Hearing the alienness of one’s voice: between normality and auditory verbal hallucinations in schizophrenia

Abstract In this paper, I argue for a novel phenomenological approach to understanding the phenomenon of hearing voices or auditory verbal hallucination (AVH) in schizophrenia. I aim to elucidate the inherent vulnerabilities or ‘fault lines’ of ordinary auditory experience that enable the AVH in schizophrenia, as well as the transition between them. AVHs involve at least three interrelated dimensions that must be considered: the relationship between normality and pathology, between the own and the alien, and the interplay between auditory perception and imagination. Drawing primarily on ideas from Husserl, Merleau-Ponty, Straus, and Waldenfels, I argue that the perceptual and imaginative modalities of the “auditory bodily self” exhibit a constitutive alienness (e.g., the reproduced voice, the sonority of the body, the incorporated voices, and dialogue with others), as well as a chiasmatic structure that contains the fault lines arising from this alienness. At the center of the transformations implied by schizophrenic voice-hearing lies the body, whose increasing alienness and destabilization of the chiasmatic structure leads to pathological “hyperreversibility.” The usual boundaries and gaps between self and alien, between auditory perception and inner speech, dissolve, causing the dimensions to reverse and giving rise to AVHs. It is argued that this approach is compatible with, and a necessary complement to, the self-disorder model of schizophrenia.