Show Summary Details
Page of

Voices and consciousness 

Voices and consciousness
Chapter:
Voices and consciousness
Author(s):

Giovanni Stanghellini

DOI:
10.1093/med/9780198520894.003.0010
Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2022. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 26 June 2022

The Ninth study is about verbal-acoustic hallucinations – a very common phenomenon in psychotic and especially schizophrenic persons. Verbal-acoustic hallucinations are usually defined as perceptions of speech that occur in the absence of any appropriate external stimulus. This definition, I argue, is false. I maintain that ‘voices’ are disorders of self-consciousness that are best understood as the becoming conscious of inner dialogue. Normally, subconscious interior conversations are experienced as a sense of partnership between distinct parts: we feel these parts as distinct, but also integrated and collaborating with each other in decision-making and in self-representation. ‘Voices’ attest to a breakdown in this process of interior conversation: the feeling of unity in duality falls apart, and the dialectic partnership on which self-representation is grounded shatters into a mere dichotomy. There is a fracture in self-consciousness. If pre-reflexive self-consciousness (the self-feeling of one's own self in which the one who feels and what is felt is but one thing, as described in the Sixth study) is lacking, the sense of unity weakens, and the sense of duality increases. This crisis of pre-reflexive self-consciousness is accompanied by an increase of reflexivity (i.e. the process through which I take a part of myself as a focal object of awareness). Hyperreflexivity contributes to the objectification of the sense of duality and to the loss of the sense of myness (agency and ownership) of inner speech. In schizophrenics, inner dialogue becomes anomalously manifest. Whereas in normal conditions, inner dialogue is the medium for self-representation, VAHs arise through, its morbid objectification: inner speech comes to the foreground in the concrete fashion of alien ‘Voices’. The essential role of metaphor for the representation and the metamorphoses of self-consciousness in schizophrenia, is sketched in the last part this study and developed in the tenth study.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.