Identifying Trauma to Understand Hearing Voices

1
Identifying Trauma to Understand Hearing Voices

• Peter Bullimore

2
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.
3
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.    
4
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
persons daily routine. It is important for
friends and family to be supportive rather than
critical at this stage.
5
When the initial anxiety and confusion has been
reduced or temporarily suspended it is possible
to concentrate on organising the voices and the
hearers relationship with them. During this
stage detailed attention is paid to such issues
as
6

• 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 hearers history.
•  
• The meaning of the voices in the persons daily
  life.
•  
• The influence of the familys attitude to the
  voices.
•  
• Accompanying symptoms of dissociation or
  emotional repression.
•  
• And/or any symptoms suggesting a delayed
  development of the self.

7

• 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.

8

• HOUSING
•  
•  BEING BELIEVED
•  
•  JOB
•  
• SELF-CONFIDENCE
•  
•  SELF-ESTEEM
•  
•   SELF-BELIEF
•  
•  
•  

9

• 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.

10

• 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.

11

•  
• 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

12
Trauma is a cognitive fog, it stops the person
thinking that the trauma has stopped, because
its 100 remembered, fogging stops a person
becoming an adult because it becomes a fear to
stop you seeing the person to tell them what they
did was wrong If you dare not look you cannot
see, if you cannot see you cannot think the
trauma is in a freeze frame it hasnt stopped for
them they are waiting for it to happen again
(Infantism) But you know ( the worker) it has
stopped
13

• Irrational logic and rational logic come from
  infancy. People are brainwashed into fear

A lot of infants deal with trauma with denial,
experiences recurring shows that trauma is not
totally over we eliminate the trauma / fear to a
level to what the person needs to continue in
life As long as we repress traumatic memories we
remain in the trauma
14
Fear
Is the master emotion
15
Frozen Terror Stops Emotional Development
16
Letters to your inner child.

• Aim To communicate with the child you were and
  to support and comfort him or her.
• Think of an incident or a time as a child when
  you were unhappy. This does not have to be during
  the time you were abused. Write a letter to
  yourself as the child you were then from the
  adult you are now. Try to make contact with him
  or her. Tell the child you are an adult who will
  listen and believe and will try to understand
  what is happening. Write your letter in simple
  language, the sort of language a child could
  understand. If you had a nickname as a child you
  may want to use it in your letter.
• Dear__________________________
• Write a reply to yourself as you are now from
  this child. Try to remember how you felt as a
  child and what you would have liked from an
  adult. You may want to write about how you were
  feeling, what was happening to you, the things
  you didnt understand.
• Dear __________________________
• 3. Continue writing letters to and from
  yourself as a child so the adult part of yourself
  is able to support and accept the child you were
  and the child feels comforted.
• As an adult you could try to explain to the
  child how she or he was not to blame for the
  abuse and did not deserve to be abused. The adult
  may be able to help the child understand his or
  her moods, feelings and behaviours. As you
  continue writing letters you may be able to get
  closer to the child who felt unloved and alone
  and offer the child love and support. You can
  help the child realize he or she is no longer
  alone. Comforting the child could take some time,
  so keep returning the this letter-writing
  exercise over the following months.

17
Examples Mayas Letters Dear Little Maya, I
am so sorry for all the bad things that happened.
None of them were your fault and you didnt
deserve to be treated like that. I am sorry that
I didnt like you before and thought you were a
nuisance. That was wrong of me and I will try to
make up for it now. When I look at your
photograph I see a beautiful tiny child with
lovely brown eyes and dimples cheeks. I just want
to pick you up and hold you, take care of you,
have fun with you. We will do all of these things
together. We will walk hand in hand and I will
show you how lovable you are and always were.
You are not alone now. I love you, Big
Maya Dear Big Maya, Thank you very much for
your letter. It means everything to me to know
you care about me. I felt ugly and unwanted
before. It is so lovely to be told I am beautiful
and that you want to be with me. I cannot believe
it yet, though, so you will have to go slowly as
I am not used to trusting people. Little Maya
18
TALKING TO A CHAIR Aim To help you express
your feelings to your abuser and to feel more
empowered. Sit on a chair and pick another
chair to represent your abuser. Place this chair
opposite you at whatever feels the most
comfortable distance. Imagine this chair is your
abuser. You are able to talk to your abuser but
he or she is not able to speak back to you. Talk
to your abuser and tell him or her whatever you
want to. Start by telling your abuser what he or
she has done to you and how it has affected your
life. Be aware of how you are feeling. You may
experience one type of emotion most strongly
anger, love, fear, hate, upset, pity, distaste
or many different emotions mixed together. Accept
whatever feeling come up and express these
feelings to your abuser. Make a note below of
any feelings that came up when you were talking
to your abuser.
19

• ROLE PLAY CONFRONTATION
• Aim To role-play a confrontation with your
  abuser as a way of feeling more empowered in
  relation to him or her and of challenging
  negative reactions to yourself.
• Chair role-play
• Get two chairs, one to represent yourself and one
  to represent your abuser as you did in the
  previous exercise . Place them at a comfortable
  distance apart.
• Sit in the chair that represents you and talk to
  your abuser. Say the things you would like to say
  if you could.
• Swop chairs and talk back to yourself as if you
  are your abuser, using your abusers reactions.
• Return to your own chair and reply to your abuser
  as yourself.
• Continue swapping chairs and confronting your
  abuser until you feel ready to stop.
• Remember you are in charge of this conversation
  and can stop it whenever you want to.

20
Landmine
Lost Cherished Pet
Bullied at School
Fear
Irrational
Lost Favourite Grandparent
21
The Trauma Triad

• 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

22
3 Main Points to Remember Before Engagement

• Truth
• Trust
• Consent

23

• Truth - What is really out there
• Trust - The Antidote
• Consent- Empowers

24
You have to be aware of your own fears and
traumas before working with another persons
experiences Focus on bits they dont want to
see ask them to explain in their own words
25
What You Need

• You need to know the persons trauma is over
• Your task is to convey this fact from you to them
• (Without parenting or re-traumatising)
• So a pre-requisite on your part is to believe it
  yourself at least to believe that this is the
  problem
• Until cognitions start again ( the fog lifts)
• It releases the cognitive traction this begins to
  reduce painful memories, the person can see they
  are 40yrs old not 4yrs old

26
Remember

• Do not Parent
• Parenting Keeps Kids Alive and Adults Insane

27
Three important questions

• How have you got here (what happened?)
• Who are you?
• Whats your biggest fear?

28
Mum
Bad sexual experiences
Moving to high school
Inability to speak about personal problems
Rape feeling that it was deserved
Not feeling safe school was to big start of
bullying
amanda
Secondary Bully
Hospital admissions
sam
Dad
Overdose Liver transplant
No real relationship, never really knew what a
dad was
Primary Bully
29

• 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.

30

• 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.
•  

31

• 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.

32
Time Place Identity of voice What it said How you felt What you did



33
Name of voice Gender What the voice normally says (content), any patterns i.e. time of day, is it linked to my feelings The influence of the voice, how it makes me feel and what I do in response to it. Origins, where it comes from, my explanation



34
Voice intensity levels
0
1
2
3
4
5
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

35
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.

36

• 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.

37

• 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.

38
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.

39
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
40
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
41
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
42
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
43
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
44
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
45
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
46

• 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.

47

• 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 Dont feel anymore, dont be
  anymore.
• Or Dont live this life anymore, live a new
  life.

48
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
49
www.nationalparanoianetwork.org
peterbullimore_at_yahoo.co.uk
www.hearing-voices.org