Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

In the field of clinical practice, there does not seem to be too much contention about what schizophrenia is, at least from a high level. After all, there are various diagnostic systems and guidelines, all of which point toward schizophrenia as a psychotic syndrome which likely forms a continuum with other psychotic disorders. It may sound obvious that, according to the current definitions, the major commonality between schizophrenia and all other psychoses is psychotic symptoms; more precisely, delusions and hallucinations. Any (...) description, or ‘phenomenology’ as most clinicians view it, can be found in these diagnostic manuals. However, is there anything at all that sets schizophrenia apart from the other... (shrink)

Patients with psychotic disorders experience a range of reality distortions. These often include auditory-verbal hallucinations, and thought insertion to a lesser degree; however, their mechanisms and relationships between each other remain largely elusive. Here we attempt to establish a integrative model drawing from the phenomenology of both AVHs and TI and argue that they in fact can be seen as ‘spectra’ of experiences with varying degrees of agency and ownership, with ‘silent and internal own thoughts’ on one extreme and ‘fully (...) external and clearly audible voices’ in the absence of a speaker on the other. We believe a spectral model will add emphasis to the continuity of experience and help to better understand how one type of psychotic symptom may interact with another, and put forward the argument that the experience of TI itself is not sufficient to classify as a delusion. In addition we aim to discuss some of the conceptual issues surrounding AVHs and TI with first-person accounts and current philosophical and neuropsychological theories in mind. We propose that the mechanisms behind AVHs and TI are more complex than source-monitoring deficits; indeed, to understand such phenomena one must appreciate that their very ‘existence’ and ‘reality’ as experienced by the individual have much deeper implications and meaning, both philosophically and clinically. (shrink)

Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion (...) and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient’s bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initi... (shrink)

In his paper, Young has eloquently put forward a novel account of how and why the phenomenon of thought-insertion seen in patients with schizophrenia does not contradict the immunity principle. He argues that, in TI, the problem lies not in misidentification but in mispredication: the individual with TI does not ascribe the right predicate to the wrong subject, but has misdetected the predicate in the first place. The author points out that an inconsistently formulated immunity principle could risk confusing the (...) two types of errors. The author defines the immunity principle as: Any agent... (shrink)