Voices Are Nourished by Fear

• The Voices Make their Appearance
• Having An Illness
• Brazilian Associations
• Assault and Mana
• Guardian Spirits and Dreams
• Something Else for the Voices to Desire
• Effects of this Practice
• The Return to Spirituality
• Laura’s Conclusions in September and October 2023
• Christoffer’s Considerations
• Consent
• Acknowledgements

Laura and I would like to share some of our experiences and considerations concerning voices or energies that we have wondered how best to understand. Were we dealing with a meaningless illness or perhaps a spiritual phenomenon? And regardless of which they may be, how does one manage them? Particularly if they are extremely transgressive and frightening. Early on, Laura arrived at the realization that “fear is something that voices eat. It makes them stronger. Instead, one must practice curiosity. That leads to a positive feeling”. This is an understanding which Laura put into practice on her own and we also made such a curiosity as she recommended the leading principle for our common exploration.

Our conversations took place at Aalborg Psychiatric Hospital (Denmark) between August 2019 and February 2023. The present paper is based on our collective recollections, notes written underway and a number of sound recordings of our conversations in 2019 and 2020. Laura had asked to consult with me in order to better understand her voices and in order to share her own experience. Word had reached her of the work of documenting knowledges concerning voices that I was then engaged in. She desired to contribute to this and some of her voices had also encouraged her to do so.  

The Voices Make their Appearance

Laura began to be able to hear voices when she was 19 years old and found herself in difficult life circumstances. She had been orphaned at 16 and had been in a poor romantic relationship for a few years, while also busy attending school. She occasionally smoked cannabis during this time. Then it happened that a number of voices began to speak to her and comment on her appearance. This was also associated with a sudden experience of being observed. Suddenly a private life no longer existed for Laura.

Christoffer: Being constantly, invisibly observed and hearing voices commenting on you and having nowhere to hide would have many people end up sitting in a corner, rocking back and forth! 

Laura: I did. I wasn’t able to do anything. I couldn’t undress. I couldn’t shower. I showered fully dressed sometimes. I knew there was no turning back. I had cried so many times. There was nothing I could do. I couldn’t put a blanket over myself; they were still there. Then they would be in my head. No matter what, they were there. I recall one day I was wearing a summer dress and waiting by a traffic light, and I could feel someone looking up under my dress, but no one was there! I went home and got in front of the mirror and undressed. Then I said to myself “they are looking at you because you are a pretty girl”.

Christoffer: Was that a seminal event? 

Laura: Yes. Every time they would say “oh, you naughty girl” or something, I would say to myself, “they say that because you are a pretty girl”. I made it who I am. I also felt that actual people looked at me and then I would hear their thoughts. I also made that into “they are looking at me because I am a pretty girl. They think that because they are human, and you think that way too and that is okay”. Every time I felt they could hear my thoughts, I would think “they think that way too”.

Christoffer: Amazing.

Laura: You look positively stunned.  

Christoffer: Experiencing something that frightening and such a loss of control and privacy, and then doing what you did. It sounds paralyzing. And maybe the reason I am sitting here wide-eyed is that as far as I can tell, it seems you went through this alone and figured this out by yourself.

Laura: I did. I am immensely proud of myself. Changing how you look at yourself—that is gold.

In addition, Laura had the experience that the voices were able to take control over her body. She strove to come to terms with that as well and to see it in a positive light. It required her to accept not being in charge of her own body; otherwise the recurring losses of control would constitute a destruction of her reality every time it happened. Instead, she opted for a kind of permanent destruction of her reality so that she could rebuild herself from there.

Christoffer: A permanent destruction of your reality—was that what you did?

 Laura: Yes. Incredibly hard, but that is what I did. I then existed in a world where someone controlled me. I could do anything because nothing was impossible now. I made it a positive thing once again. I was suddenly able to draw like I never could before. And paint like I never could before. Everything just flowed. It was the sensation of being taken by creativity and the feeling that everything is just beautiful. Everything could be painted on.

I painted the underside of my table, lying on the floor, and I painted the top of the table. There was also something with mirrors. My voices would sometimes see through my eyes and show me what they saw. They can see me as being incredibly beautiful, or fat or something else. Then I see myself that way, like you would see me. Or how someone else would see another person. I said to myself “see the world with new eyes”.

Laura did other things to handle these phenomena as well. Around the time of these events, she developed a spiritual approach to life, and consequently it was also meaningful for her to view these speaking entities and influences on her body as being spiritual in nature. She oriented herself by an understanding of spirits as being the souls of the deceased that for some reason cling to the physical reality and influence the living. Her understanding of such spirits was that they were really supposed to move on in their spiritual development and let go of physical reality, but spirits that are insufficiently evolved may struggle to realize this and experience difficulty letting go.

She intuitively sensed that these voices perhaps needed to learn something from her. She developed a strategy on this basis: If the spirits perceive the physical world through Laura, then perhaps she could contribute to their development by means of what impressions she provided them with? She began to frequent beautiful places and go for walks in natural surroundings so that the voices could share in beautiful and edifying sensory experiences.

However, some of the voices were very violent towards Laura. During a period of time, whenever she went to bed to sleep, voices would approach and molest her. This was extreme and Laura discovered that she was powerless against these nocturnal attacks. She attempted to wrap herself up in blankets, sleeping fully dressed, keeping her legs pressed tightly together, but this did not prevent the assaults. When the attacker is not physical, it is no use to lock the door. They could always reach her. One night she desperately prayed to God for help, and suddenly she heard a voice that was different from the others. It said to her that God told her to do two things:

To fix her auditory attention to the sounds of the radiator and to spread her legs as far apart as possible. She did this and the assault stopped immediately for the night! She attempted this strategy several times and it was effective for several weeks, but less effective than the first time. Around this time, some of the voices became involved in protecting Laura. Some voices assaulted her, while others were concerned with expressing themselves through her and teaching her things, and finally, some wanted to protect her. She positioned these protective voices around her body, and consequently they served as a guard against attacks.

Having An Illness

These overwhelming experiences finally led to Laura being hospitalized at the psychiatric hospital. Here, she was told that her experiences were due to schizophrenia, and she was administered an antipsychotic. She continued to be able to hear voices and experience her body being taken over by them. She would allow them to temporarily control her body so that they could use it for dancing, writing or painting. Her perception of herself changed. She was divided into present and past selves and there was a prominent sad self which she did not experience as being her own conscious identity. Her core was covered by layers of voices and on top of all those layers was Laura’s consciousness. Well-meaning voices took it upon themselves to protect Laura's body and core and to take over control because Laura herself was unable to do so. To Laura this was an experience of letting go of herself due to intense emotional pain.

This new understanding of her experiences as being the result of an illness also changed Laura’s relationship with herself and the voices:

Laura: I discovered that I myself was important. The voices can be whatever they want to be. They weren’t as important anymore after I found out I have an illness. Now I was important. I could help the rest of the world rather than them being the ones to do so. I could before as well because I did believe that I had a message to deliver. That is what I believed in. I still do, really, because everyone has messages to deliver, but it is not about the voices all the time. Now it is more about me.

It was after this that she began to deal with them as “voices” rather than “spirits”.

The violent attacks ceased over time and the experiences of being controlled by the voices became less frequent and intense. The voices did not disappear, however, and Laura continued to experience a division of herself into multiple selves, surrounded by different voices, some of which were unpleasant, possessive and sexually transgressive, while others were protective and guiding, or just kept her company. She also experienced her mind differently after receiving psychiatric treatment in the form of an absence of thoughts. She used to have a creative and active inner life, but this was now significantly reduced. Likewise, she began to distance herself from the spiritual world view she had before. Some of the voices were displeased with this.

Brazilian Associations

Our collaboration began in 2019, six years after the voices first appeared. Laura told me her story as described above. The first thing that occurred to me when I heard all this was that it reminded me of Spiritism! This spiritually oriented approach that she had initially taken, her attempt to help the spirits to evolve and the sexually transgressive behavior of some of the spirits, as well as the experiences of them taking control of her body for dancing and writing reminded me of phenomena described in the anthropological literature that I was familiar with. I asked her if she was spiritually inclined. She confirmed that she certainly was earlier, but less so now that she considered it to be schizophrenia.

Asking about any prior knowledge of Spiritism, she denied any formal involvement or training in anything of that sort. I silently considered whether it might be helpful to consider conceptual possibilities and structures that might be available to us in spiritual frameworks. Such an approach has been suggested by a number of psychologists (1-4). I therefore inquired with Laura whether she would be interested in considering spiritual conceptual frameworks. Indeed, she was. I now shared with her the associations that had coming to me regarding her story:

(I) Her understanding that the spirits needed to learn through her, which she strove to provide by means of positive impressions, reminded me of Spiritist practice. Spirits of the deceased may lack sufficient spiritual insight and moral integrity to let go of the physical world. They then try to fulfil their desires by attaching to a living person and attempt to sway that person in the direction of what the spirit wants. The solution is moral teaching and spiritual insight called ‘doctrination,’ which intends to evolve the spirit so that it may move on to its destination in the afterlife. Similarly, more evolved spirits may function as guides and helpers to the living in order to promote their own evolution through moral work. Laura’s intuitive practice appeared to have something in common with the Spiritist concepts of doctrination and spiritual/moral evolution (5, 6).

(II) Laura’s experience of spirits controlling her body reminded me of possession phenomena in both Spiritism and Afro-Atlantic religions such as Santería and Candomblé. For example, Spiritists make use of automatic writing where a spirit controls the hand of a medium and thereby delivers messages (5). In Brazilian Candomblé, possession by a spirit is desirable under the right circumstances, and these African spirits enjoy dancing through the bodies of their worshippers (6, 7, 8).

(III) In the worship of spirits like Exú and Pomba Gira in Brazil, there is a tendency for strong erotic expressions and desire for bodily sensuality from these spirits. Sexual intercourse is also a metaphor for spirit possession in Candomblé (6). Might the sexually oriented attacks and desire from the spirits that Laura described be meaningful in such a light?  

I also told Laura that while Spiritism and these Afro-Atlantic religions have common features and have influenced each other, they do also tend to differ in some regards: Spiritism aims at assisting spirits to let go and move away from the physical towards transcendence, while Candomblé rather strives to help certain spirits to obtain a stronger connection to the physical world. Such understandings and practices are a prominent part of the culture in some places in Brazil, and there are even Spiritist psychiatric hospitals (8, 9).

Then something remarkable happened! Laura now informed me that a number of her voices were quite interested in what I was describing and that indeed they desired for Laura to travel to Brazil. She did not share that desire, however, nor was it what I had in mind. I suggested that these understandings might inspire some ideas as to how Laura might establish a more acceptable relationship with the voices. It is common for spirits in Brazil to be initially violent or cause trouble in people’s lives until the right relationship is established (10, 11). Perhaps it all had some meaning?

Laura had surprising news when we met one week after this conversation. An entire group of voices had informed her that they would now leave her and go to Brazil. And so, they did. They were gone now. Many other voices remained, but a whole group had disappeared! I found this to be indeed puzzling, and I was curious to know how this was possible! Some of Laura’s remaining voices were likewise interested in this question and even asked during our conversation; “how do we go to Brazil?” Laura’s own impression was that it is something voices may choose to do, but probably only voices that have reached a sufficient level of awareness – something Laura believed she had contributed to developing. During the following couple of weeks, more voices similarly said farewell to Laura and told her that they were going to Brazil. It was very mysterious.

However, one voice reacted differently to these considerations. A couple of weeks after our discussion about Brazil, Laura paid a short visit to the psychiatric emergency room. She was not hospitalized on this occasion. The reason was that she had become concerned about a voice that had attempted to control her body and wanted her to call him/her god. Considering how our perception of the voices seemed to have the capacity to affect them, just as Laura had experienced them being affected by the shift to a psychiatric perception of them, I became worried about our considerations. Might it pose a risk to Laura to consider various possibilities for what voices may be and how to interact with them?  

Might we risk shaping them in problematic ways? Laura assured me, however, that it was okay and that she wished to explore different ways of perceiving things. She wanted knowledge of as many understandings as possible in order to better make up her own mind about it. In addition, she told me that so much had happened since we started that she definitely wanted to continue.

Over the coming weeks and months, we explored the connections between voices and selves and how Laura had developed certain systems for managing the voices. These systems proved rather difficult to put into words, however, and difficult for Laura to even recall clearly. She was able to describe a system for dismantling the voices’ control of her body, and she employed this system during part of our collaboration: First she had to notice subtle shifts in the body that indicate that a movement is not her own but controlled by voices.

Then she would consciously allow the voices to perform this control and then interfere with it by making a deliberate action contradicting theirs. By doing so, she nonverbally communicated to the voices that this was something she wanted to control herself. Over time, some voices learned in this way to step back and transfer control to Laura, a control that they had initially assumed in order to help her when she was unable to do so herself. We discovered that some voices were associated with particular selves that were in turn associated with particular periods in Laura’s life.

They were cut off from the present Laura and for that reason not necessarily up to date concerning her present situation. Laura had the feeling that they were listening in on our conversations, but as someone occupying a separate room and putting their ears to the wall to listen. Some of the voices turned out to appreciate tea and coffee, which I started serving them. Laura sensed how the voices, lacking hands, would suck the beverage from the edge of the cup.  

Assault and Mana

In early 2020, Laura and I considered whether a reduction in antipsychotic medication might alleviate her experience of being detached from her thoughts. She worried about reducing the dose for fear of the voices that wanted to touch her to once again becoming violent like they were leading up to her hospitalization.

I suggested two ways of understanding voices: 1) They are external entities that come to you for some reason. 2) They have their origin inside yourself and reflect something in your life. Laura inclined towards the second option. If the voices that desired her sexually reflected something in herself, what could it be? Was there something related to love, intimacy or sexuality that Laura was not on good terms with? Laura didn’t immediately think so.

Christoffer: Perhaps some of the voices know something about this? Voices, do you know anything about this desire to touch Laura? 

Laura: A voice says “yes”.

Christoffer: Why do you have this desire to touch her? What is the meaning of it?

Laura: A voice says, “you have been raped.” But that isn’t true. I have never been raped.

Christoffer: Are any of the voices that have been involved in touching you, and who have this erotic attraction to you, present today? Are they listening in?

Laura: Yes.

Christoffer: Why do you want to touch Laura?

Voice: I want Laura.

Christoffer: Why?

Voice: I want her to become sexually aroused.

Christoffer: Why?

Voice: Because she likes it.

Laura told me what she thinks of erotic desire, trust and consent and I informed the voice that Laura did not appreciate being touched without consent. The voice said it didn’t care. Laura went on to describe how she felt when that group of voices assaulted her while she desperately and despairingly tried to cover herself up to prevent it, and how she had to conclude that she could do nothing to stave them off. She never spoke to anyone about this while she was hospitalized because it was too intimate. Her attempt to see it in a positive way was a desperate survival strategy.

Christoffer: This sounds like traumatic events to me, and as far as I can determine, it constitutes rape. Voice who touches Laura, you have to stop this. Do you understand? You cannot do this to Laura anymore.

Voice: I don’t care.

Laura: Now my sad self is sort of over here to the one side and the voice is over at the other side and the sad self is screaming at the voice and saying, “you raped me!”

Christoffer: How is the voice responding to that?

Laura: He looks sad and he is crying. He says, “that wasn’t my intention”. But then he dries his eyes and says, “but I still don’t care”.

Christoffer: Was he actually affected, but then he puts on a hard face like a tough guy?

Laura: Maybe.

Christoffer: We have to find a way to stop this. Make a deal with these voices or convince them to change their minds.

Laura: He isn’t interested in any deals.

Christoffer: Right. Nonetheless, we have to find a way. I wonder what the circumstances were that led up to all this. Back when these voices started gaining access to your body, what went on at that time? Was your personal power to resist or spiritual barrier damaged, allowing them to enter? Does that make sense—the idea that you have an inner power that protects you and that it can be damaged?

Laura: Well, I smoked cannabis at the time.

Christoffer: Yes, but there was more. Your mother died when you were a teenager, and your father wasn’t around. And difficulties even before that.

Laura: Yes. My mother died and I moved away from home before I was 18. I lived with a guy who was hard on me and made threats to leave me. The thought of being abandoned was like being left behind in a black hole.

Christoffer: I imagine you had to adapt to him and submit yourself?

Laura: Yes, I did that. I couldn’t bear the thought of being alone.

Christoffer: I wonder if your personal power and barriers were weakened by these circumstances.

Laura: I don’t quite follow you.

Christoffer: Right. I am reading a book about a collaboration between a psychiatrist and a Māori healer in New Zealand. This healer talks about ‘mana’—that personal power and spiritual authority that a person possesses. It can be weakened, and then you become receptive to negative spiritual influences. For example, influences that try to corrupt a young person’s talents and contributions to life. The healer uses certain prayers to separate these influences, but that is not sufficient. He focuses on supporting the person to build her or his mana so that you are protected and able to push away negative forces. I can’t help but think of the concept of ‘mana’ in relation to your story. If your mana was stronger, maybe these voices could not reach you.

Laura: Oh, this is really strange.

Christoffer: What is strange? These ideas?

Laura: It is as if everything just changed. As if I stepped into another dimension. There is a wall between me and the voices, and it is like they are at a distance. I can still contact them if I want to, but I am separate from them.

Christoffer: Wow! What is happening?! Is this a good state to be in?

Laura: Yes!

Christoffer: How did that happen? This is fantastic! Was it something we were talking about? Something I said?

Laura: I don’t know. Sometimes these shifts occur.

Christoffer: Such uncanny things have happened. It is as if we sometimes push a button without knowing it. Like when all those voices went to Brazil. I wonder what it is this time. Was it something to do with mana? Or prayer?

Laura: I am interested in this mana.

Christoffer: Shall we try to find a way to restore your mana?

Laura: I would really like that, but I don’t know how.

Christoffer: Let’s give it a try.

The following week, Laura told me that this different state had faded after this conversation and that there had been no reactions from the voices. She was unable to point to any particular trigger for the event, but stated that she sometimes had experiences like that, seemingly out of the blue.

Guardian Spirits and Dreams

During our collaboration, we often discussed spiritual conceptual frameworks and particularly wondered how to make sense of the violent voices in such a light. Laura understood the spiritual realm to be full of love and in light of that, the voices’ assaults were difficult to comprehend. She also had an understanding that the souls of some deceased people could cling to the living and attempt to satisfy their own desires—for example, a desire for intoxication. Such spirits really ought to let go of this world. I made reference to widespread ideas in many cultures that the spiritual realm contains both helpful as well as dangerous forces, and that the individual often enjoys the protection of a guardian spirit. Perhaps some spirits are damaging, and humans may be particularly vulnerable to them if there is a problem with your guardian spirit or if something has happened with your mana? While we were entertaining such ideas, Laura had a recollection:

Laura: Actually, I had a strange dream. A long time ago, I dreamed that I was running along a path and a giant grey wolf was chasing me. I turn around and look into its eyes and see that… I get a feeling. I just can’t remember what it was, but then the wolf throws a fit. I get the feeling it doesn’t want to hurt me, but then it does anyway. It has an outburst of rage. Then I run down a path and a big green hill in bare feet and wearing a soiled white dress. I reach a rampart made of stones. I run past it and can feel the wolf hot on my heels. It is gigantic. Twice, thrice the size of a normal wolf. Then I reach a group of farmers holding pitchforks and torches. I run through the crowd, and they shield me from the wolf. Then I think I woke up. And the funny thing is that just recently I had another dream about this wolf. The head was on a spike, and it was blue. The eyes were still yellow. It was in a castle or something. I could see the spike through its mouth and then it spoke.

Christoffer: It was separated from the body?

Laura: Yes, it was only the head. And then it spoke.

Christoffer: Could you hear what it said?

Laura: No, I don’t remember it, but it said something. It was as if it was too far away for me to hear it, but I saw its mouth moving.

Christoffer: That means something!

Laura: The first dream felt extremely real, as if I was really running. I had the first dream just when I started hearing voices.

She didn’t know what to make of the dream, but it seemed intriguing that the dream of being chased by a wolf occurred just as the voices had started to speak to her. The second dream happened shortly before this conversation. We did consider the possible meaning of it at the time, for example whether it might reflect the bad relationship she was in leading up to the arrival of the voices, or if it had something to do with fear. It is also notable, however, that Laura recalls these dreams precisely in the context of speaking of guardian spirits.

One may interpret such a dream in several ways, whether one is partial to Freudian or Jungian frameworks. Nonetheless, I find the connection to guardian spirits particularly interesting, not least because Laura dreamed of a supernatural wolf again at a later time and because Laura received a message that the wolf was her guardian spirit while in an altered state of consciousness in connection with a meditation practice in 2022. In that case, her interaction with the wolf in these dreams should perhaps be understood very differently than as a metaphorical expression of her own fears.

Something Else for the Voices to Desire

In March 2020, Laura and I had arrived at a perception of her selves as being connected to various periods of her life, and that various voices co-existed with these selves in partially compartmentalized mental spaces. The violent voices who had assaulted Laura were now contained together with one of her past selves. It was all the pain and suffering at that time that had caused the compartmentalization as a way for Laura to protect herself. Thus, the attackers had been encapsulated. Our hypothesis was that a reunion of the selves could put Laura at risk of new attacks. We therefore needed a way to manage this group of voices before a reunion and healing was possible.

We now endeavored to solve this problem. Speaking about this, some voices opined that they had no interest in any deals and that I should mind my own business. This made me think of my collaboration with Alice (12). Alice’s voices were preoccupied with violence and gore, but Alice and I discovered that their bloodthirst could be sated by having them watch gory movies. We didn’t even have to watch it with them. I asked Laura; “would you say that these voices are attracted to things sexual or erotic?” which she confirmed. I described the experiences with Alice’s voices and continued,

Christoffer: As you have said, the problem with these voices is that you cannot lock the door on them or call the police. What to do, then? May I be frank here? This idea is forming in my head, but it may be outrageous or just far out. Would it be okay if I say something that sounds crazy, and if it doesn’t make any sense, then we just drop the idea?

Laura: You just go right ahead.  

Christoffer: Well, bloodthirsty voices like gory movies, so maybe voices with sexual interests like… erotic material? Not for us to look at, but for the voices. Does that sound completely weird?

Laura: No, it makes sense.

We have a laugh at how comical this seems, and I explain my idea of procuring a magazine with pictures of undressed women and laying it out for the voices up on my desk where Laura and I can’t see it.

Laura: I sense one of the voices in particular now—a male. It is the one we have spoken to before. The one that my sad self-screamed at. When we spoke of providing him with an erotic magazine, I sensed him lowering his shoulders. As if he relaxed.

Christoffer: So, he would be interested in that?

Laura: Yes.

Christoffer: Excellent! That is very good. Maybe we’ll get along better and find a solution.

Laura: He says “I still don’t like you.”

Christoffer: Oh, that is all right. He doesn’t have to like me. I just hope we can find a way to be in the same room, so to speak. I just hope he will appreciate our attempts to accommodate him.

Laura: He can accept that.

Thus, I procured an erotic magazine. Due to Covid-19 restrictions, we were unable to put this into practice until a few weeks later. We met in my office again in late April 2020, and had the foresight to record the conversation. I laid out the magazine and opened it and then got back in my seat next to Laura and waited. The most prominent of the voices that desired Laura and who had expressed his interest, went up and had a look, but also seemed somewhat indecisive about the situation.

Laura: Now I sense him going up there and then I felt one of my selves—the sad self who is exhausted and has an almost greyish skin tone. I also sense that he wants something more physical than the magazine.

Christoffer: Okay? How? What does he mean?

Laura: He wants me. I feel a touch on my thigh.

Christoffer: I have to point out that this is something Laura disapproves of.

Laura: He is standing there looking like a big question mark saying, “I thought you liked it.” I tell him “It is a different thing to like it with your partner, but I don’t want to be with someone who oversteps my boundaries and doesn’t take no for an answer. I don’t want to be with something that isn’t real.” Perhaps it is a bit harsh to say he is not real.

Christoffer: He is something other than we are, right? Something other than you and your boyfriend.

Laura: He is like a question mark. Then he actually feels sad because he likes me. In that case, he has a strange way of showing it.

Christoffer: Indeed.

Laura: The sad self is in pain and has suffered much due to your presence. Then he is silent. Now I sense that he wants to leave, and he is welcome to do so. He appreciates all that I have taught him about all this, and then I feel a touch on my thigh again… sigh… and I don’t want anything to do with that.

Christoffer: You just said—if I might take the liberty of speaking to you also—that you appreciated the things Laura has taught you. That includes her having boundaries…

Laura: I just have to stop you there, because he is actually angry about you speaking.

Christoffer: Sorry.

Laura: He shows me that he slaps you in the face.

Christoffer: Sorry. I didn’t mean to intrude.

Laura: He is standing there like a question mark but also frustrated. He tries to touch you instead.

Christoffer: Okay. I cannot feel it.  

Laura: No. He turns back to me because you can’t feel it.

Christoffer: Does he not know what to do right now?

Laura: I don’t think so. I think he should sit down and just relax and listen in if he wants to. Now he is showing me that he is sitting down and looking through the magazine again. I think he is having difficulty being calm. It can all seem somewhat strange, right? I just asked if he wanted coffee, but he angrily replied “no!” He definitely doesn’t. And that is okay… I am asking him if we can ask him any questions. He says “yes…. No”.

Christoffer: I wonder if maybe he finds it uncomfortable that our attention is on him just now. Shall we allow him to just sit there and then we’ll occupy ourselves with something else for a while and leave him alone.

Laura: I can sense that my sad self is feeling more safe now and is moving closer.

Christoffer: I am pleased.

Laura: Just as I say that he comes over and wants to scare my sad self off.

Christoffer: Right. He is welcome to stay put where he is. Is that okay with him?

Laura: Again, he’s saying “yes… no!”

Christoffer: Right. The sad self-feeling safer and coming forward, is that a sign that at least some of the voices that want to touch have moved away somewhat?

Laura: I would say it is. He is actually rather quiet over there by the chair, but he does want to touch me and have something to do with me. He says “that is because you like it.” But that was because my medication at that time resulted in an increased sex drive, and then it was really difficult to resist, even though I didn’t want anything to do with them. When I felt possessed and my hands felt like someone else’s—what are you to do?

Christoffer: Have there been circumstances that might give the impression that you do not have the boundaries that in fact you have?

Laura: Yes.

Christoffer: And maybe he liked that?

Laura: The way I see it, I was trying to make the things they did to me into something positive for myself.

Christoffer: Like a survival strategy?

Laura: Yes. There wasn’t much else I could do. Otherwise, I would have been in the same fix today.

Christoffer: Might some of these voices have misconstrued it? Might they have come to believe that what they were doing was okay? And then be surprised to suddenly be confronted with boundaries?

Laura: Yes. But he is right in a way. I did like it, but I didn’t like the person behind it. Now he is like a question mark again.

Christoffer: There seems to be something almost wistful about him. He is longing for physical contact and becomes almost sad at being rejected. You are perfectly entitled to do so, of course. You decide what you want to do and with whom. But it seems to make him sad, really. I wonder how to make sense of this. Is this connected to something coming from you? Or are we to understand him and this group of voices as being something in themselves? Might they be able to detach from you like some voices have done?

Laura: Well, now… This has never happened before! I ask if he would be able to, and then something in the background says “there shall be silence.” They normally reply whenever I ask them.

Christoffer: Something says it shall be silent?

Laura: I think it is my own idea of how it ought to be.

Christoffer: Your wish for silence from the voices?

Laura: Yes. I think it did something that we confronted these unpleasant voices.

Christoffer: Does this mean they are less dangerous? Or are they potentially still a problem?

Laura: They are not as big a problem for me. I used to feel them just like if you put a hand on my shoulder, and it doesn’t feel that way anymore. They are not a problem for me as such, but the sad self still feels them the way I used to. She is not comfortable with that.

Christoffer: Would it be a good thing if they distanced themselves to make more room for the sad self?

Laura: Yes.

Christoffer: Is it your impression that it is meaningful to do what we did today?

 Laura: We must confront them somehow, and I think we did so successfully. Even if he had a few eruptions.

Christoffer: Maybe that is to be expected from a confrontation. Having that magazine up there, does that get some kind of dialogue going?

Laura: I definitely think so. We haven’t had much contact with them before. We certainly had today.

Effects of this Practice

We kept this practice of laying out a magazine for these voices over an extended period. They were calm and there were no further clashes with them, except one incident when the male voice got the impression that I would deprive him of the magazine and got angry. He calmed down when I assured him, I had no such intention. We eventually changed to having consultations by phone as the voices were increasingly no longer intrusive and close contact seemed unnecessary. I continued to lay out the magazine in my office during phone consultations for a while, but that too eventually seemed unnecessary, and I ceased to do so without any protest from the voices. Laura kept working on dismantling the influence of the other voices by means of her method described earlier.

The voices became so withdrawn and generally positive or neutral in relation to Laura that she became interested in reducing her medication, hoping to retrieve her formerly rich inner life. A gradual and very slow reduction was initiated in collaboration with Laura’s psychiatrist. This was uneventful until Laura experienced a degree of emotional sensitivity and instability at the lowest dose and decided to stay at 5 mg Abilify for an extended period. She was not subjected to the attacks from the sexually interested voices that she had feared. If they were still present, they certainly kept calm and did nothing.

The Return to Spirituality

Laura became increasingly involved in spiritual practice during the reduction of antipsychotic medication. Our conversations focused on considerations about the relationship between spirituality and psychosis, and the relation between the self and the universe. Laura started practicing meditation and receiving spiritual healing, which led to many spiritual intuitions. This was emotionally demanding at times, and Laura experienced it involving her letting go of herself and simultaneously accepting herself as if simultaneously losing and becoming herself.

The separation between different selves and between Laura and the voices began to dissolve little by little, and she had several experiences of being in contact with spirit guides who advised and guided her. One of the insights she gained was that the animal in her dream when the voices first appeared, and whom she dreamed of again during our collaboration, was in fact her power animal. In other words, a guardian and source of spiritual strength. Towards the end of our collaboration, Laura was stable on a minimal antipsychotic dose and busy trying to find a job that would be meaningful for her. Our collaboration ended in early 2023.

Laura’s Conclusions in September and October 2023

Laura remains on a daily dose of 5 mg. Abilify and has been discharged from out-patient treatment at Aalborg Psychiatric Hospital. The transgressive voices are no longer a problem. She may at times re-experience the feeling of who she was before and have a sense of fear of the voices attacking her again, but this is rare, and those specific voices remain absent.

Concerning the presence of voices in general, she states that:

I do still hear voices, but I more often sense them through feelings than hearing them as such. Their presence isn’t a bad thing. They try to help me. I am also able to sense the feeling of human persons, and I can tell the difference between the sensation of my husband’s self and people I don’t know. I consider the unknown ones to be outside the human. I don’t particularly discriminate between whether it is something I am creating or something outside myself. It may be a problem if these impressions distract me, but they listen if I ask them to cease in a given situation.

I may notice behavior that is not my usual. Like following a different trail than your own. It is not outside my control, however, like the experience of being possessed that I had before.

I perceive the selves as experiences of different states of feeling. I do not control them and doubt if I am even supposed to control it. I am in a process of learning how much I am supposed to control, and how even to conceptualize ‘control’. The different selves have not merged or disappeared. It feels like jumping into a different frequency. When I focus on the physical reality, I experience being whole. When I move up into more spiritual frequencies, I am split into different selves.  

Speaking more generally, Laura says that: 

Humans need a frame, whatever it may be. That frame cannot just be everything, though. Voices are what you make of them. If I perceive and sense the voices as spiritual energies, then so they are. If I perceive them as being myself, then they are. I am still working on understanding that everything I feel is truth. Feelings have some meaning or other. If I sense that a foreign entity is coming into my body, then I choose how to understand that. I can take on the understanding that “okay, I just need to be aware of something about myself now” or “oh no, now I am becoming possessed!” I need to tell myself “okay, now I’ll just take one step away from myself,” because if you feel possessed, then you are. You must distance yourself from that feeling and figure out how to relate to it. You must make a choice about which way to go. That is free will.

The voices have been my biggest fear. They have been my best friends and guardians. They have contributed to changing who I am and helped me to grow as a person. They have been my reality and still are. No one in the world will ever be able to see anything but their own reality. Many people are skeptical about this illness and the reality it creates. When we realize that no one perceives alike, we begin to accept that anything ca be reality for another person.  

I asked Laura what role she believed our collaboration had had for her development:

Christoffer has been open to new ways of looking at this illness, which has meant that we have not been confined in our way of looking at it. Our collaboration has contributed to expanding the perspective on this illness. It has opened my eyes to how important it is to put your challenges into words, and that medication on its own would never have brought me to this place. I hope and pray that my story may change something for those people who read it.

It has given me a more positive perspective and meaning. This illness is affected by our states of mind, so what is the impact of different conceptual frameworks on this state of mind? I was immediately concerned with understanding it spiritually when I first began to see and hear things, even if I didn’t think that way before. We need meaning. If we cannot find meaning in what happens, we become crazy. The private opinions of professionals set up limitations for the meaning that is available to a patient and that is a problem. There is a need to expand that person’s perspective. Look at the situation and expand the perspective—search for meaning and possible understandings of the experience. When you realize how something can be conceptualized in different ways, it allows the patient to make a choice about how to understand it. In contrast to the professional deciding it and making the person doubt him or herself. Be curious instead of being scared. Same situation—different outcome. This should not be the professional’s decision, and they should not tell patients that they are wrong.  

Christoffer’s Considerations

During our conversations, Laura and I considered the connection between spirituality and schizophrenia. Are Laura’s experiences the result of a pathological process in her brain? Or could her experiences be spiritual phenomena? Laura moved towards ceasing to make any sharp distinction between various kinds of phenomena, and instead to focus on the consequences of different conceptual frameworks. For instance, the significance of being able to see things from different perspectives and making choices about how to understand reality. One idea that came out of this was that the concept of psychiatric illness had the effect of closing down meaning making and making the world smaller. Conversely, a spiritual understanding had the effect of producing meaning and expanding and furthering the reach of her experiences within her mind.

Whether either is good or bad may not be simple. Laura pointed out to me that at certain times in her life, she needed a contraction of consciousness and to make the world smaller for herself, in order for it to be manageable. For that purpose, the concept of illness was helpful. At the same time, this is a rather constrictive framework in other regards that doesn’t contain much room for change and for understanding connections in one’s life. For this purpose, a spiritual framework proved much more productive. Perhaps the most important thing is not to determine whether a voice you are hearing is the result of a pathological process or if it is a spirit.

The most important thing may be to consider the options and limitations and associated actions and ways of relating that different frameworks offer? And perhaps it is important to avoid ruling out or cutting a person hearing voices off from specific frameworks at the outset. At this time, a pathology framework is certainly at an advantage, enjoying vast professional and institutional support, whereas spiritual frameworks are far more marginal in our society (5, 13, 14, 15).

It may also be worth considering if Laura’s experiences might be meaningfully understood in relation to the concept of rites of passage in religious studies (16, 17). This is a widespread type of ritual that often have a central place in traditional societies. The structure of such rituals may also be found in many myths and has three phases: 1) Separation from the familiar and the person’s identity up until this point, often conceptualized as a form of ritual or symbolic death. 2) The liminal phase in which normal categories and structures of life are dissolved, and new knowledge and insight are gained, often understood to be a movement through another world, such as the land of the dead or the realm of spirits with meetings with ancestors, spirits or gods. 3) A return and re-integration into society with a new status or identity, such as now being an adult rather than the child that one was.

In some cultures, such rituals are associated with altered states of consciousness and the receipt of visions or powerful dreams. Might some of Laura’s experience make sense in such a light? For example, we might consider whether the profound loss of privacy and control of the body that Laura experienced initially could be perceived as a form of psychological death or dismantling of her previous sense of self and reality. She also gains a vision (dream) of an animal that she later comes to recognize as her guardian spirit. She moves through a prolonged process in which the formerly given is no longer so, and in which she arrives at new perspectives on life and a renegotiation of her sense of self and even what constitutes ‘the self’. She confronts and manages violent and threatening forces and enters into contact with spirit guides and a spiritual practice in the form of spiritual healing. Perhaps the process leads to a way of life that is more spiritually oriented and in which she no longer feels exposed and alone in the world.

In writing this paper, certain apparent connections have caught my attention. There seems to be a connection between the introduction of a spiritual/ritual/mythical framework and some remarkable shifts in Laura’s immediate state of mind. When I tell her how people relate to spirits in Afro-Brazilian contexts, there is a marked interest from the voices, leading to a mass of them subsequently taking their leave and moving to Brazil. When I introduce the M?ori concept of ‘mana’, there is a sudden, temporary integration of Laura’s selves and a separation between her and the voices.

When I tell her about guardian spirits in various cultures, she suddenly remembers a powerful dream that is very much in line with the subject and later connected to Laura becoming acquainted with her own guardian spirit. I am fascinated by these events, and like Laura’s original (Spiritism reminiscent) ways of managing her experiences, they give me the impression that conceptual frameworks such as these may be very meaningful and helpful in relation to experiences of this kind (3, 4, 18). They may be narrative resources or understandings of subjectivity that can contribute to uncovering meaning in experiences that transgress the usual norms and criteria of reality of our society.

Consent

The name Laura is a pseudonym. The person behind the pseudonym has asked me to publicize her story and has given me permission to write this paper and expressed her desire for her story to become available for others to inspire them to find similar ways of relating to voices. Laura has contributed directly to this paper in the form of written correspondence, commentary, corrections, and quotes. Prior to submission for publication, Laura has read the paper and accepted it and given her written consent for it to be submitted for publication in a journal.

Acknowledgements

Thank you, David Epston, for editing assistance.

Thank you to those of Laura’s voices who encouraged this collaboration.

Editor Note: This article is re-printed here with the explicit permission of the authors, and the Journal of Contemporary Narrative Therapy, a free online publication.  

References and resources for this article can be downloaded here.

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