LRN No.36: meeting the voice in your head
Plus: growing lambs in bags
I don’t have an obvious patch. I am lucky enough to be able to follow my nose, and dig into whatever interests me. But what interests me is often what one of my editors described as “icky future stuff”: dystopian tech that raises knotty ethical questions.
So it was a new experience for me to cover a technological breakthrough in depth, and come out the other side of my reporting feeling massively hopeful about its potential impact on humanity.
If you hear distressing voices, your doctors don’t generally ask what you’re hearing, beyond whether the voices are asking you to harm yourself, or others. The words themselves aren’t necessary to diagnose you with psychosis and prescribe you medicine, and it’s a rabbit hole many clinicians are reluctant to go down for fear of unearthing disturbing content, or reinforcing the belief that the voices might be real.
Avatar therapy demands that voices are listened to closely, and interacted with as if they are spoken by entirely real external beings. Patients create an avatar of their voice: a moving, three-dimensional digital embodiment that looks and sounds like the persecutor inside their heads. They are guided by a therapist to have a dialogue with the avator, engaging with it, demystifying it and ultimately gaining control over the voice.
For an encouraging number of people - some of whom have heard distressing voices for decades, even while taking anti-psychotic medication - finding the courage to look their tormentor in the eyes and challenge it makes the voice fade away entirely.
The Guardian Long Read I wrote on Avatar therapy followed a young man as he went through treatment. (It’s also a Guardian Audio Long Read podcast, read by me and released today.) The piece was 11 years in the making. Avatar therapy is still in clinical trials, and I had to get the agreement of the trial co-coordinators before I could speak to anyone undergoing it, and wait for the results of the most recent trial before my article could be published.
But, for me, it was worth the wait. It was a privilege to speak to people with psychosis and engage with the horrors of what they actually hear, on a daily basis. We think of people who hear voices as fragile, but they are resilient enough to survive years of the worst kind of internal persecution from their voices, and also the stigma their condition is met with by the wider public.
This kind of approach could go far beyond psychosis. Avatar therapy is now being used as an experimental therapy for eating disorders, with the avatar representing the ‘anorexic voice’, and as a treatment for OCD and severe depression. The transformative power of manifesting the darkest side of you - the most self-loathing part - and being supported to reason with it, tell it why it’s wrong and should leave you alone, is surely an alluring idea for most people. I would love to try it.
Speaking of technology with the capacity to do tremendous good, I was thinking about artificial wombs again this week, after reading Sophie McBain’s excellent piece on the medical and ethical challenges of trying to save superpremature babies.
I wrote about Biobags in Sex Robots & Vegan Meat, and how the creation of artificial wombs might save the most vulnerable human beings on the planet, while also challenging the basis of women’s rights. Nobody wants premature babies to suffer, die, or survive with lifelong disabilities if that can be prevented - but once it’s possible to gestate babies outside the womb, will we be removing them from pregnant women considered unfit to carry them?
You see, the dystopian stuff draws me back in every time.
I am chuffed that The Gift is reaching so many people. It was a joy to make - and it looks like we may be making more.
I’m also, er, chuffed that the New York Times liked my FT Magazine piece on posthumous sperm retrieval in Israel that they chose to recreate it less than a month after mine was published. I take this as a great compliment.
Things that have caught my eyes and ears:
My infuriatingly multi-talented friend, the writer and musician Cyrus Shahrad, has started a Substack, and his first post is beautiful. A strong recommend
Really enjoyed the Martha Stewart doc, which seemed to go slightly beyond the usual Netflix hagiographies
Could not take my eyes away from Chimp Crazy - a documentary series about people obsessed with keeping chimps in their homes - but it was one of those that would have been much better as a one-off feature-length doc
Laughed out loud at James Marriott’s review of Jordan Peterson’s new book (spoiler: he was not a fan)
Am really enjoying Bluesky. Come on in, the water is warm.