Listening to Schneiderian Voices: A Novel Phenomenological Analysis

Abstract

Background/Aims: This paper reports on analyses designed to elucidate phenomenologicalcharacteristics, content and experience specifically targeting participants with Schneiderian voices conversing/commenting (VC) while exploring differences in clinical presentation and quality of life compared to those with voices not conversing (VNC). Methods: This mixed-method investigation of Schneiderian voices included standardized clinical metrics and exploratory phenomenological interviews designed to elicit in-depth information about the characteristics, content, meaning, and personification of auditory verbal hallucinations. Results: The subjective experience shows a striking pattern of VC, as they are experienced as internal at initial onset and during the longer-term course of illness when compared to VNC. Participants in the VC group were more likely to attribute the origin of their voices to an external source such as God, telepathic communication, or mediumistic sources. VC and VNC were described as characterological entities that were distinct from self (I/we vs. you). We also found an association between VC and the positive, cognitive, and depression symptom profile. However, we did not find a significant group difference in overall quality of life. Conclusions: The clinical portrait of VC is complex, multisensory, and distinct, and suggests a need for further research into the biopsychosocial interface between subjective experience, socioenvironmental constraints, individual psychology, and the biological architecture of intersecting symptoms.

Immersion in altered experience: An investigation of the relationship between absorption and psychopathology

“…These findings align with phenomenological conceptualizations of schizophrenia that distinguish between “understandable” thematic delusions (such as jealousy and guilt) and more bizarre alterations of experience ostensibly grounded in basic alterations of self (Cermolacce, Sass, & Parnas, 2010; J. Parnas, 2004; (Schneider, 1959; Rosen, Grossman, Harrow, Bonner-Jackson, & Faull, 2011; Rosen et al, 2016b). These findings also build on prior research suggesting a distinction between voices and thought delusions, and between voices and thematic delusions (Rosen et al, 2016a).…”

Does hallucination perceptual modality impact psychosis risk?

“…The complexities of voice‐hearing are difficult to capture in a clinical rating scale, and there has been little clinical impetus to do so. However, recent studies have highlighted the fact that phenomenological analysis may play a key role in understanding and defining clinically meaningful subtypes in psychosis . Here, we highlight the role of speech as a defining phenomenological characteristic.…”

Hallucinations and Delusions as Low-Quality Attributions: Influencing Factors and Proposal for Their Analysis

“…This again makes perception-thought an oversimplified and imprecise distinction. Alternatively, hallucinations and delusions have been considered on a continuum (Strauss, 2014) between two extremes related to the attenuated sense of self (Rosen et al, 2016), or similar processes (Bentall, 1990), as a single dimension distorting reality (Barch et al, 2013) and extensive to any positive symptom (Moritz et al, 2017). The first objective of this study was therefore to contribute a concept with parameters that can integrate the findings recognized in the literature as hallucinations and delusions, enabling both to be understood as different cases of that single concept.…”