Child Psychiatrist in London

Remember that they’re trying to describe, and make sense 15 of, experiences that are quite extraordinary. Under the circumstances, unusual beliefs are quite understandable. Try not to get caught up in arguments about logic and reality - if you’re unsure how to respond just focus on how they are feeling. If your child finds talking difficult, then explore other ways of helping them to open up. Some young people find it easier to talk whilst they’re walking or doing an activity. Others prefer to write or draw about how they are feeling, and then show it a parent afterwards. There is no right way to communicate - find a method that works for you and your child.

Avoid Assumptions - if your child is distressed and tells you they hear voices it’s easy to jump to the conclusion that the voices are causing the problem. This is understandable, but it can mean that the real problem your child is worrying about can go unaddressed (e.g. bullying or problems at school). Try and be open to whatever your child wants to say to you, and check things out if you’re unsure what they mean. 

When it is indicative of a Mental Illness?

When mental illness is involved there will usually be other signs that the young person is troubled, for example:

  • The young person might talk or laugh aloud as if having a conversation with an invisible person.
  • They may become withdrawn and less inclined to mix socially.
  • They may have difficulty in concentrating on studies or TV programmes, etc.
  • They may lose interest in normal activities.
  • Their thoughts and ideas may appear to be all mixed up and sound like nonsense.
  • They may talk about or express unusual or even bizarre ideas that they are having which are not shared by any other people, for example, the feeling someone is directly inserting thoughts into their mind or they are being spied on by the Government. They will not be persuaded against these beliefs by facts and logical argument.
  • Care in their appearance and self care may deteriorate.
  • They may become lethargic and lose motivation or be agitated and overactive.

It might be that hearing voices is not disclosed by the young person but others notice that they appear to be distracted or are acting out of character.

Young people who are hearing voices and are suspected of having serious mental health problems should be considered as vulnerable and may be a risk to themselves. 

In these cases, Psychiatric advice should be sought as soon as possible and they will always be treated as a high priority by the local mental health specialists.

In Conclusion

Studies suggest that hearing voices seems to be more common in children than was previously thought. In most cases these experiences resolve with time. Hearing voices as part of mental illness is less common and would only normally occur in older teenagers. Therefore in some children these experiences persist into older adolescence and this seems to be an indicator that they may have a complex mental health issue and require more in-depth assessment.

Interventions which are used to help people who hear voices tend to be specialized and it is important to get them referred appropriately to the specialist, normally a psychiatrist or member of a specialist mental health team.

My Child is Hearing Voices

When Do I need a Child Psychiatrist?

- various literatures 

Don’t Panic - the most important thing you can do is to stay calm. Although this may seem difficult, it is vital you show your child that you are not afraid of the voices they hear and don’t see them as ‘mad’ or ‘crazy’. Believe Them: Hearing voices is a really common experience in childhood - so, if your child says they’re hearing voices it’s likely that they are. Young people can be very sensitive to the reactions of the people closest to them, so show they as clearly as you can that you’re taking what they say seriously, even if it sounds unusual.

Space To Talk - it’s hard to make sense of experiences if you keep them inside. So, if your child would like to talk about their voices encourage them to do so. Ask them whether they would like to tell you more about what’s going on for them, and show that you’re interested. Really try to listen to what they are describing, asking them questions if they find it helpful. If your child’s beliefs or experiences sound strange, try and listen without judgement. 

Dr. Viviana Porcari, Consultant Child and Adolescent Psychiatrist

First things first

From the researches carried out into the experience of adults and children who hear voices it has became apparent that:

To hear voices is in itself is a common though unusual experience.
However, it is possible that you can become ill as a result of hearing voices when you cannot cope with them
For most children (60%) the voices will disappear over time as the child develops and as they learn to cope with the life’s problems (and the emotions and feelings involved with these problems) that led to the voices starting in the first place

How do most parents react when their child talks about hearing voices?

When you find out that your child hears voices it can be devastating. This reaction is understandable, for as parents we are naturally very protective of our children and do not want to see them distressed, hurt or confused. However, there is a crucial question that needs to be asked about why we react in this way when we discover a child is hearing voices.

Our reactions are based on information we have picked up about the meaning of hearing voices. Mostly these are based on assumptions held by society, especially the widely held belief that to hear voices is the same as the mental illness “schizophrenia”. Fortunately, schizophrenia is rare in children, affecting only about 1 in 40,000, compared to 1 in 100 in adults. The average age of onset is 18 in men and 25 in women.

Therefore good news is that this belief is not always correct. Whilst it is the case that hearing voices is apparent in about 60% of the persons who have been diagnosed with schizophrenia. It is not the other way around! If you hear voices that does not mean you have schizophrenia.

There is an even more important issue that you may not be aware of: hearing voices in itself is normal – but – it is possible to become ill from hearing voices if you cannot cope with them. This means that it is coping with hearing voices that is the problem and not the voices in themselves.

"Normal” children and adults hear voices too

This little known fact is based on a lot of research. Several large scale population (epidemiological) studies have shown that about 4 % of the population hears voices. Of these 4% of the people who hear voices about 30% seek assistance from mental health services. Amongst children however, even more of the “normal” population hears voices (8%) and as with adults about 30% are referred to mental health services.

What this means is that there are apparently many more people who hear voices who do not require the support of mental health services then those that do. This is because they can cope with the voices and function well in in their everyday lives.

Unfortunately, most of the information that we have about the experience of hearing voices comes exclusively from research with patients; people who obviously cannot cope with the voices and needed help. These are people who feel that the voices made them feel powerless and who were overwhelmed by them. This is the case for research for adults and children who are hearing voices. 

Researchers carried out psychiatric assessments of almost 2,500 children aged between 11 and 16 in Dublin, Republic of Ireland. They discovered that 21%-23% of younger adolescents, aged 11 to 13, had experienced auditory hallucinations.

Of this group, just over half were found to have a non-psychotic psychiatric disorder such as depression and anxiety.

Lead researcher Dr Ian Kelleher, from the Department of Psychiatry at the Royal College of Surgeons in Ireland (RSCI), said: ''We found that auditory hallucinations were common even in children as young as 11 years old. Auditory hallucinations can vary from hearing an isolated sentence now and then, to hearing 'conversations' between two or more people lasting for a several minutes".

Some people hear voices talking when no-one is around. These could be like the voices of people they know, or complete strangers. They might hear many voices, or just one. Voices can shout, whisper, be clear or muffled. They can speak in sentences or say single words. These voices can be male, female, old or young. Sometimes they have names, but not always. People can hear other types of sounds too, including knocking, crying or music. Some voices can be positive - encouraging or supporting you. Others may say things that are confusing or distracting, perhaps echoing thoughts or repeating strange phrases. Some voices can be very frightening, saying things that are critical, threatening or commanding. Others are funny, saying things that make you laugh.

Hearing voices and traumatic experiences

Researches have found that a common theme in both groups (adults and children) is the high percentage of traumatic experiences that have been found to have been the trigger for hearing voices. In adults around 75% began to hear voices in relationship to a trauma or situation that made them feel powerless.

Examples of the kinds of traumas that trigger voices include the death of a loved one, divorce, losing a job, failing an exam, but also longer lasting situations like being physically, emotionally or sexually abused. With children the percentage was even higher at 85%, with some traumas specifically related to childhood. These traumas might include being bullied by peers or teachers, or being unable to perform at a certain level at school, another commonly reported traumatic incident related to hearing voices is being admitted to a hospital for long periods because of a physical illness.

For many children, these experiences appear to represent a 'blip' on the radar that does not turn out to signify any underlying or undiagnosed problem. However, for the other children, these symptoms turned out to be a warning sign of serious underlying psychiatric illness, including clinical depression and behavioural disorders, like attention deficit hyperactivity disorder.

Therefore hearing voices is mostly a reaction to a situation or a problem the child or young person cannot cope with. It is a signal.

So, what to do?

​Normalise - the experience can help parents to deal with the voices – try not to think of it as a terrible disaster, but as a signal for something that is troubling your child and that can be resolved. On the other hand, if parents cannot accept that voice hearing in itself is normal, but believe the voices to be an illness and are afraid of the voices, then the child naturally picks up this feeling. Imagine for a moment if you were the child and were afraid of the voices and when you looked for support from your Mum and Dad you found that they were even even more afraid of the voices then you were. This would obviously put you under great pressure and probably mean that you would become reluctant about talking about your experiences at all.

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