A verbal behavior analysis of auditory hallucinations.
Hearing voices is learned self-talk; break the intraverbal chain and the voice loses its fuel.
01Research in Context
What this study did
E and colleagues wrote a concept paper. They asked, 'What if voices in your head are just words you learned to say to yourself?'
They used Skinner's verbal operants to map how self-talk chains can grow. No lab, no clients—just a new way to see the problem.
What they found
They say hallucinations are covert intraverbals. The 'voice' is simply the next word the person has been primed to say.
Treat the chain like any verbal behavior. Change the cues, change the words, and the voice should fade.
How this fits with other research
Castañe et al. (1993) later tested the idea with college kids. Recall of 'private' events tracked prior intraverbal links, not magic memory.
St Peter (2017) extends the same lens to everyday talk. Moment-to-moment topic jumps are collateral intraverbal pulls—just like the voices.
Nelson et al. (1978) showed echoic priming in adults. Hearing a word once lifts its odds of reuse. E's self-echoic loop fits right in.
Why it matters
If a client hears voices, stop asking 'Why do you hear that?' and start asking 'What word usually comes next?' Map the intraverbal chain. Insert new prompts, change the response cost, or shift the setting. You already do this for stims and mands—now do it for hallucinations.
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02At a glance
03Original abstract
A review of recent research on the non-medical control of auditory hallucinations is presented. It is suggested that the decreases in hallucinatory behavior obtained in studies using aversive contingencies may be attributable to the disruption of the chains of behavior involved. The results of several additional studies are interpreted as indicating that methods of stimulus control and the use of incompatible behaviors may be effective in reducing the rate of auditory hallucinations. Research relating auditory hallucinations to subvocalizations is presented in support of the view that hallucinatory phenomena are sometimes related to the subject's own vocal productions. Skinner's views (1934, 1936, 1953, 1957, 1980) are then presented as possible explanations of some hallucinatory behavior. It is suggested that some auditory hallucinations consit of the mishearing of environmental and physiological stimuli as voices in a fashion similar to that which Skinner observed in his work with the verbal summator. The maintenance of long chains of such responses may be largely attributable to self-intraverbal influences (such as are present during automatic writing). With some auditory hallucinations, this progression involves first mishearing ambiguous stimuli as voices and then attributing the voices to some cause (e.g., insanity, the television, radio, or God). Later, the frequent and ongoing chains of such behavior may contaminate other verbal responses. Such verbal behavior may be parasitic on "normal verbal behavior" (and hence, not directly dependent on consquences for maintenance), may be cued by various stimuli (including respiration), and may interfere with other covert and overt behavior. Several studies to investigate this view are presented. It is hoped that such research will lead to a better understanding of the major issues involved in the etiology and treatment of auditory hallucinations in particular and perhaps of psychosis in general.
The Behavior analyst, 1983 · doi:10.1007/BF03392392