Hearing Voices, Living Fully Foreword by Dr. Larry Davidson
“Beware of strangers bearing gifts.” Claire gives several gifts to the reader of this warm and enlightening memoir, and perhaps it is only those readers who think that they already know what mental illnesses are who should be cautioned. If you come to this book with an open mind and a responsive heart, you will be rewarded with a well-told tale of human aspirations, courageous actions, and notable achievements. You will take delight in our protagonist overcoming the odds of her presumed “illness” and life situation—as so many others with these kinds of struggles do—and may bemoan the fact that mental health services did not help more to bring about her happy ending. If, on the other hand, you believe that you know what mental illnesses are and believe, or expect, psychiatric treatments to be effective in easing the suffering wrought by these conditions, you are likely to be at least bewildered if not also dismayed. Just know that that discomfort is another one of Claire’s gifts.
Claire starting hearing voices when she was 31 years old. She was encouraged by her loved ones to seek psychiatric treatment, was hospitalized twice, and tried a number of different medications at different doses at different times. While she received some short-term relief from the voices and associated delusional beliefs in response to medication, none proved helpful in the long term and, as she writes in the following, “I believe it was my decision, finally, to take responsibility for myself as well as for my young son that changed everything.” How, in these days of “brain diseases” and direct to patient pharmaceutical advertising, are we to understand how Claire “changed everything” through her own resourcefulness, ingenuity, and dogged persistence? How do we understand that the voices she heard could be helpful at times and that they responded to her thoughts, decisions, and moods? How are we to understand that she has recovered?
Claire’s story is certainly not the only one of a person who manifested the frank psychotic symptoms of a mental illness, found a way to manage and live with those symptoms, and eventually recovered her life. We now know that that happens much more often than we used to think, and that, in fact, most people who do not take their own lives experience significant improvements in their mental health over time. In this way, Claire’s story adds to the increasing numbers of such recovery narratives that are appearing as courageous people take the risk of sharing their own experiences with mental illness. Like Claire, they describe the importance of love, faith, and family support, the value of pursuing their own passions and interests, and the crucial roles that hope and their own decisions and sense of agency play in their recoveries.
But Claire’s memoir is different from many recovery narratives in an interesting and challenging way. Since she did not begin to experience psychiatric symptoms until age 31, Claire takes the opportunity to lure us into, to gently immerse us in, the story of a very ‘normal’ person. Her life was in every way unremarkable prior to her first experiences of voice hearing. She was, and remarkably remains, an exceedingly ‘normal’ person throughout the memoir. As a result, it is easy for us to identify with her, to join her story early on in the book and to follow along faithfully as if we were reading a compelling novel. Having established this connection, she then tugs us along with her into her experiences of what psychiatrists would undoubtedly describe as psychosis. But—and this is the important point—it is not described, and then inevitably dismissed, by Claire as psychosis. Rather than distancing herself from what by all accounts were sure to be terrifying and disorienting experiences, she faithfully reports to the reader both these experiences themselves and her best efforts to make sense of these experiences as they were occurring. There is no Monday morning quarterbacking going on in this book, and as a result we get—perhaps for many of us, for the first time—to witness up close and personal what it is like to have to contend with, to have to live one’s daily life in the face of, the anomalous experiences that get labeled and packed neatly away from view as psychiatric symptoms.
There is little that is neat or orderly to Claire’s story. Through her earnest efforts to be transparent, we come face to face with both the kinds of experiences involved in mental illnesses and the kinds of treatments offered for them. When she tells us that she felt “like a piece of heavy rubber with a heart and soul of wood that was going through the motions of being human,” we understand why she stopped taking the prescribed medication. When she tells us that she worked hard, to the point of exhaustion, “not to seem too crazy” to her family, co-workers, and friends, we feel for her and hope she succeeds. And when she tells us that she “wondered whether some of my colleagues were practicing some form of witchcraft or voodoo” or whether she has really sold her soul to the devil, we appreciate that no one has really offered a better explanation yet for what is going on in her life.
Current estimates are that voice hearing may be as common as left-handedness. Few people are prepared for such experiences the first few times they happen to them, however. Claire’s struggle, in that respect, is very common in people who hear voices and whose cultures do not provide constructive or adaptive ways of making sense of such experiences. While many such people end up coming into contact with the mental health system and its labeling of these experiences as symptoms, many also leave the mental health system unhealed and unhelped because they do not find such a one dimensional, simplistic explanation nearly as compelling as the voices themselves. Claire shares with us that largely hidden story of people contending with voices on a day-to-day basis, helps us to appreciate how compelling the voices can be when they are responsive to the person’s thoughts and actions, and does not shy away from telling us, even as the story comes to an end, that she still doesn’t understand what has happened, or continues to happen, to her.
While we may feel discomfited or bewildered by this fresh and honest account of Claire’s experiences and her efforts at making sense of them, our society as a whole, and our mental health system in particular, may benefit tremendously by accepting this gift as an invitation to rethink the nature of mental illness and how we treat it. Everyone who experiences what we currently consider to be a mental illness was ‘normal’ before having those experiences, remains ‘normal’ as they try their best to make sense of and manage such experiences, and emerges as yet still ‘normal’ in the aftermath of such experiences as well. Now that Claire’s memoir has made this abundantly clear, we have to begin to figure out what to do about it.
Larry Davidson, Ph.D.
Professor of Psychology, Yale University School of Medicine