Don’t We All Hear Voices? A Mindfulness-Informed View of Schizophrenia and the “Normal” Mind

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?

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15 thoughts on “Don’t We All Hear Voices? A Mindfulness-Informed View of Schizophrenia and the “Normal” Mind

  1. maybe the real issue isn’t the presence or absence of any additional voices, but how we experience our inner chatter/

    What an interesting thought.

  2. I’ve mentioned this phenomenon (hearing internal dialog) to Chris, he suggested it was schizophrenia. That suggestion probably came from my insufficient explanation, however, I maintained that it was not that because I always knew where the voice was coming from – there was never any confusion that it was my own mind speaking to itself.

  3. Schizophrenia is a diverse illness, it’s incorrect to say “the hallmark of schizophrenia is experiencing things that are not there”. It’s really not the case, many people with a diagnosis of a schizophrenia (by the way I’m not happy being referred to as “a schizophrenic” -it’s so limiting) do not even experience this at all.

  4. Hi,

    “experiencing things that aren’t there” is very broad. This covers all types of sensory hallucinations as well as paranoia induced inferences. If you remove all types of hallucinations and all types of advanced paranoia, are we even possibly talking about someone who would be diagnosed with schizophrenia? I suppose some people with schizophrenia may appear to sort of just be closed off from the world mentally, not necessarily misrepresenting it..

    On the “schizophrenic”. I think I used that expression once or twice in the whole article, but used “people with schizophrenia” many, many times. It wasn’t my intention to be offensive, but my thinking was that I had already used the other, less labeling expression so many times that I figured it was clear that I was not implicitly or explicitly pegging people with schizophrenia as “just schizophrenics”.

  5. Hi!

    I think it is incorrect to claim that a belief (such as a “paranoia induced inference”) is something that is not there. A belief is something that is definitely there even if it’s fantastically disconnected from reality -conceptually quite different from “not there”.

    Yes, there are many people do not even have paranoia or hallucinations -some medicated, some not- that are diagnosed with schizophrenia. It is a very broad term.

    I wasn’t offended by your usage of the term ‘schizophrenic’ -like you say, you had also used ‘person with schizophrenia. I just wanted to say this wasn’t acceptable to me from the word go.

    I’m glad you are engaging with the topic but I don’t think it’s appropriate for you to use definitive language when you (or indeed I) don’t know anything close to a sufficient amount about the topic to be definitive.

  6. Hearing voices is different to the internal dialogue, from what an individual has told me it feels like an intruder who talks to you (talks to the internal dialogue). The ‘voice thought’ sounds different to the inner voice in someway, maybe it sounds different or has a different tone, Either way it is not seen to belong to the individual. For example the voice may say ‘nobody likes you’ or ‘you should kill yourself’ and the individual who has the psychotic illness may speak back to the intruder, this indicates schizophrenia. Inner voice is normal, but i think if their is more than one different voices that are believed to not be ones own that is what hearing voices is. Everyone has different thought patterns and for some people hearing voices on top of the internal dialogue may be a normal part of that, but if the voices are derogatory psychiatric help maybe needed.
    It is hard for people to understand this if they have never experienced this, an individual with schizophrenia will probably not notice that what they are experiencing is unusual.
    I am not trained in this field i only know this through personal experience.

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  9. I am a firm, FIRM believer of -quote- “maybe the real issue isn’t the presence or absence of any additional voices, but how we experience our inner chatter”.
    I have always found the reported voices to be quite alike the inner voices we all experience, but that are processed by the brain as imagination instead of reality…

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