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VERBAL HALLUCINATIONS AS AUTOMATIC SPEECH

The Reactivation of Dormant Speech Habit
Published Online:https://doi.org/10.1176/ajp.107.2.110

The verbal hallucination can be explained on the basis of known physiologic and psychologic principles. It is primarily a disorder of speech and not one of perception. Hyperactivity of the neuromuscular mechanism of speech and reversal to a former habit of speech expression produce an autonomy which the patient is powerless to influence and which he fails to recognize as belonging to his ego. The characteristic effects of sound and of the human voice, the factors of attention, preoccupation, and egocentricity, the reactions to "alien" speech, and to influence by "others," the need to explain and counteract —all augment an already existent vocal hypertension and perpetuate speech autonomy. Certain characteristics of the verbal hallucination can be explained on the basis of other former habits of speech expression and immature behavior. Preliminary research indicates facile participation of the hallucinating patient's own speech mechanism during imagined speaking and hearing. Therapy should be based on reduction of focal and general tension and on restoration of the social function of speech along with education in social living.

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