Hearing Voices Workshop Comes to Vermont

Sandra Steingard, MD
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I recently had the great pleasure of hosting a Hearing Voices workshop with Ron Coleman and Karen Taylor.

We had over 200 people in attendance. The participants included representatives of the majority of community mental health centers in Vermont as well as people who traveled from New York and Connecticut. We had members of peer organizations. We had family members and voice hearers.  We had psychiatrists, psychologists, counselors, case mangers, residential staff.  The interest was striking and I deeply appreciate Ron and Karen’s willingness to address a larger group than is typical for them.  Among the many striking aspects of the day was the intimacy that was created despite such a large crowd.  From the outset, it was apparent that people were actively engaged. This was reflected by the participation of the group and the questions that were asked.

The response was overwhelmingly positive.  Many people described this as one of the best trainings they had ever attended.  Ron’s message is inherently uplifting – after all this internationally known educator was once a mental patient given a poor prognosis.  But in addition, they offered pragmatic suggestions for how to think about voices and talk to someone who is experiencing them. He spoke directly to the voice hearers in our group and a number of them were brave enough to engage with him in front of this large group.

The core message is that voices have a meaning for people.  By helping a person to understand the meaning of the voices, we may help the person to heal. 

Since much of what I write here is about drug treatment for psychosis, I want to address that directly.  For me, Ron and Karen’s  message is not inherently anti-drug.  So many of the people I know do not get a full suppression of the voices even when on drugs. If there is a way to help them that seems like a good thing. If using this technique allows people an alternative to drug treatment or a way to reduce dose, that seems like a good thing as well.  I hope that among my psychiatric colleagues, it is not controversial to suggest that these drugs have some serious negative effects that we would all want to avoid or minimize.

But beyond that, I am going to refrain from summarizing what was covered.  One conference does not make me an expert and I am worried I will misrepresent this work.  Hearing Voices is inherently a program led by voices hearers and despite my deep curiosity about this, I have never had this kind of experience. I do find interesting overlaps between the Hearing Voices approach and both Narrative Therapy and Open Dialogue. I find it reassuring that people working in disparate locales have come upon overlapping ways of engaging with people in helpful ways.

Here is a brief video except:

I want to thank HowardCenter and Collaborative Solutions Corporation for the support of the workshop.

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14 COMMENTS

  1. Sandra,

    I’m glad that you, as a psychiatrist, directly addressed the oft-heard criticism of the Hearing Voices movement, that it encourages or even coerces people to drop their drugs, by your saying that the message is not inherently anti-drug. And you explained very succinctly why the HVN message is even compatible for those who are on drugs.

    I have noticed that this criticism, which is not born out by the facts, often comes from family members who claim that by participating in a Hearing Voices group, their relative will be told, in so many words, to drop the drugs. In fact, I would go so far as to suggest that these people know very well that HVN does no such thing, but they have a further agenda that is tied into pharmaceutical company propaganda.

    Best regards,
    Rossa

  2. For me, it was a drug cocktail of withdrawal symptoms from Wellbutrin, worsened by “treatment” with Ultram (rarely taken), Voltaren, Risperdal, Seroquel, and lithium that caused me to get “voices.” They lasted the entire time I was drugged, then went away after I was weaned from the drugs. I had no prior personal or family history of any mental health issues, so obviously the chemical imbalance created by the drugs caused the “voices.”

    And in my case, the “voices” I got were the “voices” of the people whose lies and gossip were the rational for drugging me (according to my medical records). They were the “voices” of the people who sexually abused my child. I never confused the ridiculous “voices” with the real people, but my neurologist did. But the bottom line is, the “voices” were relevant to the pastoral child abuse cover up I am still dealing with in real life, despite being handed over medical evidence of the child abuse.

    I also suffered from a drug withdrawal induced super sensitivity awakening to my dreams / “psychosis.” But that’s a completely different story, it’s a theory of how Jesus would call judgement day, on faith alone. I’m not certain what to make of the story from my dreams, but it’s a beautiful and hopeful lyrical libretto about a loving God who “comes in the night like a thief,” “singing a new tune.” I hope my dreams come true some day. I’d much rather be living in a world where people understand the importance of treating others as they’d like to be treated, rather than a world where psychiatrists and neurologists are defaming, torturing, and poisoning people to cover up child abuse for pastors.

    My drug induced “voices” were relevant to my real life, and hoping one’s beautiful dreams come true is not actually a serious mental illness. But the “antipsychotics” can cause psychosis in healthy people. Risperdal caused a terrifying psychosis within two weeks of my being put on it, confessed as a “Foul up” in my medical records. The anticholinergic intoxication causing major drug interaction ladened drug cocktails caused “voices.” And super sensitivity psychosis does occur when weaned off the “antipsychotics.” I wonder what percentage of psychiatric patients are actually being made psychotic with psychiatric drugs, since most in the psychiatric profession are still in denial of the fact the antipsychotics aren’t actually “wonder drugs” for the patients?

  3. Hi Sandy,

    I am very pleased and encouraged by your hard efforts to write about and further explore helpful alternative treatments like the Hearing Voices Movement and the work shop you just hosted on this apparently very helpful method for voice hearers.

    I was also very hopeful and happy when you said that you were going to a workshop about therapy for “schizophrenia” by Dr. Bertram Karon. I had heard about Dr. Karon, but wasn’t all that familiar with his work, so I explored some web sites dealing with his work and was amazed with his work, his strategies, beliefs that schizophrenia is really about terror and traumatic lives and that neuroleptic drugs thwart recovery even in the 30% who would normally recover with no treatment! Of course, you and Bob Whitaker have reported on some of the important studies by Harrow and others that have shown that the more judicious, short term use of these drugs as much as possible for emergency use makes real recovery with a meaningful, productive life much more hopeful in many cases. As I’ve said, I have not experienced psychosis or what is called schizophrenia myself or in my family, but I’ve been pretty horrified to learn about the reality about this “sacred symbol” of biopsychiatry, which seems to be a hodgepodge of lots of different symptoms and issues that seem to be caused by toxic families and other trauma per Dr. Karon. Anyway, as John Donne says, “Never ask for whom the bell tolls; it tolls for thee…” or we’re all on this trip called life together in the same boat so to speak though some hide their fears, traumas and mistakes better than others or have less of them.

    I was very impressed with the following web site and video about Dr. Karon’s work and the study he cites that shows that the type of psychotherapy he offers has had an 80% recovery rate while the use of neuroleptics long term practically guarantees one will never recover.

    http://healingwithdrcraig.com/blog/schizophrenia-is-a-chronic-terror-syndrome-not-genetic-dr-bertram-karons-acceptance-speech-for-empathic-therapist-award/

    Although I realize you have posted about the hearing voices movement here, Dr. Karon speaks about incorporating such voice hearing, hallucinations, delusions and other symptoms that can be used to create a dialog about the meaning of these frightening experiences as is the case with the hearing voices movement. Dr. Karon warns that patients don’t like having such symptoms called delusion or hallucinations, but are willing to talk about them to find their meaning especially when asked about any voices they may hear.

    I would be very interested in any information you might provide about what you learned from the workshop/meeting about Dr. Karon’s work, your opinion about it and if you think it is something that could be incorporated where you work either here or in another blog.

    As MIA has found out, one can have thousands of people just reading and not necessarily commenting all the time, so I want you to know that though I and others may not always comment since one can get redundant at times about one’s pet peeves, we still follow, admire and applaud your great efforts to learn about new therapies, self help and other alternatives than the drugs that are proving to be less effective and more toxic than everyone was led to believe for all too long.

    I appreciate your your tenacity and bravery to continue to post/write here and elsewhere and especially like it when you stand up to the old boy network at 1boringoldman!! I have also appreciated your empathy and compassion when your realize that the anger you experience here is because many writing on this site have been deceived and hurt greatly from personal harm or harm done to family members.

    • Thanks, Donna. Perhaps at some point, I might be able to compare and contrast the various approaches I have been studying. While I respect and admire Dr. Karon, my old concerns about the psychoanalytic perspective have not abated. I do think that there are people in the world – and I believe Dr. Karon is among them – who have a facility for connecting to people who are in extreme states. I think these people have much to teach someone like me. I am just not as comfortable with the theory.

      • Hi Rossa,

        Thanks for this link. I think the article you cite is excellent, very informative and inspiring about therapy and recovery from “schizophrenia.” I know you are a long term resident expert on this topic from your very difficult family experience. Did your family find this particular type of therapy helpful? I know you have had your ups and downs? How are things going for you and your family now? Does your child still take psych drugs? Engage in this type of therapy? Are you familiar with Dr. Bentall’s work I cited below?

        Don’t want to seem nosy and obviously, if you don’t feel comfortable responding, that’s okay too. I’ve already learned a lot from you. And frankly, reading about the extreme states of those like Dan Fisher and others here, I tend to identify with many of their traumatic reactions to abuse and bullying that can happen at home, school, church, dating, work and society in general, so nobody is immune even if I haven’t ever experienced psychosis specifically. Another thing that gets me is those with narcissistic personality disorder act in a pretty delusional way about their perceived superiority, grandiosity, abusiveness, entitlement, scapegoating, supposed perfection and moral high ground and other nasty patterns that cause their targets much harm everywhere they go as shown in the article on Traumatic Narcissism I cited below. There is a good web site about them called Narcissists Suck. Psychopaths are another gem of a group destroying others with impunity. Thus, it galls me that bipsychiatry has targeted so called schizophrenics as their sacred symbol with the pretense they pose the greatest danger when in reality they are the most sensitive and vulnerable and easiest to exploit and prey on via Big Pharma for the psychiatric KOL’s in power.

        Anyway, reading reviews and information about Dr. Bentall’s and Dr. Karon’s books/work online and at Amazon, one can see schizophrenics are not much different than the rest of us with their severe emotional distress they express in their unique way. Dr. Karon says in his experience the experience of schizophrenics would drive anyone crazy! Think of all the pedophiles in churches and schools that terrorized and tormented their victims with authorities covering it up! And who did society and those in power believe including even many parents brainwashed and terrorized/guilt tripped all their lives? Anyway, these are just some rambling thoughts on this issue, but I can’t say I know a lot about it.

        Thank you again for sharing this enlightening web site. It greatly added to what I’ve been learning to dispel much disinformation about “schizophrenia,” as seeming hodgepodge of various reactions to life crises and traumas.

  4. Hi Sandy,

    Thanks for your response. I can appreciate your reservations about some of the worst abuses of psychoanalysis based on some of the works of Freud and his followers that were ultimately rejected and/or criticized by those like Alice Miller, Jeffrey Moussaieff Masson and others. From what I understand Freud did not think that psychoanalysis was suitable for psychotic people and he and his followers tended to focus on more wealthy people in higher classes for the most part if I understand correctly. At the same time, child abuse did seem to play a great role in trauma/emotional distress even with Freud given his discovery that incest seemed to cause the so called hysteria epidemic he ultimately covered up under pressure from the perpetrators described in Masson’s book, Assault on Truth, as biopsychiatry often does today.

    I read the whole page and watched the video in the link I posted with my comment to you and felt that Dr. Karon seemed to be pretty straight forward about talking to his patients and finding meaning in their symptoms and suffering rather than trying to find obscure Oedipus complexes and other dubious methods promoted by Freud and his followers. Though I’m not an expert, it seems that Dr. Karon takes a more practical approach and recommends psychotherapy in this book:

    http://www.amazon.com/Psychotherapy-Schizophrenia-Treatment-Bertram-Karon/dp/1568212321/ref=sr_1_1?s=books&ie=UTF8&qid=1399504469&sr=1-1&keywords=Karon%2C+bertram+schizophrenia+therapy

    Dr. Richard Bentall also advocates for psychotherapy for psychotic people and finds the medication approach quite harmful while the relationship between therapist and patient is critical in his opinion:

    http://www.amazon.com/Doctoring-Mind-Current-Treatment-Illness/dp/0814791484/ref=pd_sim_b_1?ie=UTF8&refRID=0HDZB57KZ1N6P83DN58F

    Sandy, when you say you aren’t comfortable with the theory, do you mean psychoanalysis or psychotherapy in general since I think there is a difference. Do you?

    Did you think the Bertram Karon workshop you attended focused on more obscure tenets of psychoanalysis for schizophrenia that you found impractical especially for Community Mental Health Centers or do you think there are some aspects of Dr. Karon’s work that might be incorporated where you work? What do you think of Dr. Bentall’s work?

    I have been quite impressed with the following psychoanalytic work and how traumatic narcissism with its relational subjugation and oppression can cause much suffering for victims with loss of self or one’s own subjectivity and reality. I read some long excerpts from this book and didn’t find the information obscure or hard to understand as I have found with some works on psychoanalysis:

    http://www.amazon.com/Traumatic-Narcissism-Relational-Subjugation-Perspectives/dp/0415510252

    This is also covered in the excellent book, Stalking the Soul, by a French psychiatrist:

    http://www.amazon.com/Stalking-Soul-Marie-France-Hirigoyen/dp/188558699X/ref=sr_1_1?s=books&ie=UTF8&qid=1399506095&sr=1-1&keywords=stalking+the+soul+emotional+abuse+and+the+erosion+of+identity

    Sometimes just validating one’s reality can help one maintain or recover one’s sanity if you recall the great movie, Gaslight, with Charles Boyer and Ingrid Bergman as I’ve said another of your posts.

    Anyway, thanks for your response. I’ll look forward to that article you might write some day comparing new theories you are learning, but even brief impressions by you would also be helpful and interesting in my opinion.

    I still admire you for investigating all these different methods to try to find the best options for your patients!

  5. Thanks for the references, Donna. Since I am not an expert on the psychotherapy of psychosis, I am hesitant to comment too much. I agree that Dr. Karon talks about engaging actively with people in a down to earth straight forward manner. He describes an instance where he went to a diner with a man who was not eating. For several days, he went and he ate while the man watched. On the 4th or 5th day, the man said something like,”I am not going to pay to watch you eat” and he started eating. I also appreciate the aspects of his work of making sense and connecting psychotic sounding ideas to real life experiences. This is a part that seems similar to dialogic practice. What makes me uncomfortable is any expression of certainty about etiology since I do not think that in any given instance one can be certain. So when Karon says that all psychosis is a terror syndrome, I am not as certain. But I do not know. Perhaps he is right about this. I prefer holding a stance of curious uncertainty. But as I said, I am not an expert by any means. Dr. Karon has done this work for 50 years. I have deep respect for what he has done and his dedication to his work.

    • Thanks for your well thought out and honest response, Sandy. I appreciate your insights about Dr. Karon and therapy for “schizophrenics.”

      It may be as time goes on, you might find that as you explore the many different approaches to treating extreme states, you may find certain insights or ideas that stand out in most of them in some type of overall pattern that makes the most sense. You seem to have a great deal of respect for Open Dialog or dialogic practice with the example you cite about the man finally refusing to pay and not eat. In such cases it seems one must be familiar with an overall picture of the dialogic or other therapy while being able to tailor it to each individual as in this specific case.

      So, though all this research and education you are engaging in now may seem like a jumbled, useless mess, it seems to me that is will ultimately broaden your horizons and give you a much greater holistic, eclectic overall perspective of what is called “mental illness” or “psychosis” which will enable you to have greater and more compassionate insights into those you try to help instead of blindly relying on the old sacred cows or symbols of biopsychiatry that seem so harmful to so many people. That’s why I especially admire your hard efforts to keep learning and growing instead of taking the easy way out like so many others.

      I look forward to reading about your ongoing “education.” My grandmother used to say you had to go to school for everything and she wasn’t talking about formal education!

  6. Its great to hear the message – that a person can recover completely, even though the expensive mainstream approach denies this.
    My own experience is that psychotherapy is ideal for ‘schizophrenia’, and what worked for me was in the already in the community and didn’t cost much.

  7. Thank you for these postings. I have found the Hearing Voices Network approach empowering.

    Despite the commitment to “helping” those of us with diagnosed “psychosis,” often mainstream helpers like Dr. Karon, operate from assumptions that have not furthered my healing. While psychotherapy may not be exactly mainstream, it usually operates from an assumption that my difference is individually pathological without examining its societal context.

    My experience with what has been considered “symptoms” has challenged me far less than the experience of “receiving help from mental health professionals.” Good intentions can still cause negative consequences. The Hearing Voices Network approach has validated my experience and supported me in taking back my own power to define myself and my experience. I am very grateful to courageous leaders of this movement like Ron Coleman, Karen Taylor, and Rai Waddingham. I am also grateful for the courage and wisdom of Sandra Steingard.

  8. Sandy,

    I posted the following comment on Daniel Mackler’s critique of biological psychiatry after you expressed some dismay about Daniel’s post. Since I questioned if you would see it, I am reposting it here in the hope that you will see it and understand the cognitive dissonance that makes some of us outraged by much of psychiatry while having a deep and growing admiration for you and your hard efforts in a very difficult field in great turmoil presently:

    ”
    Donna on June 5, 2014 at 7:08 pm said:

    Hi Sandy,

    As you know, I have given you a great deal of credit for all of your hard efforts to attempt to deal with the information you learned from Bob Whitaker’s Anatomy of an Epidemic that challenged some of your own “sacred symbols” of “schizophrenia” or psychosis. I especially appreciate your posts showing your efforts to work very closely with your patients to give the minimum dose required for those dealing with active psychosis while eventually trying to taper them down or off the drugs as is possible with informed consent for maximum safety. I also appreciate your hard efforts to learn about Open Dialog, various psychotherapies utilized by those like Dr. Bertram Karon, the Hearing Voices Movement and many other nondrug approaches.

    As you may have noticed, I wrote one of my scathing posts below about the bogus expansion of a huge “bipolar disorder epidemic” that has been used by the KOL’s of biopsychiatry to prey on mainly abused, raped, traumatized women and children subjected to domestic, school, work and other violence, bullying and mobbing including psychological and emotional abuse and terror as described by expert Dr. Heinz Leymann in his Mobbing Encyclopedia you can find on the web.

    You witnessed Dr. Ragins admitting that it is routine where he works to stigmatize raped women as bipolar as is also true of the military destroying countless lives, which many women are now fighting. As I have stated before and below, psychiatrist domestic violence experts have exposed that it is all too typical for abused women and children to be stigmatized as bipolar, ADHD, delusional, paranoid and other destructive stigmas that aid and abet their abusers in custody and other battles in the courts and do huge harm to them in general.

    Thus, I can on the one hand feel total disgust and contempt for those biopsychiatrists who deliberately cause abuse, trauma victims way more harm with life destroying stigmas and toxic drugs that do them way more harm than good and don’t address the real problems of the victims thus playing into the hands of the more powerful abusers. I have been exposed to the type of psychiatrists Daniel describes and in all honesty, he is putting it kindly given the many despicable evils I have observed among them when trying to rescue loved ones. Lying and bullying/mobbing were/are second nature to them so I don’t feel too kindly toward them and their “ethics.”

    Anyway, though I got some applause for my post below describing my disgust at biopsychiatry’s bogus bipolar predation on those suffering life crises like abuse, bullying, mobbing and others, I may get booed by stating once again that I don’t have much if any exposure to those with psychosis or “schizophrenia,” and I won’t deny that when I have encountered such people acting out in a very weird way, I feel nervous and uncomfortable around them and like Dr. Nardo says, I can feel fear of them too especially since I don’t know how to deal with them in the best, safest way that won’t cause them more stress and scary behavior. I would assume that those dealing with psychosis regularly have some methods and protocols to deal with the situation in the calmest, safest way possible. Also, though I despise the stigma deliberately doled out by psychiatry, when a psychotic person is acting out publicly, it isn’t too much of a secret that they have a problem at the time. It’s the stigmatizing of those who are not psychotic and psychotic and bipolar that really gets me!

    Therefore, I can applaud your work in dealing with these very difficult, challenging cases in the best interests of these people as you describe in your work. At the same time I can be and am disgusted and furious at the KOL’s and other psychiatrists who are trying to stigmatize everyone on the planet with the nasty, life destroying bogus bipolar I to IX “spectrum” stigma for very dubious reasons indeed other than the profit, status and ongoing stream of patients enjoyed by the charlatans like Nassir Ghaemi pushing this despicable agenda to the point of being manic himself per Dr. David Healy. Johanna Moncrieff has written about the huge bipolar epidemic she abhors as well given that so many are being given related toxic drugs like neuroleptics, lithium and so called mood stabilizers for normal life problems/stressors without true informed consent.

    Since others have access to your many excellent articles whereby you shared your extensive research of the studies showing the most judicious use of drugs for psychosis and the many non-drug approaches you’ve been exploring, I won’t repeat it here other than to repeat what I’ve said that I have a great admiration for your hard efforts to do the best you can with these very challenging cases. I also have to admit that if someone is acting out in a very psychotic way that may seem threatening to others, I can see where removing that person temporarily may be necessary for theirs and others’ safety until they can be calmed down and hopefully back to reality too in a short time. Such fear by the average bystander may be why those suffering psychosis also get subjected to violence more often because people may see them as threatening to themselves. Of course, I am speculating somewhat here since psychosis is not my area of expertise, but I feel it is important for me to address here in that I am assuming that you are dealing with people in a real potentially dangerous crisis situation while the psychiatrists I have criticized below are deliberately creating crisis situations or exacerbating them for mainly abused women and children in homes and those bullied/mobbed at work and school, which also tend to be female there for the most part too. You can check out the infamous, nefarious case of Phoebe Prince for a great example of “mean girls” ganging up on a high school student and bullying/mobbing her until she committed suicide. I was disgusted to read that she had been prescribed Seroquel to cope with this nightmare while making her out to be a mental case by some real “helpful” psychiatrist that an author used to make the problem seem to be Phoebe’s so called mental illness, which was bull. This was a case of a bunch of “mean girls” jealous that Phoebe was attracting some guys, so they had to “destroy her.” Great books like Woman’s Inhumanity to Woman, Women: The Best of Friends; the Worst of Enemies and many others expose that the great “sisterhood” isn’t everything it had promised!

    So, I hope you can see why I seem to have this cognitive dissonance in some of my critiques of biopsychiatry and most of those who practice it while having great admiration for the minority like you I’ve encountered at MIA and other web sites/books who actually work hard to learn the truth and find the best solutions for their patients rather than using bogus KOL “evidence based practice” made up with Big Pharma for the nasty purpose of lining their pockets no matter the risks to so called patients for so called mental illness they don’t have in the first place, but will after imbibing the toxic drugs.

    Anyway, I am not trying to cut off dialog with those who are as dedicated as you in your work though we may not agree on everything as we always acknowledge. As I said, I admire your courage and stamina for hanging in here and taking on those like Bernard Carroll at 1boringoldman. I must say that I rarely agree with Dr. Carroll for the most part and I like to see you hold your ground on real evidence based statements when he attacks like a pit bull! He was pretty harsh against Joanna Moncrieff, so I wouldn’t take it personally there or here since he seems quite set in his ways.

    When all is said and done, if you know you are doing the best you can for those you encounter in your work, that is the most important thing since you can’t please everyone, but you do have to live with yourself!

    Finally, I think of a biopsychiatrist as the worst kind just seeing people briefly to slap on a harmful DSM stigma that will likely make the most money (bipolar) and push toxic drugs in 15 minutes and just doing ongoing brief med checks from then on. Such a psychiatrist was the subject of a big article in the New York Times that Dr. Nardo cited on his blog since this psychiatrists’ total lack of interest and connection with his so called patients was astounding since he made no secret his major goal was to make as much money as possible to the point he would not even exchange a few extra words and hardly knew his “patients.”

    Thanks again for being here and hanging in there. Most of the diatribes here are not about YOU! They are about those who are a disgrace to yours or anyone’s profession