Can you imagine what it is like to hear voices when no one else is around
did you know that despite common misconceptions voice hearing by itself is neither a rare
experience nor a sign of mental illness for many people with psychosis however their voices can be
highly distressing intrusive and persistent and this is when a person may need professional help
with their voice hearing sometimes also called auditory verbal hallucinations
my name is Dr Clara Humpston and I am a postdoctoral research fellow at the Institute
for Mental Health University of Birmingham my research focuses on these distressing and
persistent hallucinations in the context of schizophrenia spectrum psychosis
Currently the treatment for problematic voice hearing mainly involves the use of
antipsychotic medication and cognitive behaviour therapy for psychosis
also called CBTP unfortunately these interventions can each carry their own side effects and are only
effective in a limited number of individuals this is why we urgently need new interventions
that can be used when these first-line treatments fail one promising new intervention is called
real-time functional magnetic resonance imaging neurofeedback I would just call this neurofeedback
here for short although there are other modalities of neurofeedback as well this technique involves
gaining real-time signals about the activity of specific brain regions implicated in voice hearing
while the individual lies in an MRI scanner and they are asked to change the strength of these
signals via a visual interface representing their brain activity such as trying to land
the rocket seen here my colleagues at King's College London and the University of Cambridge
have used exactly this method to help a number of individuals with distressing voices that did not
respond to conventional treatments by actively trying to modulate their own brain activity
in particular the brain regions involved in the monitoring of inner speech
these individuals were able to reduce the severity of their voices with little to no side effects
nevertheless this study was done only in a relatively small number of participants
and there are other brain mechanisms neurofeedback could target
currently neurofeedback is not offered as a routinely available clinical treatment for
voice hearing not only because of the issues with cost and feasibility as it is much more expensive
than usual treatment but also because of the limited evidence available for its effectiveness
to date only a handful of recent studies have investigated the use of neurofeedback
to specifically treat distressing voices in schizophrenia spectrum psychosis
but they still provide a promising beginning the stress associated with voice hearing is an
important trigger for seeking treatment and neurofeedback may need further development
to address that aspect if neurofeedback receives further experimental support
clinicians should inform individuals suffering from distressing voices about this possibility
in addition to other existing treatments people with voices should always be fully informed
and supported to make their own decisions regarding treatment neurofeedback as a
therapy for voice hearing is strongly dependent on the active participation of the individual
this may have additional benefit of empowering people with auditory verbal hallucinations by
putting them centre stage in gaining control over the processes in their own brains
in summary current evidence suggests that neurofeedback is a promising and innovative method
for the relief of distressing and persistent voices individually psychosis who did not respond
to first line treatments it is considered safe and far less invasive than some of the alternatives
such as electroconvulsive therapy and is less likely to have side effects than medication I
believe that one day in the near future we will be better able to use neurofeedback for the benefit
of individuals who have to deal with voices that severely interfere with their daily lives