An article by Lucy Nichol that appeared in The Metro on Sunday 20th May 2018.
There’s definitely a lack of understanding around the idea of psychosis. In fact, the word itself carries certain connotations that many find unhelpful and often distressing.
But we don’t have to use that word if it doesn’t seem to fit with the experience that friends or loved ones are going through. And we don’t have to feel frightened if somebody we know is hearing voices.
Hearing voices can be terrifying for people. But it isn’t always so. And if the person experiencing the voice, vision, belief or feeling isn’t terrified, then why on earth should anyone else be scared?
Dr Liam Gilligan, a clinical psychologist with Norfolk and Suffolk NHS Foundation Trust, says that we should try to acknowledge the emotions that the person experiencing the vision or belief is presenting themselves.
For example, if that person is not in distress, why approach them in a distressed way? It will only wind up with both of you feeling distressed.
Dr Gilligan added:
‘Even though it may be difficult to do so, it is important to try and stay calm, open and supportive throughout any conversation. Emotions can be infectious, especially when people are feeling overwhelmed.
‘Getting panicked or angry can make the experience more distressing for that person. If someone is really overwhelmed, try to keep things clear and simple and avoid language which may add to confusion e.g. metaphors or sarcasm.’
Dr Gilligan also says that it is important to validate that person’s beliefs. There is no point trying to change their belief, but you can listen, understand and offer comfort.
‘Instead of arguing about the belief, gently identify that you don’t share the belief. For example, you might say, ‘OK, I hear what you’re saying, but I’m not sure I quite see it like that…’
‘You should also validate the emotions underneath those beliefs. For example by saying, ‘I can see how if I did think like that, that it would make me feel extremely scared’.
Rai Waddingham, who contributed to the BBC Horizon programme ‘Why did I go mad?’, first experienced a vision aged just seven. Of course, this unexpected event terrified her.
Now, when Rai reflects on her experiences, she can find meaning in them and she has learned to live more in harmony with her voices, visions, feelings and beliefs. And so has her family.
‘My experiences don’t come with a guidebook. If friends, family and supporters want to understand what I’m going through, they need to talk with me about it.
‘It’s helpful if they position themselves as learners. They can learn from me about what I’m experiencing, if I feel comfortable enough to talk about it.
‘In talking about it with people I trust, I begin to learn things about my experience too – and ask questions of myself I’d never thought to ask.
‘A sound engineer once asked me whether my voices sounded different in different spaces – a small room or a large cathedral. It was one of the best questions I’ve been asked because neither of us knew the answer – I had to listen to my experiences in a different way.
‘More than that, it wasn’t a ‘mental health’ question – he was interested and open to hearing what it was like for me. It’s these kinds of conversations that have helped me feel less freakish and alone.’
Rai also agrees with Dr Gilligan about acknowledging her voices and emotions.
‘It’s important to me that my friends and family recognise that the voices I hear and visions I see are my reality – I’m not making them up; they’re not figments of my imagination.
‘I hear and see them as clearly as anyone else in my life. Believing me is crucial. How can we talk about something that you’re continually questioning?
‘But believing me doesn’t mean that you have to believe that the voices are telling the truth.
‘When I’m distressed, instead of telling me just to ignore the voices (which rarely works), I find it helpful when people ask me if I’d like to talk about them.
‘Then, rather than jumping in to deny what they’re saying – it’s useful when people ask me what I think about what the voices have said. That reminds me that I have a voice too – and a perspective on things.
‘We can then talk about what it’s like to hear these things and make a plan together about what to do.’
Rai hears voices most of the time, but she only finds them distressing some of the time.
‘It’s helpful not to make assumptions. If the voices are getting harder to deal with, it’s often because there’s something going on in my life that is getting on top of me.’
Rather than discount it, or take it literally, perhaps we should try to understand what is driving the stress. To understand where that person might be coming from. And to try to help people live a life beyond their voices.
Dr Gilligan said:
‘It’s important to ensure that you still do everything that you would want to as a friend or family member.’
‘It’s helpful when family and friends don’t get so caught up in the voices that they forget to talk with me about the other stuff I’m dealing with – starting a new job, a relationship breakdown – the usual things that we all have to find a way of navigating.’
Of course, if your friend or loved one is in too much distress, you may need support to help them.
Dr Gilligan said:
‘If the person feels that the distress is becoming unmanageable then this would be the point at which you may wish to make contact with the appropriate mental health support team or try to get them to go to A&E, so they are able to access further help.’
But the main point here is: we do not have the right to determine the way a loved one feels about their experience. Remember, some of these might be incredibly distressing – but not all. And the voices do not make a person who they are.
‘There’s more to me than being a voice-hearer. I don’t want people to pretend the voices aren’t there – but I don’t want them to forget that I have a life outside of it all too. My voices are not me.’