Auditory Verbal Hallucinations: Prevalence, Phenomenology, and the Dissociation Hypothesis

Hearing voices that other people do not hear has long been considered a cardinal sign of madness. This chapter reviews the research supporting the argument that voice hearing is a dissociative phenomenon. It begins with a brief review of population studies, followed by studies of voice hearing in various clinical and nonclinical groups. The chapter reviews the research linking dissociation to voice hearing, with particular emphasis on a series of important studies from Perona-Garcelán and his group. It discusses the increasing emphasis on the relevance of a person's relationship to his or her voices, as opposed to any attempt to get rid of them, as the major focus of treatment. The high prevalence of voice hearing in those with trauma and dissociative disorders indicates the importance of dissociation in voice hearing. Dissociation emerges as a powerful explanatory tool for understanding the development and maintenance of auditory verbal hallucinations (AVH).