Saturday 22 September 2018

Dear David Coleman: 'My daughter hears voices - usually it's saying 'Get out''

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Photo posed

Dear David Coleman: My 12-year-old daughter has been hearing voices. Usually it's a little girl's high voice saying "Get out". My daughter suffers from dysautonomia/POTS (postural orthostatic tachycardia syndrome) and mitochondrial dysfunction. She was very sick for a long while, but is much better now. Her older brother also got Hodgkin's Lymphoma during her illness which, while now in remission, was traumatic for the whole family. My daughter always tried to be the positive one to carry the family through. Why is she now hearing voices?

David replies: Yes is the short answer, it is possible to get her back into a routine. It may well be a phase for her, since children's sleeping can often be disrupted by things like growth spurts, teething, changes in home or crèche, brighter summer evenings, heat and so on. It doesn't often take much to disturb our sleep.

The big fear, for most parents, when they discover that their child is hearing voices, is that their child has, or is developing, schizophrenia. It is a common misconception that hearing voices equates to having schizophrenia and that everyone who has schizophrenia hears voices. Neither is actually the case.

While it is true that about six out of every 10 people who suffer with schizophrenia do hear voices, the converse is not true. So, just because a child hears voices does not mean that they have schizophrenia. In fact, hearing voices is more common than we might expect. Some researchers have suggested that hearing voices is not problematic; it is how well we cope (or don't cope) with the voices that can cause problems to develop.

Psychosis in children is also very rare and it is unusual for it to develop in isolation. Psychosis is more usually found in conjunction with delayed development, speech and language problems, poor academic achievement or motor difficulties.

The most interesting research finding, or at least the most relevant for your daughter, is that 75pc of children who begin to hear voices do so after experiencing some kind of trauma. Most often they will have experienced something that left them feeling powerless.

This, to my mind, is the most likely explanation for why your daughter has started to hear voices. I had to look up Dysautonomia/POTS (Postural Orthostatic Tachycardia Syndrome) and Mitochondrial Dysfunction as I wasn't familiar with either condition. From what I can gather the Dysautonomia/POTS can lead your daughter to feel faint or dizzy when she stands, and the Mitochondrial Dysfunction is most likely to lead her to feel exhausted.

Both of her own conditions may leave her feeling powerless. However, even more significant than her own illnesses, her brother's development of cancer may have left her with a strong sense of helplessness. That helplessness may explain why your daughter worked so hard to "be the positive one to carry the family through". She may have felt that the only thing she could do, in the face of this inexplicable cancer, was to be positive and to try to lift everyone else's spirits.

Perhaps her determination to be positive was her way of trying to stay in control of a family trauma that was, potentially, uncontrollable.

The effect in your family, of having two sick children, must have been overwhelming, if not catastrophic? I just can't imagine how stretched, frightened and under pressure you must have felt at times. You too, similar to your daughter, may have felt that your world was spinning out of control.

The level of stress and distress in the family was probably through the roof at times and this is bound to have had an impact on all of you. Your daughter starting to hear voices may have been a reaction to this stress and trauma.

Being in a traumatic situation, like you all were, will change you. I'd guess that you may now feel "on red alert" looking out for any kind of danger, and you may potentially have a heightened response to any issue. Perhaps your family might like to do something to help you all to heal.

Time, of course, will help with the healing process, but you might like to supplement that with some family therapy. The impact of all the trauma that you have experienced is likely to run deep and having an opportunity to air that, in the safety and structure of a therapeutic environment, may really help you all to process and deal with what has no doubt been an overwhelming set of circumstances.

If you have any parenting queries for David Coleman, please email dcoleman@independent.ie. Please note that David cannot enter into individual correspondence

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