The Guardian

Thursday 22 November 2001 14.29 GMT Last modified on Wednesday 28 November 2001 14.29 GMT

A psychosocial therapist in Holland has adapted an innovative approach to voice hearing to help very young children dispel the imaginary friends that become realistic foes

Gennette Walthaus, a psychosocial therapist and counsellor in Haarlem, northern Holland, has in the past four years treated more than 30 children who hear voices.

Her approach follows the model developed by the Dutch psychiatrist Professor Marius Romme and researcher Sandra Escher, which encourages people to talk back to their voices to understand how they relate to past traumas.

Ms Walthaus has had to modify the approach of getting people to analyse the disturbing commands given to them by negative voices when dealing with young children because they can find it difficult to explain what they hear.

“I call the work I do with children ‘imagination therapy’, particularly when they are considered too young to hear voices and have fantasy friends,” she said.

“For example, I ask them to think of the experience as a story, get them to close their eyes and visualise walking through a landscape. Then they have to take over the narrative, which helps them to describe their experience.”

However, the therapist says that even pre-school children can differentiate between voices and imaginary friends. “I saw a four-year-old girl who heard the voices of her dead grandfather and an imaginary friend. She told me: ‘I made the friend up but I didn’t make up my grandfather.'”

One method Ms Walthaus uses to enable children to control their condition is by getting them to imagine a guardian who can stand up to the voices.

“For example, I ask the children to choose a toy animal that best symbolises the voices and how they make them feel. Then I get them to choose a fierce animal that they like – such as a tiger – and can use as a ‘charm’ to protect them from the frightening voices. The next step is to get them to imagine the tiger when they hear the voices to drive them away.”

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Art therapy techniques can also be adapted to manage voices if children enjoy drawing.

“I saw a six-year-old boy who had been diagnosed with schizophrenia because he began to hear the voice of a mean one-legged pirate called Captain Black after his grandfather’s funeral,” Ms Walthaus recalls.

“The boy said the captain looked like a watercolour painting. So I got him to paint the pirate then said: ‘You’ve got a great imagination – what can you do to get rid of him?’ He smiled and threw water over the painting, washing away the pirate’s legs. He said this made the voice go away.”

The boy continued to paint and wash away the pirate until the voice disappeared. “His mother told me that he calmed down significantly and he’s no longer in psychiatric care,” said the therapist.