“Facing” the Voices!

“Avatars may help control ‘voices’ in schizophrenia.”  read the headline on the NHS Choices Health New Section on May 30th, 2013.

It was an article looking at another article previously published in one of the UK’s Newspapers – The Guardian – and which looked at the idea of creating a computerized avatar in order to ‘give a face’ to those voices that some of us who suffer from schizophrenia hear.

“Scientists are examining whether computer-generated avatars can help patients with schizophrenia,” The Guardian explains. The headlines report on a small study of a novel therapy technique that attempts to tackle auditory hallucinations, where people hear voices in their head.1

“A small study” is an accurate description since the study in question ( according to the article in NHS Choices) involved only ’26 patients who had heard “persecutory” (abusive) voices for at least six months and continued to experience these hallucinations even after treatment with antipsychotic medication.’ That is not to say that the study doesn’t still bear consideration.1

Those 26 patients were then split into two groups with 14 patients creating a computer-based face and voice to communicate with (an avatar) and 12 patients being treated as usual, which consisted of ongoing antipsychotic medication for seven weeks.

According to the article, “The patients in the intervention group created an avatar similar to the entity they believed was talking to them, essentially giving a human face to the voice they were hearing. Custom-made voice software was used to create a voice that matched the hallucination.1

The therapist was then able to use this real-time voice software to speak through the avatar, with the voice heard by the patient. This was designed to let the patient and the hallucination have a conversation. During the sessions, the therapist and patient were in separate rooms and the therapist was able to talk to the patient directly, as well as through the avatar.1

Talking directly to the patient in a traditional way, the therapist encouraged the patient to stand up to their hallucination. During the course of the conversation, the therapist allowed the avatar to increasingly come under the patient’s control, and shifted the character of the avatar from abusive to helpful and encouraging.1

Patients were then given a recording of these sessions to listen to in order to reinforce their sense of control. Patients could complete up to six 30-minute sessions.”1

The outcome of which, it is reported, were then researched and threefold..

  • Frequency and disturbing qualities of hallucinations – this was measured using the hallucinations section of the Psychotic Symptom Rating Scale.
  • Patient experience related to the voices – this was measured using two subscales of the Beliefs About Voices Questionnaire: the omnipotence scale (which assesses the power that the patient perceives the voice has) and the malevolence scale (which assesses the patient’s belief about the evil intentions of the voice). This questionnaire assesses the delusions that patients hold about their hallucinations.
  • Depression (common among people with schizophrenia) – this was measured using the Calgary Depression Scale.1

The study was carried out by researchers from University College London and the Royal Free and University College Medical School, and was funded by the National Institute of Health Research and Bridging Funding from the Camden and Islington NHS Foundation Trust.

It was published in the peer-reviewed British Journal of Psychiatry.

As a schizophrenia sufferer myself the study fascinates me on several levels.  Not least of all being a question that arises in my mind whether these “facial avatars” which (as far as I understand) the patient themselves (with the help of the therapist) creates bear any resemblance or likeness to real people in the patient’s past.

We have long since understood that messages and dialogues that we pick up in our childhood, formative or early years, along with repeated messages and dialogues throughout our lives can play a large part in our self-esteem or lack thereof and I wonder how much they play in those persecutory voices that some of us schizophrenia sufferers hear?

I would be very interested to get your feedback and input on this!  What do you think?

5 comments on ““Facing” the Voices!

  1. Dearest Kevin,
    This is a great post about a great idea!! Thaks so much for posting!

  2. I think that there is a lot to be said for giving a face to the voices, as long as that remains in the person’s control. A problem I see is that due to the nature of schizophrenia itself, hallucinations are NOT under the person’s control, so that a visual avatar could easily become an “evil” entity, giving the previously disembodied voice a visual component that could become double trouble. The other problem I see is that fixed delusions do not respond to logic. See my post “The Psychiatrist and the Lightbulb.” I do agree that for people with very sensitive neurology, the negative messages we pick up during especially preverbal childhood could very well contribute to the judgmental or deprecating content of the voices.

  3. I have a real appreciation for the fact that the last 2 decades the norm, (being medication management) has been challenged and that creative and diverse therapies are being tried.

    At 55 I have a long history of “Mental Health treatment”. I was repeatedly denied any alternate treatment including ongoing talk therapy, and was treated like a misbehaving child for refusing to take Lithium, that AFTER 20 years of fighting it, was found to “not be the correct medication for me”.

    Respect for any intuition I might have had for my own condition was totally missing.

    I went from a diagnosis of Manic Depressive, to post-traumatic stress disorder in 2005 and after being treated with EMDR (Eye Movement Desensitization and Reprocessing), my functioning was radically improved.

    We have come a long way baby.

    • Hi,

      Many thanks for getting in touch and letting me know about your site “Velcro Not Strings”. Please accept my apology for the delayed response but I am unwell with the flu .

      I am pleased to be able to tell you that I have just popped over and visited your blog and I am more than happy to include your blog “Velcro Not Strings” in our Guild Members list and in fact have just done exactly that. So welcome!

      Please feel free to copy the member’s logo from that page and to display it on your site/blog if you wish to. As a member you are entitled to 🙂

      You are also very welcome to join in any competitions that are run and to give out the Warrior Child Award to any blogger whom you feel is deserving of it. You will find details of that award on its own page within the navigation bar.

      I should perhaps mention that due to many bloggers wishing to remain anonymous as a result of the stigma that still remains in respect of poor mental health and mental illness, membership to the Guild is awarded to the blog and not the blogger. The only way that this is relevant is that it means that should you have or start a further blog or blogs, membership of the Guild does not automatically transfer to that or those blogs and they must also be approved for membership.

      I think that about covers it so all that remains for me to say is that if I can be of any help please don’t hesitate to get in touch with me here or through one of my personal blogs, http://www.VoicesofGlass.wordpress.com and again “welcome to our little band of bloggers!”

      Kind Regards and God bless you.

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