New dialogues on voices

Psychminded, February 13, 2009

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Cognitive behavioural therapy has long been accepted as a valid therapeutic intervention for people who hear voices. So what does the future hold for more radical approaches, such as voice dialogue, asks Adam James.

Rewind to 1993. It was the year Accepting Voices by Professor Marius Romme and Sandra Escher was published.

The book argued that voices (aka aural hallucinations) experienced by people diagnosed with psychosis should be accepted as real. Don’t pathologise and seek to rid people of voices. Better, help people cope with them, they argued.Some professionals were truly alarmed. In the British Medical Journal, Raymond Cochrane, a professor of psychology, slammed the book’s message as “potentially dangerous”. It meant colluding with delusions, he argued

In April last year the scientific community was similarly perturbed. This time after clinical psychologist Rufus May was shown on a television documentary using “voice dialogue” to help a voice-hearer. Directly communicating with the voices of a woman diagnosed with bipolar disorder was one of the psychological interventions Dr May used.

Dr May was also “dangerous” and should be reported to the British Psychological Society, NHS psychiatrists wrote on the bulletin board of doctors.net.uk. One of Dr May’s colleagues at Bradford NHS Trust joined the fray, accusing May of “flagrant self promotion”. “Don't let him [Dr May] near me if I become mentally ill,” weighed in Lisa Brownell, a psychiatrist at Queen Elizabeth Psychiatric Hospital in Birmingham.

But supporters of voice dialogue – involving conversing with a person’s voices to understand that person’s life experiences and the voices’ “motives” – point to some similarities it has not only with traditional cognitive behavioural therapy (CBT) but with a new wave of CBT techniques. These include Person-Based Cognitive Therapy (PBCT), Dialectical Behaviour Therapy, Acceptance and Commitment Therapy, and Relationship Theory. The solid “evidence-base” of CBT was recognised seven years ago when the National Institute for Health and Clinical Excellence (Nice) recommended it be available for all people diagnosed with schizophrenia.

Psychiatric drugs causing weight gain

Full story: Canada.com, Canada

Now you don’t even have to be hearing voices. If you have intense moods, you might be put on an antipsychotic now.” According to prescription drug tracking ...

Harvard University psychologist Paula Caplan warns of a vicious cycle, where patients who experience weight gain after taking psychotropic drugs are reluctant to discontinue their use.
“If they gain weight, they think ‘I can avoid fast foods, or I can take smaller portion sizes or I can exercise more.’ But to think, ‘go off my medication that I believe is responsible for my being able to function, is too scary.’”

In a recent article in the magazine New Scientist, Caplan says new revelations that some antidepressants are virtually no better than a placebo for all but the most severe cases of depression “make the potential scale of the side effects more worrying than ever.”
She believes the widespread use of psychiatric medications among adults and children is making the obesity epidemic worse.

Writing in New Scientist, Caplan says obesity among teens and younger children has risen over the past 10 to 15 years with a five-fold increase in prescriptions of anti-psychotic drugs to those age groups, and that “children taking these drugs are even more likely to gain weight than adults are.”

Man gets death for ‘02 killings`

The Atlanta Journal-Constitution
Thursday, February 12, 2009

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A judge issued a rare Fulton County death sentence Wednesday for a man convicted of murdering his girlfriend’s 12-year-old son and her grandparents in a fit of rage more than six years ago.

....The defense attorneys contend Martin is schizoprhenic because he reports hearing voices and hallucinates. But Lance Cross, one of the prosecutors, said there is no “credible evidence” Martin is mentally ill.

The unmedicated Martin shows no outward signs of schizophrenia and no cellmates or guards reported him hallucinating or hearing voices, Cross said.

The boy whose gift became a curse

Daily Telegraph, 16 February 2009

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How does a child genius from a loving family fall into a spiral of mental illness, addiction and finally suicide?

... By the age of 22 he was psychotic, having hallucinations and hearing voices. It was on her 50th birthday that Clare suggested they write a book together, describing his life from their individual points of view. She thought that his unusual ability to describe his own thought processes might help others. Titus agreed to the plan, he said in his introduction, because: "I have to find a reason for why my life has been so abominably chaotic."

Titus did want to get better. In 2006, he spent eight months in rehab in Michigan, where he seemed to be almost back to his old self. Clare and Ed, Titus's father, were exhausted by worrying about their son, impoverished by paying his debts and the cost of rehab, and fearful that his voices were driving him to violence. But Clare was never angry, only sad that her son couldn't sustain the good resolutions with which he left rehab. Sick of feeling doped, he stopped the medication, and his voices returned.

On December 16, 2006, as his parents were driving across a bridge into Manhattan, he opened the back door of the car, dashed out and jumped to his death. His psychiatrist told Clare that he probably jumped in order to save her because the voices were urging him to kill.

As a tribute to Titus, Clare has finished the book they were writing together, which she has entitled A Dangerous Gift. It has been published in Iceland, where the high rate of bipolar disorder has led to rehab programmes with a 70 per cent success rate. Sufferers are shown how to look after themselves and avoid the addictions that lead one in four to commit suicide.