#174 Exploring our Inner World: Hearing Voices – Johanna Badcock

Take a deeper refection into our interior subjective human experience by considering auditory hallucinations, in particular hearing voices, with Johanna Babcock, Adjunct Professor at UWA School of Psychological Sciences, and also one of the founders of Perth Voices Clinic.

Surrounded in cultural interpretation, what becomes more and more apparent in this conversation is the fact that hearing voices is not quite what you think – it’s very subjective to an individual and a lot more common than one might expect.

We also dive into the link with loneliness to mental health and the onus on those of us who are not lonely to open the door to those who are for the sake of a healthy society.

Why would you listen to this conversation? Because it’s a fascinating exploration into holding space for the legitimacy of your interior personal experiences. It highlights how much there is to explore and just how normal ‘things we don’t necessarily feel comfortable talking about’ really are.

Read Full Transcript

Bryn Edwards 

This week, I had the opportunity to have a fascinating discussion about auditory hallucinations, in particular hearing voices. I did this in a conversation with Johanna Babcock, who is the adjunct professor at UW a school of psychological sciences, and also one of the founders of Perth voice Hearing Clinic.

 

Now, what becomes more and more apparent, as we go further into this is hearing voices is not quite what you think. And it’s very subjective. And also, it’s way more common than one might expect. Often culturally, we link here with psychosis and bad things. But more and more that as we fight as you find in this conversation is naturally occurring human phenomenon. And one of the things we talked about and this is normalising the discussion around this.

 

Now, I want to make a big caveat at this point, is that when we talk about normalising the discussion, is normalising the fact that there’s a spectrum of this from from sort of just hearing voices and stuff all the way through to when they’re causing distress and needing support. So that’s the normalisation that we talk about in this.

 

We also take a look at the impact of loneliness, and that’s linked to psychosis. This is a fascinating conversation. And what we’re really deep dive into here is just holding space for the legitimacy of people’s internal subjective experience. Joanna’s super knowledgeable in this and you can really see how much research and thought she’s put into this during her career. So I’m sure you’re gonna enjoy, Johanna.

 

Bryn Edwards 

Hello, and welcome back to WA Real. I’m your host, Bryn Edwards. Today I have the great pleasure of welcoming Johanna bad cop to the show.

 

Johanna Badcock 

lovely to be here. Thank you very much.

 

Bryn Edwards 

So for those of you those who don’t know, Joe, you’re a professor at UWA.

 

Johanna Badcock 

I’m an adjunct professor in the School of psychological science. I don’t mean it’s an honorary position. Right.

 

Bryn Edwards 

Yeah. Super. And one of the things we’re going to talk about today is about the phenomenon of hearing voices. Mm hmm. Because you’ve also helped set up the Perth voices clinic as well.

 

Johanna Badcock 

Oh, absolutely. Yes, definitely led by Georgie Paulik-White.

 

Bryn Edwards 

 

Indeed. So I guess the first question I have is, how did you get into people hearing voices?

 

Johanna Badcock 

Well, as is often the case in research along a winding road, it wasn’t something that I had deliberately set out to investigate, it’s often the case in research that you get down to a field of interest. Because of chance. The chance for me was that I was doing my professional training in Melbourne, in clinical psychology. And we needed to do a thesis. And so I was hunting around for a topic to work on. And I hit on the area of people who are at risk for developing psychotic disorders, which was not an area that I knew very much about, but was really piqued my interest. And so that’s where I began. And I started to do some work on how the visual system works in people who are at risk of psychosis, again, not something that most people would even think about that your basic sensory functions might be relevant to a complex disorder, like psychosis. So many years, evolved through all of that time. And rather than focusing on the, the complex psychotic disorders like schizophrenia, I started to go down the path of focusing on the individual symptoms, which involved in psychotic disorders, right? Because there’s been a lot of debate about whether schizophrenia is a single entity, for example, or whether it’s actually a complex, they call a heterogeneous disorder made up of lots and lots of different symptoms, and no one really knows where the boundaries are. And they often say it’s got fuzzy boundaries. Yes. And for disorders like that, that are really complex, it also makes chasing down what the causes of that disorder are all the more difficult, right? And so, a simpler way into understanding what’s going on is to select one of the symptoms and just focus on that and say, Okay, what are the causes?

 

Bryn Edwards 

symptom?

 

Johanna Badcock 

And yes, and and hallucinations are one of the symptoms that are really common. And also capture media attention. You know, if you if you get to hear about Reporting in the newspapers or on TV, and so on about someone who has schizophrenia, almost always they’ll be saying things like, Oh, this person was hallucinating at the time. And yet we know, or at that time, 20 odd years ago, we knew very little really about what were the specific causes underlying those sorts of experiences. And indeed, what the experience was really like, you know, what, what is it to have an hallucination? And so yeah, that that really captured my interest, then is to try and really drill down into understanding what it’s like to have that experience on what the phenomenon is, and what causes it. And

 

 

obviously, a key word

 

Johanna Badcock 

Yes, phenomenon.

 

Bryn Edwards 

We did actually, before in research this, I did actually look up the word phenomenon. There were things and there was sort of in the definitions, it was very much around situations that are observed.

 

Johanna Badcock 

Yes, that’s right. It’s about describing what the experience is like, both to observe the experience, but also what it’s like the subjective experience of it. What, what’s the lived in experience, if you like, and I’m having hallucinations.

 

Bryn Edwards 

And that’s, that was probably the big draw to want to talk to you today about finding this balance between, you know, the sort of objective external, world, internal subjective world. Yep. And, and holding space for that. And where that internal subjective world can either be a positive or a less than positive? Yeah, experience. Yeah. And then also, I wanted to explore with you the, I guess, looking at it through another lens of whether it’s positive or less than positive experience, just how common it is versus Yeah, not as common.

 

Johanna Badcock 

Yeah. And we always used to think of hallucinations, and here are mostly talking about auditory hallucinations.

 

Bryn Edwards 

So could you just define, like, loosen a

 

 

crystal?

 

Johanna Badcock 

I knew you’d say that. And I thought, should I go away and just, you know, have have the definitions sort of clear in my mind for, but actually, I think the bigger point to get across is, it’s been incredibly difficult to come down to a single definition of hallucinations that everyone will accept, yeah. So that what you’re talking about within a looser nation is a perceptual experience. Or even a lot of people will stop there and say, actually, it’s not just perceptual, but let’s just begin with that. So it’s a perceptual experience that people have that isn’t shared with someone else. Right. So it’s the perception of something that is occurring without the corresponding external stimulus. When we, when we hear the car going down the street, we perceive that sound and there is a corresponding external stimulus, ie there is a car currently going down the street is the is the CO arising of two things. That’s

 

Bryn Edwards 

right internal experience and the external perception. That’s right. And which we then obviously draw the correlation.

 

Johanna Badcock 

That’s exactly right. And in the case of hallucinations, you have that perception of something happening. But there is no matching external stimulus that has caused it. So what you’re getting is it’s it’s an intrusive kind of experience in that it’s happening now. Yep. It has the characteristic of something that is real. I mean, we do basically believe our senses, so it hasn’t denied it feels to you as if it is a real experience. But if you ask someone else, they wouldn’t be able to share in that experience, because for them, it’s not happening. It’s generally something that’s happening beyond your control. Although again, people will argue some people will say, they can actually bring their hallucinations on in a quite deliberate way.

 

 

Right.

 

Johanna Badcock 

So there are many, many elements to this phenomenon of what an elucidation is, which has meant that defining it has been quite difficult coming down to a single unique definition that everyone will agree on, because for each of those phenomenal aspects, people will debate. So let’s go back to the start. I said it was a perceptual experience, but many people will say Actually, it’s not just a perceptual experience. For me, it’s more like a thought kind of experience, which is Little bit removed from a perception. For some people, as I’ve said, it’s quite a, it’s got a strong sense of reality, whereas for others, they do have some insight into it not being real. I’ve said that the definition typically means it’s something that’s beyond your control. And yet for others, there does seem to be an element of control. So these are, these are very hard phenomena to really wrap your head around if you haven’t had that experience yourself. There are however, really surprisingly common.

 

 

Today you go

 

Johanna Badcock 

and not have it yourself. I know, I know. And that’s that that touches on the issue of stigma. There’s a lot of stigma around these experiences, largely because hallucinations have been mostly linked to psychotic disorders like schizophrenia, which itself carries a lot of stigma. And so yeah, people tend not to want to talk about having had an hallucination, because want a better description. They’re gonna think this other person’s gonna think I’ve gone mad, because I’ve had this hallucination. And so people just don’t talk about it. And they certainly don’t talk about it if they’re having hallucinations. And actually, it doesn’t really cause them very much distress. So if they’re having this experience, and they think, oh, that’s kind of curious, I wonder what that one’s all about. And they integrate it into their sense of who they are. They just happen to have these experiences. But it’s, it’s not something that they find distressing, upsetting, challenging, doesn’t interfere with their daily life. So they just have them and they don’t talk to anyone about them. They just assume that other people have them and don’t talk about them too. Which is also interesting.

 

 

Yes, it becomes this room where all fenced in.

 

Johanna Badcock 

Yeah. So when you start to dig deeper into it, and there’s been a lot of research in this area. Now, for the last 20 years, what’s become increasingly obvious is a four start. hallucinations are not just something that occur in people with psychotic disorders. They occur in lots of other disorders. They occur in people with Parkinson’s disease. They occur in people with Alzheimer’s disease. They occur in people with depression, and anxiety, post traumatic stress disorder, borderline personality disorder. They’re really all over the shop. So they’re not just specific to psychotic disorders, right. What also blows most people’s minds though, is that they are in fact surprisingly common. Yeah. In otherwise healthy individuals in the general community with no diagnosable disorder at all. Yeah, so they’re out there. All this fantastic variation and variety for that.

 

Bryn Edwards 

This is trial of thought that, right? Yeah, follow it then. Yeah. Which is, you’ve dialled back from psychotic to regular sort of mental emotional.

 

 

illness. Mm hmm.

 

Bryn Edwards 

On well being, yeah, whatever. And then you’ve dialled back even further to kind of happens kind of regular for most everyday people. Yep. Because when you were sort of saying, you know, it’s not just in psychotic, it can also be, you know, depressed, anxious as well, given how many people are registering, depressed and anxiety at some level of shape or form that a lot of the population? Yeah, and then you dial back even further? Yep. So if you dial forwards, back again, having come back to even regular dude to having this and go forward, then

 

 

it’s psycho psychosis really thing? Look,

 

Johanna Badcock 

I probably wouldn’t go down that path. So much. Just say, Yeah, I can see where you’re going. But I think the the issue that’s probably more important for my take, is that for for people to think about those experiences, is that they are probably to some degree, a natural part of our circuitry, our brain and our physiology and also our world, our social environment. And we need to think about the circumstances where they bring you to the point where you do need help, right? Yeah. So there are considerable differences between people who have hallucinations in the general community and those who are if you want of a better description help seeking, yeah, cause hallucinations in the group who are help seeking regardless of what other diagnosis they have or not. They’re having hallucinations that do cause them. distress and upset. And typically they’re having them more often more frequently, and for longer periods of time. So when you have that kind of trio of pictures as well, the content might be upsetting, or just their very presence might be upsetting and intrusive. And they’re persistent, they start to interfere with your daily life. And then people do and should feel confident, to seek help, because there are solutions to help you manage having those sorts of experiences, which is hence, that’s where the clinic comes out. Because the clinic is for people with distressing hallucinations, mostly auditory, but we take anyone with any unusual experience in any sensory system. So it might be visual, or touch or whatever. But it’s the people who are having distressing hallucinations. And there are psychological interventions that you can use. And if you happen to be on other kinds of medication, for example, because of other background factors, that’s fine. But there are psychological approaches that you can use to help manage that that experience.

 

Bryn Edwards 

Because as I was thinking about this beforehand, thinking that because I suspected that this is where we would go in the fact that it’s more regular than we, yeah, dissipate. Yeah. Then part of me started to consider the full range of this so and we’ll dive into one of the more positive regular everyday things in a minute, but if we stay with what probably is the focus of the clinic? No, it didn’t take me long to realise Well, you know, without hearing like quite blunt, if the voice is saying, you know, cut your arm or Yep, or beat up your wife for or, you know, burn the house down or something like that, that’s not really very cool. And you need some help.

 

Johanna Badcock 

No, it’s not. And they’re often of that form. Perhaps more along the lines of, you know, you’re a crap person, or, you know, you’re really horrible or you know, nothing in a very, very derogatory comments about the person having those experiences. And, you know, view doesn’t, doesn’t take great mind to really think if you’re experiencing that a lot. And it’s really drilling into your head all the day that you’re having those sorts of thoughts, that will be really very difficult to manage.

 

Bryn Edwards 

So you’ve used the word thoughts there. Is, is there a difference between actually hearing hearing and voice almost like, trying to get trying to get some sort of understanding? I just smile already? Yeah. So it’s like a voice that’s not your voice? It’s always like a different voice. Yeah. Or is it thoughts? I mean, I’m sure there’s the full Yeah, let’s just get a feel for them. Yeah. Look, there’s there’s anybody who’s listening to this right now. They’re gonna go, they could be sitting there going? Well, I’m negative thoughts. Yeah. What does that mean now?

 

Johanna Badcock 

Yeah, that’s right. So forgive me. Cuz, you know, I always backtrack and say that it’s the complexity of the issue, right. That’s just the nature of this particular based. The content of the things that people hear in the form of an alternation is usually something that they recognise as it’s not belonging to yourself. So people with hellos, hallucinations, can distinguish between their own internal self talk, if you like, which, Well, I certainly have I presume everyone else has. So they can distinguish between this is just, you know, my self thoughts myself reflection on life, versus what’s happening when they’re having an alternation. Right. And the descriptions that often come with that are because the identity of the hallucination is perceived to be different from their own. Right. And it’s not typically something that they have kind of requested to happen or have been deliberately musing on it’s so in that sense, it’s intrusive and happening on top of their regular self talk, if you see what I’m Yes, yeah. Yeah. So so they can and do routinely distinguish between this is my own mentation, my own inner thoughts, versus No, this is my hallucination and this hallucination is I hear this voice of this old guy and you know, he’s swearing at me yet again, or there doesn’t have to be a recognisable voice, but it it’s often got certain characteristics like it might be voice of an older male, or it might be the voice of a child. So you know, so you might not be able to name the perception In the hallucination might not have perception of say it’s my mom in a specific identity, but it will have characteristics of an external person that helps to make it different from you know, if I’m thinking to myself, then it’s roughly in, you know, it’s got some agency of me attached to it. So I know it’s this female voice in my head talking to me, it’s me, I’m, I’m the agent of myself talk.

 

Bryn Edwards 

Yes.

 

Johanna Badcock 

Yes, I’m gonna throw another spanner in the works. So just to show the variety of all of this. So some people will have auditory hallucinations, that are not based on language at all. So they will have hallucinations. I remembers case that I came across with a client from Rylands hospital, in a research project there and they were constantly hearing the sound of a train going by and doing it’s old fashioned steam train, and they were hearing their proven colour. That where there is no conceivable way that you know, there was no radio playing, there is no local train that they could be hearing. People do hear the whole gamut of environmental sounds, they might hear waterfalls playing, they might hear engines, all sorts of things. So it’s not always the case that on the loose the nation, in terms of its content, involves the perception that someone is talking to you. Yes, it can include all these other things as well.

 

Bryn Edwards 

So when somebody presents, and you’re going to work with them? And not obviously, we’re working on the assumption that they’ve turned up, because it’s distressing. Mm hmm. We’ll just keep it Yeah. Basic, is that Yep. What is the underlying philosophy to the approach? of the work that you’re going to do with them? Is it? Is it to reduce? Is it to put it in its place? Is it to understand is it to put some meaning around? Is it to? Do you see what I mean?

 

Johanna Badcock 

Yeah, look that the key there is to ask the client, what is their goal. And often when talking to clients, they don’t necessarily actually want to get rid of it. We just talked about voices, hearing voices, they don’t necessarily want to get rid of hearing their voices. They want to be able to change the nature of the relationship they have with their voice. And they might want to change the meaning that they ascribe to the voice. And they want to feel better about themselves in this relationship. Yeah, but not necessarily to get rid of the experience altogether. And in fact, for some people, they say that they really quite like the sense of companionship

 

Bryn Edwards 

for the company

 

Johanna Badcock 

that the voices provide in their daily life, if only they could change the nature of this experience. So it’s about it’s about understanding how people relate to the voice and about how they’re interpreting the meaning and significance of the voice. And then learning behavioural strategies and ways to change those interpretations. To make it a more positive or at least manageable experience.

 

Bryn Edwards 

So could part of that be actually engaging with the voice?

 

Johanna Badcock 

Yeah. But it’s all it is also about changing how you think about that experience as well.

 

Bryn Edwards 

Yeah. So you almost objectify a subjective opinion? experience?

 

Johanna Badcock 

Yeah, that’s certainly an element of it. Yeah. Yeah. So these these, you know, that you will never get the same experience over and over you know, it because it’s, it’s unique to that person. Yeah, of course. Yeah. Cuz every client’s journey. Subject Yeah, it’s so subjective in the first place. And the factors driving the experience, are all unique and individual. So the story is different every time although some of the strategies that you can learn to handle them that there’s some commonalities there about about that. Yeah, so it’s, I mean, they’re just, you know, the endless variety is is the key to understanding just what a phenomenal thing these experiences are. I mean, if you if you if you change your mindset away, for example, from people with psychotic disorders and think about experiences of holosun notions in daily life. I’ve been recently reading and looking into experiences of people with bereavement. Hmm. And there the literature is saying that way over half of people who are bereaved, if you ask them will say that they have what’s often referred to as a Sensed Presence, they sense the presence of their deceased loved one. Which is essentially an elucidation because they’re perceiving that person to be present, even though they’re not. It’s happening and it’s real. It’s intruding into their daily life. So you know, in those characteristics we talked about earlier, they’re all there. So that in formal sense, qualifies as an illuminator II type experience. And they’re happening in Yeah, way more than half of people who have bereavement. But again, they typically don’t talk about it, even though in fact, in bereavement is probably the rule rather than the exception. So it’s like what is this strange world that we’re in that we are so fearful and stigmatising of these experiences? that people are not talking about them?

 

Bryn Edwards 

I had the sense listening, as I was listening to it earlier in this conversation that was around this past year, that if these are naturally occurring, human phenomenon, right.

 

 

And

 

Bryn Edwards 

I wasn’t around in this time. But, you know, it’s easy to check out the example that, you know, when we were in a more magical mythical tribal basis, that the guy who heard voices and stuff was connected to something way bigger than the rest of us, and so therefore was revered. Okay. Yeah, as we’ve moved into a more, you know, 17th century or more in a post enlightenment, rationalised view of the world, where you know, we measure things and we become more objective. And these naturally occurring human phenomenon have almost stayed still, but our sense making a meaning making has changed. And given the focus on on consistency, repetition, measuring science and science methodology, that that now that sort of internal thing is now at odds with that, and hence it, you know, as we society culture, with that our sense making of it has gone from being revered to Yeah, he’s a nutjob. I don’t know.

 

Johanna Badcock 

Yeah, look, that. That’s that. That’s the line between when you’re, when you’re asking someone about their hallucinatory experiences, it is about finding out is this something that is culturally accepted? And is it something that is causing distress? that pushes it into the area where you might need to see an external person to get help? Or, or not? Because there are lots of different cultural groups, for example, were having those sorts of experiences would be considered very much the positive. Yeah, and and just part of part of life’s journey if you like, so, yeah, I guess I do. I understand what you’re saying. It’s,

 

 

yeah.

 

Johanna Badcock 

It’s about realising that hallucinations do cover such a broad church with lots of different causal pathways in Yeah, to what led to people having that? Is it because there is if you like, a background disorder, like schizophrenia, is it because someone has had maybe drug induced experiences? Suck that drug, something like that? And is it because they’ve got other social problems that are happening in their lives? And again, this sounds so complicated, because it is, there’s also never going to be just, it won’t ever just be one single like mapping on you know, yeah, this is

 

Bryn Edwards 

a question I would love to ask you is right, okay. So, given your broad spread, do you have any sense of the of what would be sort of mega macro mechanics and dynamics that bring these about? Or is it so varied of phenomenon? Well, look,

 

Johanna Badcock 

I really would say here, this is a case where there are just so many varied factors coming together. So you have you have people who have a disease, for example, Who will end up having what’s called Charles Barney syndrome, which is visual hallucinations. And they often present in a in a fairly specific way, where it’s, it’s much more clearly tied to the visual loss that’s going on. Yes. And you will have people who have, as I’ve just said, have had a bereavement, and they’re experiencing the presence of their loved one who’s died. So it, it’s about understanding within that there are those specific causal triggers that have led to the extreme. But then how you interpret it is perhaps the more common thing as to why people who have got visual loss who have had a bereavement or who have got schizophrenia, if you’re interpreting those in a particularly unhelpful way or amplifying the negative side of it, those are the common factors that also contribute to the experience that can also be the things that you can target in therapy. Does that make sense? Yes, yes. Yeah. Does?

 

Bryn Edwards 

Yeah, I guess it’s as, as we discussed before, and as regular listeners will know, right away, I think can ask questions. He’s, like, there’s a big systems thinking part of me that likes to really blow out to a macro level and see if there are commonalities at a meta level across the different phenomena. And particularly, now I, I’ve been diving into integral theoretical framework of trying to, so it gives me stuff to be able to walk around and ask questions from different angles and understand what I am doing now. So from the internal singular experience, to the objective, singular experience, and then how do we culturally look at this? And then is there a bigger systems part to this? So those four sort of areas? Yeah. So yeah, it’s fun to look at it from lots of different ways. Yeah. Going back in to that individual experience again, and do you have a sense of how because if we go back to normal everyday Joe, and how someone can begin to live with develop a relationship with draw benefit from and, and even legitimise a norm? We’ll get to normalise later. Yeah, legitimise within themselves. Yep. What is going on in this internal?

 

 

Yeah, nominal.

 

Johanna Badcock 

There’s gonna, again, be so many individual responses to that. But the thing that probably stands out for people who incorporate them as a valued and positive part of who they are,

 

 

yeah.

 

Johanna Badcock 

captures elements of them being willing to agree that it is part of who they are. And therefore there’s no in that sense, no dissonance, no sense of challenge or threat to who they are. And how they’re interpreting the experience is positive, so that they’re saying, in broad terms. This is this is an important, if this is a, I don’t like the word message, but this, this experience is telling me something that is important to me. Yes. And I need to be mindful of that. And I need to sit and think about what it is that that might be telling. And so they in, in understanding the meaning that they attached to that experience, they incorporate that into their sense of self. Yes. So I mean, I’m simple example would be that they have an experience. And they’re saying, Well, you know, this means that I have, you know, a sense of creativity about the world and that I’m open to new experiences and and that is something I value for me as the person is that I don’t see that this is necessarily a conflictual situation. It’s just a different way of thinking about world. Yes. So they’re having an experience and they’re creating a positive appraisal in that sense. And it all becomes part of their sense of I’m an open to new experiences type person. Yeah. Then it enhances their sense of self and and there is no conflict. And so they just go about experiencing it. Yeah. Oh, okay. That’s I

 

Bryn Edwards 

guess that takes a quite a degree of self acceptance and yeah, confidence to own it. Yep. For want of a better word.

 

 

Yeah. Yeah.

 

Johanna Badcock 

It’s just there just so many varieties of experience their own. And interestingly, we tend not to really do an awful lot of research on those positive experiences. No, that’s for obvious reasons in that, you know, the government dollar is shy on giving to mental health research anyway. And so you should, as a priority, put your money into investing in things where it’s going to help people who are really needing help.

 

Bryn Edwards 

Yeah, that down the blunt end of,

 

Johanna Badcock 

but I do think at least Yeah, that’s that it might inform treatment. Yeah, yes. Because clearly, there’s a priority and

 

Bryn Edwards 

prevent really nasty outcomes, like people acting on the voice that says, burn the house down.

 

Johanna Badcock 

Yeah. That the the risk, though, in, in that is that in not spending at least a little portion of time in understanding those more positive experiences, is that they may capture some of the keys that we then need to apply. Yeah. Down here to understanding may

 

Bryn Edwards 

Yeah, it may even I’m going out on a limb here. It may even by not spending the time and to legitimise and normalise this naturally occurring human phenomenon. And because we’re talking about, you know, the, the inner depths of your own interior experience, and which you can talk to other people about but you’ve got to navigate yourself, but but nobody gives you the manual to that. So you go outside to talk to me for no one to talk to, then that can create your own little neurosis anxiety thing that’s going on, which could then you know, over a period of 10 2030 years, down that other end of the spectrum, you know, yeah, on a on a, you know, increasing chronic

 

 

loans. That makes sense.

 

Johanna Badcock 

Yeah. Yeah, absolutely. Yeah.

 

Bryn Edwards 

Plus, so it and there’s a Whoo, part of me, that goes, this may also be your great guidance to great, amazing things in life, if, if this voice is telling you the stuff that, you know, is part of creativity and beyond the thinking that you know, everyday life,

 

Johanna Badcock 

and there are probably a large number of people out there who just have these experiences, and they’re fleeting, you know, they just have them maybe once, maybe twice in their whole lifetimes. Yeah. And they pass them off as really not being particularly significant. And that’s the end of it. So we we still know very little about the natural life course the frequency of the positive end of the spectrum, if you like. But yeah, there are all gradations in between. I mean, I mean, as another example, I’m a tinnitus sufferer. I have bilateral tinnitus. And it’s a form of hallucination. You know, I’m hearing as we speak, you know, I’ve got these massive buzzing sounds in both ears, but you’re not hearing them. No, there is no external sound. That’s that’s creating the buzz in my ears. It’s an illusory nation. It’s a simple one. And even on that kind of experience, there are people who find them incredibly distressing. And, again, you know, there are now cognitive behavioural talking therapy, help for people with distressing tinnitus. And others find ways of accommodating to that and just accepting that it’s there and it’s not going to change. So it Yeah, there’s just an enormous range of experience to these. I

 

Bryn Edwards 

guess the thing that jumped out amongst many is even the lack of normalisation to be able to just have this conversation.

 

Johanna Badcock 

Absolutely. It’s it’s really, really for all the government

 

Bryn Edwards 

Yeah, research dollars. One would hope that even just you and I having this conversation, yeah. Which is, you know, relatively everyday person speaking to an expert about an internal phenomenon, and then, you know, yeah, and the fact that it happens, yeah. Is that for anybody listening to this, who’s not right down the end of needing to come to Perth voices clinic and just go?

 

Johanna Badcock 

Yes, that’s good. Okay, just just knowing that they’re happening, I can give another more personal example. So my dad has Alzheimer’s disease back in the UK at least he’s certainly got dementia, it’s probably Alzheimer’s. And my mom’s is full time carer And of light, Dad has started having visual hallucinations. Right? And he’s talking to mom and I talked to mom every night on, you know, FaceTime. And so she’s asking me, Well, what? What’s this? was like, like, Where’s the beef? Yeah. And she’s found it really helpful. Just to know. Yeah, it’s the thing. You know, people with dementia will sometimes have these kinds of experiences. Yeah. And you don’t need to panic. Yes, you know, it that that’s been the signal lesson for mom and I dare say for perhaps a lot of carers. Yeah. Yep, that’s going to happen. It’s just part of what’s going on as, as the dementia is kicking in into the brain and changing how, you know, the neural circuitry is working. It’s going to be one of those things that triggers often visual hallucinations. But other touch Yep, gustatory, you know, but you don’t need to panic, it doesn’t necessarily mean Oh, my goodness, right now, you know, I’m going to have to send this person off into residential care and so on, which, sadly, a lot of the literature does say, you know,

 

 

it’s caused to

 

Johanna Badcock 

Yeah, it’s caused so much actually, carer distress. Yeah, that’s prompted them to talk to services, and the next minute, they’ve been placed in a nursing home or residential facility. Now, that could be an appropriate step for some, but by no means is it obligatory for all. And to be able to talk to families, and carers especially to say, yes, it’s part of this overall profile. And there are ways you can talk to the person with dementia, to help calm them so that they don’t get upset about that experience, but not nor also, to trivialise the experience because for them, it is real. Because we do believe our senses coming back to that, right, we navigate. Yeah, that’s, you know, perceiving is believing. And so I think we’ve still got such a lot to do to, in this sense, normalise the experience in the sense of talking to people, generally, so that they have a much broader understanding of how frequent these experiences are, and that they are manageable. And that comes back to also we need better training of mental health professionals. And that steps back to Perth voices great, because when we conceived of this, and I say we, Georgie conceived of this, and we kind of put this story together. It was not just about providing a psychological service, though that was the core, it was about also connecting that to doing research and evaluation to improve the treatments available, but also to involve a teaching and an educational component. So at the clinic, there are placement opportunities for students, mostly psychologists in training, because we’re both psychologists, yeah. But we really felt very committed to that need as well that you need to be educating the future workforce, about these experiences.

 

Bryn Edwards 

And I suppose there is another bit which is provide some education to those people who are supporting the people who are going through. Yes, yeah, yeah. Yeah. Then the next step is,

 

Johanna Badcock 

yeah, well, of course, if we had lots of funding, then we’d be doing.

 

Bryn Edwards 

It’s interesting, cuz as a background, at this point in time, I in three others are doing a small little research project into what we’re calling spiritual or psychological awakenings. Uh huh. Where people may go to like, breath work or meditation retreats or yoga or maybe psychedelic experiences, or even finding you know, people who just brush with life and then it’s changed something within them. And, and, and it’s broken, open their sense making it the world to move to somewhere else. And then often people, one of the sentences that keeps coming out is, you know, I can’t look at the world, the world the way I did before. The biggest thing after after spending half an hour talking to people about this just so we can listen and learn to the language and some of the patterns that might go on is is is again this normalisation of often people say to us you know, this was a really not that this felt like it had to happen and it’s a normal thing, but I’ve had nobody to talk to about You’re the first person brain or whoever’s out there, three others are helping it.

 

 

Yeah, this

 

Bryn Edwards 

is I’ve never been out to sit and just talk about Yeah. Yeah. And again, I have a sense that that thing is a naturally occurring human phenomenon. And if if someone went and presented straightaway, it might be considered the psychotic event or this than the other. But what we’re finding is that they are transitory that they’re lasting between two to some two weeks, some two months. Yep. But they come out of it. And yeah, then ground back into the world. Yeah. And as something has changed, and something is dead,

 

Johanna Badcock 

we need to give a bit more space to understanding that kind of progression. So there’s a really amazing TED talk by Elena longdon, who is a psychologist as well. But in her younger days, she had hallucinatory experiences. Yeah. And she wondered whether she should tell anyone, and in the end, she did. And she ended up going into a psychiatric facility with all sorts of diagnoses. And she’s describing her journey of the lack of listening capacity for want of a better description of the service providers that she came in contact with, because it took her a while to be able to open up to talk to someone about it. But then, in a sense, that conversation got closed down, because there was an instant assumption about what it signified. Yeah, that led to a very, yes, it relate to a very specific route in her mental journey. And I do think we need to be that little bit more cautious about leaping to any conclusion about what it may or may not signify just on the basis of having an elucidation. Certainly, yeah,

 

Bryn Edwards 

it sort of raises. Probably, this could be a whole other podcast, which is the trajectory of psychology psychiatry, currently, against the naturally occurring phenomenon that we incur through our journey through life.

 

 

Hmm,

 

Bryn Edwards 

strikes me and I met, okay, I did the degrees in psychology, but I’ve not done the mega research. And I’ve not done the mega tip with clients. But I’ve done my own thing, in that sometimes it strikes me that there’s almost like this. It said, you presented this, so this means this. And so therefore, we need to treat you with as opposed to a calmness around. Okay, so let’s look at Yes, that’s going on. And is it surprising that this thing has occurred? Or Yeah, is is this is this for a while I, I particularly interviewed people between the ages of 3738 foot 243. And there starts to be parallels in that area of midlife crisis, line, mental, whatever you want to call it? And, and yes, so I just wonder sometimes whether there’s a growing gap between the two, sometimes I liken it between if a lady was giving birth, what was the experience like if doctors present as opposed to just the midwife? Yeah, work with the lady in the body? Yes. You’re always looking for something to be wrong.

 

Johanna Badcock 

Yeah. Look, we’re all subject to our biases, including our professional bias. Yeah. So, you know, I guess inevitably, if you have these sorts of experiences and rock up to someone from the more medical professional side, they are going to look at this experience through that land. Yes. I hope is probably a big hope. Yeah, that if you were to present that same picture to someone from a psychological background, that maybe they would take a slightly different approach and at least take a view to not just what might be going on if you like, biologically, but what might be going on in that person’s life, you know, have they had stress or have they had something unusual happen, that may be accounting for or at least contributing to why this person is having this experience now? And what that is,

 

Bryn Edwards 

yeah, what’s happened?

 

 

Yeah, yeah.

 

Bryn Edwards 

So this also leads into some of the other work you’ve been doing around loneliness. Yeah.

 

Johanna Badcock 

Well, again, as I mentioned before, you know how winding road the long and winding road of how you get from A to Zed the experience of psychotic like symptoms like hallucinations, I had mostly been trying to get out what were the causal processes involved, particularly about how you think about it. But of course, there’s lots of other literature looking at what the biological causes were. And a whole heck of a lot less on what were the social factors going on that might contribute to these sorts of experiences. And a few years ago, now, I got to collaborate with Professor Veera Morgan, who, and we started rummaging around in the national survey data on psychosis. So, Veera had been the lead of that project on the National Survey of psychotic disorders. And they happen to have within that survey some data on social functioning, and in particular, social isolation and loneliness. Right. And so we had a look at the association between experiencing social isolation and loneliness, and the experience of psychotic disorders, and found a very strong and striking link between the two. So at this point, we’ll have this little hiatus to say, Okay, what is this distinction between social isolation and loneliness? Because, again, that’s something that tends to get confused. So social isolation, refers typically to the objective state of lacking social connection with other people. Yes, so it’s having a small social network, possibly nobody, maybe only one other person that you interact with routinely. So that’s an objectively defined characteristic. There’s a lack of frequency of contacting other people, again, an objective state of being most extreme being that you live alone and lonely, alone, life, you may or may not be lonely. Yes. Because loneliness, again, refers to the subjective experience of feeling disconnected from other people. So you may be alone and lonely. Or you actually could be surrounded by other people, but still feel lonely, lonely in a crowd. So although the two, you know, kind of related in that they talk about your experience of social relationships, they are different. So what I was interested in was specifically Phil, the subjective element, the Association of loneliness and psychotic disorders and psychotic symptoms. So since then, we’ve done quite a few other studies in that space. But I’ve been particularly interested in that connection between whether loneliness could be something if you like, that helps to offset the sense of being disconnected from other people. And that that might be a trigger to why you’re having hallucinatory experiences. Because the idea that had been put forward was that the hallucinations when it when they do involve other people and other voices, they’re actually fulfilling a need a gap that’s missing in your social world. So if you’re lonely, you have these hallucinatory phenomena that fills that need for connection with other people, by creative voices, by creating voices in order to hear and listen to Yeah, I guess, you know, that, that sounds like a manufactured explanation, and there are undoubtedly lots of holes in it. So for example, it’s not at all clear. Why if you’re lonely, the majority of hallucinations that are really bothersome are quite derogatory. So why would you generate, you know, an Elisa nation?

 

Bryn Edwards 

So you know, generate your best

 

Johanna Badcock 

mate? Yeah, exactly. So clearly, you know, it’s a Florida or at best primitive explanation as a causal connection between the two. Nonetheless, the data do seem to show does it correlate that there is a strong correlation? And of course, it could be that relations don’t mean

 

Bryn Edwards 

cause?

 

Johanna Badcock 

Absolutely. They don’t they don’t mean causation at all. And undoubtedly, these affect each other in both directions. Yeah. Hmm. But there’s a little bit of evidence coming to pass now where you are seeing loneliness arising first. And then later, the hallucinatory type experiences and that’s slightly stronger evidence that the one is contributing to the experience of the other in a more causal direction. So we still got lots to do in that direction. Anyway, the point being, I had started doing a lot of work in that space. So what is the connection between loneliness and psychosis? And what kind of effects does it have? And it turns out that, you know, people who are lonely have also worse cardiovascular function. And that also occurs in people with psychotic disorders. In fact, loneliness is really a beast. I mean, it’s such a stressor,

 

Bryn Edwards 

that the stronger your friend network, the greater the, your life expect.

 

Johanna Badcock 

Absolutely. Yeah. And that’s like, yeah, yeah. This is really basic. This is about loneliness being a fundamental issue. And being connected is a basic human need. And of course, now with Coronavirus, and all of the physical distancing measures, you know, that that are being used by the government, this is a particularly big stress or to feel that you’re socially disconnected from the world around you. But the literature definitely shows that if you’re very lonely, it can reduce your longevity, it has links to poor physical health, like diabetes, glucose, poor sleep, compromised, or spiritually function, poor immune function, you name it, yeah, cause it’s such a major stress or it also links to poor mental health, it links to poor workplace performance, poor educational performance, the whole gamut. So through all of that, I had been talking with colleagues over east, specially Michelle Lim, at Swinburne uni. And she was in the process of setting up what was then called the Australian coalition to end loneliness. Yeah. And it’s now called ending loneliness together. And so I’ve been working with that team for the last several years now. And in fact, we’re hoping to have a launch webinar at the end of November. So it’s taken a long time to get this whole initiative going. We’ve got lots of fabulous organisations coming together behind us. So we’ve got way ahead and uniting care and relationships Australia. And, you know, so we’ve got more and more organisations joining us because they’re recognising the importance of loneliness, and how impactful its consequences across all sectors really. Hmm. And again, that’s fascinating, because

 

Bryn Edwards 

So, since meeting through the podcast, gentlemen, corpo holiday, been invited to be on the board of something called the human excellence projects, project. And even at its basic every single day. And Paul created this group, which people are free to come to, it’s first thing in the morning. So it’s like, quarter, five, six clocks, and like that, everyone greets each other with a hug, even if you’ve never met anyone before. And Paul tells very funny stories about you know, sometimes people stand on the periphery and won’t come and join him until the hook says they start getting closer and closer and closer. And he can break hugs down into like seven or eight different types as well. bear hugs and glancing and hugs and stuff. Yeah, but then

 

Johanna Badcock 

sometimes apology of hugs are like the psychology

 

Bryn Edwards 

of hugs. Yes, he says the master of it. And sometimes they might do a bit of breathwork meditation. That’s not every morning, then they’ll all see the causes and borders on dip into the ocean together. Just get wet. Yeah, about the state that Dan get changed. Go and have a cup of tea, chat about life. And that’s the start of their day. Yeah. So if you think about what you’re talking about,

 

Johanna Badcock 

yeah. That’s how I like social connections.

 

Bryn Edwards 

High quality, high quality contact with others. Yep. At the start of your day. Yep. regularly.

 

Johanna Badcock 

Yeah, that’s right.

 

Bryn Edwards 

Yeah, that’s ending loneliness right there, isn’t it? Absolutely.

 

Johanna Badcock 

So simple. It can be definitely. And it’s about people who are not lonely, helping in this mix as well, because a lot of these initiatives, like, like often happens in the sort of mental mental illness space is almost as if the onus of responsibility always lies with a person affected by the symptom or the illness, or in this case, loneliness. Whereas in fact, I don’t think that’s the right way to think of it at all. This is a community responsibility. Because we’re all part of our community, yes, it’s it’s about yes them hopefully if they can reaching out, but it is about people who are not currently lonely reaching in to help because we’re all going to go through these cycles all through our lives. Yeah. And so it, it is about helping each other out, you know, to have that. That nod Hello, you know how you doing as just as you’re walking past people in the street, that kind of connection can actually be really meaningful to someone who’s had a really pan the description really crap day. And, you know, they’re feeling shockingly lonely all the time. They don’t get to talk to anybody. Yeah. But that nod and hello from the stranger in the street or from, you know, the person in the store can make all the difference in the world to that person’s life and can sometimes even be the first stepping stone to them walking out of loneliness and back into more regular connections.

 

Bryn Edwards 

And we’re not talking here about a phrase that I use before we started this, you know, that that handwringing virtue signalling of being a good citizen, and all you need to do. This is just about being a basic good human.

 

Johanna Badcock 

Yeah, that’s right. And, you know, there’s no cost to this, right. This is just so easy.

 

Bryn Edwards 

Yeah, to do. It was interesting. And think about that. Also, this is what I think about sometimes because I had this thing for a little while, while I did what I called gorilla smiling, which is rare. I read the other side of the train or so life has fat spotted some of the glum faces. Just smile at them. Yeah. to force him to smile back. And it’s like, have just made you smile. Yes. All right. So I called it gorilla smiling. It was a good, good little experiment. But part of the thinking behind that was, well, Crikey, if I’m having a bad day, and I lived in a community where somebody gorilla smiled me, and I, and and it broke my state. Yep. It’s a great community to be. Yeah. Because I’m not an island.

 

Johanna Badcock 

Well, it’s also just recognition that, you know, for loneliness, certainly, it’s something we’re all gonna go through. I mean, I don’t know that anybody will go through the whole life without having at least a short spell of feeling a bit on the outer and a bit lonely. And so it doesn’t take any great brains to think, no, maybe, maybe we could be kind to other people along our journey and help them back in when they’re feeling like that. But for people who end up chronically lonely, they, again, there is quite a lot of evidence that they’re almost pushed to the outer of society, you know, they’re pushed to the perimeters of the social networks. Yeah. And that’s a much harder place to get back in from. Yeah, you know, so it’s not tough. Just, you know, put the iPod down or whatever. And as you say, smile, or say hello, or even, you know, gosh, maybe initiate a conversation with someone. stranger.

 

 

Yeah, it’s not transactional.

 

Johanna Badcock 

Yeah, that just just helps you step back into that. I do wonder if maybe we used to do that a little bit more in the past, and we were just less practised at it now.

 

Bryn Edwards 

Yeah. There’s another gateway to another whole conversation about

 

 

handheld devices to social media.

 

Johanna Badcock 

Yeah, looking, I’m certainly not anti, you know, devices and so on. It’s about how they use that.

 

Bryn Edwards 

But if it’s at the detriment of this, like,

 

Johanna Badcock 

that, that’s about how they use so if they’re gonna be used, you know, you’re plugged in 24, seven, and you’ve, you’re, you know, getting rid of your external contact, then that’s, that’s problematic. No, clearly, clearly at human scale. Clearly that they have their place and their value, but but we do need to use them mindfully.

 

Bryn Edwards 

What have you learned about yourself on this journey?

 

Johanna Badcock 

Oh, goodness, what have I learned about myself? Mmm hmm. Well, on on a basic level, how fortunate My life has been, I mean, just incredibly lucky to have a loving home a loving upbringing, fabulous family, you know, all of the things that make a good life.

 

 

Yeah.

 

Johanna Badcock 

And therefore, I’m probably been acutely aware of it through

 

 

your work.

 

Johanna Badcock 

Well, yeah, absolutely. Yeah. But Aries but but they’re in also, life’s not just about what you get. It’s what you give. You know, it’s like giving Back, like in helping those that you can not necessarily through, you know, a professional capacity, but just being kind to people and making a bit of time in your day to give back. Yeah.

 

Bryn Edwards 

Last question I ask all my guests Yes.

 

 

Is

 

Bryn Edwards 

if you could upload one question into the collective consciousness. So everyone had to sit still five or 10 minutes and just consider it. What would that be?

 

Johanna Badcock 

what sparked your interest today? Well, if we do things that are routine, and always the same, but that to me would be boring. And you would you would lose your motivation to continue. So it’s all about finding, what’s the next thing that’s interesting, and that you haven’t maybe thought about and, and sparking that curiosity for the next step.

 

 

Can’t Feel what you’ve done?

 

Johanna Badcock 

A little bit. Hopefully, there’s more to come.

 

 

Indeed.

 

Bryn Edwards 

Joe has been absolutely fascinating talking to you today. It’s been a pleasure. It’s been amazing to really dive into something, which again, for me, has been previously stigmatised. People have gotten, yeah.

 

 

metacity really

 

Bryn Edwards 

go into the difference between sort of the objective and the subjective. And then to go further into that. And because there seems to be growing theme and the podcast at the moment about holding a space that’s non judgmental for people to explore their actual interiors. Because it’s it turns out, it’s not as wild and wacky as everybody thinks it isn’t. It’s not scary. Just think sometimes we don’t normalise the discussion and therefore we we starve ourselves if necessary tools. Yeah. for exploring this ritual. Yeah. That’s with it, as well as with that,

 

Johanna Badcock 

yeah. That we don’t need to be fearful about having chat with people about these things, because that’s part of being human. And day to

 

Bryn Edwards 

day. Yeah. If people want to reach out and find you, where can they find you?

 

Johanna Badcock 

Through the UW? Yep, email contact. They’re

 

Bryn Edwards 

super. Sorry. Thank you very much for your time.

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