The auditory hallucination: a phenomenological survey

TLDR

The study aimed to broaden the phenomenological understanding of auditory hallucinations in form and content to inform future theory. The authors used a semi‑structured questionnaire with 100 psychotic patients to examine auditory hallucinations and related phenomena such as thought insertion and insight. All participants reported voices, with detailed descriptions of location, characteristics, and address; precipitating and alleviating factors were identified, and a progressive increase in complexity over time was linked to reduced distress and better coping, suggesting implications for neurological and cognitive models.

Abstract

A comprehensive semi-structured questionnaire was administered to 100 psychotic patients who had experienced auditory hallucinations. The aim was to extend the phenomenology of the hallucination into areas of both form and content and also to guide future theoretical development. All subjects heard 'voices' talking to or about them. The location of the voice, its characteristics and the nature of address were described. Precipitants and alleviating factors plus the effect of the hallucinations on the sufferer were identified. Other hallucinatory experiences, thought insertion and insight were examined for their inter-relationships. A pattern emerged of increasing complexity of the auditory-verbal hallucination over time by a process of accretion, with the addition of more voices and extended dialogues, and more intimacy between subject and voice. Such evolution seemed to relate to the lessening of distress and improved coping. These findings should inform both neurological and cognitive accounts of the pathogenesis of auditory hallucinations in psychotic disorders.