RE: Voices

Bob Green (
Sun, 13 Jul 1997 20:27:16 +1000

Comments from Chris and Bill have given some more food for thought
(apologies if no one else is interested in this) and the light of day helps
the thinking processes as well.

I perceive the points raised by Bill as having two aspects, firstly there is
the conceptual point of whether experiences such as voices should be
construed differently to any other form of construing. Rather than being
conceived of as symptoms, voices (whatever their cause) are a form of
construing. The second aspect concerns how these various forms of
construing are responded to.

I agree saying simply labelling someone as psychotic, does not convey
anything terribly useful. Like any form of experience there are a multitude
of individual manifestations. This discussion however has suggested to me
some constructs which may distinguish some of these experiences.

Sleep related voices "Psychotic' voices

Can reconstrue V can't reconstrue
(e.g in light of invalidation)

present around time of sleep V can be present anytime

more readily able to be V highly idiosyncratic and unlikely to
construed similarly by others be construed in similar terms by others

more predictable V quite unpredictable

responds to shared phenomena V responds to phenomena which others
can't perceive (eg hearing one's
on the radio).

I tried to outline the above in terms of construing rather than a checklist of
symptoms. Thus someone who stopped eating because they believed they were
being poisoned and spied upon by the army, who broadcast their thoughts on
the local radio station without cessation, despite all reassurance and
evidence you could offer would be located at the extreme of the right hand
construct poles. Someone who upon wakening, screamed after they believed
they saw an intruder approaching them, would mostly be located in terms of
constructs on the left hand side. A difficult work colleague or someone
creative would have a mixed pattern of ratings, including some extreme ones.

Responding to someone who could be construed as being located on the extreme
right hand side, is the other consideration. No doubt such responses will
be influenced buy additional constructions concerning risk or other issues,
such as supports and personal resources.



>Following is a post I wrote before Chris, so he might like to elaborate
>I don't profess to know much how about the following hence my reliance on
>references and others opinions.
>HYPNOSIS: described to me by a psychiatrist as a 'normal' mental state
>involving a narrowed consciousness. A person who was hypnotised might
>appear to be hallucinating if told to react in a certain way.
>Kaplan and Saddock, authors of a standard text (Modern Synopsis of
>Psychiatry) define hypnosis as, " ... a form of concentration characterized
>by attentive, receptive focal concentration with diminished peripheral
>awareness". Further, " .. focal awareness, which is diffuse in sleep, is at
>optimal capacity during the hypnotic trance".
>They further state hypnosis involves a "relative suspension of critical
>HALLUCINATIONS: Sainsbury and Lambeth (Sainsbury's Key to Psychiatry) state
>"An hallucination is a false perception occurring without an external
>Hallucinations can take the form of tactile (bugs crawling on the arms),
>visual (seeing the devil in your room), gustatory (taste of arsenic in your
>mouth), olfactory (smell rotting flesh while in a bookshop), auditory (hear
>a voice accusing others around you of being spies plotting to kill you),
>ie., in the absence of the bugs, flesh etc being present.
>They state hallucinations are generally indicative of a psychotic state and
>"signify a break with reality".
>Exceptions include: pseudohallucinations, hallucinations as the result of
>sensory deprivation, certain drug induced experiences and electrical
>stimulation of the cortex, certain epileptic experiences.
>PSEUDO HALLUCINATIONS: In a text by Kendell and Zealey (companion to
>Psychiatric Studies) there is the following statement:
>"True hallucinations should be distinguished from hallucinations which the
>patient produces of his own imagination (pseudohallucination). Such
>pseudohallucinations often occur when the patient is falling
>asleep(hypnogogic) or waking up (hypnopompic)."
>McKellar (Abnormal Psychology) has a lot more to say about
>The term hypnogogic was coined in 1861 and hypnopompic in 1904.
>Warrens Dictionary of Psychology (1934) defined hyponogogic imagery as,
>"Imagery of any sense modality, frequently of almost halluncinatory
>character, which is experienced in the drowsy state preceding deep sleep."
>My unsophisticated way of summarising the above is to say: we may all be
>able to be hypnotised, some people may have what have been referred to as
>pseudohallucinations, while relatively few people experience 'true'
>hallucinations. This point has relevance to the issue of 'causation'. for
>example, I may choose to be hypnotised, but as much as I try it is unlikely
>that I could choose to have auditory/visual halluciations. There would seem
>to be a vulnerability or propensity for some people to have hallucinations.
>Some people can use drugs such as LSD or speed without major event, while
>for others the result is a state characterised by experiences which could
>be labelled psychotic.
>What also distinguishes these experiences is the presence or absence of
>sleep, as well as the source of these experiences, eg externally induced as
>in hypnosis.
>There are thus certainly similarities between the above experiences but also
>differences, which have to be considered multidimensionally, like two
>reference or factor axes.
>Feel free to object if you believe I am referring to your comments
>inappropriately, but a key phrase in your comments below, to me, is:
>> (snip) and find myself resistant to re-construing
>An aspect of many people labelled as acutely psychotic is this aspect of not
>even considering reconstruing. Today I was speaking to somone about
>practical matters and in the middle of this he/she started mumbling to
>themself. When I asked what the person was saying, I was told he/she was
>just speaking to God.
>As you note, a common thread is that all the above experiences are construed
>as 'real', however I suspect what 'real' means in these situations may
>differ. For example, many 'delusions' can be unswervingly held, even in the
>face of massive invalidation. Lindsay started to say some interesting
>things on this subject.
>Perhaps this is a key issue, responding to construing that can't be directly
>experienced/validated by another, but which is construed as more real than
>experiences which can be shared with others. I have no doubt such a
>description is flawed, however it is a crude attempt to explore this matter.
>>Actually, since mentioning it, I've been wondering whether the problem of
>>hallucination v. dreaming isn't a matter of construing. At what point does
>>a dream become a hallucination? My "psychosis" episodes are usually
>>sleep-associated, i.e. they occur in conscious, but
>>'recently-become-conscious', states. I construe them as memories of
>>conscious episodes, not as memories of dreams, and find myself resistant to
>>re-construing them as the latter. In sleep paralysis the victim is
>>conscious but paralysed, thus sharing characteristics of waking and dream
>>states both, and often seems to experience a presence in the room. The
>>common consequence seems to be to explain the experience by construing it as
>>a 'real' one rather than a dream and its content depends on local mythology
>>(Blackmore's investigation of "the Old Hag" in Newfoundland, sundry alien
>>encounters in "X-files" land, visions by shamans).