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Auditory Verbal Hallucinations and Their Phenomenological Context

Matthew Ratcliffe

The Oxford Handbook of Phenomenological Psychopathology July 4, 2019 DOI: 10.1093/oxfordhb/9780198803157.013.75 (opens in new tab)

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Characteristics Theoretical or philosophical paper Peer reviewed
Key points Argues that auditory verbal hallucinations are phenomenologically diverse and often unlike hearing speech, that in psychiatric illness they are typically embedded in wider disturbances of self-experience, and that the self-disorder account of schizophrenia and the Hearing Voices Movement's trauma-based account can be partially reconciled using Wolfgang Blankenburg's work.

Abstract

This article explores the phenomenology of auditory verbal hallucinations (AVHs), while also stressing the indispensability of phenomenological research to a wider understanding of these phenomena. I begin by making clear that the kinds of experience routinely labeled as “AVHs” are diverse and that many of them are not at all like hearing someone speak. I then note that AVHs in psychiatric illness are usually embedded in much wider-ranging phenomenological disturbances. Recent work in phenomenological psychopathology has sought to characterize these disturbances in terms of a type of schizophrenia-specific self-disorder. I offer several criticisms of this view. Next, I contrast the self-disorder account with an approach associated with the Hearing Voices Movement, according to which AVHs originate in traumatic experiences and are not to be labeled as symptoms of schizophrenia. By drawing on work by Wolfgang Blankenburg, I conclude by briefly sketching how these two approaches might be reconciled.

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