Background. In this paper we consider verbal hallucinations
as inner speech with pragmatics.
The specific pragmatic properties of verbal hallucinations investigated
included the number of
voices, the characteristics that individuate the voices, the sequential
characteristics of the
dialogues between voice hearers and their voices, the dialogical
positioning of voices hearers,
voices and other individuals, and how the voices influence voice
hearers' activities.
Methods. These properties were examined in structured
interviews with 28 individuals, 14 of
whom had a diagnosis of schizophrenia, while 14 were students who
did not use psychiatric services.
Results. The analysis showed that voices were most frequently
individuated with reference to
individuals significant to voice hearers. The talk with voices was
typically mundane and related
to voice hearers' on-going activities, as is the case for ordinary
inner speech. The voices were
typically orientated towards the voice hearer, without direct access to
each other or to other
people. Contrary to received wisdom, the voices typically did not
impel actions of voice hearers,
rather they influenced voice hearers' decisions on how to act.
This was so irrespective of the
diagnostic status of informants. Finally, we have found some differences
between the voices of
informants with, and without, schizophrenia. These concerned the alignment
of voices, the type of action required by a voice and the degree
of dialogical engagement between voices and voice hearers.
Conclusions. We conclude that verbal hallucinations can
be fruitfully considered to be a genus
of inner speech. Pragmatics can be used as a framework to distinguish
verbal hallucinations in different populations.