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.

References:

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.