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Most helpful thing this voice-hearer heard: ‘The voices are real’

Ron Coleman, a voice-hearer diagnosed with schizophrenia, offers others an alternative path to institutionalization and medication.

Ron Coleman: "It’s never that the drugs don’t work. It’s somehow that we don’t work. And we find that quite offensive."
MinnPost photo by Sarah T. Williams

Ron Coleman and his wife, Karen Taylor, were joyfully anticipating the birth of their first child when a colleague in psychiatry posed a jolting question: “Why are you bringing another schizophrenic into the world?”

It was a galvanizing and politicizing moment for the couple, who immediately took to the airwaves to defend their marriage, their mission, and their strong belief that people who hear voices can learn to understand and control those voices — rather than be pathologized, medicated or institutionalized because of them.

Their backgrounds were complementary: Taylor had been a psychiatric nurse. And Coleman (a voice-hearer and veteran of 10 years of involuntary institutionalized psychiatric care) had been national coordinator of the Hearing Voices Network in the United Kingdom. They met at a conference in 1998, and immediately fell in love.

Fueled by “the question,” they eventually formed Working to Recovery, a small consultancy and training company based in Scotland that focuses on facilitating recovery for those who self-harm or hear voices. They travel internationally — from Japan to the Middle East and the United States — to conduct workshops and training sessions on such topics as “Working with Voices,” “Living with Voice Hearers,” and “Making Recovery Happen.”

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When they aren’t on the road, Coleman and Taylor retreat to their haven on the Isle of Lewis in the Outer Hebrides. Their family, by the way, now includes his (two), hers (three), and theirs (two) — and four grandchildren.

MinnPost caught up with Coleman, a bearish man with a Scottish brogue, who was in Minneapolis with Taylor last week to conduct a People Incorporated workshop for 120 voice-hearers, spouses and care providers. It was the second stop on a 15-city U.S. tour. 

MinnPost: How would you characterize the Hearing Voices movement’s relationship with conventional psychiatry?

Ron Coleman: We were started by a psychiatrist, Marius Romme. … And there’s no doubt that without him, many of us, including myself, wouldn’t be alive today. Because we’d seen our lives as effectively over before he started his work.

So I would say that the relationship between psychiatry and ourselves is productively tense. It’s not really adversarial because none of us would say if psychiatry works, stop it. We’re for anything that works for the individual. And I think psychiatry has a place within this field.

What it has to do, though, is change what’s on offer. If all we ever offer is meds, and they don’t work, it’s a disaster. What we always find amusing about that is that when medication doesn’t work on us, we’re blamed. We’re told we’re “treatment resistant” or “noncompliant.” It’s never that the drugs don’t work. It’s somehow that we don’t work. And we find that quite offensive.

I was treated with medication for 10 years, and I heard the same voices. It never affected them, really. So for me, it’s about whatever works for the individual. And the network is about celebrating diversity of experience, not saying this one’s right, this one’s wrong. We don’t really want an adversarial contest with psychiatry. … I would much rather that we have a conversation than a battle.

MP: The movement’s founders discovered that many voice-hearers can point to a traumatic triggering event or events. I understand that that’s true for you as well.

RC: Before I heard voices, I had three traumas that were clearly, on reflection, related to what’s happened to me. The first was at a young age. I am a survivor of sexual abuse within the Catholic Church. … The priest who abused me was one of the voices I heard. And I would hear that voice telling me that [the sexual abuse] was my fault, I led him into sin, and I deserved to burn in hell.

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Because you’re hearing this voice, there’s a lot of doubt about whether you’re innocent — even after you have disclosed, and people tell you it wasn’t your fault. You’re still carrying this load of guilt that’s about it being your fault.

So when I self-harmed, I would burn myself. It looks crazy when people are looking at it from the outside. But when you look at it as a Catholic, in terms of how sinners are dealt with in purgatory – cleansed by fire – then burning yourself actually is rational because you’re trying to get rid of this amazingly big sin you’ve committed. And the only way you can get rid of it … is by burning yourself.

People who know the context understand much more what the voices are about. Because people [care providers, families, voice-hearers themselves] don’t look at the context, and only look at the behavior or the symptom, then it doesn’t make sense.

You actually question your sanity when you’re a voice-hearer — a lot at the beginning. Marius Romme described that as the “startling phase” of voice-hearing. Everything’s raw and you’re so overwhelmed. And then, with [colleague] Sandra Escher, he started looking at how people organize that. And how I organized that was around needing to get rid of the sin to cleanse myself. And that makes perfect sense, given the starting point. It doesn’t make sense as a good outcome, it makes sense only as an attempt to organize my thinking and the voices.

The second trauma was the death of my first wife, Annabelle. And that to me was a double whammy. Annabelle was where I learned really to feel un-abused. When she died, I felt very abused by God again. Annabelle and I became born-again believers together. After that, I described myself as a “dead-again” believer, and that was my description for many years. Still is in some ways, although it’s more of a joke between myself and my minister and other people in my church I go to now [Church of Scotland].

From that [second trauma] I isolated myself. I didn’t get involved with people. I didn’t like people. I remember describing myself as a child of [Margaret] Thatcher. I went from being quite left wing to being a fairly right-wing conservative. Thatcher argued that there was no such thing as society. And if you believe that all people do is hurt you, then not having a society is a good thing. Not having a society met my need to isolate myself from everybody.

Because I was so young, 17 and a half, when Annabelle died (you can marry at 16 in Scotland), I never considered myself as being a widower, but I was. I never thought about it in that particular way. You just got angry with the world and God and everybody. That to me was the end of religion as far as I was concerned.

My third trauma was breaking my hip when I fell while playing rugby [at age 23]. And that really was the tipping point. Of the three traumas, it was the one that would probably be considered the most minor. But rugby had always been my way of coping. Because it’s such a violent sport, I was able to use it to channel my anger. It was a coping mechanism. It was probably my first form of self-harm, to be honest.

The third one broke the camel’s back. I had lost my way of coping. And I started hearing voices.

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MP: What was the first voice you heard?

RC: It was a woman’s voice. I was in my office. I had come out of the hospital on crutches and gone back to work [for the city of London, buying futures]. I was waiting on an analysis from some data I put into the computer. And I heard a voice behind me saying, “You’ve done that wrong.” And I looked around behind, I thought it must be a secretary or someone, but there was nobody there.

I went to the pub and got absolutely slammed, which is a fairly normal response to stress. That’s what I thought: You’re stressed, go and break out for the night and you’ll be fine. Within weeks, I was hearing about six voices. That woman’s voice became really unimportant as I started hearing other voices saying all sorts of things. And even then I didn’t make sense of it at the beginning.

I would hear the priest’s voice, although I never said to myself initially that it was that priest. He would say things like, “It’s your fault.” Romme and Escher are spot on: It’s a phase you go through in the beginning, where it is overwhelming — you don’t know what’s coming wherefrom.

I lost my job within weeks of that starting, and then I went on a drinking and drugging binge for three months. I was out of my head. I can remember very little of that time except that I had a lot of [severance] money because of where I worked and what I did. …

By the time I blew most of my money, I ended up going to see my general doctor. After I told him what was happening, he told me he wanted me to see a specialist. The specialist came to see me in the doctor’s surgery, just a couple hours later. He did a Present State Examination. At the end of it, he said, “Well, Mr. Coleman, I think you have a very serious mental health problem and you should come into the hospital to get treated.” I very bluntly told him where to go and crashed out of the room.

Three days later, I was standing at the end of the railway station shouting at the voices and thinking about going under the trains. The police came and took me straight to hospital. I was seen by a different psychiatrist, and he said exactly the same thing [as the first]. And I stayed in the hospital.

They told me that the treatment [chlorpromazine] would start working in about 10 days. It didn’t do anything, really. You always felt fuzzy in the head, you never felt like you were thinking properly, and that really frustrated me. I couldn’t read, and I’m an avid reader. After a couple of weeks, I decided to leave, but they wouldn’t let me. And I ended up detained.

My first admission, which was meant to be for 10 days, was for a year and a half. And over the next 10 years, I spent seven and a half in institutions. I was never a voluntary patient.

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MP: Where was your family during this time?

RC: I refused to see them. I didn’t want my family to see what I had become. I was the oldest son, I had responsibilities, and I would never be able to carry them out.

MP: How did you find your way to the Hearing Voices Network?

RC: In hospital, actually, through a support worker named Lindsay Cooke. She was amazing, because even though I’d been in the system by then for 10 years, she still believed in the capacity to get better. She never gave up on me — ever. Any other person who came near me, I managed to tell them to get lost. But she was so persistent, and she believed in your capacity, and she took me to my very first Hearing Voices group.

I remember the people there because they’re a big part of my history. Anne Walton was doing the meet and greet. She met me, said hello, and she said to me, “Do you hear voices?” I said yeah. And she said, “They’re real.”

And that changed my life. Not that minute. But [it started] that process, that understanding. For years, I’d been given the message that the voices weren’t real, and that I’d have to wait until the drugs worked to get rid of them. For someone to say, “They’re real,” meant I could do something about it. If they’re not real, I can’t do anything. That’s how I looked at it.

And so I spent the next year really learning about myself. I learned about the voices, and met Marius Romme, Sandra Escher and Paul Baker [another founding member]. Paul and I still work together, we have worked together for 20 years now. I met all these people who believed in my capacity to recover. I found ways of understanding my voices, of taking control of the voices, which meant I really took my life back.

MP: Can you describe the process of taking control of the voices?

RC: Quite often, what people do is just listen to the voices and get caught up in it. I learned very quickly that I could talk to them. And they would talk back. And they heard everything that everybody else said and [would] comment on it.

So I started negotiating time with my voices. If I was going to work in the office, I couldn’t do that and listen to voices all day. I needed time away from the voices so I could do office work. … Every evening my voices got free time that was theirs, as long as during the day, during working hours, the time was mine. I used to go home and sit in an armchair, set an alarm clock for an hour, and let the voices have their happy hour, if you like. That worked for me. It didn’t work immediately, I had to work to get it. But once I got it, I got it.

Now I can more or less bring my voices when I want to hear them, and I don’t need to negotiate. I think I know my voices are always there. I believe my voices are somehow or another connected to my subconscious [mind].  I have a very psychological frame of reference. So I’ll listen to my voices a lot, because quite often they access stuff I can’t access on a conscious level.

MP: How do you guide others through that same process?

RC: I ask people things like: How many voices do you hear? How many are male? How many are female? How many have no gender? How many are positive? How many are negative? Do any of them tell you to do things? Do any of them give you good advice? Do any of them give you bad advice?

We start breaking it down so that we’re creating the characteristics of the voices. Once you have the characteristics, then you have a personality you can work with.

The person can look back, find the origin of the voices, and then we can deal with the real issue. For me the real issue was never abuse or Annabelle. The real issue was guilt and shame around my abuse and the fact that I desperately loved and missed Annabelle. As long as we can look at the emotions, we can deal with it. If we look at behavior, we cannot deal with it. Because what you do is try to eradicate the messenger.

And I guess that’s what psychiatry does — it tries to eradicate the messenger before understanding the message. And I’d much rather understand the message. And I think most people would. And I think we need to ask people what they’d prefer.

MP: How many voices do you hear now, and what are their characteristics?

RC: I still very occasionally hear the voice of the Catholic priest. But that tends to be when I’m very tired or I’ve overdone it at work. The minute I hear it, I can get rid of it straightaway.

But what’s important about it is that it’s an early warning for me. It’s saying, “Take a break,” basically. Even though it’s really negative, it has a useful purpose. And that’s more important than what it says.

I hear Annabelle. And I hear her now only on the anniversary of the day we met and on the anniversary of her death. I don’t even hear her on her birthday anymore. That would almost make her equal with my wife, and she isn’t. My wife’s my wife, and that’s the person that I’m living my life with. Annabelle’s the person I might have lived my life with.

I hear my father’s voice, and that’s a very positive voice. It wasn’t always, but it is now. And that’s because my father and I reconciled after I came out of psychiatry. I can see from a father’s view now because I am a father. You want your sons to succeed and to look after their partner, their kids, and be able to provide. So I can understand how my dad must have felt about me. I don’t think he was right, but I can understand it.

I hear a voice called “Teacher,” which I call the “Voice of Self,” because I think we are our own teachers and we learn through reflection. I think that voice really is a reflective voice.

I hear another three voices, two of them more than the others. But I keep them to myself. I’ve put most of my life out in the public domain, and those are my little bits that I keep and don’t share with people.

MP: How do you address the fear that some people have that voice-hearers might be directed to harm someone or do something terrible?

RC: When we actually look at the real figures, you’re far less likely to get killed by voice-hearers than anybody else, really. I’ve never read a newspaper headline that says, “Diabetic kills person.” But I’m sure there are lots of diabetic murderers around the world.

The fear is that we cannot control those voices. And the problem I have is that a lot of people cannot control the voices because they’re not allowed to even try. They’re told that medication is the answer, but if you look at the research you will find that people who are on their medications still commit those things. Medication doesn’t stop bad things from happening. There’s no evidence of that. So what’s the answer, keep the voice-hearers locked up forever? Or help them to find a way to control the voices?

As Marius Romme says, it’s only those who are denied the space to talk about their experience who go on to commit those acts.

MP: If you could get rid of your voices altogether, would you?

RC: I wouldn’t want to get rid of my voices. I’ve had them for longer than I’ve not had them — they’re part of me. Would anybody want to hear Ron Coleman the non-voice-hearer? Would you want to hear about my non-voices?