Chapter

Voices and consciousness

Giovanni Stanghellini

in Disembodied Spirits and Deanimated Bodies

Published on behalf of Oxford University Press

Published in print September 2004 | ISBN: 9780198520894
Published online March 2013 | e-ISBN: 9780191754302 | DOI: http://dx.doi.org/10.1093/med/9780198520894.003.0010

Series: International Perspectives in Philosophy & Psychiatry

Voices and consciousness

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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.

Chapter.  9366 words. 

Subjects: Psychiatry

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