Making Sense of the Voices 

by Vishnu 


Two years ago, I was living in Chennai at Gopalapuram, a few streets away from the ex-Chief Minister’s house. I was on a break from my career and doing random things. I often took a walk in the late morning and went to a gym nearby in the evenings. On the way, I use to see a man in ragged clothes often talking to him and shouting profanities aimed at someone others can’t see. I used to see him seated at the same exact spot everyday with a bundle of food. He used to come in the mornings and disappear in the evenings. He always seemed agitated and everyone passing by, including myself, kept a distance. I was not sure whether he was armed or anything. He didn’t seem to be inebriated and was obviously mentally ill. But a grownup man angrily shouting is sure to put off most people.

I would not have understood the actions and plight of this man some 3 years back. But now I don’t have to go far to understand them. A few years back, I was diagnosed with ‘Referential Delusions’ [1]. Over a period of time I started believing that my thoughts and actions were being broadcast and that I’m being spied upon. These beliefs didn’t come spontaneously. It gradually developed over a period of years based on auditory hallucinations and distortions of auditory stimuli. It is easy to dismiss some mentally ill as holding irrational beliefs without analyzing why or how they formed those beliefs. I believe that some of their distorted and unreal perceptions lead them to form beliefs that seem irrational to us. Some of our beliefs are models formed by our brains out of our experiences including reading, listening and other modes of input. It makes sense that when our experiences are based on unreal stimuli, our models are not going to be anywhere near real as defined by inter-subjectivity. I think some of them develop their seemingly irrational beliefs over time trying to make sense of the erroneous perceptual input that comes out of their own minds. I’m basing this my own experience. The hallucinations are not just random voices. These are the voices of people I knew. Like my friends, relatives, colleagues and some voices of strangers. At least in my case, the voices were not random. When a particular friend is near me, I often heard comments in his voice. For example, I may hear comments from my Boss’s room in his voice when he is there. But only that he didn’t actually make that comment! So most of the times the hallucinations are not just random voices, it is the voices of people we know. This is what that makes the discrimination of real and imaginary stimuli very difficult.

Since the comments those voices carry arise out of our own minds, the content comprise lot of personal details. Things only you know and are thinking. For example, let us say you are thinking about some personal topic and you hear a comment about what you are thinking in your boss’s voice. What would you think? You may think he eavesdropped on your thoughts and commenting on it. If this happens once, we may dismiss it as a figment of our imagination. What if this happens every day for a year, in the voices of so many people you know and don’t know? You will seriously start looking for explanations.

As someone with a background in science, I started searching for the availability of technologies that allows one to eavesdrop on your thoughts. I know that such a technology doesn’t exist. And I very well know that it takes very large machines like fMRI to even detect brain patterns and hence that is not possible. Nobody can do it remotely. I came upon this technology called sub-vocal speech detector that comes closest to the cheapest technology that can detect what we are thinking. However, it is obvious that no such machine is attached to my throat. While you are logically striking off these possibilities, you are actually experiencing things to the contrary. So you come to the conclusion your thoughts are not being tracked, may be your activities are being monitored. There is cheap technology available to monitor your every move.

Once you start believing this based on your distorted experiences and perceptions, you start wondering why anybody would do this. And you start coming up with conspiracies, reality shows to other weird explanations and schemes to explain what you are experiencing. And your judgements are being clouded by the “very real” fear and anxiety about the situation. Imagine how much fear and anxiety you will experience when your every move is being tracked and broadcast. When you are being tracked, you start talking to those who are tracking you. You plead with them, beg them to leave you alone, shout at them and threaten them. I remember shouting once in a public place in response to a critical comment by a voice. I got so embarrassed that I left that place immediately. May be the man in the street and countless others like him are caught in a similar situation.
So looking at this sequence of events, the seemingly irrational beliefs of mine were actually semi-rational attempts to explain perceptual abnormalities. I’m not saying this is exactly what happens in all people with hallucinations and delusions. But I’m able to sympathize with them. Someone who is very religious may interpret the voices in different ways and may form radically different beliefs. The content of the voices, very much based on the individual personalities, is sure to lead to different beliefs.
In my case, with the help of my family and friends, I sought medical treatment from a psychiatrist. Over time the voices have died down and I’m able to see that experience in a clear light. Thanks to the unwavering support of my family and friends, I’m now on the path to get a PhD in Biomedical Science. If not for the support and treatment that I got, I might have ended up in the streets just like that man and countless others!

Sometimes all it takes is a little bit of support and awareness. The knowledge that there is treatment and help available for people experiencing such difficulties is only spreading now. But I’m afraid this information is not reaching the uneducated and underprivileged. They often fall victim to superstitions and abandon the mentally ill in the streets and temples. May be part of their reason is economic. Moreover the stigma associated with such illnesses is still prevalent and this further complicates the situation. Many of these illnesses have been associated with abnormalities in the levels of certain chemicals in the brain. In many cases there are medicines available, to bring them back to their previous selves.
The illness has not affected my ability to love and experience the beauty and joys of life or even my aspiration to contribute positively to the society. In fact, that experience made me realize the tremendous value of a healthy human life. Now I see the point in the age old wisdom that stresses the value of treating our body and mind as sacred entities. Life is indeed special and sacred for all of us and how much we realize that is a very good indicator of a society’s health.

I decided that I should help that man on the street somehow. I thought I should talk to him, but didn’t know what to talk or how to do it. I was not in a position to help him buy medicines. One day I decided that I should inform some foundation that helps the mentally ill and destitute about him. When I went to check whether that man was in his usual spot, he was not there. I never saw him after that. I don’t know what happened to him. May be someone else took care of him or the worst happened to him. I felt that I failed to act in a timely manner, which is very important in such scenarios. There are countless people like him who need our collective help and support. Spreading the awareness is indeed the first step and as with many other illnesses it goes a long way towards helping them.

***

Glossary:
1. Referential Delusions – a delusional conviction that ordinary events, objects, or behaviors of others have particular and unusual meanings specifically for oneself.
2. fMRI – functional Magnetic Resonance Imaging.
3.  Hallucination – Hallucinations are false or distorted sensory experiences that appear to be real perceptions. These sensory impressions are generated by the mind rather than by any external stimuli, and may be seen, heard, felt, and even smelled or tasted.
4.  Delusions – an idiosyncratic false belief that is firmly maintained in spite of incontrovertible and obvious proof or evidence of the contrary
Reference:
Bucci S, Startup M, Wynn P, Baker A, Lewin TJ., Referential delusions of communication and interpretations of gestures. Psychiatry Res (2008), 158(1):27-34
Sandra Bucci, Mike Startup, Paula Wynn, Andrew Heathcote1, Amanda Baker and Terry J. Lewin., Referential delusions of communication and reality discrimination deficits in psychosis. British Journal of Clinical Psychology (2008), 47, 323–334
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