TRANSCRIPT
A 38-year-old woman that I currently work with in psychotherapy came in with command hallucinations telling her to kill. I worked with her for a while, and at one point she was living with her parents. She wanted me to see her mother, who was pushing her to come in because she had various things to tell me. So, I told my patient I would see her mother for half a session, and then I would see her, and we would talk about it.
The mother came in, and she was one of the most obnoxious, horrific women I had ever met. I contained myself. I retained my composure. I had a discussion with her. I was polite and nice to her. When her part of the session was over, I escorted her out. I thanked her for coming. Then, I sat down with my patient and I said to her, “Look, I have to be honest with you.”
“There were several times while I was talking to your mother that I felt like wrapping my fingers around her throat and squeezing until her eyeballs popped out.” At that point, my patient looked at me startled and she said, “Oh my god! I know what the voice is! It’s my own voice telling me to kill my mother!” And I looked at her and said, “I can understand that.”
What happened after that is her command hallucinations went away. I did not plan that. I did not understand before I said what I said what the nature of her command hallucinations were. But once that happened, it was obvious. What she was doing is she was experiencing horrific murderous thoughts toward her mother, and she was unable to accept them. So, what she did was project them outside of her, and those thoughts became a voice telling her what to do. Therefore, she wasn’t responsible for them.
She’s been voice-free now for about a year and not on any medication. Prior to that, before she came to me, she was on three different kinds of medication. She had read about the medications, and she really didn’t want to be on medication. But every time she tried to come off, she would wind up back in the hospital. After she saw me, she came off the medication over a period of six months. Several times she started to feel symptoms, and the covering physician would raise the medication slightly, leave it at that for a while, and then we would start to decrease again. Again, she’s medication-free. She’s hallucination-free. And she’s functioning!
Did she start with the diagnosis of schizophrenia? She started out with the diagnosis of schizophrenia from childhood. Would she still qualify for the diagnosis? Not really. Not really.
How universal would you say this story of this woman you work with is? If you were to take everyone diagnosed schizophrenic and put them in a situation where they could explore and look at the issues of where the whole symptoms were coming from and get to the bottom of them, the issues would melt. The issues would slowly go away.
Now keep in mind, I got very lucky with this patient. I had no clue that that was going to happen. I just told her the truth about the way I felt. But I could accept my feelings, and she never had permission to. And my telling her the way I felt gave her permission to feel. And she did. And when she did, she didn’t need that symptom anymore. She didn’t need to defend herself in that way.