Phenomenology of auditory verbal hallucination in schizophrenia: An erroneous perception or something else?

Auditory verbal hallucinations in schizophrenia differ from ordinary perception in several ways, and only a minority of patients experience them as localized externally. The official definition of hallucinations as a perception without object does not fit the lived experience of these voices. Auditory verbal hallucinations are associated with anomalies of subjective experience known as self-disorders, and they should be understood as a product of self-fragmentation. This has implications for how hallucinations are defined, how clinical interviews are conducted, how psychotic states are conceptualized, and what targets are pursued in pathogenetic research.

Study at a glance

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.