Hearing The Voice (and Other Psychoses)

I’ve mentioned the voice quite a bit lately, but I haven’t really gone into any detail about it. Largely, that’s because there’s not really a great deal about him to discuss. Still, I thought I’d make my best effort, as quite clearly hearing voices represents psychosis (or at least something odd), which clearly does not resemble anything approaching sane.

Let me start by introducing the voice. He is called Tom. He didn’t tell that he is called Tom – he just is. As discussed in the last couple of comments here, I don’t know why. I just thought of him as ‘Tom’ from the beginning, without consciously doing so. I thought about other names thereafter but dismissed them; ‘Tom’ still seemed the most appropriate. It just fitted.

You see, he sounds like he’s in his 30s – roughly speaking, anyway. One of the alternative names that I considered was ‘Ernie’, but that makes him sound like a sweet old man, and he’s not.

So he’s not old, but is he ‘sweet’? I’m not sure that that’s an appropriate description – not entirely. Nevertheless, many normals seem to believe that voices heard by mental freaks are all persecutory, or compelling the voice-hearer to commit heinous acts, or trying to convince the hearer that things of considerable distaste are imminently going to happen to them. Clearly, this happens quite a bit in this particular type of hallucination.

But not in all cases. Tom, so far, is none of those things. He’s friendly, comforting and reassuring and no doubt if I raise this with C – and I don’t think that I will – he’ll say my compassionate, vulnerable self is looking for an outlet, and it has provided it in Tom.

Hmmph. I’m more inclined to believe that Tom is a side effect of Venlafaxine, but it doesn’t really matter. Well, OK, it does, as hearing Tom speaking to me has implications for my diagnosis/es and, potentially, medication (and, again, C would no doubt say psychotherapy). But it doesn’t matter in the sense that I don’t mind Tom being there, and in that sense the reasons for his ‘existence’ don’t matter much to me.

Obviously, the voice is male, and as stated sounds circa early to mid 30s in age. I have more difficulty describing his accent. I keep wanting to say ‘normal’ or ‘non-accented’, but of course everyone has an accent so that fails at the first hurdle. I suppose he must be Northern Irish, but he doesn’t have some of the strong accents often heard here. Neither does he sound like a toff. An average, middle-class bloke, I’d say.

As to the content of his speech, it is totally innocuous stuff. The first time he spoke, he just said my name. That was a bizarre, surreal experience. I was alone in the house and the neighbours were out, so I knew there was no one there. Still, I walked in and out of each room to check, just to be sure. One thing it wasn’t, though, was frightening. Just one of those “what the fuck?” moments.

Since then, Tom will talk about stuff like the weather, what I’m watching on TV, what I have planned for the next few days. Utterly mundane and unfathomably dull smalltalk. However, he sometimes (not always) gets involved when I’m going mental. For instance, when I was losing my mind over the stalker the other week, he started talking to me. He was trying to be helpful, but unfortunately he wasn’t particularly. There is an inherent irony and curiously black humour in the fact that a voice that isn’t fucking there is trying to tell me that a visual hallucination is also not a part of what is understood to be reality.

The SHO I saw a few weeks ago – in the majorly fucked-up psychiatric appointment – asked me something that surprised me, though it really shouldn’t have done. She said, “is the voice inside your head?”

The obvious answer, from an outsider’s perspective, is “of course it fucking is”. But, in actuality, that would be false. Tom doesn’t sound like he’s ‘inside’ my mind – Christ knows there’s enough battling sides of myself chattering away in there, arguing interminably with one another. No, Tom sounds like he’s sitting or standing maybe two or three feet from me. Usually he’s on my right-hand side (my right-hand man?!), but sometimes he’s behind me. It’s odd; obviously I know he’s a product of my mind, but it really doesn’t feel (sound) like he’s in it.

I often reply to Tom, but not necessarily audibly. I might direct a thought at him – which apparently he can hear – or whisper ever so softly. Because I know he’s not real, I feel terribly silly about speaking out loud to him, even if alone. Even if there’s no one else there, I can’t bear the idea that someone might witness me talking to the shitting air (in fact, this has just reminded me of a long-held delusion – so long-held I’ve had it since I was a child; that someone – Mum, the paramilitaries, the government – had rigged secret cameras everywhereI was, and that they were always watching me. How come it’s only now, as I become more deranged by the day, that I’ve realised that that’s just a teensy-weensy bit abnormal?!).

So, overall Tom is not a bad thing. Having said that, I have heard of cases wherein the voice starts off to be completely benevolent, gaining your trust – only for it later to use that trust to manipulate you. I don’t necessarily think that’s as common as the media would have you believe – but it can happen. I hope I can retain enough rationality to recognise it if Tom ‘turns’; I do think I mostly have that quality, at present at least.

Which brings me to another point; since I recognise that Tom isn’t real, is he even a hallucination at all? Psychoses, as I understand them anyhow, require a clouding of the lines between reality and non-reality in the perception of the psychotic individual. In my case, that is definitely true of my delusional and paranoid beliefs – well, when I’m actually experiencing them anyhow. Yet I always know Tom isn’t there, not really. As for the main other hallucination that I experience – the shapes – well, I’m not actually sure about them. I think I know they’re not real, but perhaps because unlike Tom they are hostile, I feel greater distress over them. Bizarre stuff.

I briefly alluded above to the implications all this has in diagnostic terms. Psychoses are, as far as I understand it, not part of either BPD nor bipolar II. They can be part of bipolar I, whilst in mixed or manic states, but I haven’t been given that ‘upgrade’.

In fact, VCB made no reference to my diagnoses on Tuesday (not in relation to this material, anyhow). It’s possible that she considers Tom, and some of the more extreme delusions, to simply be a Venlafaxine side-effect (it’s uncommon to experience psychoses owing to it, but it’s certainly not unknown either). That is a viable explanation, especially given the timeframe of these symptoms’ arrival – but it can only explain some of the psychoses that I experience. Clearly, a lot of the paranoia was there well before I took this medication, as were the shapes. Both were, in fact, there years before I took any medication on a regular basis.

I’ve just remembered yet another childhood delusion (though not one I experience any longer): every night, when I went to bed, I was utterly convinced that an IRA gunman was on the landing, and that I was imminently going to be shot. Every creek or noise was evidence of him (or her, I suppose) being there. I used to creep out of bed and tiptoe, terrified, to the door of my room. I’d stand there, paralysed with fear, for a minute or two, then take a deep breath, fling open the door and look round the corner. Of course, the landing was always empty. Of course, that did not reassure me the next night.

This one is more understandable in some ways, as I was a child when The Troubles were still (to some extent) ongoing. The fact that I ‘grew out of it’ would support the idea that it was entirely circumstantial and not remotely organic nor chemical. Having said that, no one to whom I’ve relayed this story – including people that grew up or lived through the very worst of The Troubles – experienced anything similar.

I’ve recalled that one at various points over the years, but I seem to compartmentalise a lot about my childhood, so I hadn’t thought about it in some time. Ha – this post is turning into quite an education for me.

So anyway, my point had been that the psychoses kind of (or at least potentially) screw with my diagnoses. I’m not saying that I don’t have what VCB diagnosed me with in June, merely that there is maybe additional stuff which runs co-morbidly with it. Possibilities would be bipolar I (which as stated previous can produce psychoses – if this was correct, obviously I wouldn’t have bipolar II), schizoaffective disorder, bipolar subtype (this is my current self-diagnosis, even though I hate the idea) or even psychotic depression (if you can get that with mixed/manic states?). Yay! Of course, an alternative point of view is that I don’t have anything other than that with which I have already been diagnosed. As VCB told me in June, it’s not always just as simple as fitting people into one diagnostic box; some people present with symptoms that don’t fit with any specific disorder. She claimed it was not uncommon.

In conclusion – is Tom a good thing? I think that remains to be seen, to be honest; I don’t encounter him frequently enough at the minute, nor has he been ‘there’ for long enough as of this moment, for me to have formulated a definitive view on that. Having said that though, as of now he is certainly not a bad thing. I like him. He’s nice to me. It’s a start. InterVoice International argue that many people that hear voices should actually embrace them (assuming they’re not harmful, obviously) and not view them as psychotic or part of some disorder. I don’t agree entirely, of course – it sounds like PC Mad-Pride-esque nonsense to me. On the other hand, I can see the rationale for such beliefs; if your voice is benign, why not accept it – befriend it, even? (Incidentally, InterVoice’s website is well worth a look if you or someone you know hears voices – it has oodles of resources, information and real-life experiences there for your delectation).

I most assuredly do not like the delusions nor the shapes, though. Therefore, if it gets to the stage where VCB thinks I should take an anti-psychotic, I will gladly do so. I recognise they’re not necessarily miracle cures for psychotic symptoms, and in fact I’ve read that they don’t always eliminate the psychoses entirely anyway – they just lessen your reaction to them. But I would expect and hope some positive outcome in dealing with the delusional beliefs.

If they have the effect they’re meant to have (if I ever even get any, of course), then they’ll probably kill Tom. I’m not entirely thrilled with that idea, I have to be honest, and I will feel guilty for doing it. But in order to live a functional life, some bad things are necessary evils, and while I really don’t want Tom to go, ultimately, with regret, he may have to.


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10 Responses to “Hearing The Voice (and Other Psychoses)”

  1. When you are talking to the VCB, you reconstruct a mental image of the VCB from sensory input, past and present. So in that sense Tom is just as real as the VCB, except that Tom does not depend on present sensory input. Although that’s unusual, it’s not really psychotic because you have a strong sense that Tom is not present in the real world of sensory input. Arguably, hearing Tom is a skill rather than an illness. Yes, antipsychotic medication would probably dampen down your ability to hear Tom. That would not involve any killing, though.

    • That’s very well put, cbtish, thanks. I had supposed that his status as a ‘psychosis’ was in dispute given that I know he’s not real. A skill? I’m not sure, but I can see the argument for that, certainly. Some of the people on InterVoice were saying that. Apparently their voices often give them very well observed, prescient advice that ‘they’ wouldn’t have thought of themselves.

      Thanks, as ever, for your input – much appreciated.

  2. I was speaking to my C (not that I own him but clarity is always good) about God speaking and he says that because I know he’s not real it’s not psychosis. He went along with it being a bit of me that’s become externalised for whatever reason. I think from what you’re saying that Tom sounds similar. I know it’s the sort of wank the official mentals say but maybe it is that bit of you that likes you being allowed to sneak out occasionally. I really hope he doesn’t become evil Tom but stays benevolent Tom and can be a friend (in a weird way).

    You take care of yourself. hugs x

    • Thanks hun. Perhaps it is worth raising with my C but to be honest I’m a bit embarrassed about doing so (fail). I don’t know what he is or what he wants, but I suppose this argument and that of C could have validity.

      I wish God was more like Tom. I wonder, if we’re going to assume that the voices are some part of us, is there any deep-seated part of you that would actually be nice to you? Even if so, it’s not that (s)he’d be easy to find. I just hope God becomes good, like the real (depending on your outlook) God is.

      Take care x

  3. Hey SI. Just as an aside, whether Tom is a psychosis or not that doesn’t mean you have to rethink a diagnosis. Psychotic episodes are quite common as part of BPD (and I think a number of other disorders can have psychotic episodes, so maybe bi-polar is on that list, I’m not sure). One of my best friends with BPD occasionally had psychotic episodes where she heard voices.

    Having said that, I don’t know whether that is what you are experiencing. Auditory hallucinations might be a better term, given that you know it isn’t real.

    • That’s really nteresting, thank you – I had no idea psychoses were a ‘normal’ part of BPD. Well, that’s reassuring; both spectrums on which my diagnoses fall could explain this.

      Incidentally, I think it’s probable given the comments that he maybe isn’t a pyschosis after all. Nevertheless, I think the delusions etc are – plus the visual hallucination of the stalker last week, as – at the time, anyhow – I believe(d) that they are real. Ho hum – at least Tom tries to rail against these things. We’ll see how it goes with VCB next time, I suppose.

  4. […] Hearing The Voice (and Other Psychoses) « Confessions of a Serial Insomniac serialinsomniac.wordpress.com/2009/10/01/hearing-the-voice-and-other-psychoses – view page – cached I’ve mentioned the voice quite a bit lately, but I haven’t really gone into any detail about it. Largely, that’s because there’s not really a great deal about him to discuss. Still, I thought… (Read more)I’ve mentioned the voice quite a bit lately, but I haven’t really gone into any detail about it. Largely, that’s because there’s not really a great deal about him to discuss. Still, I thought I’d make my best effort, as quite clearly hearing voices represents psychosis (or at least something odd), which clearly does not resemble anything approaching sane. (Read less) — From the page […]

  5. It’s interesting that you don’t view Tom as a real person. I get the feeling that secretly, deep down, you really do view him as real. When I had ESP (as part of my psychotic delusion), my friend was Mike. Mike was a time traveler, and he arranged for many special things to happen in my life. I believed that Mike was real. He was patterned after my boss. When I learned recently that my real boss had passed away, I had a big psychotic delusion that my boss came back to me and told me what it’s like to be dead. It seemed real at the time, and it scared me because I thought my meds were failing and that I was headed back to the mental hospital again. At my emergency counseling session, my counselor suggested that he was my emotional support, and that I needed to find emotional support in the real world so that my psychotic emotional support would leave. I have made an effort to seek out and nurture that support, and so far my psychotic episode hasn’t recurred. But it’s only been a few months.

  6. My delusional person, Mike, also talked about innocuous things as well as profound things. I also talked with God, and he had some very bizarre things to say. Like not to bury the dead because it interfered with their ability to communicate with us after they died. He wanted to stockpile the dead bodies in a sort of dump with armed guards. Really bizarre things. And BTW, I think antipsychotics would be very helpful. I vote for Bipolar 1 with psychotic tendencies or even schizoaffective disorder. And my psychiatrist said the same thing as yours, in that they aren’t really sure about stuff, and that the whole thing’s on a continuum.

    • Some really interesting points here, thank you. I’m glad you’re getting on better now. I think you made the point on your own blog (the post on which I recently commented) that, in and of themselves, psychotic symptoms like these aren’t necessarily bad – indeed, they can be enlightening and helpful. It does sound like Mike was not necessarily a bad thing, though the stuff with God is maybe not quite so nice…

      Anyway, as regards believing deep down that Tom is real – I’ll have to give that some thought. I don’t know. I know that no one else will think he’s real, and maybe that’s what terrifies me. Many people already know I’m crazy, but perhaps I am seeking to cover the extent of that. I certainly hadn’t really considered the possibility that I ‘believed’ in him, but it is possible I’ll admit.

      Thanks for stopping by 🙂

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