Phenomenology of auditory verbal hallucination in schizophrenia: An erroneous perception or something else?
Josef Parnas, Janne-elin Yttri, Annick Urfer-parnas
Schizophrenia research March 1, 2024 Peer reviewed DOI: 10.1016/j.schres.2023.03.045 via PubMed
Summary
Auditory verbal hallucinations in schizophrenia differ from ordinary perception in several ways and are rarely experienced as coming from outside the head, challenging the official definition of hallucinations as perception without an object. These hallucinations are linked to anomalies of subjective experience, or self-disorders, and are best understood as a product of self-fragmentation. The findings have implications for how hallucinations are defined, clinically assessed, conceptualized in psychosis, and targeted in research.
Study at a glance
| Design | theoretical or philosophical paper |
|---|---|
| Key finding | Auditory verbal hallucinations in schizophrenia are rarely localized externally and are associated with self-disorders, suggesting they stem from self-fragmentation rather than being perceptions without an object. |
Abstract
This study presents phenomenological features of auditory verbal hallucinations (AVH) in schizophrenia and associated anomalies of experience. The purpose is to compare the lived experience of AVH to the official definition of hallucinations as a perception without object. Furthermore, we wish to explore the clinical and research implication of the phenomenological approach to AVH. Our exposition is based on classic texts on AVH, recent phenomenological studies and our clinical experience. AVH differ on several dimensions from ordinary perception. Only a minority of schizophrenia patients experiences AVH localized externally. Thus, the official definition of hallucinations does not fit the AVH in schizophrenia. AVH are associated with several anomalies of subjective experiences (self-disorders) and the AVH must be considered as a product of self-fragmentation. We discuss the implications with respect to the definition of hallucination, clinical interview, conceptualization of a psychotic state and potential target of pathogenetic research.