For some, it’s a whisper; for others, it’s a shout or the excited babble of a crowd of football fans. The number of children and young people who hear voices is higher than we might imagine.
Dr Ian Kelleher of the Royal College of Surgeons in Ireland (RCSI), who also works at Karolinska Institute, Stockholm, led research on a 2012-published study, which found that more than one-fifth of 11- to 13-year-olds in Ireland had auditory hallucinations.
Dr Kelleher refers to other studies that found 17% of children aged nine to 13 heard voices, whereas by age 13 to 18 only 7.5% did. “It’s much more common than we thought, especially in young children and pre-teens but it decreases in the course of development.”
Auditory hallucinations can range from isolated sentences heard occasionally to minutes-long conversations between two and more people. People can hear screaming and shouting or whispers and murmurs.
“It can be a blip, especially with a young child. Why it happens isn’t entirely clear,” says Dr Kelleher, who believes it may be related to brain maturation.
“As the brain’s developing, you can get crossed wires. Coming up to the teens, brain connections are being fine-tuned. We call it synaptic pruning. This fine tuning can lead to miscommunication. In stressful periods, it may come to the fore in people with an underlying vulnerability.”
Pre-teen voice-hearing is likely to be “benign, transient and to resolve itself”, says Dr Kelleher. But a North Dublin-based study of 13 to 16-year-olds found 80% presenting with auditory hallucination had at least one psychiatric disorder – not necessarily psychosis.
“In the study, psychosis was very uncommon. Hearing voices was much more commonly associated with depression, behaviour or anxiety disorders. When the underlying cause was treated, the voices resolved,”
Rachel Waddingham is project manager with Voice Collective at Mind in Camden, a London-wide initiative supporting young people who hear voices or have visions. She was in Ireland recently training youth mental health workers to set up peer support groups for voice-hearing teens. Waddingham began seeing visions at age seven — monsters in the mirror. By age 14, she was seeing aliens and at university realised she was hearing voices other people couldn’t.
“I spent a few years in hospital and was diagnosed with schizophrenia. I’m a cautionary tale for what can happen if young people can’t open up.”
She turned a major corner in her early 20s when she was introduced to voice-hearing support groups, where she saw others “finding ways to deal with their voices” and realised she was “a human being worthy of being heard”.
Through her work, Waddingham has met children as young as six — one six-year-old began hearing voices when her brother left for university and her parents split up.
She has met teenagers who heard positive voices when they were younger but whose voices became distressing upon entering their teens.
“The voices can be useful. A friendly voice can have a real purpose in making an isolated child feel less so. And if a child gets the right support to stand up to a critical voice, this can be helpful in enabling them stand up to real bullies,” comments Waddingham, who says voice-hearing is often a signpost — “a big flashing light” — to an emotional trauma in the child’s life.
Dr Harry Gijbels, senior lecturer in UCC’s School of Nursing and Midwifery and member of the Irish Institute of Mental Health Nursing, says voice-hearing can be sparked by “usual stresses of life”. But he cites research showing 75% of voice-hearing links back to trauma such as abuse or growing up in a dysfunctional household – “very distressing situations from which the child can’t escape”.
What’s important, says Gijbels, is finding what the voices represent in a person’s life. “The whole trick is ‘what do the voices mean in my life?’ People don’t necessarily want to get rid of their voices. They don’t want the silence. They need to understand the voice and be in control of it.” He says it’s important nobody from the outside imposes a particular explanation. “Psychiatry tends to diagnose something faulty in the brain, but many famous people heard voices – Gandhi did. So did Joan of Arc.”
Today, Waddingham, 36, continues to hear 13 different voices. “I’m no longer diagnosed with schizophrenia. I don’t take medication. I work full-time. I’m married. I have three cats. I travel the world and love my work. I think I’m pretty successful!”
* Plans are underway to set up a Hearing Voices Ireland Network. www.voicecollective.co.uk.
“The first was a female voice whom I now call Sarah Feeney, a very artistic positive voice. The voice reassured me that whenever I felt abandoned or not good enough that I could do great things.
“The voices became incredibly distressing when I was 11. They were destructive, violent, aggressive and instructed me to harm myself, which I did. I didn’t tell anybody about them.
“These voices were voicing the trauma. When you’re repressing something, the voices can express the memories you have buried.
“At 15, I had a huge public breakdown. I still didn’t tell anyone in case I’d be branded crazy. I made up that I’d taken ecstasy. At 17, I went to a psychotherapist who, after five minutes, branded me bipolar and suicidal. A GP said I was making up the voices for attention. At 19 or 20, I started doing my own research, asking: how did I end up here? I channelled my trauma through art and music.
“Today, I am the expert of my experience. I’m someone who has gone through traumatic events. I have voices to help me with those traumatic experiences. I hear up 200 different types of voices that come in all forms, including sounds, music and human voices. We get along. Sometimes we don’t. Most of the time, I’m able to focus in on the most important voices.
“I still hear Sarah Feeney, who’s grandiose and has big ideas. I have a really good comforting mother voice. I love my musical voices the most. I have my own inner MP3 player.”
* Michelle facilitates voice-hearing support groups in Clonakilty. Email firstname.lastname@example.org