Presents Peter Bullimore Day 1 9.00am – 12.30pm Workshop 1 Understanding & Working with Voices

1. Presents Peter Bullimore Day 1 9.00am – 12.30pm Workshop 1 Understanding & Working with Voices

2. Hearing Voices Peter Bullimore

3. 450 people who heard voices responded •  300 were unable to cope •  150 accepted their voices and could cope with them

4.  Hearing voices in psychiatry • Is hearing voices in itself a psychiatric condition? • Does it indicate the presence of a specific disorder? • Do certain characteristics of hearing voices indicate certain disorders?

5. Hearing voices in itself is not a sign of a mental illness, but a sign of a problem. • Becoming a patient is due to the inability to cope with voices and underlying problems.

6. In our society there are more healthy people hearing voices, than there are ill people hearing voices. • Voices are messengers that sometimes bring awful messages. • Hearing voices is apparent in healthy people.

7. The focus of helping at this stage should be the reduction of anxiety through anxiety management techniques. Medication may be useful at this time in helping to reduce anxiety.

8. Help must be given with full recognition and acceptance of the actual voice hearing experience of the person. The next step is to seek possible ways of gaining control over the voices. It is important to foster a sense of security by showing amongst other things, emotional involvement and by taking careful note of events and their timings.

9. Contact with other voice hearers during this phase can be valuable in reassuring people that they are not alone. In due course one should try to bring some fundamental order to the person’s daily routine. It is important for friends and family to be supportive rather than critical at this stage.

10. When the initial anxiety and confusion has been reduced or temporarily suspended it is possible to concentrate on organising the voices and the hearer’s relationship with them. During this stage detailed attention is paid to such issues as;

11. Analysis of the possible significance of the voices to the hearer with the regard to both past and present. This can be done through an exploration of the hearer’s history. • The meaning of the voices in the person’s daily life. • The influence of the family’s attitude to the voices. • Accompanying symptoms of dissociation or emotional repression. • And/or any symptoms suggesting a delayed development of the self.

12. Particular circumstances under which the voices are heard. • What they have to say. • The nature of any triggers and accompanying perceptions. • Attention will be paid to the social position of the person, her or his degree of dependence, the necessary social provisions, and the available opportunities to develop and present a full identity as someone who hears voices.

13. HOUSING •  BEING BELIEVED •  “JOB” • SELF-CONFIDENCE •  SELF-ESTEEM •   SELF-BELIEF

14. In this phase, the focus is primarily on expanding knowledge and developing the personality through the use of various therapies. • This is the period when people have begun to learn to live in balance with their voices, the voices are seen as being a part of the person.

15. The relationship with the voices is more reasonable, they have a more positive influence and become less controlling, but people can choose to follow their advice if they want to. • In this phase people are less anxious about their voices.

16. What you did was wrong • I am angry at you for doing it • I am going to stop you doing it again • Helps unlock frozen terror

17. ‘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. Therefore to assist people to cope we should not give them therapy that does not work. We should let people decide for themselves what helps or not. It takes time for people to accept that hearing voices is something that belongs to them.’ Marius Romme

18. Hearing Voices Exercise

19. Voice profiling looks at who the voices are and how they influence you. • The purpose of profiling is to make it clearer to yourself and others what exactly are the natures of your experiences and how they influence your life.

20. You need to try and identify who the voices are and how they affect you. • If you do not know who the voice/s are give it a name maybe one that sums it up. • A voice profile is a representation of who your significant voices are and how they affect you.

21. This helps in two ways. Firstly, when you can be clear about the identity of the voice/s you tend to feel more in control. •  Secondly, if people want to help you they can see from profiles what the real problems are and when you need them most. • Remember profiles can change over time, for many people there are many voices, only one or two of them are usually problems, sometimes the other voices can be helpful. • To start voice profiling use a I have just heard a voice check list.

24. Voice intensity levels 5am 6am 7am 8am 9am 10am 11am 12am 1pm 2pm 3pm 4pm 5pm 6pm 7pm 8pm 9pm 10pm 11pm 12pm 1am • Use the chart to identify the intensity of the voices simply draw a line to represent the intensity (0 just a mumble, 5 very loud) • Why is this information useful • What do you notice about your voices and their intensity levels • What is the best time of day for you to work on your voices

25. Thought stopping This is a technique originally developed for people with disabling obsessions. It is used to try to control unwanted intrusive thoughts. For some people there are a lot of similarities between these kind of thoughts, voices and persecutory feelings and so it was thought that the technique might be useful.

26. FIRST SESSION – You raise your hand when the voices start. The person with you then shouts, “stop it”, until you drop your hand to indicate that the voices have stopped. This is then repeated. Counting the number of times “stop it” is shouted before there is an effect can be a useful barometer of progress as this usually decreases with repeats of the exercise. SECOND SESSION – Everything is the same apart from now it is you that shouts, “stop it”, until the voices go. You can try decreasing the volume of your voice as you get more practised.

27. Practice between sessions before saying, “stop it” in your head if in a public place. THIRD SESSION – As before but you whisper “stop it”, until the voices go. FOURTH SESSION – As before but now you practise just thinking “stop it”, until the voices go.

28. Focussing Focussing on your voices can have positive effects for a number of reasons. Firstly, unless you know who your voices are and what they are saying it is hard to understand them and take some control. People who hide or run from their voices end up with little peace. Focussing on voices has been shown, for some people, to reduce the frequency of and distress caused when people hear voices. This approach has worked best for people who can attribute elements of their voices to how they themselves feel. Focussing looks at your experience today and by knowing more about that, things can be made less frightening and your power over your voices can be increased.

29. FOCUSSING ON YOUR VOICES QUESTIONNAIRE How many voices are you hearing now? 0 1 2 more than 3 Crowds Are they separate or mumbling? Separate Mumbling Do you know who the voices are? Yes No Can you tell what they are saying? Yes No Are the voices the same gender as yourself or different? Same gender Different No gender

30. How loud or quiet are the voices? Compare them to someone speaking to you. Whispering Quiet Normal Loud Shouting How do they make you feel? Nothing Good Bad Happy Sad Afraid Powerful Special Overwhelmed Other.................................................................. How do you hear them? Ears Body In my head Telepathically Other............................................................. Can you communicate with the voices? Yes No

31. Sue Aged 21 I hear two voices They are separate I know who they are I know what they say One is male and one female They shout and make me feel bad and sad I hear them in my head I cannot communicate with them

32. A Conversation between myself and Sue Aged 21 Me) So there are two voices, you describe as male and female and you know their identities. Can you tell me who they are? S) Mum & Dad Me) They shout at you and this makes you feel bad & sad. Can you tell me what they say? S) At times we wish you had never been born Me) Do you hear this constantly in your head? S) Yes Me) Do you believe what they say is true? S) Yes because they said it

33. Me) Can you tell me when they said it?S) When I was 16 years old Me) Do you no why?S) YesMe) Can you explain the circumstances?S) I had stopped out until 4am with my new boyfriend and not told them where I wasMe) Do your parents love you?S) YesMe) Could they have been really worried?S) I Guess so

34. Me) Did you ever apologise to them? S) No Me) Your parents said at times we wish you had never been born, not we wish you had never been born. Would you have been angry if you had been in their situation? S) Guess so I would ground a child of mine if they stayed out that late Me) Do you think you are feeling guilty still for not apologising? S) I do feel guilty Me) Do you think the voices might be trying to help with your guilt? S) It makes sense

35. Me) Did you ever apologise to them? S) No Me) Your parents said at times we wish you had never been born, not we wish you had never been born. Would you have been angry if you had been in their situation? S) Guess so I would ground a child of mine if they stayed out that late Me) Do you think you are feeling guilty still for not apologising? S) I do feel guilty Me) Do you think the voices might be trying to help with your guilt? S) It makes sense

36. Checking if what they say is true...

37. Postponing orders/ Extending time (Bennie)

38. Creating boundaries/ Chastise them/ Don’t accept abuse We all have rights as human beings and can use these in our discussions with our voices. We should not expect to be spoken to or treated badly and the same is true of the voices that you hear.

39. Express anger safely and productively Agree to disempower Is it really a conversation? Ask them why Challenge the dominant voice Visualisation Challenge the validity of the voices draw on pat experiences when they have said similar things Ear plug therapy Nintendo Wii Tape recorder Empty box

40. My experience of mental distress

41. A Critical Voice is a "self", that criticizes the person before anyone else can. The Critical Voice is extremely anxious, almost desperate, for the person to succeed in the world and to be accepted and liked by others. The Critical Voice does not know when enough is enough. It has a tendency to grow until it is out of control and begins to undermine and to do real damage. At this point, its original intent gets lost.

42. Example: • Voice: ‘You are worthless, you would be better of dead’. • The ultimate protector in a situation when the primary self cannot cope. A reaction to life stresses, when experiences are overwhelming, in a vulnerable person. • Translated: ‘Don’t feel anymore, don’t be anymore’. • Or: ‘Don’t live this life anymore, live a new life’.

43. Case studies ANDY STAY SAT ON YOUR ARSE WHERE YOU ARE AND DIE GO OUT INTO THE WORLD TAKE A SHOT AND DIE

44. KATIE VOICES ARE GOD AND DEVIL DEVIL SAYS GOD IS ONLY KEEPING YOU ALIVE TO BE TORMENTED 4 MAIN POINTS 1 SHE IS INVOLVED IN A CULT 2 VISITED DAD ON A FRIDAY THROUGH LOYALTY BUT HE WAS ALWAYS DRUNK 3 VOICES 4 BAD SELF HARM

45. www.nationalparanoianetwork.org peterbullimore@yahoo.co.uk