Professional Documents
Culture Documents
hoices
Workbook
GiVE
©MissCHazell
1
Overcoming Distressing Voices
Workbook
This workbook is your way of making the Overcoming Distressing Voices book personal to
you. The workbook is yours to keep and it’s up to you if you want to share it with anyone.
Feel free to write notes in this workbook, and to complete as many or as few of the activities
as is helpful to you.
The workbook is broken down into topics that will match the chapters in the book. There is at
least one chapter that goes with each topic.
If you would like additional copies of any of the activities that are in this workbook
then just let your therapist know.
This workbook has been designed in collaboration with people who have lived
experience of hearing voices.
Contents:
Session Topic Book Chapter
1 Coping 4
2&3 Me 2&6
2
Planning My Sessions
My therapist is: ____________________________________________
When are my sessions?
Session Date Time
Number
1
3
What is hearing voices?
‘Voice hearing’ means hearing someone or something talking when the source of the
voice does not seem to be present.
Voice hearing is common to many different mental health problems. But lots of people who
do not experience mental health problems hear voices too. Many famous people report
hearing voices, including actor Anthony Hopkins, and footballer Vinnie Jones.
Everybody’s experiences with voices are different. It can be a pleasant experience, but
sometimes it can be very distressing.
Here are some examples of different ways people might experience hearing voices:
Whilst it may not be possible to make voices go away for everybody who hears them, there
are lots of ways to make these experiences more manageable. You have received this
workbook because you are seeing a Voices Clinic Therapist for an individual therapy that
looks at ways of managing voices and trying to live well despite their continued presence.
4
The
hoices
Workbook
Coping
©MissCHazell
Session 1
5
Coping with Voices
Trying to understand our voices can help reduce the confusion and distress they cause. It is
a good idea to ask someone you trust whether they can hear the voice, just to check it is
something that only you can hear.
It might be helpful to try and find effective ways of coping with voices. There are a number
of strategies you can use to make voices less prominent, even if only for a while.
Stress Management
Voices can be worse when we are stressed and anxious. These activities can
soothe and relax us.
Having a sauna
Breathing exercises
Exercise
………………………………………………………….
…………………………………………………………..
……………………………………………………………
………………………………………………………………..
6
Socialising
Being with other people can keep our minds occupied and take our attention
away from voices.
Some ideas:
Engage in a positive activity with others
……………………………………………
…………………………………………..
…………………………………………
……………………………………………………………………………………………
…………………………………………………………………………………………….
There is also medication. Medication can help people who hear distressing voices in
the short term, and sometimes varying the dose can be helpful (please discuss any
changes in medication with your therapist or doctor in the first instance).
7
My Coping Strategies
Finding successful ways of coping with voices is not always straightforward and persistence
is often the key.
You might find it helpful to think about the coping strategies you currently use and what you
might want to consider trying out in the future.
If your coping strategy isn’t always effective you might find it helpful to think about adapting it
in some way, or trying one or two new ones.
8
The following questions might help give you some ideas:
4) Is there anything that mental health services could offer that you might
not have tried in the past?
..............................................................................................................................
..............................................................................................................................
..............................................................................................................................
..............................................................................................................................
..............................................................................................................................
9
Once you have come up with a few possible coping strategies (old or new), take some time
to think about which one you could actually try out.
If you decide not to use this coping strategy again you might want to go back to the list you
made at the beginning and think of another coping strategy that you could try. Once you
have tried this new strategy, check how effective it was.
Finding a coping strategy that works for you can involve some persistence, and trial and
error.
10
Key Points:
Notes:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
11
Reflections
After working through this session you might find it helpful to take some time to reflect on
what you might have learnt. There is space for you to write an answer in relation to each of
these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapter 4 of your Overcoming Distressing
Voices book. Don’t forget to complete this week’s diary.
12
The
hoices
Workbook
Me
©MissCHazell Session 2
13
Playing the Curious Detective
Throughout this course, your therapist will help you to identify the beliefs that you have about
yourself and your voices. Next you will consider whether these beliefs are helpful or not. If
you decide that they are not helpful then you might want to check the accuracy of these
beliefs.
This is where you will need to play the curious detective who finds and interrogates the
evidence that proves and/or disproves your beliefs but...
BEWARE OF THE CONFIRMATION BIAS!
Here is an example...
Pretend that you are playing a game. The first time that you play, you win the game, and
you just happen to be wearing a blue shirt.
The second time you play this game you are wearing the same blue shirt. You win the game
a second time. The third time you play the game, you are not wearing your blue shirt (it is in
the wash), and you lose the game. You may come to the conclusion that the blue shirt is a
“lucky shirt”.
As you continue to play the game you are likely to remember all the times that you won the
game wearing your blue shirt. If you lose a game when wearing the blue shirt you might
make excuses and subsequently forget these occasions. So, nothing changes and the blue
shirt remains “lucky”. This confirmation bias can become a problem when it maintains
unhelpful beliefs about ourselves and our voices that may not be completely accurate.
Try to keep this in mind and play the “curious detective” – look at the evidence,
question your beliefs, and ask yourself:
Is my shirt actually lucky?
14
Self-Esteem
Low self-esteem and hearing voices tend to go hand in hand. To find out if low self-esteem
is a problem for you, you might find it helpful to complete the Rosenberg Self-Esteem Scale.
Just choose the option that best applies to you, then add up your score.
You can compare your score to the score that most people get to see if low self-esteem
might be a problem for you.
Most people score around 22 or 23. If you score lower than this then you might have lower
self-esteem than most.
15
Core Beliefs
There are lots of reasons why someone might have low self-esteem, although for most
people self-esteem starts to develop during childhood. People who hear voices are
particularly likely to have had difficult early life experiences.
To understand why you have a low self-esteem it can be helpful to identify your core
beliefs. Core beliefs are phrased as ‘I am…’ statements, and are beliefs that are thought to
be true all the time (i.e. don't change depending on the situation). They can be both positive
and negative. If you have a low self-esteem you will most likely have more negative core
beliefs than positive ones.
Core beliefs can become stronger over time as we all have a tendency to remember and
notice things that fit with and support our beliefs. We also tend to ignore the things that go
against our beliefs. This means that we can end up gathering lots of evidence to support our
core beliefs, which can make it easier for us to carry on believing them. If we believe
negative things about ourselves then it is easier to believe that our voices have power and
control over us and that any unpleasant comments they make are true. If you have found
that you might have a problem with low self-esteem you might find it helpful to try and
identify a negative core belief and consider how your core belief affects you.
16
Searching For Evidence
Beliefs are not the same thing as a fact. Although we have very good reasons for having
beliefs, they can sometimes start to have negative effects on us over time. It can be helpful
to take the time to look at these negative core beliefs and test whether they are actually true
or not.
Choose one negative core belief that you identified previously and start to think of evidence
and experiences that would mean this belief is not completely true all of the time. You might
find this hard so try to think about different times in your life, or ask family and friends if they
can think of any examples. We’re interested in small things as well as big things.
The negative core belief I want to check out is:
……………………………………………………………………………………………………………
Evidence and experiences that mean this negative core belief is not completely true
all the time…
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Re-check: Right now I believe this core belief is true with about ………………..% certainty.
17
Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this /session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapters 2 & 6 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
18
The
hoices
Workbook
Me
©MissCHazell Session 3
19
Alternative Beliefs
Hopefully, by finding evidence that does not support your negative core belief, you will see
there are times when your negative core beliefs aren’t completely true. You may have
noticed a change in the truthfulness of this belief or you may have noticed little change.
Core beliefs have developed over a long period of time so it may take some time before
change is apparent. You might find it helpful to continue looking for evidence that goes
against your core beliefs or you might want to try this exercise with another negative core
belief.
As well as re-evaluating our negative core beliefs, we can try to strengthen alternative, more
positive beliefs in order to try and boost our self-esteem. Try to think of a positive core
belief that you might feel a little bit or would like to feel about yourself. Then try to think of
evidence and experiences that would support this belief.
Here are some example alternative beliefs you might want to use…
“I am worthy of respect” “I am valuable” “I am talented”
“I am successful” “I am good” “I am interesting”
Again you might find this difficult so try to think back in time, and you could ask friends and
family to help you think of examples.
2.
3.
4.
5.
6.
7.
8.
9.
10.
20
Beliefs not only affect the way we feel about ourselves, they can also influence the way we
behave. Looking at your alternative belief, can you think of the ways you would behave
differently if it were true? Try to think of some ideas and make a note of them here.
2.
3.
4.
5.
Once you have identified some actions, why not try them out? If we act like our alternative
belief is true then this can help us to believe it more over time. This might seem scary at
first, so maybe just try to make a small change at first. You can think of this as ‘testing out’
your new alternative belief.
You might find it helpful to make a note of specific things that you could do and when you
could do them. It might be helpful to start with a small change and then build on this when
you feel ready.
Once you have had a go at gathering evidence to support your alternative belief, and tried
testing it out you might want to ask yourself again how much you believe your alternative
belief, and see if there has been any change.
Re-check: Right now I believe this is true with about …………………% certainty.
21
Key Points:
Notes:
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
22
Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapters 2 & 6 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
23
The
hoices
Workbook
My Voices
©MissCHazell Session 4
24
Beliefs about Voices
We have previously played the curious detective by evaluating the accuracy of our negative
beliefs about ourselves. During the next two sessions we will use the same approach to
explore the accuracy of the beliefs we have about our voices.
If a person believes the voice is all powerful, all knowing and has bad intentions this will
make the voice more distressing, compared to a voice that is seen as powerless or with
good intentions.
25
Cognitive Behaviour Therapy (CBT)
CBT for hearing voices is based around the idea that when someone hears a voice, the way
they feel and behave will be affected by their beliefs about the voices. The diagram below
can help to explain how CBT works using the ABC model.
Activating Event
Hearing a voice or voices
Consequences of A & B
Common responses to voices
Behaviours Feelings
Bodily
sensations
26
The ABC model shows that it is our beliefs about an event that can influence different
consequences.
Martin Sarah
A Voice says:
"If you go out I will punish you"
Beliefs:
Beliefs:
- The voices have no control over
C
Behaviour: stay at home
Behaviour: Go out
Bodily Sensations: knot in stomach,
Bodily Sensations: relaxed muscles
headache
This diagram shows the ABC model for two different people: Martin is on the left and Sarah
is one the right.
In this diagram you can see that two people can have the same Activating event, but their
Beliefs are different.
The difference in the Beliefs can lead to different Consequences.
In order to have more positive consequences we need to think about, and work on our
beliefs. The techniques within CBT can help us to do this.
27
Beliefs about Voices
The first step is to identify what you think about your voices. Before you do this, choose one
particular voice to focus on. If you hear two or more voices it might be best to choose the
voice that you want to change the most. If you hear a crowd of voices then choose a belief
you have about the crowd.
It can be difficult to work out what we think about our voices. You might find completing this
questionnaire a helpful way to identify your beliefs. A higher score means a stronger belief
in the power and control of the voice or more harmful intentions.
28
We can use the ABC model to look at what we think about our voices in more detail and
understand the consequences of this. You can use the diagram below to do this.
Activating Event
What does my voice say?
Consequences of A & B
How does my voice make me feel and behave?
Feelings:
Behaviours:
Bodily Sensations:
29
From doing these exercises, you may have noticed that you have some negative beliefs
related to voices. You might find it helpful to take the time to think about the beliefs you
have and decide which one you would like to work on.
If you are finding it difficult to choose, it might help to remind yourself of the most common
types of negative beliefs that people can have about their voices...
Power
Beliefs
about
voices
Intent Control
Next you might want to think about the impact that your belief about the voice has on you.
You can use the information that you put into the ABC model to fill this in.
30
Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapter 1 & 5 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
31
The
hoices
Workbook
My Voices
©MissCHazell
Session 5
32
Searching For Evidence
CBT is not about positive thinking, it is about carefully and accurately looking at the
evidence. We next need to ask ourselves is there any evidence or experiences that do not
fit with our belief about the voice?
Using the belief you selected in session 4, write down any evidence or experiences that
mean the belief you have chosen is not completely true all the time. To help you do this
exercise you might want to look back over the entire time you have heard voices and think
about whether you are giving yourself the chance to find evidence that will help you re-
evaluate your belief.
The belief about my voices I want to re-evaluate is:
……………………………………………………………………………………………………………
Right now I believe this belief is true with about ………………..% certainty
Evidence and experiences that mean this belief about my voice is not completely
true all the time
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
33
When you have collected your evidence you might want to ask yourself again how much you
believe this belief.
Before you make your decision, take time to think about all the evidence that you have
gathered.
Re-check: Right now I believe this belief about my voices is true with about ..…..% certainty.
You might notice you believe this belief with less certainty now you have had the chance to
gather evidence. On the other hand, you might notice you believe it just as strongly as you
did at the start. This is not unusual because our beliefs about voices have been around for a
long time and they can be difficult to change.
If this happens you might want to spend more time finding new evidence or experiences, or
try re-evaluating a different belief.
Are there other beliefs that you can try to re-evaluate, which might help you to overcome
distressing voices?
If you have found this helpful you could repeat the process thinking about another voice that
you hear, and the beliefs you have about this voice.
34
Key Points:
However, beliefs are not facts; they are best guesses and
can sometimes be wide of the mark
Notes:
_____________________________________________
_____________________________________________
35
Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapter 1 & 5 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
36
The
hoices
Workbook
My Relationships
©MissCHazell
Session 6
37
Understanding Relationships
Relationships are usually something that happens between two people. Relationships can
be positive when they work well. But they can also be negative and a source of pain and
distress.
Relationships
Closeness Power
38
Relationships with Voices
Many people speak of having two-way conversations with their voice. There are similarities
between the kinds of relationships that you might have with a person, and with voices. Just
like our social relationships, power and closeness are also important in understanding the
relationship we have with voices.
To understand the power and closeness in your relationship with your voice you might find it
helpful to fill in the questions below. The higher the score the more powerful and close you
view your voice.
39
Responding to Voices
After completing the questions you might now have an idea about how powerful and close
you view your voice. It is common for voices to be rated as very powerful and too close.
Distressing voices tend to be seen as more powerful than the person who hears them. This
power is often used in a negative way, for example trying to dominate or intrude upon
privacy.
There are lots of different ways that you can respond to voices. Some of the most common
ways that people respond to their voices are listed below. Each of these responses is
understandable and natural in the face of a threatening situation.
Try to escape
Fighting back
Giving in
40
Responding Differently
Relationships with voices are often imbalanced and one way. A one-way relationship tends
to be a negative one. It is important to try and develop a more balanced and less distressing
relationships with our voices.
Research shows that people who have more positive social relationships tend to cope better
with their voices. Having positive relationships gives the opportunity to talk about voices
openly.
There are often similarities between the relationships we have with voices and the
relationships we have with family and friends. If you have any difficult relationships there are
things you can do to try and change them.
Firstly it is important to identify any relationships you have that are difficult, and to assess the
likelihood of these relationships being able to change. These relationships might include
your relationship with your voice.
41
Next you need to decide which relationship you would like to work on. It might be best to
choose the one that is most likely to change. There is no right answer as to which one you
should choose.
In order to better understand the difficult relationship you have chosen to work on it can help
to think about the kinds of things the voice/other person says to you. You can use the
questions below to remind you of what they say.
Do they...
Criticise you? Call you names?
If yes, write down what they say If yes, write down what they say
42
Becoming More Assertive
We often feel we have no say within our difficult relationships. This is what we will be trying
to change.
You can use the table below to explore some of the things that are said to you in the
relationship you have chosen to work on, and identify how you feel, what you say and how
you act in response.
One way to change the relationship is to talk back in a more assertive way. This is not the
same as being aggressive.
Assertiveness involves communicating our feelings and opinions in an honest way that
promotes a healthy view of ourselves and others.
43
To see what scope there is for you to be more assertive you can re-examine your responses
to the voice/other person in the relationship, and try to change this to a response that is
more respectful to both yourself and them.
• "In my opinion..."
• "As I understand it..."
You might want to use the table below to think about whether your typical responses are
passive, aggressive or assertive. If they aren’t assertive try to think of an alternative
response that is more assertive.
They say... I respond by... Is my response: An assertive
Feelings, actions, passive, response would
what I say aggressive or be...
assertive?
44
Other possible assertive responses I could use:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
The next step is to use these assertive responses the next time you are faced with a
difficult conversation with the voice/other person.
You might want to practice your assertive response with your therapist. One of you
could roleplay the person or voice to whom you are trying to respond assertively.
How does it feel when give the assertive response? How did the other person feel
and respond to you when you were being assertive?
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
45
Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapters 3 & 7 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
46
The
hoices
Workbook
My Relationships
©MissCHazell
Session 7
47
Becoming More Assertive
When trying to be assertive, you also need to be aware of your tone of voice, gestures and
non-verbal communication. You might think these non-verbal communications are more
relevant to speaking with people rather than voices, but we want to get into good habits for
all types of relationships so try to use them with your voice as well.
Eye contact –
Voice tone –
not too much,
steady and
not too little
warm
Facial expressions
Breathing? – regular,
– consistent with
helping you to stay as
what you are
calm as possible
saying
Hand placement –
resting on your lap Posture –relaxed and
(if sitting down) confident, not
slouched or bolt
upright
48
Having a Different Conversation
Please continue to use roleplays to try out these assertive responses and non-verbal
communication in the relationship that you have chosen to work on.
Once you have had the chance to have an assertive conversation, take the time to review
how it went. You can use the table below to help you do this.
Other people and voices can sometimes respond aggressively as they may not like you
standing up for yourself. They may try to manipulate you by playing on your weaknesses.
You might find it helpful to look at the evidence and experiences that you identified in
sessions 2 and 3 to build your self-esteem. This evidence can be used in the conversation to
help build your confidence and enable you to stand-up for yourself – even if the other person
or voices persist in being difficult.
If you have found this helpful, you can repeat the process with another of the difficult
relationships that you identified. You can create a more assertive response to the
voice/other person, and practice this with someone you trust first. When using your assertive
response, remember to think about the non-verbal parts of communication.
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Key Points:
You need to change your responses into ones that are assertive
– which respect both yourself and the voice/person you are
relating to
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Reflections
After working through this session you might find it helpful to take some time to reflect on
how you have found this session. There is space for you to write an answer in relation to
each of these questions, as well as space for you to add your own reflections.
How have you found this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What one good thing can you take away from this session?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
What positive action could you take over the next week?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Use this space to make a note of any questions that you have for your therapist
related to this session.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
Personal reflections…
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
To learn more about these ideas see chapters 3 & 7 of your Overcoming
Distressing Voices book. Don’t forget to complete this week’s diary.
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The
hoices
Workbook
Across these topics we have learnt different ways to understand and overcome distressing
voices.
We have seen that hearing voices is not such an unusual experience, and that some people
are not particularly distressed by their voices.
Hearing voices itself is not the problem, therefore the focus of this course has been to
overcome the distress caused by hearing voices.
There is no right way. You can choose the ideas that you find most helpful and focus on
these. Here is a reminder of all the ways we have looked at to overcome distressing voices:
Self-Esteem
Including beliefs about
myself as a person
Chapters 2 & 6
Workbook: Me
Chapters 3 & 7
Chapters 1, 4, 5 & 7
Workbook: My
Worbook: My voices and
relationships
Coping
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Reflections
Now that you have had a chance to try some of the techniques and ideas in the previous
modules it might be helpful to think about what you liked from each of them.
This can assist you to identify some of the things that have helped. Once you know this you
can make plans to continue using them.
What are some of the helpful things that you can take away from this course?
...................................................................................................................................................
...................................................................................................................................................
...................................................................................................................................................
...................................................................................................................................................
You might find it helpful to make a plan of how you can continue to do the things that you
have found helpful:
What?
When?
Where?
How?
Why?
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Moving Forward
Once we have begun to overcome distressing voices, this can create room in our lives for
doing things that bring us pleasure and a sense of achievement.
You might want to think about what things you would be doing if it wasn't for distressing
voices.
Could you be doing any of these things now, even if voices are still around? If yes, which
ones?
...................................................................................................................................................
...................................................................................................................................................
...................................................................................................................................................
...................................................................................................................................................
...................................................................................................................................................
By starting to do the things we enjoy or that give us a sense of personal achievement, even
if voices are still around, we might find more evidence that the voices don't always have
control and that they don't always speak the truth.
We might find more evidence to weaken the negative core beliefs we hold about ourselves
and to strengthen positive self-esteem beliefs – and we might have plenty of opportunities to
practice acting assertively in our relationships with other people.
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Your Goal
You may have felt that the things you would be doing if voices weren’t around are too difficult
at the moment. It might be helpful to break down these ideas into smaller steps.
For example if you wrote ‘get a paid job’ but this feels too difficult at the moment, then a first
step might be looking for voluntary work. What steps can you take in moving towards your
goal?
My goal is: ................................................................................................................................
...................................................................................................................................................
START
GOAL!
To learn more about these ideas see chapter 8 of your Overcoming Distressing
Voices book. Don’t forget to complete this week’s diary.
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Other Resources
There are lots of other resources out there that you can access that you might find helpful to
overcome distress voices. Below are list of some of the organisations, website and books
you might find useful.
Hearing voices does not have to be a barrier to doing the things that we want to do
in our lives.
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Intervoice – online international community for hearing voices
Intervoice is The International Community for Hearing Voices. It undertakes training,
education and research. Online resources include a discussion forum and links to hearing
voices groups worldwide.
Website: www.intervoiceonline.org
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Overcoming Books
Books on Psychosis
Bentall, R. (2003) Madness explained: Psychosis and human nature, London: Penguin
Books
Bradstreet, S., R. Chandler & M. Hayward (eds) (2012) Voicing Carer Experiences, Scottish
Recovery Network
Chandler, R. & M. Hayward (eds) (2009) Voicing Psychotic Experiences: A reconsideration
of recovery and diversity, Brighton: OLM/Pavilion
Turkington, D., D. Kingdon et al., (2009) Back to life, back to normality: Cognitive therapy,
recovery and psychosis, Cambridge: Cambridge University Press
Dryden, D. & D. Constantinou (2004) Assertiveness: Step by Step, London: Sheldon Press
Greenberger, D. & C. A. Padesky (1995) Mind over Mood: Change how you feel by changing
the way you think, Guildford Press: London
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Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK ONE My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
60
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK TWO My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
61
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK THREE My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
62
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK FOUR My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
63
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK FIVE My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
64
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK SIX My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
65
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK SEVEN My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
66
Dear Diary…
Take the time to think about what you have learnt this week, and choose one thing you
would like to try this week to make a positive change.
WEEK EIGHT My goal for this week is:
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
.
Use the diary below to monitor your progress towards your goal
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
67
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