New Psychiatric Technique Asks Schizophrenics to Engage in Dialogue With the Voices in Their Heads

Researchers have come up with an ingenious new approach to treating psychosis: creating an “avatar” for the often upsetting voices in one’s head and talking to them like they’re real, living people.

As The Guardian reports, there have now been multiple clinical trials displaying the power of this so-called “avatar therapy.” Case in point, a new paper in the journal Nature Medicine demonstrates that giving voice and face to the dark forces inside the heads of people who suffer from auditory hallucinations can be a promising treatment strategy.

Like customizing a character in a video game, people who undergo this experimental treatment create digital avatars that resemble or symbolize the voices they hear. Some people are talked down to by cruel authority figures and others are menaced by demons — and by creating an externalized avatar on a screen and having a therapist simulate the things they say, those persecuting voices can often be controlled.

It’s a deceptively simple scheme that has time and again borne out promising results. These digitally-assisted interventions not only help people who hear voices in their heads feel calmer and less suicidal — a common comorbidity with schizophrenia and psychosis — but in some cases even make the voices go away entirely.

Initially conceptualized by the celebrated British psychiatrist Julian Leff, a specialist in schizophrenia who died in 2021, the therapy’s name is apparently a bit of a misnomer.

“It’s called avatar therapy, and that sounds like it’s primarily about the visual representation, but not everyone has an existing image that goes with their voice,” explained Neil Thomas, the director of the Voices clinic in Melbourne, Australia and lead investigator of that country’s avatar therapy trial. “I think the auditory transformation is particularly powerful.”

That was certainly the case for Claire, one of the participants in the UK’s Avatar 2 trial, who told The Guardian that before she enrolled, she’d heard voices for more than 40 years.

An abused child, Claire said the first voice she heard was a man’s voice who told her to jump out of the window when she was 10 years old. Decades and many suicide attempts and hospitalizations later, she began doing avatar therapy.

Despite worrying the treatment could worsen her psychosis, four sessions into her allotted 12 she found that the voices were straight up gone.

“My aim wasn’t to get rid of them — just to get along with them,” Claire told the newspaper. “I wasn’t quite sure I wanted to let go. I’d never really been on my own. As abusive as it was, it’s still a relationship.”

While researchers in the UK, Australia, and Denmark continue their reserach into the treatment, people in the United States seem left out in the dust. As STAT News reports, Americans seeking avatar therapy may still have to wait years to get it on this side of the pond.

More on schizophrenia: Scientists Say They’ve Traced Back the Voices Heard by People With Schizophrenia