[en] Both in research on Auditory Verbal Hallucinations (AVHs) and in their clinical assessment, it is common to distinguish between voices that are experienced as ‘inner’ (or ‘internal’, ‘inside the head’, ‘inside the mind’,..) and voices that are experienced as ‘outer’ (‘external’, ‘outside the head’, ‘outside the mind’,..). This inner/outer-contrast is treated not only as an important phenomenological variable of AVHs, it is also often seen as having diagnostic value. In this article, we argue that the distinction between ‘inner’ and ‘outer’ voices is ambiguous between different readings, and that lack of disambiguation in this regard has led to flaws in assessment tools, diagnostic debates and empirical studies. Such flaws, we argue furthermore, are often linked to misreadings of inner/outer-terminology in relevant 19th and early twentieth century work on AVHs, in particular, in connection with Kandinsky’s and Jaspers’s distinction between hallucinations and pseudo-hallucinations.
Disciplines :
Neurosciences & behavior
Author, co-author :
Knappik, Franz ; Department of Philosophy, University of Bergen, Bergen, Norway
Bless, Josef J. ; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Laroi, Frank ; Université de Liège - ULiège > Psychologie et Neuroscience Cognitives (PsyNCog) ; Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
Language :
English
Title :
Confusions about ‘Inner’ and ‘Outer’ Voices: Conceptual Problems in the Study of Auditory Verbal Hallucinations
Aggernaes, Anton. 1972. The experienced reality of hallucinations and other psychological phenomena. An empirical analysis. Acta Psychiatrica Scandinavica 48: 220–238.
Baillarger, Jules. 1846. Extrait d’un mémoire intitulé Des hallucinations, des causes qui les produisent, et des maladies qu’elles caractérisent.. Paris: Baillière.
Bentall, Richard P. 1990. The illusion of reality: A review and integration of psychological research on hallucinations. Psychological Bulletin 107: 82–95.
Berrios, Germán E. 1996. The history of mental symptoms. Descriptive psychopathology since the nineteenth century. Cambridge: Cambridge University Press.
Billon, Alexandre. 2013. Does consciousness entail subjectivity? The puzzle of thought insertion. Philosophical Psychology 26 (2): 291–314.
Bleuler, Eugen. 1911. Dementia praecox oder Gruppe der Schizophrenien. Leipzig & Vienna: Deuticke.
Blom, Jan Dirk. 2010. A dictionary of hallucinations. New York: Springer.
Bumke, Oskar. 1919. Die Diagnose der Geisteskrankheiten. Wiesbaden: Bergmann.
Casey, Patricia R., and Brendan Kelly. 2007. Fish’s clinical psychopathology. Signs and symptoms in psychiatry. 3rd ed. London: Gaskell.
Cipher. 2017. Schizophrenia Forum [online], posted April 2017. Available via https://forum.schizophrenia.com/t/can-you-hear-your-thoughts/79710/6 (Accessed 25 June 2020).
Copolov, David, Tom Trauer, and Andrew Mackinnon. 2004. On the non-significance of internal versus external auditory hallucinations. Schizophrenia Research 69: 1–6.
Brierre de Boismont, Alexandre. 1862. Des hallucinations, ou Histoire raisonée des apparitions.. 3rd ed. Paris: Baillière.
Docherty, Nancy M., Thomas J. Dinzeo, Amanda McCleery, Emily K. Bell, Mohammed K. Shakeel, and Aubrey Moe. 2015. Internal versus external auditory hallucinations in schizophrenia: Symptom and course correlates. Cognitive Neuropsychiatry 20: 187–197.
Farkas, Katalin. 2013. A sense of reality. In Hallucination. Philosophy and psychology, ed. Fiona Macpherson and Dimitris Platchias, 399–415. Cambridge: MIT Press.
Fish, Frank. 1962. Schizophrenia. Bristol: John Wright.
Fish, Frank. 1967. Clinical psychopathology. Signs and Symptoms in Psychiatry. Bristol: Wright.
Gelder, Michael, Dennis Gath, and Richard Mayou, eds. 1985. Oxford textbook of psychiatry. Oxford: Oxford University Press.
Goldstein, Kurt. 1908. Zur Theorie der Halluzinationen. Archiv für Psychiatrie 44 (584–655): 1036–1106.
Haddock, G., J. McCarron, N. Tarrier, and E.B. Faraghe. 1999. Scales to measure dimensions of hallucinations and delusions: The psychotic symptom rating scales (PSYRATS). Psychological Medicine 29 (4): 879–889.
Hagen, Friedrich Wilhelm. 1868. Zur Theorie der Hallucination. Allgemeine Zeitschrift für Psychiatrie 25: 1–107.
Hare, E.H. 1973. A short note on pseudo-hallucinations. British Journal of Psychiatry 122: 469–476.
Hunter, Michael D., Timothy D. Griffiths, Tom F.D. Farrow, Ying Zheng, Iain D. Wilkinson, Nakul Hegde, et al. 2003. A neural basis for the perception of voices in external auditory space. Brain 126: 161–169.
Jaspers, Karl. 1911/1963. Zur Analyse der Trugwahrnehmungen (Leibhaftigkeit und Realitätsurteil). In Jaspers 1963, 191-251. First published 1911 in Zeitschrift für die gesamte Neurologie und Psychiatrie, vol. 6, 460–534.
Jaspers, Karl. 1912/1963. Die Trugwahrnehmungen. Kritisches Referat. In Jaspers 1963, 252-313. First published 1912 in Zeitschrift für die gesamte Neurologie und Psychiatrie. Referate und Ergebnisse, vol. 4, 289–354.
Jaspers, Karl. 1963. Gesammelte Schriften zur Psychopathologie. Berlin & Heidelberg: Springer.
Jaspers, Karl. 1997. General Psychopathology, translated by J. Hoenig and Marian W. Hamilton, vol. 1. Baltimore & London: Johns Hopkins University Press (translation of the 7th edition, published in 1959).
Junginger, John, and Cynthia L. Frame. 1985. Self-report of the frequency and phenomenology of verbal hallucinations. The Journal of Nervous and Mental Disease 173: 149–155.
Kandinsky, Victor. 1885. Kritische und klinische Betrachtungen im Gebiete der Sinnestäuschungen. Erste und zweite Studie. Berlin: Friedländer.
Koehler, Karl. 1979. First rank symptoms of schizophrenia: Questions concerning clinical boundaries. British Journal of Psychiatry 134: 236–248.
Kraepelin, Emil. 1899. Psychiatrie. Ein Lehrbuch für Studierende und Ärzte. Vol. 1. 6th ed. Leipzig: J.A. Barth.
Launay, Gilles, and Peter Slade. 1981. The measurement of hallucinatory predisposition in male and female prisoners. Personality and Individual Differences 2: 221–234.
Leudar, Ivan, Philip Thomas, David McNally, and Alfons Glinski. 1997. What voices can do with words: Pragmatics of verbal hallucinations. Psychological Medicine 27 (4): 885–898.
Looijestin, Jasper, Kelly M.J. Diederen, Rutger Goekoop, Iris E. Sommer, Kirstin Daalman, René S. Kahn, et al. 2013. The auditory dorsal stream plays a crucial role in projecting hallucinated voices into external space. Schizophrenia Research 146: 314–319.
Lowe, Gordon R. 1973. The phenomenology of hallucinations as an aid to differential diagnosis. British Journal of Psychiatry 123: 621–633.
McCarthy-Jones, Simon, Tom Trauer, Andrew Mackinnon, Eliza Sims, Neil Thomas, and David L. Copolov. 2014. A new phenomenological survey of auditory hallucinations: Evidence for subtypes and implications for theory and practice. Schizophrenia Bulletin 40: 231–235.
Mellor, C.S. 1970. First rank symptoms of schizophrenia. British Journal of Psychiatry 117: 15–23.
Mental Health Research Institute. 1992. Mental Health Research Institute unusual perceptions schedule (MUPS). (n.p.).
Nayani, Tony, and Anthony David. 1996. The auditory hallucination: A phenomenological survey. Psychological Medicine 26: 177–189.
Oulis, P.G., V.G. Mavreas, J.M. Mamounas, and C.N. Stefanis. 1995. Clinical characteristics of auditory hallucinations. Acta Psychiatrica Scandinavica 92: 97–102.
Oulis, Panagiotis, Rossetos Gournellis, George Konstantakopoulos, Thomas Matsoukas, Panagiota G. Michalopoulou, et al. 2007. Clinical dimensions of auditory hallucinations in schizophrenic disorders. Comprehensive Psychiatry 48: 337–342.
Ramanathan, A. 1982. Reality of auditory hallunications in schizophrenia. Indian Journal of Psychiatry 24: 55–60.
Ramanathan, A. 1983. A study of experienced reality of auditory hallucination in schizophrenia. Indian Journal of Psychiatry 25: 148–154.
Ratcliff, Kirk, John Farhall, and Frances Shawyer. 2011. Auditory hallucinations: A review of assessment tools. Clinical Psychology and Psychotherapy 18: 524–534.
Ratcliffe, Matthew, and Sam Wilkinson. 2015. Thought insertion clarified. Journal of Consciousness Studies 22 (11–12): 246–269.
Rorty, Richard. 1979. Philosophy and the mirror of nature. Princeton: Princeton University Press.
Ryle, Gilbert. 2000. The concept of mind. London: Penguin (originally published in 1949).
Schneider, Kurt. 1959. Klinische Psychopathologie. 5th ed. Stuttgart: Georg Thieme.
Scrutton, Anastasia Philippa. 2017. Epistemic injustice and mental illness. In The Routledge Handbook of epistemic injustice, ed. Ian James Kidd, José Medina, and Gaile Pohlhaus, Jr. London: Routledge, 347–355.
Sedman, George. 1966. ‘Inner voices.’ Phenomenological and clinical aspects. British Journal of Psychiatry 112: 485–490.
Singh, Gagandeep, Pratap Sharan, and Parmanand Kulhara. 2003. Phenomenology of voices: A factor analytic approach. Psychiatry and Clinical Neurosciences 57: 333–336.
Spitzer, Manfred. 1987. Pseudohalluzinationen. Fortschritte der Neurologie Psychiatrie 55: 91–97.
Stephane, Massoud, Paul Thuras, Henry Nasrallah, and Apostolos P. Georgopoulos. 2003. The internal structure of the phenomenology of auditory verbal hallucinations. Schizophrenia Research 61: 185–193.
Taylor, F. Kräupl. 1981. On pseudo-hallucinations. Psychological Medicine 11 (2): 265–271.
Taylor, Michael Alan, and John F. Heiser. 1971. Phenomenology: An alternative approach to diagnosis of mental disease. Comprehensive Psychiatry 12 (5): 480–486.
Telles-Correia, Diogo, Ana Lúcia Moreira, and João S. Gonçalves. 2015. Hallucinations and related concepts—Their conceptual background. Frontiers in Psychology 6: 991.
Trygstad, Louise Nigh, Robin K. Buccheri, Martha D. Buffum, Dau-shen Ju, and Glenna A. Dowling. 2015. Auditory Hallucinations Iterview Guide: Promoting recovery with an interactive assessment tool. Journal of Psychosocial Nursing and Mental Health Services 53 (1):20–28.
van der Zwaard, Roy, and Machiel A. Polak. 2001. Pseudohallucinations: A pseudoconcept? A review of the validity of the concept, related to associate symptomatology. Comprehensive Psychiatry 42: 42–50.
Wing, J.K., J.E. Copper, and N. Sartorius. 1974. Measurement and classification of psychiatric symptoms. An instruction manual for the PSE and Catego program. London: Cambridge University Press.
Wittgenstein, Ludwig. 1993. Last writings on the philosophy of psychology: The inner and the outer, 1949–1951, ed. Heikki Nyman and Georg Henrik von Wright, vol. 2. Oxford: Blackwell.
World Health Organization. 1990a. Schedules for Clinical Assessment in Neuropsychiatry. Version 2. Manual. American Psychiatric Press.
World Health Organization. 1990b. Schedules for Clinical Assessment in Neuropsychiatry. Version 2. Glossary. American Psychiatric Press.
Xade. 2017. Schizophrenia Forum [online], posted March 2017. Available via https://forum.schizophrenia.com/t/do-your-hallucinations-sound-internal-or-external-to-your-body/77432/8 Accessed 25 June 2020.