As an instructor you always wonder if what you are teaching makes any sense to the ones that are on the listening end. You want to be able to get your point across without over-whelming anyone with the information. Trying to stress the seriousness of clients illness but allowing them understanding that what we do not hear is real to the ones that we take care of.
Becoming a mental health nurse who is not judgmental and learns how to hear what your client is saying through the hallucinations and delusions can be challenging. When your client knows that you hear them and can understand them they begin to trust you. Trust is the deepest and most rewarding gift a nurse can receive from a client that is so sick inside their own mind they are not sure what is real and what is not – for them to know that you care helps them heal.
In the classroom setting showing the students what the clients see and hear is not always easy – however giving them 15 minutes with a headset to hear voices as they attempt to do a simple task of putting a puzzle together. They get to spend 15 minutes with voices in their head as a schizophrenic.
Voices are: Characterized by paranoia, anxiety, hallucinations and delusions, schizophrenia and schizoaffective disorder, a related condition, are complicated mental illnesses that make it difficult for one to determine the difference between reality and pretend. While there are medications and therapies that can help, the effects of this condition are often far- reaching.
To some listening to these tapes it is disturbing as it should be, but they all walk away with a new look and feel of how the clients feel. To live in a world that is full of voices ones that are not always nice to you running around in your head causing many emotions from anger to confusion.
A student that sat in that class wrote a post on facebook – and I ask her permission to share it with you.
by Amy Gallagher
"Come on," said our nurse educator, Angela. "Let's go hallucinate." My fellow orientees at the Hospital (a psychiatric inpatient facility) looked nervous. We glanced around the room at one another. The apprehension was palpable.
"Where are we going?" asked one.
"What are you going to do to us?" asked another.
"Come on. Let's go down the hall. You're going to see what it feels like to have voices in your head," said Angela. Angela smiled. She could trademark that grin. It's innocent and wicked in one. She was genuinely gleeful as she led us down the hall.
We entered a small room set up with a few tables and chairs. On the tables were jigsaw puzzles. She handed each of us a small tape recorder and a set of headphones. The instructions were pretty simple. We were to listen to the tape as we attempted to work on the puzzles. We made a few jokes about the "old school" technology. "What on earth is this?" (a cassette tape). "These headphones are huge. Where's my iPod?" I even joked that kids today wouldn't even know they were hearing voices since they wore iPods stuck in their ears all the time.
We all sat down and put on the headphones. A woman's voice came on and began giving us instructions. Her voice was very calming and soothing. It was sort of creepy how calmly she spoke. I don't remember all of the instructions, but they seemed sort of silly.
"Do not listen to this tape while driving a car."
"Okay, duh." I thought.
"Do not listen to this tape if you have suffered from auditory hallucinations in the past."
"How would you know the difference?" I snickered at my sense of humor.
There was a pause as the tape continued.
"Is this it?" I asked. "Do we just listen to her? Am I supposed to be hearing something? I don't hear anything but the tape hissing."
"Just wait," said Angela.
Then it began. I heard a woman's voice. She sounded older and was muttering the same string of syllables over and over again. Sometimes it sounded like she was scolding me. It sounded like profanity of some kind. While she rambled, a man's voice came through. It reminded me of rap artists who "beat box" to "lay down some bass." It was a throbbing, repetitive sound. I was working on the puzzle and found myself bobbing my head to the "beat."
When I realized what I was doing, I glanced around, feeling self-conscious even with the headphones on. I imagined how it must feel (and look to others) if the voices were "real" and not on a tape.
The muttering continued as did the low, throbbing sound. A clear, soothing voice spoke up. She sounded very cultured. She kept repeating the same idea over and over again. It felt like she was trying to hypnotize me.
"You are the one," she said, "We know you are the one. You know you are the one. You are the one because you were chosen to be the one. You are the one. You know are the one. You were chosen and you are the one. You are the one because you were chosen to be the one. You know you are the one. We know you are the one." It sort of reminded me of Mojo Jojo from the Powerpuff Girls at first. It was funny at first, but then it felt like a self-help audiotape gone terribly wrong.
Just as she was really getting on my nerves, the voices stopped. I looked at Angela, "Is it over? I don't hear anything now."
She said, "Just wait. The voices are being nice to you." She grinned again and actually rubbed her hands together as if anticipating the next few minutes.
Then "he" spoke up. He was rude. He was louder than the rest. He was insulting. He told me I stank, that I was shitty, that I was a loser. He said he "knew what I had done." He told me to sit down, to put my hands down, to stop what I was doing, to "explain myself." He rhymed his insults and strung together nonsense sentences.
"You're shit. You're shitty. You're shitty, stinky, shit. You smell bad. You're a pig. You're a swine. You're a loser. You're a jerk. Work. Alert. Jerk. Jerk. Jerk. Put your hands down. You're worthless. You're nothing. Everyone knows what you did. They know. We all know." He would laugh as if my distress amused him. His was a voice of control.
I found myself tempted to answer him. To respond to his questions. To laugh at him. I even found myself answering him back. I could be flippant, dismissive, derisive, or cajoling, but nothing stopped him. I refused to plead. I decided to ignore him. I kept working on the puzzle. I hadn't gotten very much done. I was talking to B. and M. who were working on their puzzle together. They were nearly finished. I had gotten very little done. I found myself explaining that while I liked puzzles, I had never been very good at them.
"I love puzzles," said M.
"That means you have a lot of spatial intelligence," I responded, calling up my knowledge of Gardner's theories. During all of this, the voices were still going.
"I stink, too," said M. "I am a swine."
"Me, too. I am shitty pig," I answered. We laughed, but it felt like whistling past the graveyard. B. seemed completely unaffected by the "voices" in his head.
I am not sure how much time had passed. I think it was about 15 minutes. In just a short time, I had names for my "voices." "Crazy Cult Lady" was the voice who kept telling me I was "the one." "Demonic Old Woman," was the one who would mutter, "Laying Down the Bass Man," was the deep throbbing sound, and "Bastard Beatnik" was the alliterative jerk who kept telling me what a worthless, stinking swine I am. And just to mix things up, there was another voice (and funny as this sounds, she was really crazy). She just giggled and laughed. But it wasn't a joyful laugh. It was a creepy laugh. It was the laughter of a madwoman who just killed someone and was fingerpainting with her victim's blood. It was a Manson Family laugh. Surely. I couldn't even give her a name. To name her felt wrong, dangerous. Like acknowledging her would bring her back.
We can talk about auditory hallucinations and attempt to understand what it means to "hear voices," but to experience it, even with a simple audio tape is something else entirely. It was awful. It was horrible. I didn't listen to the entire tape and found that when the voices "paused," I wasn't relaxed or relieved. I was more alert, straining my hearing and waiting for them to "start in again." When they restarted, I actually relaxed more because I could "deal" with their patter, the routine of it, the repetition. I "knew" what to expect from them. When the crazy laughter started up, I was done. I took off the headphones and looked at Angela. Everyone else had removed theirs, too.
"Are we done? Are we finished?" I asked.
"Is the tape over?" asked Angela.
"I don't know. How long is it? Do we have to hear the entire thing?" I was actually getting nervous at this point.
"No, no," she said. "You can stop."
Some of my fellow employees told me later that "their voices" instructed them to "kill her" or "kill him" over and over again. I am no longer surprised at the high rate of suicide among patients with schizophrenia. I will never question the validity of a patient's claim that he or she is "hearing voices." I will never tell a patient the voices are "not real." I will acknowledge that in HIS reality or in HER perception, they are as real as that tape was for me.
Angela Brooks is a mental health nurse educator who spent the last 22 years working in a state funded mental hospital. She is the author of "The Nurses Voice" who exposes raw truth as a nurse. She is transitioning from nursing to one of the top positions in a health company changing life's one oil at a time. Come talk to her on social media