Sophie McBain writes:

Patsy Hage began hearing voices when she was eight years old. She was playing with her brother in the attic when her scarf caught alight on a candle. She would always remember running downstairs to her mother, her clothing on fire, convinced she was going to die. She was rushed to hospital and treated for serious burns. It was in hospital that the voices first started talking to her. She heard them for the rest of her life.

Hage was born in 1955 in Tilburg, a city in the south of the Netherlands. She initially thought of the voices as her protectors. If she got into a fight or there were arguments at home, they would tell her jokes to distract her. She heard around 20 voices and liked to talk to them while she cycled to school.

But as she got older, the voices became her tormentors. They would ban her from doing anything she enjoyed. They sabotaged her friendships and her romantic relationships. If she tried to ignore them, they would punish her by forcing her to do things she didn’t want to do, like cut herself. At 16 she ran away from home, but the voices followed her into foster care. Later, she dropped out of university, struggled to hold down jobs, became suicidal, was diagnosed with schizophrenia and spent her early adulthood in and out of hospital.

In 1987, Hage, then 31, was interviewed by the TV presenter Sonja Barend on her Monday night talk show, Sonja op Maandag. Hage told Barend she was desperate: “What I’m afraid of is that this ends with a life where I’m just stuck sitting in a chair at home, not allowed to meet anyone or do anything, and that I end up climbing the walls with loneliness and isolation.”

The other guest on the show was Hage’s psychiatrist, Marius Romme, a tall, white-haired, square-jawed professor of social psychiatry at the University of Maastricht. The two of them had asked to come on Barend’s show because they were casting around for more help. “Helping her so that the voices go away is not something psychiatry can do,” Romme told Barend.

Medication did not silence Hage’s voices, unless she took such a high dose that she felt unbearably numb and detached from her life. Hearing voices that others can’t was then, and it often still is, seen by psychiatrists as a classic symptom of serious mental illness. And yet over the three years that he had been seeing Hage, Romme had started to feel that almost everything he’d learned in medical school about voice-hearing – or what many psychiatrists would term auditory hallucinations – was wrong.

Romme was never a conventional psychiatrist. The son of a prominent postwar politician, he had an activist streak and in the early 1980s was involved in campaigns against the building of psychiatric hospitals, believing people are better cared for within their communities. Romme’s psychiatric training had taught him that indulging patients’ delusions risks reinforcing them, but Hage insisted that the voices she heard were not symptoms of a medical condition. Her problem wasn’t that she heard voices, it was that they were sabotaging her life. Unless Romme could accept the voices were real, Hage didn’t see how he could help her.

Together they read and discussed The Origins of Consciousness in the Breakdown of the Bicameral Mind, a 1976 book by the Yale psychologist Julian Jaynes that argues that in ancient times humans lacked consciousness as we know it today and instead experienced thought as a series of auditory hallucinations, commands that they ascribed to their leaders or gods. These voices, Jaynes speculated, may have been similar to those heard by people with schizophrenia. Hage found it “reassuring”, Romme later wrote, to consider that three or four thousand years ago her experiences might have been normal.

It struck Romme that the dominant psychiatric model for understanding voices, as an upsetting symptom of a misfiring brain, as meaningless as radio static, was only one of many accepted explanations for the phenomenon. In some cultures and communities, voice-hearing is considered a gift: a way of seeing into the future, reading minds, or communing with the departed or the divine. Romme began to wonder, too, whether other voice-hearers might help Hage answer the questions he couldn’t: what are these voices and what do they mean? How might she learn to live with them?

After the Sonja Barend show aired, around 450 people who claimed to hear voices contacted a special hotline, of which around 150 said that their voices did not bother them. This was a turning point for Romme, as the psychiatrist, now 87, told me recently when we spoke via Zoom. “When you are active in psychiatry you don’t see the people without complaints, and you don’t seem to think about them,” he said. Later that year, Romme held a first congress for people who hear voices. Hage was one of the speakers, and 360 people showed up, including psychiatric patients, psychics, spiritual healers and religious devotees who frequently heard the voice of God.

One thing many of them had in common, Romme discovered, was that they had started hearing voices after suffering trauma, such as bereavement, abuse or life-threatening illness. With time, Romme became convinced that far from being a symptom of debilitating illness, hearing voices could be a creative and useful response to trauma. Even the most hostile, intrusive voices might be rich in meaning, and if people could learn to understand what their voices were telling them they might regain control. The voices might present problems, but they could also offer solutions.

For Romme and his wife, the journalist Sandra Escher, the conference marked the beginning of decades of research into the relationships between the voices a person hears and their life history. The meeting was transformative for many attendees, too. For years they had felt isolated and misunderstood, and now, inspired by a newfound sense of community, they set up the Resonance Foundation, a peer-support group that began campaigning for broader social acceptance of voice-hearing and other related phenomena such as seeing visions. Over the past four decades this model has spread to more than 30 countries, forming an international coalition known as the Hearing Voices Movement. This movement is reshaping our understanding of hallucination and redefining what it means to be labelled mad. [Continue reading…]