The hallmark of schizophrenia is perceiving things that are not there. Auditory hallucinations, including “hearing voices”, is particularly common. [Post-publishing edit (Jan 19/2013): I'm not insinuating that schizophrenia's defining feature is hearing voices, but rather hallucinatory and delusional errant perception in general, including sensory illusions and paranoia-laden perceptions and inferences. Perhaps, however, I should have said "a major hallmark" rather than "the hallmark".]
What if this clinically distinguishing feature of schizophrenia differs from the cognitively distinguishing feature? What if, cognitively speaking, what distinguishes schizophrenia is not the presence of voices, but rather how one interprets them?
WHAT IF WE ALL HEAR VOICES?
Have you ever tried to engage in mindfulness meditation?
If not, try this: Pay attention to your breathe. Attend to the sensations of your lower stomach as you inhale and exhale. That’s it. Don’t think of anything else. Do this for five consecutive deep, slow breathes. Go ahead. I’ll wait…
Fail yet? I’m going to assume that you were unable – hopelessly unable – to quiet your mind of extraneous thoughts. What this exercise shows is that your mind has a mind of its own. The voice in your head talks on its own. Not only does it not need you to tell it to talk, it’ll talk even if you tell it not to. (Note: Feel free to ponder such tangential questions as What is the Self? and Am I my mind?).
HALLUCINATION OR MERELY ALTERNATIVE INTERPRETATION?
All of our minds jabber on endlessly. I do not have schizophrenia. As such, when I’m successfully paying attention to something, my experience is that I’m paying attention with my mind. When I’m just phasing out or struggling to focus on something, I still feel that it’s still my mind, and my inner chatterbox that is drifting and darting around. Like other non-schizophrenics, I have an Internal Locus of Control for my inner voice – even when I’m not really in control. My experience is that I have a single, coherent inner voice and mind.
A person with schizophrenia may experience things differently. Some of the time their inner voice will feel like their voice – e.g., when they are successfully paying attention to something. But some of the time when their mind is wandering, whereas others may simply view this mental activity as their mind engaging in idle chatter, the person with schizophrenia may experience this chatter as foreign. “Those thoughts are not mine. I didn’t make that thought happen. I didn’t just mentally say that”. For some mental activity then, they have an External Locus of Control. Some of the time, their mental activity feels self-generated. Other times, not. There appears to be more than one mind or one inner voice in their head, and they’re not all theirs.
Clinically it may make sense to talk about whether or not one “hears voices”. But cognitively speaking, maybe the real issue isn’t the presence or absence of any additional voices, but how we experience our inner chatter. When the person with schizophrenia tries to meditate, do they experience their mind wandering or do they experience the thoughts of someone else inside their head?