Tuesday 21 January 2020

Dear David Coleman: My 9-year-old is hearing voices - please help!

My nine-year-old is hearing voices
My nine-year-old is hearing voices
David Coleman

David Coleman

Clinical psychologist David Coleman offers parenting advice in his weekly column.

Q. My 9-year-old daughter is a happy, bright and caring girl who has plenty of friends at school and at after-school activities. Recently, she has started mentioning noises and voices in her head that frighten her. She says it starts like one voice and then gets louder and louder and she ends up terrified. On one occasion, I rocked and soothed her until the 'noises' went away. I've explained to her that it's just her own thoughts and nothing to be frightened of. But should I be worried, could it be something more sinister? I'd appreciate any advice.

David replies: Many parents get terrified when their children describe hearing voices. Typically it is because we associate hearing voices with schizophrenia, which is a very debilitating and life-changing illness.

It is true that about 60pc of sufferers of schizophrenia do hear voices as part of their psychosis, but just because your child identifies that they hear voices in their head does not mean that they have schizophrenia. There are many other symptoms of schizophrenia beyond just hearing voices.

In fact, estimates suggest that about 8pc of all children may hear voices and that for the majority of them it is just a very temporary, short-term thing.

When children do report hearing voices it is important to take it seriously, but without panicking! Hearing voices does often indicate that a child has some kind of problem that isn't resolving itself.

For example, about 85pc of children who report hearing voices do so in response to a significant traumatic event or series of events. Examples might include bullying, failing (or feeling like failing) in school, abuse of some kind, parental separation, or even traumatic physical injuries that might lead to hospitalisation.

One way to characterise the voices is to consider that they are the child's way of unconsciously trying to process some experience in their lives. Sometimes the voices themselves are directive and related to the experience (like a message about the experience).

Other times the anxiety or fear that they provoke is representative of the fear attached to the experience.

While I was researching this topic, I came across a really good example of how the voices might be like a messenger pointing to the root of the problem. The example was of an 8-year-old boy who was hearing voices telling him to blind himself.

Naturally both the boy and his mother were very distressed about this. When the therapist explored if there was anything in the life of the boy he could not face, the mum understood the message the voice was giving: the boy could not cope with the problematic marriage of his parents. He did not want to see it.

As with all things that are frightening or distressing for children, they will usually look to their parents for comfort and reassurance. Your response to your daughter sounds like it has been ideal. Your explanation of the voices as her own thoughts in a form of internal dialogue sounds helpful.

This kind of confident adult response (despite your internal worry) is really important. If you seemed frightened or upset it would only serve to increase her anxiety and distress.

Beyond comforting her, it might be worth exploring with your daughter if there is anything going on in her world that is different, distressing, challenging or overwhelming for her. See, with your daughter, if you can clarify exactly what the voices are telling her. That might point to the issue either directly or symbolically.

Especially think back to the time when the voices started to appear. Were you aware of any changed circumstances in school, or with friends or family? Were there any births, deaths or big family changes that occurred?

Even if you can't identify anything significant, I would hope that your continued warm and confident responding to your daughter, if she gets upset, will mean that the voices are short-lived.

If you remain concerned, or if the voices become increasingly distressing for her, then look for a referral to your local Child and Adolescent Mental Health Service (CAMHS) via your GP. While the chances of this being the early signs of something like schizophrenia might be small, you may be reassured to rule it out.

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