Debra Lampshire Presents The M O D E

Debra Lampshire Presents The M. O. D. E. R. N. Voice-Hearer

History • • • Hearing Voices since childhood Developed unusual beliefs Long periods in institutions Stayed inside house for 18 years Got voices under control began working with Mental Health

Personal Perspective • I am engaged in a relationship with my voices • I am in an abusive relationship with some of them • They can only express themselves in unhelpful ways it is my job to interpret their content into helpful ways.

• I am their therapist at times • They can do nothing without my consent • Addressing them as quickly as possible makes it easier to deal with them • They can misguide me at times but respond well to kindness and respect

• They are part of who I am. I would never choose to be free of them completely • I only work on my negative voices positive voices require no attention at all • They need my assistance to express themselves appropiately • The only they have is what I give them!

What you might not know about voices • They hate to be ignored • They can be witty and amusing • They get away with saying things you would never say • They can make you feel special • They have access to special information

• M • O • D • E • R • N Manifestation of Distress Explore Relevance Nomalise

M. O. D. • Voice hearing experience is viewed as a manifestation of distress alerting the person to the fact that they concerned, worried or troubled by something which may not be obvious initially.

Advantages of this view • Allows both client and clinicians to place within the realms of manageability. Voice hearing experience is not pathologies but seen as a coping strategy and legitimate response to stress

E = EXPLORE • Participants are invited to explore the experience and also the content of the voices. • We write down the very first thing the voice says • We introduce the 5 part model as a way of gaining an objective component into the process of understanding the voices • Clients determine which approach suits their personal thinking style

example You need to kill yourself ! GO! Jump of the bridge !

R = RELEVANCE • Using the 5 part model we would examine what had been happening prior to hearing the voices • Going back to any circumstance which may have precipitated the voice. • Look for any links that may indicate that this is related to making us aware of stressors.

• Focus is on the content of the voices not on the voice itself. • Provides opportunity to be aware of the factors which contribute to stress • Places the voice hearing experience on the response to stress spectrum • Gives an alternative explanation to their intrusion that they are motivated by stress rather than random encounters

Example Stop it ! Fix it!

• Christmas time - extra money needed for children • Only bread winner in large family • Working double shifts • Not sleeping well • Flu going around at work lots of people off sick • Boss told him how much he depends on him and knew he wouldn’t let him down • Dog had been hurt and was with vet • Dog may never be fit for work again

N = NORMALISE • Provides a context in which to evaluate situations more broadly. • If you are a voice hearer this is how stress manifests itself – situation seems quite reasonable. • This is not a catastrophe it is a opportunity to learn.

Example • Fix it – Your running yourself ragged you need to take care of yourself. If you keep this up your get sick! • Stop it – You cannot maintain this level of functioning. People are taking advantage of you. If you wont take care of yourself then I will!

What you might not know about voices. • They hate to be ignored They can be witty and amusing • They get away with saying things you never would • They can make you feel special • They have access to special information

Tactics of Voices • They like to isolate. Significant relationships are the biggest threat to their existence • They are jealous and interfere with relationships so they can have you all to themselves • The are extreme and always go to the worst possible scenario first

• They need fear to thrive so will induce as much anxiety as they can into a situation. • They don’t always tell the truth • They know your deepest secrets so can needle you in the mostefficient ways.

Common Traits of Voice hearers • Find it hard to tolerate silence • Tend to think symbolically and metaphorically • Prefer their minds to be occupied • Sensitivity to low frequency humming noise • Highly Anxious

• Tend to be language people who like to communicate • Have a tendency to jump to conclusions rapidly and find it difficult to change their minds once they have formed an opinion • Usually quite intelligent • Experience fear intrusively • Have a sense of over-responsibility and a need to make things right.

History of Groups • Groups have been running for 7 years in DHB • Open to all DHB clients regardless of diagnosis or service • Groups are modified to met the needs of the range of participants e. g. Culture, age, gender, time in service • Training provided to staff

Approach of Groups • Have an experience-based expert leading the group • CBT/DBT – basic skill set • Elements of Motivation Interviewing • Normalising/Validating

Results • Participants reported overall a 50% reduction in frequency and distress of voice hearing over the six week period. These voice hearers had on average 20 years of voice hearing experience. • Current participants are reporting between a 30%– 70% reduction in frequency and distress. • Benefits to participations are effective up to 3 months of completion of group without follow-up

Where to get more information Debra Lampshire P. O. Box 163 -172 Lynfield Auckland New Zealand E-mail address: Debra. L@xtra. co. nz NZ mobile Phone: +64 27 268 6676