A COGNITIVE ANALYSIS OF THE MAINTENANCE OF AUDITORY HALLUCINATIONS: ARE VOICES TO SCHIZOPHRENIA WHAT BODILY SENSATIONS ARE TO PANIC?

Abstract

A cognitive approach to auditory hallucinations that is based on the models of panic and anxiety developed by Clark (1986), Beck (1976) and Salkovskis (1991) is outlined. It is suggested that auditory hallucinations are normal phenomena, and that it is the misinterpretation of such phenomena that cause the distress and disability that are commonly seen in patients experiencing hallucinations with a diagnosis of schizophrenia. It is also proposed that these interpretations of auditory hallucinations are maintained by safety seeking behaviours (including hypervigilance). The existing literature is reviewed in relation to these hypotheses and found to be largely consistent. The clinical implications of such a model are briefly discussed and a number of testable predictions are made.