Voice hearers gather in groups and face taboos – 09/03/2023 – Equilíbrio

“Is no one else listening? There’s a man ordering me to kill and destroy.” The condition that led Leandro Torquato Amaral, 38, to ask for medical help can be seen by medicine as a mental disorder. But for an international organization of people who hear voices, it is not synonymous with illness.

In the Hearing Voices International Movement (HVM), hearing is analyzed based on each person’s trajectory and discussed in support groups. The proposal also aims to break taboos associated with the phenomenon.

Voice hearers gather in therapeutic groups that confront stereotypes, including madness, and find ways to deal with what they hear, such as identifying triggers. The process also involves looking for stimuli that drive away the voices seen as negative or, in some cases, talking to them.

The idea was born in the Netherlands in the 1980s and arrived in Brazil in 2015, when two centers were opened in the interior of São Paulo. Four years later, there were more than 40 groups, estimates psychologist Leonardo Duart Bastos, a national reference at the HVM.

In some municipalities, the approach was adopted by the SUS (Unified Health System) and integrated into the Caps (Psychosocial Care Centers), as was the case in Ribeirão Preto. It was there that Leandro, a retired industrial operator, found out about the project. He says that, after being diagnosed with schizophrenia, he started taking medication – the treatment eased the crises, but did not make the voices disappear.

“This is common in clinical practice. Many patients continue to hear voices, the drugs alone do not solve the anguish”, says Professor Sabrina Stefanello, from the Department of Forensic Medicine and Psychiatry at UFPR (Federal University of Paraná).

Thus, Caps health professionals suggested that Leandro participate in one of the groups. He says it took him a year to get up the courage to tell his story. When talking about himself, he realized that the uncomfortable voice was the same as that of an abusive boss who fired him in the middle of a burnout crisis.

“It had to do with an anger that I had not been able to expose since the dismissal. It was as if my subconscious was calling me for a conversation”, he says. Today, six years later, he has developed a way of dealing with what he hears. It already identifies triggers and is able to refute destructive commands.

The strategy of avoiding orders is just one of the methods used to face the situation, says Clarissa Mendonça Corradi-Webster, who coordinates LePsis (Laboratory for Teaching and Research in Psychopathology, Drugs and Society) at USP (University of São Paulo). seek stimuli that drive away negative voices, there are those who talk to them or try to deceive them as a form of defense.

Although support groups are sought by people in mental distress, voices do not have a negative connotation for HVM. Only those who live the experience can say whether it is good or bad. This is because not every listener suffers from the phenomenon. “I knew a man who listened to a nurse talk when he was scared and that calmed him down”, says Clarissa.

It is common for the chat to go beyond voices and also include art, religion, trauma and prejudice. Thus, each group gains a specific configuration.

The one in Curitiba (PR) was created a year and a half ago by psychologist Loraine Oltmann de Oliveira, who worked at Caps and researched the subject in her master’s degree in collective health, at UFPR (Federal University of Parará). The meetings, which are online, bring together participants from all over Brazil and receive not only ombudsmen, but also those interested in the subject. A much-discussed topic there is to what extent it makes sense to silence voices with the use of medication.

Plastic artist André Coelho Fernandes Castro, 29, who lives in the city, has heard voices since he was a child. In the weekly conversations, he found a space of autonomy and freedom. “Today I’m just trying to understand what the voices want to tell me”, he says. To give vent to what he hears, the young man, who is also the group’s mediator, represents the phenomenon through art in graphic pieces.

The Voices Hearing Movement emerged amid debates that erupted in the second half of the last century and culminated in movements such as the anti-asylum struggle and psychiatric reform. In Brazil, one of the consequences of this scenario was the Anti-Asylum Law of 2001, which challenged treatment centered on the isolation of people in large hospitals, prioritizing patients’ autonomy and citizenship.

“We still see traces of an old psychiatry. But there are currents resisting this view. We are moving forward”, says physician Políbio José de Campos Souza, coordinator of the residency in psychiatry at Hospital Odilon Behrens, in Belo Horizonte (MG).

The proposal also advances by expanding the range of therapeutic possibilities. “Some patients want to silence their voices, others have no interest in that. We need to stop seeing people in the light of the same key”, points out psychiatrist Sabrina Stefanello.

Despite being used as a therapeutic practice, the approach is little known by traditional psychiatry. At the head of one of the oldest research programs on schizophrenia in Brazil, professor Mário Louzã, from USP, has never followed the proposal closely, but believes that support groups among peers can alleviate psychic suffering in cases where hearing indicates some mental disorder. The specialist reinforces only that, for this, medical treatment needs to be maintained in parallel.

The movement has been guiding debates in the public sphere. In Ribeirão Preto, a municipal law of 2020 instituted September 14 as Voices Hearing Day. On the date, meetings are held to break taboos about the phenomenon. The HVM also holds a global congress, which takes place annually. In 2022, the event was in Brazil.

This report was produced as part of the 7th Science and Health Journalism Program of Folha de S.Paulo, which had the support of the Serrapilheira Institute, Roche Laboratory and the Albert Einstein Beneficent Society.