Inner speech travels under many aliases: the inner voice, verbal thought, thinking in words, internal verbalization, “talking in your head,” the “little voice in the head,” and so on. It is both a familiar element of first-person experience and a psychological phenomenon whose complex cognitive components and distributed neural bases are increasingly well understood. There is evidence that inner speech plays a variety of cognitive roles, from enabling abstract thought, to supporting metacognition, memory, and executive function. One active area of (...) controversy concerns the relation of inner speech to auditory verbal hallucinations in schizophrenia, with a common proposal being that sufferers of AVH misidentify their own inner speech as being generated by someone else. Recently, researchers have used artificial intelligence to translate the neural and neuromuscular signatures of inner speech into corresponding outer speech signals, laying the groundwork for a variety of new applications and interventions. (shrink)

One of the leading cognitive models of auditory verbal hallucinations (AVHs) proposes such experiences result from a disturbance in the process by which inner speech is attributed to the self. Research in this area has, however, proceeded in the absence of thorough cognitive and phenomenological investigations of the nature of inner speech, against which AVHs are implicitly or explicitly defined. In this paper we begin by introducing philosophical phenomenology and highlighting its relevance to AVHs, before briefly examining the evolving literature (...) on the relation between inner experiences and AVHs. We then argue for the need for philosophical phenomenology (Phenomenology) and the traditional empirical methods of psychology for studying inner experience (phenomenology) to mutually inform each other to provide a richer and more nuanced picture of both inner experience and AVHs than either could on its own. A critical examination is undertaken of the leading model of AVHs derived from phenomenological philosophy, the ipseity disturbance model. From this we suggest issues that future work in this vein will need to consider, and examine how interdisciplinary methodologies may contribute to advances in our understanding of AVHs. Detailed suggestions are made for the direction and methodology of future work into AVHs, which we suggest should be undertaken in a context where phenomenology and physiology are both necessary, but neither sufficient. (shrink)

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations, the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH (...) at 3 contextual levels: cultural, social, and historical; experiential; and biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; “front-loading” research in cognitive neuroscience; and suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences. (shrink)

Many philosophers and psychologists have sought to explain experiences of auditory verbal hallucinations and “inserted thoughts” in schizophrenia in terms of a failure on the part of patients to appropriately monitor their own inner speech. These self-monitoring accounts have recently been challenged by some who argue that AVHs are better explained in terms of the spontaneous activation of auditory-verbal representations. This paper defends two kinds of self-monitoring approach against the spontaneous activation account. The defense requires first making some important clarifications (...) concerning what is at issue in the dispute between the two forms of theory. A popular but problematic self-monitoring theory is then contrasted with two more plausible conceptions of what the relevant self-monitoring deficits involve. The first appeals to deficits in the neural mechanisms that normally filter or attenuate sensory signals that are the result of one’s own actions. The second, less familiar, form of self-monitoring approach draws an important analogy between Wernicke’s aphasia and AVHs in schizophrenia. This style of self-monitoring theory pursues possible connections among AVHs, inserted thoughts, and the disorganized speech characteristic formal thought disorder. (shrink)

We respond to Moseley and Wilkinson's defense of inner speech models of AVH.

A theory which has had significant influence seeks to explain auditory verbal hallucinations as utterances in inner speech which are not properly monitored and are consequently misattributed to some external source. This paper argues for a distinction between inner speech and imagined speech, on the basis that inner speech is a type of actual speech. The paper argues that AVHs are more likely instances of imagined speech, rather that inner speech, which are not properly monitored : 86–107, 2012), Cho and (...) Wu and Cho and Wu, although they prefer a quite different explanation of AVHs). (shrink)

Despite the popularity of research on intrapersonal communication across many disciplines, there has been little attention devoted to the factors that might account for individual differences in talking to oneself. In this paper, I explore two possible explanations for who people might differ in the frequency of their self-talk. According to the “social isolation” hypothesis, spending more time alone or having socially-isolating experiences will be associated with increased self-talk. According to the “cognitive disruption” hypothesis, having self-related experiences that are cognitively (...) disruptive will be associated with increased self-talk frequency. Several studies using the Self-Talk Scale (Brinthaupt, Hein, & Kramer, 2009) are pertinent to these hypotheses. Results indicate moderate support for the social isolation hypothesis and strong support for the cognitive disruption hypothesis. I conclude the paper with a wide range of implications for future research on individual differences in self-talk and other kinds of intrapersonal communication. (shrink)

Two challenges that face popular self-monitoring theories (SMTs) of auditory verbal hallucination (AVH) are that they cannot account for the auditory phenomenology of AVHs and that they cannot account for their variety. In this paper I show that both challenges can be met by adopting a predictive processing framework (PPF), and by viewing AVHs as arising from abnormalities in predictive processing. I show how, within the PPF, both the auditory phenomenology of AVHs, and three subtypes of AVH, can be accounted (...) for. (shrink)

Inner speech has been shown to vary in form along several dimensions. Along condensation, condensed inner speech forms have been described, that are supposed to be deprived of acoustic, phonological and even syntactic qualities. Expanded forms, on the other extreme, display articulatory and auditory properties. Along dialogality, inner speech can be monologal, when we engage in internal soliloquy, or dialogal, when we recall past conversations or imagine future dialogs involving our own voice as well as that of others addressing us. (...) Along intentionality, it can be intentional (when we deliberately rehearse material in short-term memory) or it can arise unintentionally (during mind wandering). We introduce the ConDialInt model, a neurocognitive predictive control model of inner speech that accounts for its varieties along these three dimensions. ConDialInt spells out the condensation dimension by including inhibitory control at the conceptualization, formulation or articulatory planning stage. It accounts for dialogality, by assuming internal model adaptations and by speculating on neural processes underlying perspective switching. It explains the differences between intentional and spontaneous varieties in terms of monitoring. We present an fMRI study in which we probed varieties of inner speech along dialogality and intentionality, to examine the validity of the neuroanatomical correlates posited in ConDialInt. Condensation was also informally tackled. Our data support the hypothesis that expanded inner speech recruits speech production processes down to articulatory planning, resulting in a predicted signal, the inner voice, with auditory qualities. Along dialogality, covertly using an avatar’s voice resulted in the activation of right hemisphere homologs of the regions involved in internal own-voice soliloquy and in reduced cerebellar activation, consistent with internal model adaptation. Switching from first-person to third-person perspective resulted in activations in precuneus and parietal lobules. Along intentionality, compared with intentional inner speech, mind wandering with inner speech episodes was associated with greater bilateral inferior frontal activation and decreased activation in left temporal regions. This is consistent with the reported subjective evanescence and presumably reflects condensation processes. Our results provide neuroanatomical evidence compatible with predictive control and in favor of the assumptions made in the ConDialInt model. (shrink)

Psychologists and philosophers agree that personal narratives are a central component of one’s identity. The concept of narrative self has been proposed to capture this aspect of selfhood. In recent times, it has been a matter of debate how the narrative self relates to the embodied and experiential dimension of the self. In this debate, the role attributed to inner speech is that of constructing and maintaining personal narratives. Indeed, evidence suggests that inner speech episodes are involved in self-reflection and (...) autobiographical reasoning. That is, previous works have focused mostly, if not solely, on the role of inner speech for narrative self-understanding. However, inner speech is also involved in enacting personal narratives. In such cases, the content of the inner speech episodes is not in the service of the construction of narratives, rather it implies the identification with the character of the personal narratives. I introduce two instances of the use of inner speech for narrative self-enactment: positive self-talk and stereotype threat. I conclude by considering the implications of the examples introduced for the debate regarding the relation between the narrative and the embodied dimensions of selfhood. (shrink)

The use of visual mental imagery has been proposed to be a risk factor for the development of bipolar disorder, due to its potential to amplify affective states. This study examined the relation between visual imagery , intrusive verbal thought, and hypomania, as assessed by self-report questionnaires, in a sample of young adults . Regression analyses found that levels of intrusive visual imagery predicted levels of hypomania, but that neither trait use of visual imagery nor intrusive verbal thought did. These (...) results were consistent with the proposal that being a ‘visualiser’, as opposed to a ‘verbaliser’, is a risk factor for bipolar disorder, with the caveat that it is specifically intrusive experiences of imagery, rather than the tendency to utilize imagery per se, that acts as a risk factor. (shrink)

We welcome Cho and Wu’s suggestion that the study of auditory verbal hallucinations could be improved by contrasting and testing more explanatory models. However, we have some worries both about their criticisms of inner speech-based self-monitoring models and whether their proposed spontaneous activation model is explanatory.