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Let’s talk about this concept of self-love, self-compassion and why it’s so pivotal when hearing voices.

My experience with the diagnosis Schizoaffective (Bipolar Type) may be different than yours, vastly, and much more so if you have been diagnosed with the blanket term Schizophrenia. I read a post the other day on an alternative treatment center dedicated solely to Schizoaffective, discussing their push to separate the label from the umbrella term schizophrenia, citing a need to treat it in its own category. I don’t think it’s so much the category that needs individualization, but the treatment itself. That’s a story for another day.

My point of bringing that into the story is that not everyone hears voices constantly and not everyone hears them the same way. Researchers are starting to catch up with this fact. There have been just a *few* studies into the differences between thought-like voices and external (hearing outside of the ear) voices, and some of the studies are fascinating. One, which I will link later when I find it again, cited 17% as the amount of time people say they heard exclusively external voices. For your personal interest, here is a survey and a study highlighting the differences between external and internal experiences.

Some of the marked differences included the types of responses. The researchers hypothesized that internal voices may have a more distressing quality to them–and this does not mean that external sounds and voices aren’t distressing, it just means they have a particular scale they were using to rate this. They obviously have no idea what it’s like in either experience. Let’s not make this into a petty competition about “who has it worse”. I hate that. It happens a lot in the mental health community, I’ve noticed.

The last table of the study showed some interesting percentages:

If you look at the study, they also listed their Chi-squared test results (statistical measurement) and their P values, bolding the significant differences. I’ve bolded the ones which were significantly different.

What Does This Mean?

They use this as evidence to confirm their hypothesis, I use it as evidence to show that variability in our experiences of the world. I also use it as evidence to show kindness and compassion is a necessity to yourself. If you are constantly being attacked by Persecutory Voices telling you the police believe you’re a murderer or a pedophile or a liar who has put their entire family in danger of the C.I.A, it takes a lot of strength to tell them “I’m better than you’re saying” or “I’m not any of what you’re telling me I am.” It takes double the strength to do so in a composed, neutral manner. It also takes a lot of practice. I still yell sometimes. I try not to do it in public.

It also takes a level of confidence in yourself, and comfortability with yourself, acceptance that what other people say about you isn’t necessarily true, and all of that can be easily stripped away from years of hospitalizations and being told you’re sick, ill, and broken. It rarely gets built back up because people with schizophrenia and psychosis alike are not encouraged into therapy much of the time. They aren’t encouraged to explore themselves. They aren’t encouraged to melt into the darkness because, well, it’s too dark. This prevents the growth necessary to heal.

Therapists and professionals are scared to talk when someone is, to them, incomprehensible, and for some reason they’re also scared to listen, as if they might hear something that makes sense in a bout of babbling that shouldn’t make any sense. And so a lot of the work is left up to us. After all, we are the ones with the voices, the thoughts, and the thought-like voices.

What Does Compassion Mean?

I had an experience a few months ago that was another cog in the machine of changing the way I see my voices. Although they’ve been telling me to kill a lot lately, mostly myself, sometimes other people if I’m around them, they’re not usually as aggressive, not since I’ve accepted them as beings tied down by the law of opposites: good must exist in the bad for the bad to exist, and bad must exist in the good for good to exist. When I realized they can’t possibly exist outside of that truth, I stopped labeling them as demons. For the past two years they’ve shaped into your regular, uncertain, lost souls, just like the rest of us.

But one night I felt particularly scattered, my thoughts weren’t making sense, and one of my voices told me to go for a drive. They urged and urged until I got off my ass and did so. We drove out to the cliffs, and I worried if I stopped the car I’d have a heart attack. So I kept driving and cry-singing because that’s always the best medicine, and at some point I think I asked them “why are you doing this to me?” And the response I got was something along the lines of “pain is necessary”. And I stopped crying not because the answer was profound, it’s certainly not, but because it reminded me of everything I’ve ever read, everything I’ve ever calculated, everything I’ve ever understood. There was a beauty in the pain I’d forgotten about, there had to be because pain cannot exist without the concept of pleasure and visa versa. He reminded me of my own duality and that this too shall pass; it must, for something that comes must also go.

And so part of the compassion involved with dealing with voices is submitting yourself, not in a passive way, but in an understanding way. If you don’t listen to them, they will never listen to you. To talk back is to not be “more crazy”, it’s to learn about yourself. That’s all you’re doing. You’re not “feeding into the sickness”. You’re not “making yourself worse”. You’re learning more than your therapist will ever know.

Another part of compassion is building your self-esteem. This can’t come from repeated mirror mantra’s of “you can do this”. Studies show it can make you feel worse; when you don’t live up to your expectations, you take a harder hit than someone who didn’t look at themselves in the mirror and convince themselves of a lie.

I say it’s a lie because if you don’t actually believe it while you’re saying it, it’s pointless. And telling yourself you believe it is not the same as believing it.

I’ve built my self-esteem along the years through support of others encouragement. Most of believing in myself came from other people believing in me, believing I could do something when I didn’t believe I could. Now, you see the opposite effect a lot of the time: in hospitals, for example, you may encounter a professional who has no confidence in your healing path (although they may consistently say “you can do this) and the less they believe in you, the more you’re convinced you’re sick for life, doomed to a plethora of medication and condescending doctors. Imagine the opposite. Imagine surrounding yourself with supportive people who understanding that falling down, that relapse, is apart of the process. Remember the law of opposites: one thing cannot exist without the other. You will have days of confidence, days of no confidence, and it’s how to grow from each happy and not-so-happy experience that will dictate your future path.

I think there are a bunch of cliche things you can list for self-compassion and care: eat healthy, exercise, reach out for help when you need it. Those are blanket examples, things that promote over-all wellness, but I think when dealing with voices, your self-compassion must be very individualized. What you and your voices need may be different from what me and my voices need, and this is why modern-day psychiatry has failed in so many aspects.

Showing yourself compassion also means avoiding judgement. Be careful labeling a feeling, voice, thought, as good or bad. Be careful labeling yourself as good or bad. What I’ve found more helpful is asking myself how the moment (if I hear something negative or positive, if I think of something strange, bizarre, or scary) can help me grow. If a voice tells me to pick up a rock and kill my partner with it, I ask myself if killing my partner will help me grow. The obvious answer is no. And therefore I respect the request, acknowledge the voice (laugh about it kind of) and continue on with my day, judgement-free.

Is Being Alone Okay?

Yes. This is part of the individualistic plan. For me, I haven’t yet gotten comfortable talking about my voices to anyone other than my significant other, and at times (if I’m feeling spunky) my therapist. Most of you know I work in peer services, and have the opportunity to talk about my voices everyday with others who experience similar things, and I find it very difficult to do so. I was raised to stay quiet and it’s been a long journey realizing that I don’t need to force myself to speak, even if others say that’s what I need to do to heal. I also don’t need to force myself to stay quiet. There’s a delicate balance here.

If keeping to yourself, exploring your feelings and voices with yourself, is what has helped enlighten you, what has helped you process your emotions, then that is okay. Remember how we mentioned it doesn’t matter what other people say? About how accepting that mind-state may help also with voices, particularly ones that accuse you of things? Well, shocker: it also supports you in dealing with pushy people who think they know how you should live.

We get told a lot of things. We get told we have to do this, eat this, act this way, fit this mold, fit this criteria, apply for this, stop doing this, take this, etc. We are rarely given the chance to truly decide for ourselves, and taking away that level of independence doesn’t built self-esteem. You are capable of making decisions for yourself.

I find that processing things in my head is quicker, more efficient, and when I come to a realization I get a warm feeling from the top of my head to the soles of my feet. Those are moments that change my perspective. I rarely have those moments when discussing feelings with people. That being said, there are moments I can’t keep things in my head, when I need to vent to someone, or ask for an outside perspective, and those times are okay too.

Overall . . .

. . . I think it’s important to recognize that no one is one-size-fits-all and that every way of living is an acceptable way of living, as it is life doing what life does. We may not see one person’s life as the way we think it should go. We may see more potential in them than they do in themselves, and that makes us want to help, make us want to push them into being “better” and that’s a judgement. It is. It is inevitable in life that some people will never heal. You may judge or perceive this as sad, but if everyone always healed then there would be no such thing as being stuck. If there was no such things as being stuck, well, there would be no such thing (or need for) healing. We wouldn’t exist as complex beings, only cookie-cutter versions of each other.

Each way to wellness (or not wellness), whether that be medication, no medication, therapy, no therapy, family, or no family, is an acceptable path. Once you are able to avoid judgement of where you are, once you are able to avoid the trap of “I should be here, but instead I’m here“, you will see life get much simpler.

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