The following message was posted by a consumer (who reports on whether
the techniques worked for him) would make a great consumer column:
"Sensory Deception" from Johns Hopkins press discusses several methods
to control hallucinations, including focusing on them instead of trying
to ignore them. This may be as simple as saying the word "Stop" until
the hallucination goes away. Some of the things that patients do to cope
is engaging the hallucinations and taking the hallucinations advice. The
book also recommends taking personal responsibility for the hallucinations
instead of attributing them to an outside source) and counter-stimulation
(reading something outloud). Following is a paraphrase of some of the
techniques from the book:: "Sensory Deception: A scientific analysis of
hallucination" from Johns Hopkins University Press, authors Peter Slade
and Richard Bentall. Psychological Treatment Approaches:
- Operant procedures - Conditioning Use of timeouts for hallucinatory
- Systematic desensitization
- Thought stopping - Raise finger every time you hallucinate and say
stop until the hallucination stops.
- Reduction in sensory input Conflicting results
- Counter-stimulation use of headphones reading out loud humming and
- Self-monitoring record occurences of hallucinations rate frequence
of hallucinations signal occurence, duration and termination of hallucination
with a button imagine a vivid nauseous scene when experiencing hallucination
take a written record of voices and rate their 'demandingness' retrospective
monitoring has no effect
- Aversion therapy shock or white noise self-administered during a
hallucination (works somewhat, sometimes nature of voices changes)
- Earplug therapy use of an earplug in one ear (no dramatic impact
- First-person-singular therapy voices are really talking to myself
(worked for two patients) bring on and dismiss hallucinations + counter-stimulation
worked for 1 out of 5 subjects p199
A careful examination of the data outlined above suggests that there
success might be explicable in terms of three processes, namely:
- (a) focusing; (b) anxiety reduction; and (c) distraction or counter-stimulation.
- Focusing event recorder, contingent response, focus attention on voices.
suggestion that avoiding attending to hallucinatory experiences may,
in the long run, have the effect of maintaining them. Anxiety reduction
systematic desensitization, try to decrease arousal.
- Distraction or counter-stimulation Works in the short term, but may
allow person to come up with other strategies. Table 7.2
- Coping strategies reported by 40 people with persistent auditory hallucinations.
From Falloon and Talbot 1981 Psychological Medicine, 11, 329-339 Type
of strategy N Behaviour
- change Postural (sit, lie down, stand, walk, run)
- Specific activity Work (including household) 11 Leisure (hobbies,
music, reading, TV) 29
- Interpersonal contact: Initiate contact
- 19 Withdraw from contact 2 Drug taking:
- Prescribed medication (extra dose) 11
- Non-prescribed medication (alcohol, analgesics, illicit drugs)
- Physiological arousal Reduction Relax or sleep
- Decrease sensory input (block ears, close eyes)
- Increase Physical exercise
- Stimulating music/loud noise
- Cognitive strategies Reduced attention to 'voices' (ignore, block
thoughts, distracting thoughts)
- Supression of 'voices' (tell to keep quiet, go away)
- Reason/debate with 'voices'
- Accept 'voices' (listen attentively, repeat content, accept guidance)
- The authors go on to state that focusing was only reported by only
a small proportion of the patients, in two forms: reasoning or debating
with the voices and accepting the voices.
- From page 203: The second study to be considered in this context was
carried out by Tarrier (1987) British Journal of Clinical Psychology,
26, 141-143, who used a similar approach to elicit coping strategies
from 25 patients, suffering from auditory hallucinations and coherently
expressed delusions, who were living in the community and receiving
- The strategies employed included distraction or attention switching,
thought stopping, self-instruction, increasing or decreasing activity,
increasing external stimulation (mainly playing music), ad strategies
apparently aimed at reducing arousal. .... reported at least some symptom
relief; this was particularly the case with patients who employed more
than one strategy.
- What I have personally used: Meditation--focusing on breathing (keeps
me calm) Keep a journal of your thoughts, hallucinations, and bodily
functions while they are happening (anyone want me to find this and
share it?) Taking long walks (doesn't work very well, I hallucinate
while walking, plus I have weird happenings like a person on a motorcycle
("Zen atAoMM"?) coming up to me and saying something nonsensical)
Actively engage the hallucinations, do battle with them (solve puzzles,
battle psychic psychiatrists, play with the time film going through
my head, etc).
- This tends to wear me out. What I am looking for: A way to disable
beliefs and the belief mechanism. ------------------------ >
- Dan and John, As to handling positive symptoms. I'm afraid I have
to tell a story (a woman thing you know)(g) about my son. He has both
visual and auditory hallucinations.
- Every medication he has ever tried makes him flat out sick. And he
has tried a lot! So as he says he is stuck with the "noise."
Well a young lady informed him that she was going to be hospitalized.
My son asked her why. She replied that she was hearing voices. He looked
her in the eye and told her this. "If you hear it, kick it. If
it moves it is real, if it doesn't move it is a hallucination."
And he let out a good laugh! I don't believe he has ever kicked anyone.
- But, he has developed a method of "testing the waters" so
to speak. He makes a deduction as to whether his "noise" is
real or not and then acts accordingly. Not a bad plan for him at least!
>Another friend of mine has a very logical mind. And he has, it seems,
a sort of formula in his mind. "what are the chances that this
is real" "what are the chances that this is not real."
And then he acts accordingly.
- >Both have very varied hallucinations. If there was a repetition
of a theme both felt it would be easier to tell what was "real."
But they never know what to expect from their minds. Both have made
a conscious decision not to act on anything that they think might be
a hallucination. >I think there is a lot to be said for prevention
though. But I'll put that in another post.
- Yours Sue Bretz AMI