Voice hearers' groups inspire new ways to listen.(profile)

Traditionally, auditory hallucinations have been considered a symptom of schizophrenia or psychosis, with the solution being medication to get rid of the voices. But for the last 10 years, Dr. Margaret England, associate professor in the Faculty of Nursing at the University of Windsor in Ontario, has tested alternative ways of helping people understand and manage voices, which includes holding voice hearers' groups.

While it is common for nurses and other mental health professionals to avoid talking to clients about these voices, England says the opposite should happen. "Nurses were taught early on not to get into conversations with people about their voices;' says England. "I found when I first started doing these groups that that was exactly what nurses needed to do but were taught not to. I began to realize that people were not getting accurate information from patients about the problem of the voices;' says England, who volunteers as facilitator for two voice hearer groups, in addition to doing voice hearer research at the university.

A growing number of mental health professionals understand that medication needs to be enhanced with other kinds of treatment, such as psychosocial and cognitive interventions. Some even believe that hearing voices can occur without mental illness. Intervoice and the Hearing Voices Network are two international organizations that propose alternative ways of understanding voices.

These alternative perspectives are beginning to gain attention from the mainstream mental health system. In a March 2009 article in the Canadian Journal of Psychiatry, author Dr. Emmanuel Stip, a professor in the Department of Psychiatry at the University of Montreal in Quebec, notes that many people who hear voices can cope with them and even view them as a positive part of their lives: "Having attended some European meetings and symposia organized by the International Network for Training, Education and Research into Hearing Voices, I observed that this phenomenon can be considered either as a purely pathological or as a completely normal phenomenon?'

Often the problem is not hearing voices, but the voice hearer's reaction. Voice hearer groups are rare in Canada, but the ones facilitated by England in Windsor and groups offered in Quebec City give voice hearers a non-judgmental place to talk about their experiences, as well as a forum where participants get valuable feedback and suggestions for how to cope.

Le Pavois in Quebec City facilitates social, professional and school integration of people with severe mental illness. In 2007, the organization created a 15-week group called "Vivre avec les voix" (Living with Voices), which was inspired by the Hearing Voices Network.

"This hearing voices group has been created to answer needs that remained unsatisfied despite all the efforts of the mental health system" explains Brigitte Soucy, one of the group's founders. "We realized that the voice hearer is left alone with his or her feelings. A lack of comprehension can lead the voice hearer to deny voices, to perceive them only as a symptom of mental illness, to feel helpless and misunderstood and to avoid social ...