But voice hearing also terrifies us because it calls two things into question: the reliability of our senses, and the indivisibility of our minds. We all like to think that our senses faithfully report the real world, but that's not always the case. We like to think we are the sole inhabitants of our heads, but the truth is that there is a ton of things going on in the brain, and consciousness is only one of them. That is never more evident than in voice hearing.
"Psychiatry has always been torn between two visions of mental illness," writes Edward Shorter in A History of Psychiatry. "One vision stresses the neurosciences, with their interest in brain chemistry, brain anatomy, and medication, seeing the origin of psychic distress in the biology of the cerebral cortex. The other vision stresses the psychosocial side of patients' lives, attributing their symptoms to social problems or past personal stresses to which people may adjust imperfectly."
The conflict between these two ideas has played out in different ways in the United States and in the United Kingdom. In both places, psychiatry has come to view madness as a brain disorder, treatable with drugs. But if you're psychotic in Britain, you are increasingly likely to be referred to the your local Hearing Voices group — part of a network of support, by and for voice hearers, which has thrived in the UK for the past two decades.
The Hearing Voices movement holds that voice hearers aren't necessarily crazy — that they deserve to be dealt with on their own terms. These are ideas that fly in the face of psychiatric orthodoxy. Yet the Hearing Voices Network has become a part of mental-health care in the UK, and it has gone international, with groups in at least 20 countries.
Now, the first Hearing Voices groups are starting to form in the US. The epicenter of the movement is here in Holyoke — in this room with its wall of books and its lamps and its couch, in this group of people for whom Marty has become a leader.
There's a baby crying, a piercing wail from a misshaped mouth.
The delivering doctor, the child's uncle, weeps when he sees her — sees the cleft palate stretching up through the roof of her mouth into her nose.
That's how Marty tells it: the story of her birth, in 1959. She is born to a prosperous family in West Roxbury, the descendants of a Lebanese Christian immigrant who had palled around with the writer Kahlil Gibran. The immigrant's last name was Arabic and unpronounceable, so Gibran told him to adopt the name el-Haj, a name taken by those who makes the pilgrimage to Mecca. I know you're not a Muslim, Gibran said, but you've certainly travelled around enough to earn the title. So Marty's last name means "pilgrim" — someone on a journey.
Now the baby is on a journey to a hospital: there will be surgery and more surgery, a bone graft and a skin graft. She can't nurse. When she is older, in yet another surgery, her lips will be sewn shut for a time and she'll eat through a straw. She will grow up knowing that she is ugly.