Helping People to Constructively Engage with Voices

When people have problems with voices, the most common recommendation they are given is to try to avoid them — to take drugs to make them stop, to simply ignore them, to use distraction, or similar approaches. But these strategies often don’t work. Or even if they do seem to work, they may themselves cause other kinds of problems that may not be acceptable. So what else can people try? One possibility is to try the opposite of avoidance: to deliberately engage with the voices! But this sounds scary or wrong to some people. Won’t engaging with the voices make people take them too seriously or see them as more real than they are? Might that lead to people getting even more lost in the world of voices, and so more distressed? While the mind is tricky and things can always go wrong, we now know that it is possible for people to engage with voices in ways that make things better. Specifically, when the engagement is done with creativity and compassion, the result can be a positive change in the relationship with voices, leading to much greater peace of mind. But how can people learn how to facilitate this sort of constructive engagement? Fortunately, Charlie Heriot-Maitland (known for producing the Compassion for Voices video), Rufus May, and Elisabeth Svanholmer have just made available a free series of videos, in which they offer practical ideas about how to do just that. These videos cover topics such as how to:
  • Prepare to engage with voices
  • Identify and nurture the compassionate self and engage with voices from that perspective
  • Change the power balance with voices
  • Identify the function of voices
  • Work with voices that don’t seem to want to engage
  • Map out voices
  • Engage constructively with voices that sound like an abusive person from the past
  • Martial arts exercises that can help in work with voices
This is the first video in the series:
You can access the rest of the series here. I spoke to Rufus May, one of those involved in making these videos, and asked him what inspired him and his colleagues to do this. He answered that:

“We know there is a growing interest in this approach and we wanted to make some accessible resources. In the Bradford Hearing Voices group I volunteer with, I might facilitate a dialogue with a group member’s voice and then encourage them to regularly engage with their voice or voices. In this way group members have found they have been able to improve the relationship they have with their voices.

People ask me, how can you talk with someone’s voice? I sometimes joke ‘I‘ve got a special microphone!’ But the truth is we ask someone to ask their voice questions and then report the answers the voice is giving them. We have found if we use good communication skills such as empathy and non-judgemental questions the voice sometimes begins to respond in a different way.”

I asked Rufus for an example of this:

“Through a facilitated dialogue with a person’s voice that was being quite harsh and critical towards the person, we established the voice wanted the person to be more assertive with people in their social network. The person went on to consult with the voice on who to be more assertive with, and when she became more assertive the voice seemed to relax and become more constructive.

We have also found if people compromise with their voices the voices often behave in a less controlling way. So finding out if the voices like certain types of music or food or drink and listening to the music the voice likes or consuming the food the voice likes can role model to the voices a more respectful collaborative relationship.”

He then explained where these engaging approaches have come from:

“In many traditional cultures, consulting with voices is something that has been done for hundreds of years. The original Hearing Voices research carried out by Romme and Escher in the 80s in Holland found that many voice hearers who had never used mental health services negotiated and engaged with their voices.

The challenge is how to talk with voices that are hostile and controlling. This means we as communities need to support voice hearers to become more confident in being assertive with their voices and then learning how to engage in a power with style of relationship, rather than power over.

Hearing Voices groups can be good spaces to learn this ‘living with voices’ approach. We have also found tools like Nonviolent Communication and mindfulness and compassionate mind exercises helpful in supporting this process.

We have tried to make short films that demonstrate how you can engage voices and find ways to learn from them. The three of us — myself, Elisabeth and Charlie — have used both role-play and some demonstrations of mapping out and talking with Elisabeth’s voices.

We don’t want engaging with voices to become a therapy that only highly trained professionals can use. While we welcome therapists using these approaches, we also want people who hear voices, and their friends and family, to know about dialoguing and creative ways to understand and engage with voices.”

I think that last point Rufus makes is really important! It’s helpful when mental health professionals can offer certain kinds of assistance, but it can be even better when people learn how to help themselves and each other. That’s what really creates a healthy society. So I hope lots of you take an interest in this approach and do check out the video series.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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    • And dfk, Richard Schwartz and Internal Family Systems Therapy is just another way of delegitimating survivors and making the losses which they have suffered into a personal self-improvement project, instead of seeing it all as a public social justice issue and then bringing about redress and reparations.

      Schwartz turns it all back onto the survivor, because that is the one he has been able to lure into his office.

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    • Hi dfk, I agree with you that the internal family systems approach is a very similar approach to the one described in these videos.

      And PacificDawn, it sounds like you are saying no one should offer therapy, because that makes it sound like there is something wrong with the person who was hurt, while all the attention should go to social justice issues etc. I see that as wrong – like saying that no doctor should sew up wounds or set broken bones of those who have been beaten up, because the real problem is with the assailants. It seems more reasonable to both help people who have been hurt AND to attend to the social justice issues, prevention of more harm, etc.

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      • Psychotherapists don’t sew up wounds or set broken bones. They make the client believe that what they see and know should be ignored, as they must somehow just live with it. Psychotherapy works very much like religion.

        Freuds first patients, all of them female hysterics, he found to have suffered from childhood sexual molestation. Each one, I think 14 of them.

        But then when this was roundly rejected in polite circles, and these young women were the daughter’s of his friends, he changed his views. In Interpretation of Dreams he introduced the view that this was all “infantile sexual fantasy”.

        This is how it is in therapy today, they won’t call the client a liar, but they will try to convince the client that the only real problem is their own insistence on social awareness and justice.

        Really, if it wouldn’t get them incarcerated, they would still to this day be doing what they used to, telling juveniles that they are imagining on going sexual abuse.

        The idea the survivors need this healing is a myth, and a malicious one. What they need is political awareness, and this only comes when it is in conjunction with political activism.

        The middle-class family is the flip side of capitalism, and it runs by exploiting children, and then by publishing pedagogy manuals to cover this up.

        Hard to stop psychotherapy, especially when it is between consenting adults. But what we can do is stop our government from licensing it. And we can put some of these therapists out of business. This is what I say we should be doing right now.

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        • The idea that emotionally traumatized people “don’t have anything wrong with them” and that the focus should all be on social issues, social justice, is an interesting one.

          It’s the exact opposite of the psychiatric idea that the problem is all inside people, with no social justice issues at all!

          I am proposing that the truth, as with physical trauma, is somewhere in between.

          In the case of physical trauma, it would be quite weird if someone claimed to have had serious physical trauma, but then not to have had, even for a while, (before it healed) something wrong with them or with their body.

          I think it is also true of emotional trauma that an event that doesn’t create something bad or wrong within a person is not much of a trauma! That doesn’t mean the injury is necessarily permanent, and some injuries are healed without special assistance, but as with physical problems, some may stay unhealed till the right assistance is received.

          Of course, there is no guarantee that what people offer as “help” will truly be helpful – sometimes what is offered makes things worse. Figuring out what is truly likely to be helpful is an important goal.

          I really get how rotten a thing it is to tell an emotionally traumatized person that the problem is all inside them, and that there was no problem with what happened to them or with whoever caused it!

          But I also think it can be disabling to emotionally traumatized people to tell them that the problem is now all outside of them, even while they continue to be miserable. And what if their abusers are now dead, and if there is now no way to seek justice? At this point, something inside may need to change to relieve the misery, and it’s the idea that people can do internal work toward healing, and get help doing that work if they need it, that provides hope.

          That’s not to say that there isn’t also something to be accomplished by helping people get in touch with the sense in which they have always been completely OK, the sense in which the trauma didn’t affect them. In IFS, mentioned elsewhere in these comments, there is the idea that we all have an undamaged “Self” that, if we learn how to bring it forward, can help us heal or unburden the parts of us that have been messed up by trauma. So it’s complex, but I’m hoping we can talk about the complexities so we might have a chance of actually helping people who are caught up in stuff that often isn’t real simple.

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          • I’m with Sam in appreciation, this is an enlightened response, Ron.

            There is an inherent connection between what we carry inside of us (beliefs, feelings, thoughts, focus) and the reality outside of us–a back & forth interplay, which, from what I understand and have come to believe, is the basis of how we experience life and our personal reality. Complex, indeed, and totally relevant and practical when it comes to the human experience, imo.

            And, these are flexible, they are not fixed to one point in time. Life is an ever-evolving process (human beings and our environments change constantly), so there’s always room to explore, discover, learn, grow, and refine our processes, for a better life experience than what came before. More ease, clarity, assuredness, etc., along with less fear of the unknown. Why not? Makes life better in all respects, regardless of from where we have come.

            I especially like this and resonate with it–

            “there is the idea that we all have an undamaged “Self” that, if we learn how to bring it forward, can help us heal or unburden the parts of us that have been messed up by trauma.”

            Yes, I agree with this, that we are always whole human beings. Bringing different parts of ourselves into conscious being is called “awakening” and “soul retrieval,” in other healing vernacular.

            Great and very clear truth here, Ron, thank you.

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          • Pacific Dawn, I am a survivor of psychiatry and I’ve experienced psychotherapy which leaned toward complacency, but I do not believe this is universal. I do counseling work with others for the purpose of helping people to get unstuck when that is what they feel, so they can move forward with their goals and intentions.

            I always encourage speaking one’s truth, which is way more often than not a vital component in the healing process, and especially if it is a particularly challenging situtation (which it usually is, that’s actually often the main sticky issue), then I’m there as support, to help hold and witness the process of healing and personal change. That’s my life’s work, and I feel it has great value right now, given how the world is seeking change, big time.

            What you say is true in a lot of instances, but I do not believe it is across the boards. Some of us do encourage and desire real truth to come to light, even when it is a hard truth, which is always the most powerful catalyst to change. Without that, I don’t see healing happening. And we all need healing, including the planet on the whole.

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          • Alex, a therapist is never going to encourage revolutionary actions. And they are not going to use the legal system to punish perpetrators.

            Rather, they will support the Self-Reliance Ethic, which will always say that it is the survivor wanting redress who is in the wrong.

            We need to act against the mental health system, and against Psychiatry, Psychotherapy, Recovery, and the sham of Life Coaching.

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          • I agree with you about the “mental health” system being of great harm, and that is because it is government related and in bed with the law, so it is a closed and corrupt system. I appreciate recovery, and life coaching is what it is, but I don’t see it as a threat to society on the whole.

            I am curious, though, what do you feel would most benefit human kind at this time, in a loving kindness kind of way? Anything?

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          • Alex, Recovery is a way of further mind fucking people. And Life Coaching is based upon the scam that the coach knows more than you do about your own life.

            All excuses for not organizing, fighting back, and scoring victories over abusers.

            How many Psychiatrists and Psychotherapists have you put out of business? How many has your recovery group and your Life Coach put out of business?

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          • “Recovery is a way of further mind fucking people.”

            Recovery is something that occurs when people have experienced something traumatic and/or debilitating and they get better eventually. I’m not referring to any movement.

            “And Life Coaching is based upon the scam that the coach knows more than you do about your own life.”

            I think in some cases, it is based on having someone outside of you witness your changes, and that is very generous and heart-based work. No one knows more than another, but support from a kind-hearted and wise-minded person who has had their share of life changing experiences is an asset to humanity, I believe. I’m sure there are scammers, like in any field, but I don’t believe you are characterizing this vocation universally.

            “How many Psychiatrists and Psychotherapists have you put out of business?”

            I have put two mh-related agencies out of business while merely trying to have a dialogue. But instead, they both lost their funding, based on my information and feedback. Not my intention, because I knew that people relied on these services, but I also knew the services were not terribly competent, to say the least, and yes, at times, abusive, and I said so, out loud and in their direction.

            But instead of playing fair and engaging in reasonable dialogue with me, they chose to be hard headed and stubborn and stick to the program, so they went down. One of these was because I wrote a letter (that’s all it took), and the other one because I took legal action and won, and then I made a film where I mention this, and sent it around the system. Their funding stopped after my film circulated.

            In addition, I have helped people to bypass the system and psych drugs altogether.

            “How many has your recovery group and your Life Coach put out of business?”

            I don’t have nor have I ever had “a recovery group,” nor a life coach (and it’s not what I am), so this is n/a.

            I own my life and live it my way, in full health and well-being, and grounded. I am complete with all this, other than to share my experience for the sole purpose of supporting others on their path. And a I know just how rugged this particular post-psychiatric path can be, and how confusing and disorienting these awakenings are.

            Life is tough for everyone, and everyone I know has been conned one way or another. Yes, we want change, and I believe I have done a great deal to instegate it, to its full effect. I continue to do this by the way I live my life. K?

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          • Alex, Recovery is based on the idea that you have a moral defect. It comes from substance addiction treatments, and it is no good there.

            But it then got spread to incest survivorship, and then to those coming out of the mental health system and its abuses.

            No good at all.

            Life Coaching and Motivationalism don’t have the additional problem of being gov’t licensed forms of abuse, but they are still based on the idea that you need this external stimulation, rather than to just learn to look within yourself.

            Survivors and the vulnerable continue to be abused, and continue to lack social and civil standing because we have not even begun to fight back.

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          • As I’ve described, I have fought back considerably, and have had some success in doing so. Win some, lose some. We each have to fight our own battles, I like to choose them wisely.

            And I do agree that the answers are within, that’s always my practice.

            We seem to agree on a few things, but differ in perspective in many ways. Regardless, I very much respect your position and I certainly understand from where you are coming.

            I wish you continued strength, courage, and the power to create the change you desire. I have no doubt that these are within all of us, and is a matter of accessing and trusting them. That’s good hardy inner work which can only lead to positive life changes. The former is what most influences the latter.

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    • Thanks dfk,

      This is understandable and really worth reading. It’s 1000 times more worthy than a psychiatric paper.

      I like Rufus May (as well) because he has personal experience, and he also has solutions. Voices are the mainstay of “Schizophrenia” and Rufus and Others are showing people how to practically accommodate them.

      I’m amazed to see this getting into the NHS!

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  1. There is nothing legitimate about Psychotherapy, Psychoanalysis, or Psychiatry. All it does is enable the abuse of children and adults.

    But hard to outlaw the talk portions of it. But we can and should stop our government from licensing it.

    And a good place to start is with lawsuits and with shut down campaigns against some of the worst of it.

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  2. PacificDawn, wow I like your comments but sometimes disagree. Your bringing up of the feminist perspective is right on target. Yes but or maybe and so……
    Andrea Dworkun seems to fit in here as well as Andre Lorde and Kate Millet and somehow the kids of Parkland especially the young female who said so beautifully “ I call BS.”
    Although Andrea was a feminist she also acknowledge – hey I like those male writers- to her great loss. She lost out on the support of other feminists because she deigned to say yeah Joyce was a good writer.
    Same in the movements here. Sometimes folks on the so called other side have good thoughts.
    One needs to realize in Nazi Germany there were folks who tried to take down Hitler. And there was Schindler and Walkenberg and Corrie Ten Boom. And oh Kathe Kollowitz.
    Name a time, place, and group and yes even as Nero fiddled I would bet my life there were some folks who said this is f’d and tried to do what they could. Emphasis on tried and what they could do.
    Keep on posting! And keep on, on the journey. Bilbo Baghins poem-/ The Road Goes On and Tolkien WWI vet all his brigade simply totally disappeared fighting in the trenches. He got lucky getting sick and evacuation. Orcs are Trauma based.

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  3. We have a huge underclass, and for most of these people its Psychiatry, Psychotherapy, Recovery, Evangelical Religion, Street Narcotics, Psychiatric Narcotics, and Alcohol.

    But where does it really start, with Capitalism – Middle Class Family. Then the above parasitic industries have developed to support it by further abusing the survivors and making them believe that the issues are really inside of themselves.

    I say that we on this forum need to organize and start taking actions. And I don’t mean argumentation, I mean putting some Psychiatrists and Psychotherapists out of business. That will change things.

    Safer place to talk, and we can use PM’s

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  4. Research at Yale looking at the causes and treatment of auditory hallucinations or “voices” will continue with over $600,000 in combined funding from the National Institute of Mental Health (NIMH), the Donaghue Foundation and the Charles A. Dana Foundation.
    “About 70(!?) percent of patients with schizophrenia hear voices, with a population incidence of one percent overall,” said Ralph Hoffman, principal investigator on the study and recipient of the grants.

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        • 70% x 1% will be 0.007%. From my point of view, it sounds realistic. It’s like imagining visual hallucinations as a godzilla walking on the streets and claim that 70% have such hallucinations, when color perception slightly changes in reality.

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          • I meant 70% of 1%. My mistake. It comes to 0.7% of the population at large, not just the ones labelled schizophrenic. I hear other statistics, like 4% of the general population (admit to) frequently hear these voices.

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          • We should instead have a project intended to get people into political activism, and to fight to put an end to Psychiatry, Psychotherapy, and Gov’t support for the Recovery Movement.

            Auditory and visual hallucinations could prove to be serving very important purposes.

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          • PacificDawn,
            perhaps if you have no interest in discussing anything except activism, you should approach the MIA staff and see if they would start a corner for those with similar feelings, and also to keep track of national rallies and other events of that nature. I say this genuinely because you seem to have no interest in discussing anything else and label all other topics as means of controlling people.
            Wishing you well.

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          • Until we start to take definitive actions, then Survivors will always lack social and civil standing.

            And it was this compromise to our social and civil standing which got us into Psychiatry, Psychotherapy, and Recovery in the first place.

            No one is going to give us our social and civil standing back voluntarily. We have to take it back by acting on people using involuntary means.

            In a civilized society you start with lawsuits, non-violent protests, and campaigns to put violators out of operation.

            But as long was we see the way forward as in Therapy and Recovery, we are helping to sustain the abusers.

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    • As to the “causes and treatment of auditory hallucinations or ‘voices’” … The “cause” is the “treatment.”

      “The symptoms of an anticholinergic toxidrome include … hallucinations … psychosis … Substances that may cause this toxidrome include … antipsychotics, antidepressants ….”

      How many years will it take for the “mental health” workers to learn that the drugs they prescribe create the DSM disorder symptoms?

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      • Someone else,

        I do understand that for those who have taken any number of psychiatric drugs, or for that matter, all kinds of mind-altering substances, your statement would be correct.

        But there is a real phenomenon of hearing voices, like my wife experienced, and she was NEVER on any kind of drugs psychiatric or otherwise. My best guest is these ‘voices’ come from dissociated parts of the brain/mind and so they seem foreign to the person at first, but with time and work and help, those voices can be welcomed into the person’s narrative and eventually take part in the overall personality.

        At least that has been our experience.

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        • I don’t doubt that, Sam. I’ve researched into things like our government’s Monarch mind control program, et al, plus things like SRA. It’s my understanding even merely sleep deprivation, and steroid treatment, can cause “voices.” Lots of things can cause “psychosis.” None of which are the DSM disorders, however.

          But the fact that the “antipsychotic” drugs are one of those things that can cause “psychosis,” is not yet something to which the psychiatric industry has confessed. I’d like that lack of ethics, to the point of being staggeringly hypocritical, problem with our psychiatric industry to be confessed.

          I agree, from what I’ve read of your comments, your wife’s issues were likely caused by traumas, which resulted in dissociation. You might consider looking into Russ Dizdar’s research and writings, if you haven’t already, Sam. God bless, and thanks for standing with your wife, and working to help her. I respect that.

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  5. Ron,
    thank you for the link. I will definitely check out this group as my wife and I have been living with her ‘voices’ for the last 11 years, engaging them respectfully, lovingly, helping them heal first and then integrate into a community with each other. There’s so much that SO’s and family and friends can do. My wife’s angriest voice that despised me is now deeply attached to me and engaged with me. The hurt and traumatized ones have healed and are now full of life.

    People are afraid of legitimizing voices, but that’s exactly what we did and it made all the difference. Instead of the United States of Tara scenario, all the voices are fiercely loyal and thoughtful at this point to our family and relationship.


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    • I was told by my psychiatrist to ignore my, what I learned from later medical research, anticholinergic toxidrome induced “voices.” Since the anticholinergic toxidrome induced “voices” were the “voices” of the satanic child rapists who, I was eventually handed over medical evidence of the abuse of my child, abused my child. This wasn’t altogether bad advice, and so I did largely ignore – to the best of my ability – those evil “voices.”

      But withdrawal from the psych drugs also causes “psychosis.” This type of “drug withdrawal induced super sensitivity manic psychosis” did not consist of only evil “voices,” however. It largely consisted of those within the theorized “collective unconscious,” who wanted to help me heal. Thus it was definitely worthy of engagement with these kind souls/”voices.” Albeit, I had to limit their “voices,” since a person can’t live a normal life with “voices.” Thankfully, they all understood that. And agreed to go back to functioning merely as a “voice of reason,” or the “common sense,” within a day.

      So I do agree, non-drug induced “voices” are likely worthy of engagement, but I’m quite certain the evil psych drug induced “voices,” are not. But that does not mean their bragging about their crimes are “irrelevant to reality,” they are not. Since the medical proof of those crimes was eventually handed over.

      And I’m quite certain it’s time for our “mental health” industries to get out of the child rape covering up business, which they’ve been in for over a century, apparently. Especially since they’re now actually attempting to murder people with their psych drug poisonings to cover up child abuse, which is a serious crime.

      Even the decent within the religions are speaking out against this “dirty little secret of the two original educated professions.” I’d be one of the many “widows” mentioned in the Preface of this book, about my childhood religion’s child rape covering up crimes.

      I hope to end “the dirty little secret of the two original educated professions,” systemic child rape covering up system, by shedding light on it.

      And currently, no “mental health” worker may EVER help ANY child abuse survivor EVER, unless they first MISDIAGNOSE EVERY child abuse survivor, with the “invalid” DSM disorders. Because distress caused by child abuse is NOT a billable DSM disorder.

      This flaw in the DSM needs to be corrected, but the reality is the entire DSM is “invalid” and “unreliable.”

      And the reality is that our “mental health” industries have never been anything but a bunch of fraud based, primarily child abuse covering up, profiteers, which is shameful.

      And forgive me, Ron, I do know there are decent people within the system speaking out against it. Thank you. But it is the system that is the problem, and it is the system that needs to be changed, immediately, permanently, and drastically. And it needs to be done by taking the system down, as opposed to pretending the system is redeemable, merely because a few within are trying to do the right thing. The “mental health” system is fundamentally fraud based, satanic in it’s child abuse covering up nature, thus unredeemable.

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      • Someone Else, I think you bring up some important concerns, though I’d encourage you to also consider that others may have other experiences.

        So it is really important that mental health professionals acknowledge that “antipsychotics” can for some people actually cause them to hear voices etc. At the same time, the much more usual pattern is for these drugs to quiet voices at least somewhat. Of course, this quieting is itself not necessarily a good thing…..

        One way of making sense of that is to think of the voices as messengers, that let you know something is going on that needs to be dealt with. So for you, the voices functioned as messengers that you were reacting badly to the drugs, and needed to get off them. For others, the voices may be messengers about underlying distress for example about past traumas, and the drugs create indifference around that past trauma, which quiets the voices – but only as long as the drug is taken, and it keeps the person from engaging with the parts of themselves that have continued to be distressed by the trauma. So it may both de-escalate a crisis and also prevent healing.

        I don’t agree with the assertion that the mental health system needs to be completely overthrown in order to address child abuse. Rather, I would say there are parts of it that need to be overthrown, while in other parts of it, there is really a lot of knowledge and expertise about how to help people recover from abuse. I’d hate to throw all that out.

        I do think we would do well to throw out the DSM. A lot of people would say, well, then you have to throw out modern mental health care, because it is “based on” the DSM. But I think a lot of it is based on something much more simple, which is simply that a lot of people are feeling stuck in states of distress and would like some kind of help getting out of it. To many professionals, the DSM is just a way of putting the distress into a category so the insurance company will be happy – then the real work of figuring out what is going on with the person, and how to work toward change, begins.

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