From Thoughts to Voices: Understanding the Development of Auditory Hallucinations in Schizophrenia


Drawing upon core phenomenological contributions of the last decades, the present paper provides an integrated description of the development of auditory hallucinations in schizophrenia. Specifically, these contributions are (i) the transitional sequences of development of psychotic symptoms of schizophrenia as envisioned by Klosterkötter and rooted in the basic symptoms approach, (ii) Conrad’s Gestalt-analysis of developing psychosis, and (iii) Sass and Parnas’ self-disturbance approach. Klosterkötter’s contribution provides a general descriptive psychopathological approach to the transitional sequence of the development of auditory hallucinations. The key concepts in Conrad’s proposal (such as trema, apophany, anastrophy, Reflexionskrampf [hyperreflexivity] and transparence) are discussed, as their role is central as driving forces of the process from non-psychotic symptoms to overt hallucinations. Finally, Parnas and Sass link psychiatry to philosophy and psychology, and provide an in-depth and thorough description of these phenomena in their work on schizophrenia as a disorder of consciousness and self-experience (disturbed ipseity) with hyper-reflexivity and diminished self-affection as key aspects.

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Handest, P., Klimpke, C., Raballo, A. et al. From Thoughts to Voices: Understanding the Development of Auditory Hallucinations in Schizophrenia. Rev.Phil.Psych. 7, 595–610 (2016).

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  • Schizophrenia
  • Auditory Hallucination
  • Mental Content
  • Psychotic Experience
  • Prodromal Phase