Explaining Schizophrenia: Auditory Verbal Hallucination and Self- Monitoring

Do self-monitoring accounts, a dominant account of the positive symptoms of schizophrenia, explain auditory verbal hallucination? In this essay, I argue that the account fails to answer crucial questions any explanation of auditory verbal hallucination must address. Where the account provides a plausible answer, I make the case for an alternative explanation: auditory verbal hallucination is not the result of a failed control mechanism, namely failed self-monitoring, but, rather, of the persistent automaticity of auditory experience of a voice. My argument emphasizes the importance of careful examination of phenomenology as providing substantive constraints on causal models of the positive symptoms in schizophrenia. I am very grateful to Ian Gold and a second, anonymous referee, for their very helpful suggestions, challenges and comments on this paper. Earlier versions were presented at the Center for the Philosophy of Science, University of Pittsburgh, at the Berlin School of Mind and Brain, Humboldt Universität zu Berlin, and at the Center for the Neural Basis of Cognition, Carnegie Mellon University and I am grateful for the many helpful comments I received. I am also grateful to Ray Cho, Casey O’Callaghan, Michael Pauen and Jason Rosenstock for advice that affected the content of the paper and to Ralph Hoffman, Stephen Moritz, and Massoud Stephane for answering questions about their work. Address for Correspondence: Center for the Neural Basis of Cognition, 115 Mellon Institute, 4400 Fifth Avenue, Carnegie Melon University, Pittsburgh, PA 15213 Email: [email protected]