HALLUCINATED INNER SPEECH

A notion introduced in or shortly before 1958 by the American psychiatrist and psychoanalyst Arnold H. Modell (b. 1924) to denote a *verbal auditory hallucination (VAH) originating from endogenously generated linguistic elements. It is based on a detailed phenomenological description of the VAH experienced by 10 individuals with a clinical diagnosis of * schizophrenia, who all heard the voices of formerly significant individuals. Modell hypothesizes that VAH experienced by such individuals "can be understood in part as reflecting those organized configurations of the mind we term internalized objects". As he continues in a psychoanalytic vein, "The concept of internalized objects is akin to what Freud described as the precipitates within the ego, those records of abandoned object relations.This implies that the voices have had some representation within the ego prior to their emergence." The notion of *inner speech (i.e. without the adjective 'hallucinated') is borrowed from the Russian developmental psychologist Lev Semenovich Vygotsky (1896-1934). It was conceptualized by Vygotsky as speech spoken by oneself without vocalization (also referred to asverbal thought, or'thinking in words'). The content of vygotskian inner speech typically involves an argument with oneself over a course of action to be taken, a rehearsal of what one is going to say or do, or a reassurance to comfort oneself. With the introduction of the notion of hallucinated inner speech, Modell distances himself somewhat from the vygotskian concept, in that he envisages inner speech to have a bearing not only on the ego's own verbal thoughts, but also on the verbal utterances of internalized objects. In Modell's own words, "The voices are identified as formerly loved persons, principally the parents, who in some unexplained way are fused to the self. These voice objects function as parents in terms of giving advice and being a source of prohibitions, and also in gratifying wishes stemming from all stages ofinfantile development." It would seem that Modell seeks to legitimize this broadened scope of the notion of inner speech by referring to a hypothetical breakdown of ego boundaries in individuals with a clinical diagnosis of schizophrenia: "With emergence of voices the ego loses its former character. The boundary separating the ego from its objects is dissolved. There is not only loss or alteration of identity, but also loss of control of certain ego functions that now are felt not to emanate from self but from the influence of the voices." It appears that it was Modell's concept of hallucinated inner speech rather than Vygotsky's original notion of inner speech which profoundly influenced the * inner speech model of verbal auditory hallucinations which dominated neu-ropsychological thinking on VAH from the 1980s onwards.

Modell, A.H. (1958). The theoretical implications of hallucinatory experiences in schizophrenia.Journal of the American Psychoanalytical Society, 6, 442-480.

Modell, A.H. (1962). Hallucinations in schizophrenic patients and their relation to psychic structure. In:Hallucinations.Edited by West, L.J. New York, NY: Grune & Stratton.

Vygotsky, L. (1986).Thought and language. Translation newly revised and edited by Kozulin, A. Cambridge, MA: MIT Press.