In the realm of honesty, it can be plausible on the basis of cognitive-neuroscientific research, that auditory-verbal hallucinations (AVH) that are found in patients with schizophrenia arise when subvocal speech is mis-identified by their own psyche. In those without the disorder, when they ascertain someone’s speech, the brain generates motor commands and an “efference copy” (or corollary discharge) that creates a form of prediction regarding the sensory consequences of one’s own speech, putting a minor dampening on our auditory cortex’s response to our own voice, all so we can focus on the validity that we were the one to generate it. As an example, when we are tickled, or tickle ourselves, the sensation of speech is weaker. In patients with schizophrenia who hear voices (which is not always the case), the signal of generation is unreliable, so internally generated speech is hardly flagged by the person as “self,” and instead the auditory system processes it as an external voice is speaking. This model is supported by studied showing that patients with AVHs attribute their own speech to someone, or something else, or someone.
For instance, one study had patients read words aloud with auditory feedback being warped by an outside force; those with hallucinatory tendencies more often reacted through judging their own voice as someone else’s. An electromyographic investigation found that the muscular activity on the lips increased during AVH events; raising the suggestion that the articulation subvocally, AKA inner speech, is engaged when voices are put in the front lines, even if the person themselves are not speaking. Taken together, these lines of evidence favour the theory that these “voices” are not always external entities, but may be vocalizations that the brain fails to recognize as self-generated.
Moreover on this claim, the framework laid out before us does have clinical-based relevance: if the root is a mis-labelled signal from within, interventions might target improving how you could monitor yourself and how you train these predictive mechanisms.
So, in that regard, the claim this answer is regarding is exaggerated in the sense it is attempting to present a “unified” model for what is in reality a very individualized phenomenon. Many people with schizophrenia do not experience voices that map on their inner speech or insecurities; some voices are very clearly perceived as external, raising spatial awareness, non-verbal, or tied to something that is more on the experience side of reference.
Also, the claim focuses on auditory verbal hallucinations, but schizophrenia entails an array of experiences that cannot be funneled into a single label. Such as visual, tactile, non-verbal auditory, thought insertion, olfactory, and more.
To be fair, a strong counterpoint for what you have presented would be that many auditory hallucinations do not feel like the reflection of one’s own voice. And that is simply proven by the fact that the base of hallucinations resides in misrecognition – as those who experience them often struggle to understand that they are not real. Medical sources note that up to ~80% of people with schizophrenia reported hearing voices that differed in location, tone, identity, and content from their own internal identity. It causes a rift in understanding that they are the products of their mind, and are not real, as opposed to the belief that what they are hearing are totally true, and exists in the same reality as everyone else.
Thus, while the echo of someone’s “vocalizations” model is a compelling account for many experiences in schizophrenia, it is not sufficient to explain every case. Plural mechanics will always exist, as will individual variability, and the possibility some hallucinatory voices are not carried with any real truth or meaning behind them.
