All of which goes a long way to explain why I am so enthusiastic about the Hearing Voices Network.
The greater number and seriousness of the traumas a person has suffered, the more difficult is it to unravel the complex meanings encapsulated in a voice. Network members have discovered different ways of doing this, and these methods fit very well with the methods used by personal construct psychologists like myself and my colleagues. In a recent email a colleague told me about one of his clients. Here he has summarised work that was carried out over 18 months, but he does give some idea of how the meaning of a voice might be revealed through conversation. He wrote,
I had some nice news today, I was contacted by a guy I used to work with in a psychiatric hospital. In a nutshell, he'd been there for a number of years, was labelled a 'dangerous paranoid schizophrenic' because he'd attacked other people on the unit over the years. However, I got to know him...it turned out that when he was in his teens his younger sibling was abused by someone he knew. He was scared of this person so didn't 'sort him out' the way he felt his father would have done. Following this incident he tried to bury his guilty feelings and low self-worth with drink and drugs. He then started hearing a voice calling him a very unpleasant name, which is when he'd attack other people on the ward. We explored this over 18 months, and he has now been able to re-examine what happened to his sibling, no longer blames himself for what happened, and has given up the idea that he has to be 'a hard man'. He has now been discharged and has turned into a 'gentle giant' by all accounts. Where has his 'paranoid schizophrenia' gone?
I wonder whether the psychiatrist who gave this man the diagnosis of paranoid schizophrenic had now given him a retrospective diagnosis. This is what would happen when a patient diagnosed with severe depression would spend many months talking with me and finally come to the conclusion that she was not to blame for all the disasters that had befallen her. No longer depressed, she had much more interesting things to do than come to the hospital to talk to me. When I would report this to the psychiatrist, as I had to do, he would do a retrospective diagnosis and decide that the patient had merely been anxious and not severely depressed.
August 7, 2011