7/18/2023 0 Comments Auditory hallucination downloadSection 6 concludes by stating recommendations for future work in the area. In section 5, we turn to a set of empirical studies that address the diagnostic value of the distinction between ‘inner’ and ‘outer’ voices. Section 4 examines the item on ‘internal voices’ in the Present State Examination as important example for conceptual flaws in assessment tools for AVHs. Section 3 focuses on two cases from the 1960s/1970s debate on diagnostic criteria for schizophrenia. The following sections analyze the emergence and effects of ambiguity and confusion concerning ‘inner’ and ‘outer’ voices in AVH research since the 1960s. We argue that in the context of this tradition, the inner/outer-contrast is understood in the metaphorical sense of whether voices are experienced as having mind-independent reality or not. In section 2, we reconstruct an influential tradition in earlier work on hallucinations (including Kandinsky, Jaspers and Schneider) according to which ‘outer’ and ‘inner’ voices belong to two different subtypes of hallucinatory experiences, namely, genuine hallucinations and pseudo-hallucinations. In section 1, we distinguish the readings of inner/outer-terminology that are most relevant in this context. To argue for these claims, we proceed as follows. The resulting confusion has deleterious effects in various regards, as we shall argue-including impaired reliability of empirical data, confusion about what exact hypotheses are supported or disproven by empirical findings, as well as potential negative effects on decisions in diagnosis and treatment and on the patient-therapist relation. As we will argue, much of this work is flawed by an ambiguity between different meanings of inner/outer-terminology-in particular, between a literal meaning (do voices seem to come from within or without the physical boundaries of one’s body/head?), and a metaphorical meaning concerning the reality that voices seem to have (do voices appear to really be there in the ‘outer’, mind-independent world, or is it obvious to subjects that the voices are there only ‘in their mind’?). 1999), and variables in empirical studies (e.g., Junginger and Frame 1985 Nayani and David 1996 Copolov et al. Contrasts between ‘inner’ and ‘outer’ voices-voices that seem to be located inside or outside one’s body, head, or mind-have been used to define subtypes of AVH-like experiences (e.g., Kandinsky 1885 Jaspers 1911/1963, 1912/1963 1959/ 1997), diagnostic criteria (in particular, for schizophrenia e.g., Fish 1962 Sedman 1966 Mellor 1970), items in assessment tools (e.g., World Health Organization 1990a, 1990b Mental Health Research Institute 1992 Haddock et al. Inner/outer-terminology is one important linguistic resource that voice-hearers, therapists, researchers and teachers use to articulate abnormal and sometimes bizarre experiences. In this article, we aim to show that ambiguous and misunderstood usage of inner/outer-terminology has had pernicious effects also in a more specialized context, namely, the study of Auditory Verbal Hallucinations (AVHs)-i.e., of episodes in which subjects ‘hear voices’ in the absence of a stimulus. Philosophers like Wittgenstein, Ryle, and Rorty have influentially argued that the uncritical use of such language is responsible for major philosophical confusions about the mind (Wittgenstein 1993 Ryle 1949/ 2000 Rorty 1979). Contrasts between the ‘inner’ and the ‘outer’, that which is ‘inside’ and ‘outside’ of us (our minds, our heads), pervade the way we talk about mental phenomena and their relation to the non-mental world.
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