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Vice Blog

LONDON - HEARING VOICES

I was having a moment of self-loathing on the train yesterday as I recalled a drunken misadventure, and without meaning to I groaned and hit myself in the head a few times with my book, saying, "Idiot, idiot, idiot." Everyone turned and starred. I realized that must be what it's like to be mad. The voice in your head becomes so overwhelming that it requires action.

I was thinking about insanity after a 30-year-old lady came into the emergency room last week covered head-to-toe in her own shit. She was clearly psychotic. We had to sedate her to clean her up because every time we tried to wipe any of it away she would flail and scream, agonized. She was very attached to it.

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Still a little stinky, during examination she was inconsolable about no longer being covered in her own feces. Eventually, we learned what had happened: Her husband had died six weeks previously, launching her into a psychotic episode where voices in her head convinced her that her husband was not dead but inside of her. She desperately tried not to shit, becoming toxically constipated, but eventually her bowels would explode in protest, so she would scoop it up and smear it over her body in an attempt to preserve every last pellet of her husband. It was utterly tragic, and part of me wished that we had scraped her shit into a little jar to take home with her.

One in a hundred people will have an episode of schizophrenia--you see people walking around with earmuffs in summer or headphones unplugged, and often these are coping mechanisms. Auditory hallucinations are very persistent--as is true with small children, telling them to be quiet or threatening them just doesn't work. It is like your inner monologue, the wanky one that insists you're a twat, becomes self-sufficient, no longer needing you to exist. Like a coke-fueled motor-mouth, it goes on interminably, only you hear it as a constant outside noise.

I once sat in on a hearing voices class where people were encouraged to articulate their inner dialogues, talk back, and negotiate with them. A pretty twenty-something girl had thought her co-op was compelling her to buy things she had no use for, so she couldn't walk within 100 meters of the entrance. A Nigerian man's voices were personified by a six-foot blond transsexual and an angry midget who would constantly argue in his head. And one old lady believed her husband worked for the Secret Service, and that they had kidnapped her and planted a chip in her brain, which made her act out their will. They all agreed the best coping mechanism was using a mobile phone. They held it to their ear when they had the urge to talk to their voices so people didn't think they were insane. Many of them had learned to live successfully alongside their voices--the aim of the classes. The pretty twenty-something girl even said she had a new voice, who sounded like a younger version of herself, except incredibly witty, and she enjoyed their conversations.

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The funny thing is psych consultants are all a bit nuts too. They like to provoke patients and get their voices to act up in an attempt to prove to them they are not real. I sat in on a psych consultation with a 45-year-old who had been suffering for four years. The doctor asked, "So, where is your voice now?"

Perfectly sane, the patient replied, "He's in that chair," pointing to a very empty chair in the corner.

So the psych doctor stood up, walked over to the chair and sat in it. Saying smugly, "So, where is your voice now?"

The patient looked at him, and replied, "He's in the corner and he's telling me, you're a fucking cunt." It made me think that sometimes I would quite like a voice, which I could blame for calling people a cunt.

DR. MOORE