‘You tried to tell yourself I wasn’t real’: what happens when people with acute psychosis meet the voices in their heads?

In avatar therapy, a clinician gives voice to their patients' inner demons. For some of the participants in a new trial, the results have been astounding

In the summer of 2019, when Joe was 21, he went on a university rugby tour of California. One night, one of his teammates bought some cannabis edibles to share, and Joe ate some. For the next 12 hours, he believed he was in hell. He was on fire; his body was suffused with pain. His ears were filled first with incoherent screaming and then with sinister whispering. Joe's friends thought their teammate's bad trip was funny, even as they wrestled him away from the windows when he tried to jump from the seventh floor of their hotel.

When he woke up the next morning, Joe was still in hell. A devilish, humanoid form lurking in the periphery of his vision was telling him he had died the previous night. A chorus of other voices joined in, wailing in agony. They were entirely real to him, even though he knew they couldn't be. He had a rugby match to play, and 10 minutes in, he couldn't see or feel his hands; he couldn't move. His teammates laughed as he came off the pitch. Poor old Joe.