Hearing voices does not mean you are crazy. This is so even when a voice tells you to commit suicide or to kill someone else. People do sometimes obey those commands and this fact makes it urgent to do something about command hallucinations. Many common attempts to do something are simply futile. One cannot close one’s ears to the voices. Medications dull consciousness long before affecting the voice. Auditory hallucinations often persist even after electroshock treatment. Such treatment efforts are protracted and demoralizing to the person and the end point is usually an uncertain claim that the voices are “gone.”

An entirely different approach to dealing with voices is recommended by some clinicians that work with trauma, which is the most common origin of voices. They say, “talk to the voices.” They explain the voices as vocal parts of yourself that have their own ideas and opinions. If you are willing to negotiate with them you may be able to help them become less extreme in their efforts to participate in your life. First, it will help to learn more about their nature and their role as parts of you.

The Nature of Voices

Usually the individual voices have been constant companions and are recognizable to the person as male or female and young or old. Sometimes there is a single voice, but more commonly there are groups of voices; some with prominent roles and some just bit players. There may be the crying of infants or young children and there may be cries of other traumatized selves. When there are young, helpless children there may be older protectors. There is no limit to that internal world. Voices keep arising as consequences of traumatic experiences.

A person may hear only one or two voices. This “layer” often contains a commanding voice urging total subjugation and humiliation. It may impel the person to drink or to starve or self-cut, or it may demand suicide. The person typically reacts with automatic, trance-like obedience and may be saved only by appeals from another voice saying “No,” or the intervention of another actual person. One may come to realize that these voices represent past selves that are still locked in the trauma that froze their action. Other voices are protectors of young traumatized selves and some are keepers of the “secret” as commanded by a perpetrator.

The Externalized Dialogue With Voices

Talking with a voice requires externalizing the voice, which is best done by writing a message to the voice, addressing it as “you.” This will be the first of a series of taking turns, each addressing the other as “you” or by name. Now it is the turn for “Voice” to speak. You may have to write for the voice at first but before long Voice will speak for itself, your hand moving by its will.

The rules for the externalized dialogue are three: 1. Take turns. 2. Don’t interrupt. 3. Write complete sentences. The dialogue with commanding voices can begin with an exploration of their roles and their feelings. Usually their roles began as attempts to help the person. Unfortunately, even suicide might be regarded as a helpful solution for the need to escape. A successful negotiation with the suicidal part can substitute less extreme solutions.

Voices Have Quirks

There are certain quirks that characterize the majority of voices. Knowing about these quirks helps to understand the power of the externalized dialogue.

Voices are gullible: Voices arise outside of consciousness in the brain tissue that normally relies on the conscious language processing of the brain to provide syntax and leadership. The dissociated states of self with their voices may be desperate for leadership and for the missing elements of syntax. The practical consequence for voices that represent self-states frozen in past traumas is that their identity and roles are ripe for reframing by the individual’s present verbal mind. The externalized dialogue is a practical vehicle for communicating with those voices, influencing them, and reframing their identity and roles.

Voices hear voices: When someone negotiates with a voice that urges suicide and finally gains agreement to pursue a different option, this may not be the end of the matter. There may be another suicidal voice ready to fill the role vacated by the first suicidal voice. Separate negotiations with different voices may be necessary.

The best defense is a strong offence: The fiercer the voices sound at the beginning, the meeker they are in the long run. People may be terrified of their voices and also fearful for the safety of others if that fierce voice “gets out.” However, once engaged in the dialogue the voice becomes simply another aspect of the person and, more often than not, a younger aspect.

Voices can be wise. Some voices become helpers by providing a clear-headed response to the negative voices. Some voices exemplify a wise archetype or a role of “inner-self-helper” described in the psychiatric literature. That helpful voice can be called on during the course of therapy using the externalized dialogue process.

A Safe Self-Help Technique?

Many people have used this as self-help after going through a one or two-week intensive trauma therapy program and they reported no difficulties or complications.