“Living with Voices” by Marius Romme et al: Hearing Voices Movement says voices derive from childhood trauma, but fails to diagnose multiple personality.

“The stories in this book demonstrate that recovery means ‘taking life back into your own hands’…‘living your own life, not the life of your voices’…often they had also received long-term traditional psychiatric care that had not helped. Most of them were diagnosed with schizophrenia…Most do not use medications anymore…hearing a voice is not a sign of pathology but a signal of existing problems…Our own studies show that there is a causal relationship between trauma and hearing voices…” (1, pp. 7-8).

This book provides fifty clinical vignettes to prove the value and effectiveness of Living with Voices therapy.

However, apparently unknown to the authors, some of the vignettes describe persons with undiagnosed, and incompletely treated, multiple personality. Here are two examples:

Jolanda

“…I hear three voices and they all have names: Hannah, Eva and Nina…Nina is about 7 years of age. She is still a child. I think Eva is 18 or 20 years old, and Hannah stays about the same age as me…

“Nina cries a lot but is immediately present when other people, or I myself, want to have bodily contact. At that moment Nina sets the rules. She does not get angry but she takes control over me and behaves like a 7-year-old child. I might even say things that come from Nina…Nina originates from a long time ago and she is connected to the sexual abuse…

“Eva is a voice that always has comments…Eva cannot talk decently. She uses vulgar language. Eva also thinks that I have to harm myself. She thinks I shouldn’t exist. Eva came when I was 18 and my family withdrew the formal complaint to the police about the person who had sexually abused me…

“Hannah is the voice that got older with time. She was always there. I was a bit of a loner and Hannah was my mate…

“The voices have had influences in many ways on a lot of things: they took over things I had trouble with, like Nina taking over my intimacy, Eva my defensibility, and Hannah putting my thoughts in order…

“I think I have created the voices myself as I needed them badly in order not to become stressed out. Don’t ask me how I did it. I think it was my survival strategy…

“I have been quite often in psychiatric care and no one talked about my voices. My psychiatrist, Iwona, is the only one. That was eight years ago. She is worth her weight in gold…Iwona also taught me to…invite my voices for a meeting. Then I needed her help to learn how to chair the meeting…” (1, pp. 225-228).

She and her psychiatrist apparently don’t know that this a common technique in the treatment of multiple personality, called “internal group therapy” (2, pp. 261-262).

Lisette

“…I suffered much, especially when I had lost pieces of time. For example, I could walk on the beach; I didn’t know how I had arrived there, but suddenly I was sitting on the beach…Then, I didn’t know how, I came back and all at once I was in the room where I was supposed to be, for example, in the classroom…

“I had never talked about my hearing voices because my voice didn’t allow me to. He had scared me so much that I really hadn’t dared…When I began to talk about him for the first time two years ago he started my self-harm. He does it, the self-harm. I am not aware of it; it is kept out of my consciousness…I have often lived outside my consciousness…

“The voice is male and called Stefan…The voice, the flashbacks and my incestuous past were all mixed up. One moment I was 15 years old and the next I was 9…

“I still experience time gaps regularly [and Lisette] still hears the voice…” (1, pp. 234-237).

Lisette clearly describes the memory gaps of multiple personality.

Comment

Jolanda and Lisette have benefitted from “Living with Voices” therapy, which recognizes: first, that hearing voices does not automatically mean that the person has a psychosis, schizophrenia; second, that hearing voices may originate as a way to cope with childhood trauma; and third, that voices must be given recognition and treated with respect.

However, this therapy apparently does not recognize when voices are the voices of alternate personalities.

Jolanda and Lisette might have made an even better recovery if their multiple personality had been diagnosed and more completely treated.

1. Prof Marius Romme, Dr Sandra Escher, Jacqui Dillon, Dr Dirk Corstens, Prof Mervyn Morris. Living with Voices: 50 stories of recovery. UK, PCCS Books, 2009.

2. Frank W. Putnam MD. Diagnosis and Treatment of Multiple Personality Disorder. New York, The Guilford Press, 1989.
3. Wikipedia.  https://en.wikipedia.org/wiki/Hearing_Voices_Movement