The Difference between Thoughts and Voices
- You can't hear thoughts
- Thoughts can be about anything
- You've had thoughts your whole life
- Thoughts don't have a gender
- You can try to focus your thoughts on one topic (e.g. when problem solving a task)
- You can hear voices
- It is someone else's voice
- There is typically a gender of the voice
- The volume of the voice can be loud or soft
- The voices seem to mostly tell you to do specific things / make commands / be judgmental
- Voices can be suggestive
- Voices can narrate what you're doing
- It feels like you can't control when the voices come or the content of what they're saying
- You didn't always have voices, but they started later in life
Related to this last bullet point, it seems important to connect the onset of the voices with mental illness. First, not everyone is fully aware or willing to admit mental illness, but talking about the onset of voices is a good way to get your foot in the door. It also seems useful to draw parallels between when the voices started and stress levels at the time. This provides further evidence that the voices are part of a mental illness and not "real." In session discussion should also focus on how much patients believe the content of the voices and how compelled they feel to act on the voice's commands. I always make it a point to emphasize that one could have a voice without believing it was true or needed to be acted upon.
In short, a therapist can teach patients to that voices are part of mental illness, one does not have to believe what the voice is saying, and they don't need to act on a command from a voice.
P.S. If anyone has questions or even some good additions to add to the list, please feel free to leave a comment.