Conversation with ourselves- an interview with Ron Coleman NZ Herald.

The following is an excellent interview conducted by Chris Barton in today Saturday 4th Junes Weekend Herald in New Zealand. Chris interviewed Ron Coleman here in Auckland and attended one of the workshops the Hearing Voices Network held there.

You can see the article on the New Zealand Heralds website here.

Here is the article below:

“You have voices telling you to kill yourself. Do you ask them why?”
No, they don’t listen.

“If I told you to go and stand in the middle of the road, you wouldn’t do it.”
No, if you told me to I wouldn’t.

“If I asked you to do it you would want a reason, but you don’t want a reason from the voices.”
Yes I do.

“Then ask them.”

This is not one’s idea of a normal conversation, but for the participants it makes perfect, potentially life-altering sense. Ron Coleman has just begun a workshop at Western Springs Community Hall on a radical self-help technique called voice dialogue.

In a five-minute conversation with a young woman he draws out, to her considerable surprise, an outline of her situation. She hears two negative middle-aged voices – one male, the other female. The male voice is worse.

She is also dealing with drug addiction, but that’s not the cause of her voices. They began when she was 10.

She has never asked what the male voice is called.

The woman is clearly astounded by Coleman’s revelation that she can ask her voices for information. “Nobody’s suggested that to you before,” he tells her, “because we are caught in the world of voices rather than having dialogue about it.”

Coleman, diagnosed with schizophrenia in 1982, should know. He spent 10 years in and out of British psychiatric hospitals, including six as a mostly compulsorily “sectioned” in-patient. During that time he was heavily medicated with a range of antipsychotic drugs and given 40 sessions of ECT.

Today he lives happily with his wife, family and seven voices. The workshop at the Western Springs Community Hall is part of a global grassroots organisation known as the Hearing Voices Network.

“What we try to do,” he tells the Herald, “is help people live with their voices.”

Born in Dundee, Scotland, Coleman turned his life around in 1991 when the Hearing Voices Network was just getting under way in Britain. He’s since gone on to become a key figure in the network and travels the world spreading its message and governing principle: “It doesn’t matter whether we conclude our voices are coming from ourselves or whether they are the voice of God or the voice of demons. We accept the diversity of everybody’s experience,” he tells another voice hearer.

“Do you hear a lot of voices?”
I hear angels.

“Are they all positive?”
Yes but sometimes my voices worry me because I worry about whether I’m saying it or whether the angels are saying it.

“So what is the purpose of angels?”
To guide me.

“So how do you test what they are saying is from the angels themselves?”
I say, ‘Is that the angels there?’

“And they say yes?”
Yes. But sometimes I don’t hear at all. I get scared because of some of the things I hear. I get scared because I don’t know if the devil can lie to me.

Coleman points out that that the devil was an angel – “an archangel and he was tossed out of heaven”. A good test as to whether an angel was talking, he suggests, would be if it asked her to do something to harm herself or anybody else. If it did, he says, that would be inconsistent with angels.

“See, I’m not going to change your mind whether there are angels or not. The only thing I’m interested in is whether it’s good for you. That it works for you.”

The network believes that auditory hallucinations or “voice hearing” shouldn’t be seen as something pathological that needs to be stopped, but rather as something meaningful and tied to the hearer’s life story. This tends to be at loggerheads with conventional psychiatry. Support groups around the world run by voice hearers for voice hearers openly challenge the standard psychiatric relationship of expert physician and psychotic patient, but increasingly some psychiatrists and other mental health professionals are seeing merit and logic in the Network’s approach.

Coleman says his recovery began when, at his first Hearing Voices group, someone told him his voices were real. “What I’d been told in the psychiatric system was that they weren’t real, they weren’t really there. That I had to ignore them and I couldn’t get involved with them. When they’re real it means you can do something about them.”

Hearing voices is like reading a really good book when you can hear the author’s characters. “As you read you can create the characters in your head. Imagine that externalised. That’s how it is with voices. You actually hear them.

“They have different characteristics. They speak with different accents. They are male or female. They are positive and negative.”

Hearing voices isn’t as unusual as we think. Many will have experienced it in the threshold consciousness between waking and falling asleep. There are also numerous examples of well-known and accomplished voice hearers throughout history.

“The Bible is written by voice hearers,” says Coleman. Think Moses and the burning bush and Jesus wandering for 40 days and 40 nights, hearing the devil’s temptations.

The roll call of other voice hearers is as variable as Winston Churchill, Socrates, Galileo, Pythagoras, Carl Jung, Gandhi, Joan of Arc, Teresa of Avila, Mohammed, William Blake, Zoe Wanamaker, St Francis of Assisi, Leonard Cohen and Sir Anthony Hopkins.

Voice hearing, as Coleman’s own story demonstrates, is often linked to unresolved personal trauma. In his case he was sexually abused by a Catholic priest when he was 10 years old.

“My explanation for voices is that I created them because I needed to deal with what was going on.”

Coleman’s voices didn’t actually arrive until he was adult. Prior to that he had a different coping mechanism – rugby. “I played as prop and when I went into the scrum I’d put the face of the Catholic priest who abused me on to my opposite number and I’d just try to kill the guy.”

Then he broke his hip and couldn’t play rugby anymore.

“I ended up not having the outlet, but still having the priest in me as a constant reminder of everything and no way to get rid of my anger. Eventually it came out as voices.”

One of the first voices he heard was the priest telling him it was his fault. “That I led him into sin and I should burn in hell”.

Another voice was his father. “I felt like I’d failed my family so I had my father’s voice saying things like: ‘You’re no good. You’re f***ing worthless. You’re a failure’.”

Then there was the voice of first wife Annabelle who died suddenly. “She used to tell me to kill myself so we could be a family again. It was more about the fact that I missed her so much.”

Negotiating a way to cope with his voices took a year. With Annabelle he realised he could be with her as a voice. “I said: ‘I don’t need to die to be with you. I can be with you now – let’s talk’.” He’s since remarried and now has agreement with Annabelle only to talk to her on anniversaries.

His father’s voice changed from negative to positive after his family finally learned what happened to him as a child through a 1995 BBC Horizon documentary, Hearing Voices. His father asked why he never told him about the abuse. Because, said Coleman, he didn’t think anyone would believe him.

“My dad said yes he would, and he would have killed the priest.”

Coleman says he still hears the priest’s voice from time to time when he’s overworked and tired. What does the priest say now? “But I still think it was your fault.”

Coleman takes it as a sign that he needs to take time out and go fishing. “As soon as I hear him I tell him to f-off. ‘I’m not going to listen to you. I don’t need you. You have no power any more’.”

Getting to that point – where he could refuse to hear the priest – required dealing with his own guilt and shame. “I can’t change the past, but I’ve resolved my feelings about my own abuse.”

Another voice Coleman calls teacher. “That was my own voice – a voice trying to keep a bit of sanity in my mind. It’s always a voice of reason. In a funny sort of way I was externalising my own self rather than having inner dialogues. I tend to externalise it now, because I’m so used to hearing voices.”

There are three other positive voices – one called Dave who was someone he knew who died, and two other he keeps to himself. “The reason I don’t talk about them is I share an awful lot of my life and those are voices just for me.”

As well as providing support for voice hearers, the Hearing Voices Network is also a human rights movement – to protest at the way those diagnosed with schizophrenia are treated and to reduce the stigma attached to mental illness. Coleman says he’d like to see professionals in mental health systems spend much more time listening to people before treating them.

“I would like acknowledgement when the treatment is not working that we do something different rather than give them other drugs or just increase the drugs.”

He wants proper informed consent too – people told about the reduced life expectancy downside of antipsychotic drugs before they are given them.

He believes that if there was a properly controlled test – comparing outcomes for voice hearers engaged with the network and those using the mental health system – the network would come out on top. “We’re saving lives.”

Coleman wears his diagnosis on his skin – a tattoo on his arm reads “Psychotic and Proud”. He did it to have a constant reminder of where he came from.

“It says I refuse to be ashamed about what happened to me. I refuse to be ashamed of my diagnosis and I refuse to be ashamed of the fact I was a psychiatric patient.”

Voice of reason

* The Hearing Voices Network, founded in Britain in 1988, developed from the research of Dutch psychiatrist Marius Romme.

* It has since grown into a global self-help organisation, active in 20 countries, for people who hear voices.

* Members advocate the use of techniques employed by those who have successfully coped with their voices. This can include acceptance and negotiation with the voices.
* Hearing Voices Network Aotearoa NZ has about 100 members and holds support groups in West Auckland, Grey Lynn, Glenfield, Hamilton, Palmerston North and Wellington.

* Approximately 75 per cent of patients diagnosed with schizophrenia, 20 per cent of patients with mania and 10 per cent with depression hear voices.

* About 30,000 New Zealanders are affected by schizophrenia.

Find out more on Hearing Voices Network Aotearoa NZ

www.hearingvoices.org.nz  part of international organisation Intervoice, www.intervoiceonline.org

Mental Health Unit ‘failed teen’. New Zealand Herald Sat Oct. 16th

This article was  in the NZ Herald today, you can see it on their website here written by Chris Barton.

A coroner has strongly criticised the care provided by a specialist youth mental health unit leading up to the suicide of 17-year-old Toran Henry.

Auckland Coroner Murray Jamieson said Marinoto Child and Adolescent Mental Health Services’ care of the teenager “was deficient on occasion and in particular on the day of his death”.

His remarks were included in the findings of the inquest into Toran’s death on March 20, 2008. The report was issued yesterday.

Dr Jamieson was critical that, in the face of escalating developments on the day of Toran’s death, the Waitemata District Health Board’s service left his care in the hands of a relatively inexperienced “key worker” who spoke to Toran by phone.

“Toran stated, that day, that he lost faith in one of his key workers, feeling that she had abused his trust,” said the coroner.

He said the situation would have been better dealt with by immediate consultation with a specialist psychiatrist, who could have taken direct action “such as arranging an urgent home visit together with immediate admission to a secure facility if required”.

There was criticism, too, of the way Toran had been prescribed the anti-depressant drug fluoxetine, better known as Prozac, which is not approved for treating major depressive disorders in children and adolescents in New Zealand. But it can be given to that age group by what is known as “off label” prescribing, which requires informed consent from the patient.

Dr Jamieson said the information given to Toran about the drug was not satisfactory. It was not a single comprehensive document, not up to date, not designed for a person of Toran’s age and did not include clear advice about taking the drug in combination with alcohol or other drugs.

He recommended that Marinoto should review the information provided to adolescents, especially the importance of taking the medication as prescribed.

The coroner was also critical of the last occasion Toran was prescribed fluoxetine, at a cafe near Marinoto early in March 2008, by a registrar in psychiatry who had not met Toran or his mother, Maria Bradshaw, before.

The coroner said the consultation should have been carried out by a specialist psychiatrist “fully apprised of the history and clinical picture at a venue appropriate for such an important clinical encounter”.

Dr Jamieson did not make any finding on whether taking the drug contributed to Toran’s death.

Although the question came up during the inquest, the coroner has not addressed concerns that the drug packets in New Zealand do not carry a “Black Box” warning as required by the Food and Drug Administration in the United States. The warning explicitly states that “anti-depressants increased the risk compared to placebo of suicidal thinking and behaviour in children, adolescents, and young adults in short-term studies of major depressive disorder and other psychiatric disorders”.

Malaga a le Pasifika, the cultural support service of Marinoto, was also criticised for the way it attempted, but failed, to organise a meeting between Toran and his father, Geoffrey Henry, a Cook Islander, whom Toran had not seen since he was 14 months old.

The coroner concluded that the circumstances relevant to Toran’s death were:

* The career plan that Toran had set his heart on in early 2008 had proved impractical.

* Toran had been reminded of the absence and apparent rejection of him by his father.

* His relationship with his mother had been tense.

* His relationship with his girlfriend had recently been unhappy.

* The day before his death he had been humiliated in front of many peers when he was involved in a brief fight with a younger Takapuna Grammar School student.

* His abuse of alcohol clouded his judgment.

Clinical director of Mental Health and Addiction Services at Waitemata Murray Patton said a new fluoxetine information sheet had been developed for adolescents and children.

Marinoto clinical staff have also undertaken training to ensure all service users and families have knowledge of common and serious side-effects of psychiatric medicine and how to monitor for them.

Tragic toll
About 540 people a year take their own lives – many more than last year’s road toll. More than 2500 New Zealanders are admitted to hospital each year through intentional self-harm.

Age range for 2009/2010:
* 10-14….7
* 15-19….53
* 20-24….189
* 25-29….136

DISAPPOINTED MOTHER QUESTIONS CORONERS FINDINGS

This linked article can be found here on NZ herald site and is also written by Chris Barton

Toran Henry’s mother, Maria Bradshaw, is disappointed with the findings into her son’s death.

“Was it worth $70,000 to get a [coroner’s] finding where the only recommendation made was that children should take their medication?”

Mrs Bradshaw is yet to learn whether she will get legal aid to cover some of the cost of her legal counsel at the inquest. She has had to sell her house to cover her costs to date and says she will file a complaint about the inquest.

She says she is particularly concerned that the coroner appeared to dismiss arguments during the inquest that selective serotonin reuptake inhibitors (SSRI) – the class of drugs which includes Prozac – were not associated with suicide. She said the coroner did not clearly lay out the reasons for his findings or why he favoured some evidence over others, particularly about the drug’s side effects on Toran. “I just don’t feel that it has been thorough,” she said.

Mrs Bradshaw finds it difficult to comprehend that the coroner finds no criticisms of anyone at Takapuna Grammar. “When they called the police on the day before Toran died to report the fight outside the school, they didn’t mention to the police Toran was under the care of mental health services.

// They didn’t call me … I would have thought that might have attracted some comment from the coroner because that was another opportunity that this could have been prevented.”

Torans Mother is speaking at a Public Mental Wealth learning day coming up 29th October. I will post details in the next post, contact Psychiatric survivors if you are interested to attend on 021-206 8759 and on (09) 846-9945