is growing for a network that promotes alternative ways for people
diagnosed with schizophrenia to understand and manage their voices,
reports Adam James
used to be a chronic schizophrenic. He was, by his own admission,
as mad as they come. When not compulsorily detained in hospital,
commuters might have spotted him at Manchester's Piccadilly station,
bearded and dishevelled, shouting back at abusive voices that tormented
For 12 years,
doctors tried to "cure" Coleman with cocktails of anti-psychotic
medication and 40 courses of electro-convulsive therapy. It all
failed. He had as good as resigned to his psychiatrists' view that
his voices were an "auditory hallucination" - a symptom
of schizophrenia. His voices were not real, he was told. He should
But then, in
1991, Coleman's life made a dramatic u-turn. His support worker
suggested he attend the meeting of Manchester-based group Hearing
Voices Network, a self-help organisation for people, many of them
diagnosed schizophrenic, who hear voices.
"In the meeting someone said to me: 'Ron, your voices are real.'
Now imagine what it is like to think the world was flat and to discover
it was round. I carried the words 'your voices are real' around
with me for years. I was, in a sense, blinded by truth. Like Paul
on the road to Damascus."
recovery was rapid. With help from the network, which he coordinated
from 1992 to 1995, he began to work with, rather than against, his
voices. He assessed what and who they represented and was given
the support to relate them to his childhood sexual experiences -
and to see how it was the denigrating voice of his abuser that lay
at the heart of his distress.
Now chief executive
of Keepwell, a mental health training consultancy, employing 14
people and with an expected turnover this year of £1m, Coleman's
recovery is a testimony to the impact the Hearing Voices Network
can have on people's lives.
Founded in 1989
by five mental health workers, last October the network celebrated
creation of its 100th self-help group for voice-hearers. Priding
itself on its service user-led credentials, which Coleman largely
initiated, the network has grown to be arguably the most politically
and personally empowering movement for people diagnosed with a psychotic
illness since Eugen Bleuler coined the term "schizophrenia"
has been matched by a gradual shift in the attitudes of mental health
professionals over the past decade. Network coordinator Julie Downs
says: "We have now gained a lot of respect from professionals.
In fact we had a call from a psychologist who seemed to be quite
cross when we told her there was not a self-help group in her area."
It was largely
the result of a cross-fertilisation of ideas between the network
and psychology that led to the latter putting clear ground between
themselves and medical psychiatry when the British Psychological
Society's division of clinical psychology released a report, Recent
Advances in Psychological Understanding of Psychotic Experiences.
This recognised that, in some cultures, hearing voices "is
seen as a spiritual gift rather than as a symptom of mental illness"
and suggested how voice-hearing can "even be adaptive and life
coordinating editor, Anne Cooke, says: "The network has had
a lot of influence. One of the report's messages is that there are
various explanations [for voices] and different people find different
explanations helpful. Damage has been done by professionals saying:
'I'm the expert - and this is the reason why you are having this
To be fair,
the network has not been entirely bypassed by psychiatry. Although
critical of some of its associated "extreme" politics,
Douglas Turkington, consultant psychiatrist at the Royal Victoria
Infirmary, Newcastle upon Tyne, and author of Cognitive Behavioural
Therapy for Schizophrenia, has joined his psychologist colleagues
in taking on board some new concepts of "aural hallucinations".
He says: "When the network first started, their ideas were
totally not recognised. But I, for one, have developed a whole range
who views voices as a form of "inner speech", is also
willing to lend credence to the spiritual understanding a patient
may have for their voices, especially if it benefits patient-doctor
rapport. Three years ago, and after long deliberation, he organised
a clerical minister to carry out an exorcism on a patient who requested
it after insisting she heard the voice of the devil.
did not cure the voices, but it was positive in that it helped the
patient and I to move on together," says Turkington. "It
is important to be open-minded."
Yet for psychotic
patients, their first contact on an acute ward will almost certainly
not be with a psychiatrist with a perspective such as Turkington's.
This slow pace of change in service provision is frustrating for
Coleman and others in what has been loosely dubbed "the hearing
voices movement". Many are eagerly awaiting the opening this
year by Keepwell of a three-bed residential unit in Gloucester for
self-harming patients, some of whom will hear voices.
still hears voices which he "consults" when making important
decisions, says: "This service will be what we have been aspiring
to for years. Providers always say they are looking for a 'model'
and 'evidence'. Well, we are now going to provide that. Then we
will be able to say to the mental health services: 'Now you go and
some of the network's politics has not come to fruition, many of
its idea have - particularly the notion of a diversity of explanations
for why people hear voices. This has effected the way a generation
of professionals work. And I do not think professionals would have
necessarily started that particular ball rolling themselves."
Voices Network's intellectual mentor is Dutch psychiatrist Marius
Romme, who co-authored Accepting Voices in 1993 with his journalist
wife, Sandra Escher.
that voice-hearing was not necessarily a symptom of a biologically
based mental illness and proposed that, throughout history, "prophets"
such as Joan of Arc, Gandhi, and Jesus had heard voices. He estimated
that 4% of the "normal" population hears voices.
that professionals should accept the subjective reality of their
patients' voices and allow their patients to explore them and negotiate
with them. But his bolder proposition was that the most enduring
recovery tool for voice-hearers was emancipation from victim status,
looking forward to an age when people would be "glad"
to hear voices.
a message that Ron Coleman, for one, took a step further. Echoing
the language appropriation of the gay and black movements, he declares
himself "psychotic and proud" and longs for a time when
he can "walk the streets talking to his voices and not be denied
is unlikely to be heard in the London corridors of the Institute
of Psychiatry. And what many in psychiatry have found equally distasteful
is Romme's view that if a patient believes their voices are of a
spiritual nature, then this should be accepted rather than labelled
is author of Raising
Our Voices: An Account of the Hearing Voices Movement, at £5.
The Hearing Voices Network: 0161-834 5768
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