Content Matters, a Qualitative Analysis of Verbal Hallucinations

Abstract

Auditory verbal hallucinations have traditionally especially been researched from a form-based approach, with content getting much less attention. In this article, we argue for the importance of looking at content to get a fuller understanding of the hallucinatory experience. Guided by Lacanian psychoanalysis, we conducted a thematic and a narrative analysis on interviews with 10 schizophrenic patients about their hallucinations. We discerned five themes in the data, which were based on Lacanian theory and had to do with existential questions: parenthood and authority, sexuality and relationships, gender identity, life in the light of death, and what does the other want? Furthermore, we added a theme for unclassified content. Narratively, we found that participants constructed a story of four steps about their hallucinatory experiences. These steps were disturbing events in the past posing an existential question, triggering event, period of confusion, and hearing voices that allude to existential themes. Participants succeed in different degrees in integrating their hallucinatory experiences in their own life history. These stories can be situated on a continuum by making use of three prototypical narrating styles: the meta-delusional, delusional, and chaotic narrative type. Overall, our analysis shows that hallucinations can both be thematically and narratively organized, by making use of a theoretical framework like Lacanian psychoanalysis. Our research demonstrates that hallucinatory contents are not random but are about existential issues imbedded in a life narrative. Future research would benefit of integrating content and form-based approaches.

Whispers, echoes, friends and fears: forms and functions of voice‐hearing in adolescence

“…I get so visibly upset when I hear him, usually hysterically crying, terrified of what he is or about to tell me to do'. Similarly, just as some participants described the 'haunting' nature of the voices, Alexis described the voices as 'echoes', which other participants stated reminded them of past instances, also seen in adult-based research (Moernaut, Vanheule & Feyaerts, 2018). The metaphorical description of such voices was also described with a sense of relational distance, with participants 'hearing from' the voices, rather than experiencing a reciprocal relationship with them; as Freddy ( 14) describes, 'Sounds like a growl and like a Pennywise kind of voice'.…”

The Diagnostic Spectrum of Sexual Hallucinations

“…An adjuvant reason may be the equally widespread tradition to neglect the content of hallucinations. 100 This is not the place to discuss the merits of the traditional form-based approach to psychopathology, but in recent years it has become clear that attention to content may be of substantial aid in establishing the origin of hallucinations and in weighing therapeutic options. 85 In sum, as regards the hallucinations under discussion here, we believe that stressing their sexual content and addressing them as "sexual hallucinations" are in many cases of vital importance for diagnosis and treatment.…”

Listening Between the Lines: How a Theoretical Framework Prevents Superficial Analysis in Qualitative Research

“…Especially the more phenomenological approach from one of my co-authors was of major help herein. Next, I remembered a remark I made myself in my first publication about how the use of a theoretical framework helps to come to a deeper understanding of the data (Moernaut et al, 2018). Some advice I also always give to my own students and apparently now had to give to myself.…”