Companions

                Mrs. Watson is a 58-year-old Swiss woman.

                She was brought to the emergency department by her family physician, who explained that he had tried for years to convince her to see a psychiatrist. This time he wanted to make sure that his patient would be hospitalized and that she would receive proper treatment at last. Mrs. Watson had called him in the middle of the night complaining that the situation had gotten out of hand, that  "they" were really behaving quite badly now, and that something had to be done to put an end to their tricks. "They" were using some kind of invisible rays, laughing all the time and making obscene comments as they sent electricity into her genitalia and tried to get her sexually excited.

                Mrs. Watson's family physician explained that for the previous 3 years his patient had been hearing voices almost continuously, but until the present she had obstinately refused to take any drugs or to see a specialist. She had always asserted that the voices did not really bother her and that , because she now lived all alone, she had come to enjoy their company.

                History: Mrs. Watson was born and brought up in Paris. She had worked as a typist until her marriage. Her husband was a railway ticket collector. They had no children. There was no history of mental illness in Mrs. Watson's family, and she had never been treated for a psychiatric disorder.

                The patient's problems began about a year after her husband died of lung cancer. She lived  alone , she no longer had any relatives in Paris, and she had no real friends,  as neither she nor her husband had ever cared much for company . She noticed one day  that two voices in her head were commenting on what she was doing . She became rather upset by this at first and decided that it obviously had to do with the parabolic antenna that her neighbors had recently installed not far from her window. She took care to shut the blinds, but then she noticed that her radiators seemed to have become charged with electricity. She asked her physician to check whether she might have been contaminated by some strange rays. He could find nothing wrong with her , and the blood tests and other investigations , including a brain scan, were negative. He advised her to see a psychiatrist, and when she refused to do so, he gave her a prescription for haloperidol. The drug made her drowsy, so she stopped taking it after a few days. In the end, she decided to live with her voices, and because they were polite and friendly, she stopped worrying about them after a while and gradually grew accustomed to their company.

                Findings: Mrs. Watson was oriented in time, place, and person . She got angry at her voices, telling them from time to time to "please stop it now ," but she talked in a perfectly coherent way . She explained that she heard voices in her head and that they usually limited themselves to commenting on her thoughts and actions , or talked about her between themselves. At times they gave her advice or even instructions, or they put thoughts into her mind that she knew were not her own . However , because most of the time these instructions  were quite sensible , she did not object to this .On a few occasions the voices had been unpleasant , and she had to call them to order. Mrs. Watson also reported that she frequently strange sensations in her body , something  such as electricity , radio waves , or invisible rays , and then she knew that "they " were experimenting on her . Those sensations did not become particularly disagreeable until the preceding few weeks before she came to the hospital.

                Course:    Mrs. Watson was treated with 20mg of haloperidol for the first 2 weeks . Her voices gradually  diminished in frequency and prominence  , and her somatic sensations disappeared completely.

She began to accept  that her voices were related to an illness but seemed somewhat disappointed when they stopped completely. She explained that , after all , the voices had been " good company " most of the time.