Dorothy Rowe

When I was much younger I used to hear my mother's voice saying something that to an outsider might sound banal but for me carried a weight of meaning. When she was nowhere near me, in school or at the beach, I would suddenly hear her say, 'You kept me awake all night with your coughing.' Or I would hear one of her brief negative comments. The voice never praised me or told me that she loved me, but then she didn't do that in real life either. She believed that it was wrong to praise children because it spoiled them. There was no one I could tell about this. Indeed, I felt very much alone. Looking back now, I know that, had some disaster befallen me, this voice would have become much more negative, even to the point where the voice became strange. By great good luck there was no disaster, and I was able to escape to Sydney to go to university. As the years passed the soundtrack of these memories, my mother's voice, faded and the memories became simply narratives that I could call to mind when I wished. What does remain is a retrospective fear of what would have happened to me had there been a disaster. Commenting that, 'Dorothy was always a bit odd', my family would have consigned me to the care of the psychiatrists at Stockton Asylum.

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