Children/Youth Who Hear Voices: Information for Family and Caregivers
- About 2-3% of the general population hears voices (Tien, 1991)
- In children, a study showed that 8% of children reported hearing voices.
- 5-15% of people will report hearing voices (Romme & Escher, 2001)
- Most (⅔) are able to cope well enough that they do not require psychiatric care, nor do they receive any psychiatric diagnosis. In these individuals, a common theme is that they accept the voices, and see them as advisors and messengers of some feeling or stress.
- Some (⅓) end up being seen by mental health services and become patients. In patients, voices are generally not accepted and seen as troublesome, distressing symptoms to be eliminated.
- Children who are otherwise fine.
- Trauma and dissociative disorders
- Most (80% in one study) report hearing more than one voice, with 70% stating that they heard specific characters
- 50% report their voices were sounds that they had heard
- 50% felt the voices were more like thoughts, or somewhere between sounds and thoughts
- 50% felt the voices were more like a voice
- 66% reported feeling bodily sensations (e.g. tingling or hot sensations in the hands or feet) while hearing voices)
Get enough sleep. The average person in modern society does not get enough sleep. Ensure that your child is handing in the electronics to parents and getting to sleep at an early enough time.
Avoid caffeine or stimulants. Stimulants such as caffeine or nicotine (from cigarettes) can worsen voices.
Ensure a healthy diet, without too much sugar or artificial processed foods. In some individuals, artificial sweeteners, or food enhancers (such as monosodium glutamate) can be overstimulating for the brain. Try avoiding processed foods to see if it makes a difference.
Avoid sensory overload or situations that overly stress you out. In people with voices, often things are worsened if it is too loud, too bright, too stimulating. Help create a quiet, calm environment for the person.
Nature. Get outside with your loved one as nature is soothing for the brain, ideally at least 1-hr outside daily.
Validation and acceptance
Accept that the voices may carry some message, such as expressing a feeling, or distress. Some people may have troubles being aware of how they feel. The voices might be a way of expressing that which people are unaware, or unable to express.
- If the voice is an angry voice, consider that perhaps your loved one may be feeling angry about something (or worried about feeling angry), but been unable to express that.
- If the voice is a critical voice, consider that perhaps your loved one feels judged and worries about not being good enough.
- Gently ask your loved one if they might be having a certain feeling, and validate that it is okay to have those feelings. It is true that certain behaviours are not good (e.g. harming yourself), but you can always validate the feelings (e.g. that everyone feels sad, or angry or overwhelmed at times).
Dealing with stresses
Help your loved one identify and cope better with stresses/triggers and emotions in general. In the beginning, it can seem like voices come out of nowhere. However, often there are specific stresses or triggers for the voices, and it helps to identify those.
You might ask:
- “When do the voices happen?” For example, if the voices always happen at school, it suggests there may be a stress with school.
- “What else is happening around the time when the voices happen?”
- “Is it possible that ___ might be a trigger?”
- “Everyone has stresses. What stresses are you under at school? Work? Relationships?”
- Once you have identified the stresses, try to come up with a way to deal with each stress.
- Keeping a diary. When it is difficult understanding stresses and triggers, it may be helpful to keep a diary. By keeping track of thoughts, feelings, daily events, it can help a person have insight into stresses and how it affects how they feel. With younger children, you might not expect them to keep their own diary, but as a parent, you might ask the questions and keep a ‘parent diary’ of your child’s days and weeks.
Reduce sensory overload. Some people are sensitive if things are too bright, too cluttered, too loud, too stimulating. Especially if your loved one is getting upset, it may be helpful to:
- Reduce background noise
- Keep your voice quiet -- many people are exquisitely sensitive and can be triggered if others raise their voice, or even change their tone of voice.
- Ask others to give some space.
- Try soothing sensory input, such as cuddling a pet, a heavy blanket, giving a back rub. Its best to do this after you've already discussed this ahead of time.
Grounding techniques help the brain to get focused on compelling sensory input rather than the hallucinations. When you notice your loved one starting to get stressed, consider grounding strategies such as:
- “5-4-3-2-1” exercise.
- If your child is upset, here are some things that parents can say to guide them through the grounding exercise:
- Orient your child in case your child is disoriented
- Parent: “Hello (person’s name)... I’m here… It’s your mom.... It’s Saturday… We’re at home….”
- Parent: “Let’s think about 5 things that we can see…”
- E.g. other people, things in the room or outside
- Parent: “Let’s think about 4 things we can touch and feel…”,
- E.g. stomp the ground, rub or clap your hands together, feel your pulse
- Parent: “Let’s think about 3 things we can hear…"
- E.g. sing a song, talk to yourself, turn on the radio, the sound of the wind or birds (i.e. turn on music, sing out loud etc.)”
- Parent: “Let’s think about 2 things you can smell (put lotion on your hands etc.)”
- E.g. lotion on your hands, lip balm, chewing gum, sucking on ice chips, popsicle, mints, perfume
- “Let’s think about 1 thing that we are grateful for….” / “Or one thing positive…”
- “5-4-3-2-1” exercise.
- Listening to music
- Physical activity such as going for a walk with your loved one.
- Mental activity such as playing a game, doing a puzzle, doing coloring, etc.
- Do mindfulness and relaxation activities to feel calmer, which can reduce stress and thus can reduce voices such as
- MindMasters App, which has various relaxation activities which can be freely downloaded.
Other strategies that people with voices have reported as helpful are:
- Agreeing to listen to the voices at certain times
- Listening selectively, e.g. accepting the things you like, and ignoring other things
- Sending the voices away, e.g. "Thank you. I will listen to you later!"
Review when things are calm what is working or not working to help
Do try to talk ahead of time about how you will support your child/youth when they are upset.
Don't use a strategy if it isn't working, i.e. don't use a strategy if it gets your loved one more upset. Sometimes people are too overwhelmed to be able to use a strategy such as deep breathing, grounding, etc.
If so, then back off, let them know you'll check in later. Later, when the incident has subsided, problem-solve for the next time.
Don't tell your loved one to “just ignore them”; most likely, if it were that simple, your loved one wouldn’t be complaining about having voices.
Don't ignore the feelings or stress that are connected to the voices.
Don't try to fight the voices or to argue with them. The voices are coming from the person's brain, and often represent parts of the person’s own worries or fears.
If the voices are distressing despite trying other strategies, consider asking a doctor for more information.
Start by seeing a family physician. If your child/youth is hearing voices, it is a good idea to start by ensuring your loved one starts by seeing a family physician, who can help assess the situation and help with referrals to other professionals if required.
See if there is a local Hearing Voices Network chapter. If not, learn about the Hearing Voices Movement, and the coping strategies espoused by the movement.
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Date of Last Revision: Jun 23, 2020