14 Steps to Help Me When I Am Hearing Voices

I sometimes hear voices when I am manic. I have also heard voices when under extreme stress, or during dissociative episodes.

I usually don’t share what is going on in my head… except with my husband sometimes and at support groups. When I have told people about the voices, they never seem to know how to respond, and don’t say things that are helpful. I thought it might help if I wrote out how people could help me during this time. Psychotic episodes can be very different for different people. For me, the battle is mostly inside my head and I know the voices are part of my illness. These are things that would help me, and hopefully, it could help someone else as well.

1. Establish my trust.

I am always really scared to share that I am hearing voices. If I tell you, please reassure me that you are a safe person I can confide in. You could do this by making eye contact and showing empathy in your voice. Tell me you care about me and want the best for me. Give me some time before I share more details. It takes a while for me to build up the courage to talk more.  Remain calm, and be sensitive to whether I want to sit apart from you or closer to you. Tell me you don’t think I’m “crazy,” and that other people have this problem too.

2. Listen.

After you have given me a little time and established I can trust you, I might start talking a little more about what’s going on. Listen with empathy and without judgment.

3. Respond to the feelings I share.

I know it’s hard to understand what it’s like to hear voices, but you can relate to my feelings. So you could say things like, “That seems so scary. I understand how you would be upset.”

4. Summarize what I am saying.

It helps me to feel heard if you respond to what I am saying by putting it in your own words and asking me if you understood it right.

5. Ask me what the voices are saying.

I may not be ready to share what the voices are saying, especially if they are saying bad things to me. But sometimes it helps to get the words out in the open and not in my chest. If I am too nervous to share, you can skip to the next step.

6. Ask me whether I am going to listen to the voices.

The voices might be telling me all sorts of bad things, but if I ignore them, it’s not so bad. If I start believing what the voices say or act on what they say, it can be a real problem. So ask me if I’m going to listen to them, or how I am going to deal with them. Maybe we can talk it over, or you will notice I need professional help to find ways to manage these voices.

7. Decide whether I am in crisis.

If the voices are telling me dangerous things and I’m listening to the voices — if I seem to be a threat to myself or others — call 911 or refer me to get professional help. If I don’t seem to be in crisis, you can go to the next step.

8. Bring the focus back to me.

When I think or talk about the voices too much, I start focusing on them too much, and they get louder and stronger. So we can talk about the voices some, but then bring it back to me. Explain you are concerned about my health and care about me.

9. Ask me what you can do to help.

Sometimes I can think of something helpful, or I might share something unhelpful.

10. Ask me what has helped in the past.

I personally have dealt with voices many times in the past. I’ve developed coping skills, but in the moment I sometimes forget them. Ask me what I have done in the past, and I might remember things I have done before that have helped.

11. Ask me if I’m feeling better.

Hopefully talking to you has helped me feel better. I might say how you have helped me. It helps me focus on the positive and see things are getting better.

12. Ask me what I’m going to do next.

Ask me what my plan is to deal with these voices. Encourage me to get professional help to talk about hearing voices, if I’m not already.

13. Say you care about me.

Reassure me that you care about me and want to be here for me.

14. Follow up.

Check in on me later on, whether it’s hours or days later, to see how I’m doing. Convey to me that you care about me and want to help me if possible.

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Thinkstock photo via AntonioGuillem