By Grace Rubenstein

Eleanor Longden’s new TED Book, Learning from the Voices in My Head, charts her harrowing journey from terrified young woman trembling in a psychiatric ward to a Eleanor Longden: The voices in my head stable, successful doctoral candidate who has learned to live peacefully with her inner voices, medication-free. She recounts how her mind shattered into pieces and how she slowly and delicately put it back together.

In recent decades, psychiatry has come to view mental illness through a mainly biological lens, hunting for causes and cures in our brain chemistry. While that approach helps some patients, Longden says, it very nearly destroyed her. She testifies to the need to view patients as individuals, not diagnoses, and to empower each one to heal in his or her own way. As a Ph.D. student in psychology, she also serves up a hefty scientific literature on the problems with over-medicalizing mental illness.

Here’s a glimpse at what the numbers say about psychiatry’s medical obsession:

With the array of possible diagnoses exploding, Longden writes, “it’s apparently becoming harder and harder to be counted as sane.” Meanwhile, the number of prescriptions being written for certain psychiatric drugs is ballooning:

In the nightmarish throes of her initial diagnosis, doctors told Longden she’d have to take antipsychotic medication for life. That was the conventional wisdom on psychosis. But should it apply to every person with the diagnosis? For Longden, clearly not. This landmark study suggests there are many others like her:

In her TED Book, Longden writes, “This is the story of one, but in many ways it is also the story of a whole — of all those who hear voices in the head. The details will vary, acknowledging the enormous diversity in the voices people hear and the ways in which they understand them, but for many of us the essential messages remain the same. It is also a call for an alternative conception of voice hearing, one in which the occurrence is not catastrophized as bizarre and precarious, but acknowledged as a meaningful human experience that can be intensely disturbing yet may also be readily supported and understood.”

Learning from the Voices in my Head is available for the Kindle, the Nook, and through the iBookstore.

Eleanor Longden shares her experience of hearing voices at TED2013. Photo: James Duncan Davidson

Eleanor Longden’s riveting story — featured in today’s talk and more in depth in the new TED Book, Learning from the Voices in My Head — raises many provocative questions. Longden talks about her recovery after a diagnosis of schizophrenia, in the process calling into question the attitudes of traditional psychiatry, the role of drug manufacturers and the very definition of madness. If her tale piqued your interest, there’s plenty more to explore. Here, take a look at a list of resources Longden put together exclusively for TED.

Articles:

Transforming Diagnosis, by Thomas Insel, director of the National Institutes of Mental Health, April 29, 2013. [See also Insel’s TED Talk, Toward a new understanding of mental illness.]

Statement of Concern by the International DSM-5 Response Committee, March 24, 2013.

Psychiatrists: the drug pushers, by Will Self, The Guardian, August 2, 2013.

Antipsychotics: is it time to introduce patient choice?, by Anthony P. Morrison et al, British Journal of Psychiatry, 2012.

The Illusions of Psychiatry, by Marcia Angell, The New York Review of Books, July 14, 2011.

Negative childhood experiences and mental health: theoretical, clinical, and primary prevention implications, by John Read and Richard P. Bentall, British Journal of Psychiatry, 2012.

Books:

Anatomy of an Epidemic: Magic Bullets, Psychiatric Drugs and the Astonishing Rise of Mental Illness, by Robert Whitaker. (Crown, 2010.)

Doctoring the Mind: Is Our Current Treatment of Mental Illness Really Any Good?, by Richard P. Bentall. (NYU Press, 2009.)

Agnes’s Jacket: A Psychologist’s Search for the Meaning of Madness, by Gail A. Hornstein. (Rodale Books, 2009.)

Living With Voices: 50 Stories of Recovery, by Marius Romme, Sandra Escher, Jacqui Dillon et al (editors). (PCCS Books, 2009.)

Podcasts:

An Interview with Pat Bracken on Post-Modern Psychiatry and the Social Context of Trauma podcast interview, by David Van Nuys, Seven Counties Services, Inc., Louisville, KY.

Jon Ronson, who spoke at TED2012, has a conversation with Eleanor Longden, who gave today’s talk at TED2013. Photo: James Duncan Davidson

By Jon Ronson

In 2010, I made a radio documentary about Eleanor Longden for BBC Radio 4. When I heard that TED was doing a talent search — looking to give the TED2013 stage to people who might not normally have access to such a place — I thought of Eleanor. I told the TED people about her, they auditioned her in London, and she got through.

Doing a TED talk is very anxiety-inducing. You have to stand in front of people like Al Gore and Bill Gates. Plus people keep telling you it’s the most important 18 minutes of your life. Jon Ronson: Strange answers to the psychopath test In my year, 2012, Susan Cain was doing her introvert talk and everyone kept saying, “Oh she’s so brave giving a TED talk when she’s an introvert.” But when I was chatting with Susan Cain backstage, I was the one so nervous and fidgety I destroyed my TED ID badge. It exploded in my hands. Whereas Susan Cain was just fine.

I worried what the stress of being at TED might do to Eleanor, given her previous mental health problems. But it’s six months later and Eleanor’s TED talk has just gone online, and TED has published a book called Learning from the Voices in My Head to go alongside it. Eleanor Longden: The voices in my head They asked me to do an email Q&A with Eleanor. The entirety of the conversation can be found on The Guardian’s website; or read short excerpts from it below. I started by asking Eleanor about how she handled the stress.

Eleanor Longden: Yes, [I was] definitely very nervous in the run-up. In fact, the day of the talk itself was agony — like waiting to take an exam in front of a colossal audience. I was never worried that it would have a severe impact on me, though. In fact, having experienced such serious difficulties in the past has probably given me very useful skills in managing emotion and taking care of myself, more than I most likely would have had if the breakdown had never happened.

Jon Ronson: Let’s back up a minute and talk about what happened to you. Whenever I tell anyone your story, I always begin with a bit of a narrative flourish: You are just a regular student somewhere in England. And then one day you got out of bed and … what happened?

Eleanor Longden: Well, essentially what happened was that — although I couldn’t possibly have known it at the time — my whole life, and the life I’d expected to have, was about to change beyond all recognition. This brewing catastrophe began in a relatively mundane way; the appearance of a single, neutral voice that calmly narrated what I was doing in the third person: “She is going to a lecture,” “She is leaving the building.” I was startled at first — very shaken. It was quite a weird sensation. But I got accustomed to it pretty quickly, because it was so unthreatening. I knew what voice hearing was, of course, but this didn’t seem anything like the types of voices you read about in the media or see in films — frenzied, violent voices that drove people to acts of destruction. And after a while, I even began to find it quite reassuring. Owing to a series of childhood traumas, I was a very confused, anxious and unhappy teenager, and the voice started to feel like a reminder that in the midst of crushing unhappiness and self-doubt, I was still carrying on with my life and responsibilities. I wondered whether other people had similar commentaries but just never talked about it. Also, although this took a bit longer, I began to feel that the voice was very closely connected to my sense of self, in that it reflected emotions I couldn’t express. So, for example, if I felt angry and had to hide it, then the voice would sound frustrated. It began to seem vaguely fascinating, creative even — how my emotional world was being externalized through this voice.

Jon Ronson: So this story is about to get hugely worse. But before it does, let me ask a question. I remember when I was a kid once or twice hearing a kind of weird babble of voices in my head. Like there was a party going on and a whole bunch of people were all talking at once, and I couldn’t make out what anyone was saying. It didn’t bother me at all. I think a lot of people have had a similar experience: hearing a voice just as they’re falling asleep, or whatever. Before everything got worse for you, is that the kind of thing we’re talking about? Something as innocuous as that?

Eleanor Longden: That’s a really interesting question, because what research actually suggests is that voice hearing (and other unusual experiences, including so-called delusional beliefs) are surprisingly common in the general population. The recognition of this had led to the popularity of “continuum models” of mental health, which suggests different traits and experiences are all part of human variation — not strictly categorical in terms of “us and them,” “sane and insane,” “normal and abnormal.” However, I do think life events play a vital role in determining who becomes distressed and overwhelmed and who doesn’t. This might include experiences of abuse, trauma, inequality, powerlessness, and so on, but it can also include the immediate reactions of the people around you. If you don’t have people who will accommodate your experiences, support you, and help you make sense of what’s happening, then you’re much more likely to struggle.

Jon Ronson: So when did you first notice that the voices were becoming less threatening? Can you remember a moment when the voices became noticeably nicer?

Eleanor Longden: It happened gradually — and some voices took longer to change than others. But primarily it was when I stopped attacking and arguing with them, and began to try and understand them and relate to them more peacefully. It was about putting an end to the internal civil war I mentioned earlier, because each of them was part of a whole: me! I would thank them for drawing my attention to conflicts I needed to deal with. I remember one very powerful moment, several years down the line, when I said something like, “You represent awful things that have happened to me, and have carried all the memories and emotion because I couldn’t bear to acknowledge them myself. All I’ve done in return is criticize and attack you. It must have been really hard to be so vilified and misunderstood.” There was an immensely long pause before one of them finally responded: “Yes. Thank you.”

Jeanette Winterson, in her memoir Why Be Happy When You Could Be Normal, summarizes a related concept process really wonderfully: “I often hear voices. I realise that drops me in the crazy category but I don’t much care. If you believe, as I do, that the mind wants to heal itself, and that the psyche seeks coherence not disintegration, then it isn’t hard to conclude that the mind will manifest whatever is necessary to work on the job.”

Jon Ronson: When was the very last voice that you heard?

Eleanor Longden: I last heard voices yesterday. They were repeating something I’d read on the Internet. The comment was: “I’m going to spoil the ending for you. The ending is — everything’s going to be great!”

Read the entirety of my conversation with Eleanor at The Guardian »

Eleanor Longden gave a candid talk about the fact that she hears voices at TED2013. Today, we also release her TED Book, which delves further into her experience in the mental health system. Below, all the questions you’d want to ask Longden. Photo: James Duncan Davidson

During her freshman year of college, Eleanor Longden began hearing voices: a narrator describing her actions as she went about her day. Diagnosed with schizophrenia, Longden began what she describes as a “psychic civil war,” fighting to stop the voices as they became antagonistic. Eleanor Longden: The voices in my head What helped her was something unexpected: making peace with them. By learning to see the voices as a source of insight rather than a symptom, Longden took control.

What’s it like to hear voices? Read Eleanor’s FAQ below — where she tells you everything you wanted to know about voice hearing, with her signature honesty and humor.  

Want more? Longden first spoke during our Worldwide Talent Search; then told a longer version of her journey toward acceptance of her own mind on the mainstage at TED2013. And today, Longden premieres her TED Book, delving deeper into her experience. Learning from the Voices in My Head is available for the Kindle, the Nook and through the iBookstore.

Do your voices ever talk to each other (and exclude you)? 

Sometimes. In the old days they would talk about me a lot more, but now they usually speak to me directly. And when they do discuss me, it’s more likely to be compliments or positive encouragement. Or sometimes they’ll discuss something I’m worried about and debate possible solutions. There’s one particular voice that will repeat helpful mantras to the others. A recent one was: “If you can do something about it, there’s no need to worry. And if you can’t do anything about it, there’s no point in worrying!”

Do the voices sound like they are coming from inside your head or through your ears?

This is something else that’s changed a bit over time. They used to be more external, but now tend to be internal or outside, but very close to my ears. It can also vary depending on which voice is speaking.

What would you miss if you lost the voices? Would you be lonely?

My voices are an important part of my identity – literally, they are part of me – so yes, I would miss them if they went. I should probably insure them actually, because if they do ever go I’ll be out of a job! This seems extraordinary given how desperate I used to be to get rid of them. But they provide me with a lot of insights about myself, and they hold a very rich repertoire of different memories and emotions. They’re also very useful when I do public speaking, as they’ll often remind me if I’ve missed something. They can be helpful with general knowledge quizzes too! One of them even used to recite answers during my university exams. Peter Bullimore, a trustee of the English Hearing Voices Network, published a beautiful children’s book that was dictated to him by his voices.

Do your voices ever overlap? Could they harmonize?

They sometimes talk over each other, but don’t really say the same things in unison. I’ve met people whose voices do that though, like a chorus. Other people sometimes describe voices that sound like a football crowd, or a group talking at a party. At a recent conference, I heard a really extraordinary fact: that people who’ve been deaf from birth don’t hear voices, but see hands signing at them.

Do your voices happen all the time? Like, even during sex? Do you have to shush them during a movie?

No, not all the time! Although they’re often more active (and sometimes more negative or antagonistic) when I’m stressed. Even this can be useful though, as it’s a reminder to take some time out and look after myself. I relate to them so much better now, so if they become intrusive and I ask them to be quiet in a calm, respectful way — then 99% of the time they would.

Can you make certain voices pop up at will?

Yes, some of the time. Actually, this was something I used several years ago during therapy – my therapist would say for example, “I’d like to speak with the voice that’s very angry,” or “the voice that talks a lot about [a particular traumatic event],” and he’d dialogue with it.

Is there a time when you want to hear voices or are you always trying to get them to be quiet?

I sometimes discuss dilemmas or problems with them, or ask their opinion about decisions, although I would never let them dictate something to me that I didn’t want to do – it’s like negotiating between different parts of yourself to reach a conclusion ‘everyone’ is happy with. So, for example, maybe there’s a voice that represents a part of me that’s very insecure, which will have different needs, to a part of me that wants to go out into the world and be heard. Or the needs of very rational, intellectual voice may feel incompatible with those of a very emotional one. But then I can identify that conflict within myself and try to resolve it. It’s quite rare now that I have to tell them to be quiet, as they don’t intrude or impose on me in the way that they used to. If they do become invasive then it’s important for me to understand why, and there’ll always be a good reason. In general, it’ll be a sign of some sort of emotional conflict, which can then be addressed in a positive, constructive way.

Do you ever confuse your internal voice with ‘the voices’?

No, they feel quite distinct.

When you talk back to the voices, do they react differently if you speak out loud or just think your response?

I rarely respond to them out loud now, but they wouldn’t react differently to when I ‘speak’ to them internally.

What’s the difference between schizophrenia and voice hearing?

While the experiences that get labeled as symptoms of schizophrenia –and the distress associated with them — are very real, the idea that there’s a discrete, biologically-based condition called schizophrenia is being contested all over the world. While voice hearing is linked with a range of different psychiatric conditions (including many non-psychotic ones), many people with no history of mental health problems hear voices. It’s also widely recognized as part of different spiritual and cultural experiences.

Do you feel like other voice hearers understand you better?

They can appreciate what it’s like more precisely, but I’m fortunate enough to have met some really empathic, imaginative non-voice hearers who really want to understand too. In this respect, I think there’s actually more continuity between voices and everyday psychological experience then a lot of people realize. For example, everyone knows what it’s like to have intrusive thoughts. And most of us recognize the sense of having more than one part of ourselves: a part that’s very critical, a part that wants to please everyone, a part that’s preoccupied with negative events, a part that is playful and irresponsible and gets us into trouble, and so on. I think voices often feel more disowned and externalized, but represent a similar process.

What makes the voices talk more at some moments than others?

Usually emotional experiences, both positive and negative. In the early days, identifying these ‘triggers’ were very helpful in making more sense of why the voices were there and what they represented.

Do the voices ever make you laugh out loud?

Yes, sometimes! Some can be very outrageous with their humor, very daring, whereas others have a droll, Bill Hicks-like cynicism. Well, maybe not quite like Bill Hicks. Wouldn’t that be great though … having Bill Hicks in your head!

Photo: James Duncan Davidson

Eleanor Longden did well at school, and gleefully entered student life at university in England. By all appearances, she was a happy, typical student … but it wasn’t true. Underneath it all, Longden was “fundamentally frightened,” and while she did a good job of concealing her fear, she was about to come undone. She started to hear the voice in the second term of that first year, a narrator in her head calmly describing everything she did in the third person. The voice was neutral, impassive, even reassuring, though it would sound frustrated were Longden to hide her anger. “It was clear that it had something to communicate to me about my emotions, particularly emotions that were remote and inaccessible,” she says.

Longden’s first fatal mistake was to tell a friend about the voice. That didn’t go so well–the implication was that normal people don’t hear voices–and she was persuaded to go to a doctor, her next mistake. “She is digging her own grave,” the voice said at the appointment. Doctors don’t like voices in heads, and things began to unravel. Hospital admissions followed, then a diagnosis of schizophrenia, and then a “psychic civil war.” The voices increased and grew menacing, and Longden retreated into a nightmarish world. It’s hard to listen. “A vicious cycle of fear, avoidance, mistrust, misunderstanding had been established.”

Two years later, her deterioration had been dramatic. The voices had turned terrifying, and her mental health status was a catalyst for verbal, even sexual assault. A doctor told her, “Eleanor, you’d be better off with cancer; it’s easier to cure than schizophrenia.” She even attempted to drill a hole in her head to get rid of the voices.

Yet Longden is a survivor: “Many people have harmed me, and I remember them all, but the memories grow pale in comparison to the people who helped me.” With a group of supporters around her, she began a long journey back to health. She first had to understand that the voices were a reaction to traumatic childhood events. “Each voice was closely related to aspects of myself, sexual trauma, anger, shame, guilt, low self-worth,” she says. Crucially, “the most hostile and aggressive voices represented the parts that had been hurt most profoundly. These had to be shown the most compassion and care.”

Eventually, she came off medication, and returned to psychiatry … as a professional. To this day, she argues the relevance of a particular approach. The important question in psychiatry isn’t “what’s wrong with you?” but “what happened to you?”

Now Longden lives with her voices with peace, respect, compassion and acceptance. She is a part of Intervoice, the organizational body for the hearing voices movement. The group has networks in 26 countries on five continents, and it promotes a sense of dignity, solidarity and empowerment for individuals in mental distress. “We don’t have to live our lives forever defined by the damaging things that have happened to us,” she concludes. “My psychiatrist said: ‘Don’t tell me what other people have told you about yourself. Tell me about you.'”

Eleanor Longden’s talk is now available for viewing. Watch it on TED.com »

Here, the speakers who appeared in this session. Click on their name to read a recap:

Ben Affleck, straight off his Argo Oscar victory, introduced the Orchestre Symphonique Kimbanguiste.

Diana Reiss studies cognition in animals and the evolution of intelligence. She and her colleagues demonstrated that bottlenose dolphins (and Asian elephants) can recognize themselves in the mirror.

Musician Peter Gabriel is the co-founder of WITNESS, which distributes digital cameras to empower people to document human-rights abuses. A founder of the band Genesis, Gabriel is now a solo artist and record mogul, championing world music and innovation.

As Director of MIT’s Center for Bits and Atoms, Neil Gershenfeld explores the boundaries between the digital and physical worlds.

Computer scientist Vint Cerf helped lay the foundations for the internet as we know it.

Beijing-based artist Liu Bolin silently comments on modern sociopolitical conditions by dissolving into his art.

Lakshmi Pratury is the host of The INK Conference and was the co-host of TEDIndia in 2009. She talks about her new website, Billionaires of Moments.

Eleanor Longden overcame her misdiagnosis of schizophrenia to earn a master’s in psychology and demonstrate that the voices in her head were “a sane reaction to insane circumstances.”

Born in North Korea, Hyeonseo Lee left for China in 1997. Now living in South Korea, she has become an activist for fellow refugees.

Shane Koyczan makes spoken-word poetry and music. His poem “To This Day” is a powerful story of bullying and survival, illustrated by animators from around the world.