Murmurs of thought: Phenomenology of hallucinatory consciousness in impending psychosis

Abstract

First‐person accounts and detailed phenomenological descriptions are decisive to improve our understanding of auditory verbal hallucinations (AVHs). This is crucial in order to adequately appreciate the biographical–existential complexity of the “voices” and to increase the communication and share‐ability of such experiences. Besides the clear normalizing/de‐stigmatizing value, such an approach has an eminent therapeutic value since it offers a non‐reifying way to approach the broad, gestaltic metamorphosis of consciousness which precedes fully formed, florid AVHs. However, an important feature – namely, the very experiential genesis of the voices before their manifestation as full‐blown AVHs – has up to now not received sufficient attention. “Voices” indeed are often anticipated by subtle pre‐psychotic distortions of the stream of consciousness – such as abnormal sonorization of the inner dialogue and/or perceptualization of thought – which could emerge at the beginning of the prodromal phase. We suggest that a careful attention to these not‐yet psychotic precursors in their experiential continuity with AVHs could have important therapeutic implications.

Keywords:

• hearing voices
• auditory hallucinations
• anomalous subjective experiences
• consciousness
• psychosis

Acknowledgements

This study was supported by the European Union Fellowship, Marie Curie Research Training Network “DISCOS – Disorders and Coherence of the Embodied Self” (035975).