracken very rarely give out medication and only do it if the person genuinely wants it and only then after it has been talked through. they look for alternatives and have employed users to work with other users as Bracken and Thomas know that even as radical psyhiatrists they may not be trusted.

It is about, ultimately, giving rights to the user and empowering them to make the decisions. I have never met anyone who has had a positive experience of the m.h. system and that it primarily to do with rights and freedoms being taken away. And everyone is making the decisions for you. It really increases the distress as opposed to reducing it.

I believe in a "place of safety" but not your average psychiatric hospital as they are not safe. For me, it has to be true asylum where you are free of constraints and most importantly, listened to.

Apols for long post.. -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:5:55 PM COMMENT-BODY:Dave
In terms of medication I was refferring to psychotic episodes (schizphrenia for example). I am not pro medication as such ,but I do not rule it out . I have seem too many people distressed and tormented by their voices. I am not against other ways of dealing with it and helping people, but am wary at stating schizphrenia can be 'cured'by talking about the past. I would like to see the evidence of its effectiveness, as this is people's lives and not just about philosphical standpoints.

Improvements in medication would help, alongside other ways of supporting people.

In terms of ritalin I do not know enough about it. I do though know a lot about largactil. Its barbaric to pump any child with that . Its also pretty horrendous for adults, my father was given it. It has awful side effects.
I would like to know more about how ritalin is used for autism, whether as a control (chemical cosh) or to actually help the child rather than make them easier for others. I think a worrying trend is how its use has spread more and more as a way of controlling a child's behaviour, rather than questioning why a child should act in such a distressed way (talking more about non autistic children, where its seen as a behavioural problem).

Interesting article in the Independent about the increase in mental health problems in children. -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:6:38 PM COMMENT-BODY:red aspie

Sorry for posting 'essays'. I think though it is because you do post on interesting issues that require some thought. -------- COMMENT-AUTHOR: Louisefeminista COMMENT-DATE:6:41 PM COMMENT-BODY:Largactil is a vile drug and is a "chemical cosh". I was forcibly given it when I was 18 and the memory is still pretty vivid.

It astounds me that psychiatric medication is given to kids and that it seems more kids are being given crap like Prozac. I was on amnitriptlene (sp) when I was 8 and it really screws with your head.

So, why do they need to still hand it out like sweets is beyond me. -------- COMMENT-AUTHOR: Redaspie COMMENT-DATE:7:09 PM COMMENT-BODY:Blimey this is turning into a right old debate.

Dave: welcome to my world. My personal opinion on the issue of aspies getting medication is that I can't think of a single good reason to give somebody medication *because* they have Aspergers Syndrome. Indeed, I don't believe in medication for autism full stop, as I'm opposed to treating autism and believe it should be completely de-medicalised.
Mental illness is, of course, a different thing altogether. I pretty much agree with Louise on this one although I can see where Stroppy is coming from. Some individuals probably are in a position where asking them to think rationally about what they should do is asking too much. But is the answer then to simply take away *all* their power to decide things? -------- COMMENT-AUTHOR: stroppybird COMMENT-DATE:7:18 PM COMMENT-BODY:I was not in anyway saying take all someone's rights away. I was saying in some circumstances, when someone is extremely distressed and the voices are telling them to harm themself, or they are suicidal because they want to get away from the voices, then it may be necsessary to act to stop them hurting themselves.
But it is important that people are listened to and have control over their lives and what 'treatment' they have. I agree with Louise about crisis cards and centres. I don't really disagree with louise, juts making different points.

Its difficult to get across all my views and examples in a comments box. I have no problem with user led movements.My experience of mental health and aspergers is not just professional but personal in terms of my father and other people I love.I also consider myself affected by a difficult childhood and would not say I was 'normal' whateber that is. -------- COMMENT-AUTHOR: Louisefeminista COMMENT-DATE:7:26 PM COMMENT-BODY:"But is the answer then to simply take away *all* their power to decide things?"

Yes and that is what happens a lot of the time to people. Look at the proposals for the new M.H. Bill and it just offers containment and coercion while the advocacy bit has been pulled completely. It took us years for advocacy to be taken seriously in the m.h.system and representing people who have had their rights stripped from them is depressing and soul destroying for some poor sod on a section. Yes, there are times when rational thinking goes out of the window but that is when Crisis Cards are invaluable for people.

You can give an advance directive and explain your needs etc. Users carry them around with them and it only works if the m.h. professionals take what is written seriously and we were successful in some cases but the cards are useless if no professional takes what you say seriously cos at the end of the day, the user is ultimately the best person to know what their needs/demands are.

Incidentially, people have been sectioned not because they are a "threat to themselves and others" but because of sometimes oppressive and reactionary psychiatrists. A woman activist I knew was sectioned because she was a lesbian and her psych told her that was why she was depressed, "because she was bent"! She spent 3 mths in the bin because her sexuality. The homophobic misogynist got the sack in the end.

Oppression and discrimination is rife within the psychiatric system. -------- COMMENT-AUTHOR: Redaspie COMMENT-DATE:10:34 PM COMMENT-BODY:I think Lenin probably was actually! --------