C. P. Fernyhough 'Thinking Aloud About Mental Voices'

In recent years I have been exploring a Vygotskian account of auditory verbal hallucinations (AVHs) which sees them as resulting from the internalization of dialogue in development (e.g., Fernyhough, 2004; Jones & Fernyhough, 2007). I will begin by outlining this account and describing some supporting evidence from developmental psychology and adult psychopathology. I will then consider some of the challenges facing this account, both conceptual and empirical. Some of these are general to all inner-speech accounts of AVHs (of which the Vygotskian is one variety), and are relevant to evidence from phenomenological reports (e.g., Langdon et al., in press) and neuroimaging studies (Jones & Fernyhough, 2007). Other issues are specific to aspects of the Vygotskian framework, such as the crucial distinction between expanded and condensed inner speech (Fernyhough, 2004). I conclude by pointing to some ongoing empirical work designed to test hypotheses arising from this account, which may allow us to become clearer about its future prospects.


Langdon, R., Jones, S. R., Connaughton, E., and Fernyhough, C. (in press). "The phenomenology of inner speech: Comparison of schizophrenia patients with auditory verbal hallucinations and healthy controls". Psychological Medicine.

Jones, S. R., and Fernyhough, C. (2007). "Neural correlates of inner speech and auditory verbal hallucinations: A critical review and theoretical integration". Clinical Psychology Review, 27, 140-154.

Fernyhough, C. (2004). "Alien voices and inner dialogue: Towards a developmental account of auditory verbal hallucinations". New Ideas in Psychology, 22, 49-68.