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Despite the negative impact of voice-hearing often being bound up in what is said, there has been a distinct lack of attention paid to exploring the linguistic content of voices and/or the language voice-hearers use to describe their experiences. In this chapter, I will take a close look at how voice-hearers in the Voices in Psychosis (VIP) transcripts use language non-literally in order to convey their complex experiences, and what that might tell us about the nature of voice-hearing experiences, as well as about the function of different forms of figurative language. The topic of figurative language is a vast area of debate and theorizing, with many different accounts of what is involved. For my purposes here, it suffices to say that figurative language is a way of talking about something (the primary subject/topic or tenor) by using words or phrases that do not typically, conventionally, or literally refer to that thing (the secondary subject or vehicle). Although they are often treated as synonyms, I take ‘figurative language’ to be a slightly narrower category than ‘non-literal language’. In other words, all instances of figurative language are instances of non-literal language, but not vice versa. Metaphors and similes are both instances of figurative language, and hence also of non-literal language. However, hyperbole (exaggeration) and approximation are non-literal, but they are not fully figurative in my sense (they could be described as ‘loose use’, or ‘less than literal’). An understanding of figurative language requires a more complicated and lateral inference than simply understanding that someone is overstating for effect (hyperbole) or drawing a close approximation. That is, in part, why figurative language is so widely used in literature: it is a more adventurous use of language. It is more open to communicative failure, or to being interpreted differently by different people, but the pay-off can be great, with metaphors having the potential to yield

Inner speech has been implicated in important aspects of normal and atypical cognition, including the development of auditory hallucinations. Studies to date have focused on covert speech elicited by simple word or sentence repetition, while ignoring richer and arguably more psychologically significant varieties of inner speech. This study compared neural activation for inner speech involving conversations (‘dialogic inner speech’) with single-speaker scenarios (‘monologic inner speech’). Inner speech-related activation differences were then compared with activations relating to Theory-of-Mind (ToM) reasoning and visual perspective-taking in a conjunction design. Generation of dialogic (compared with monologic) scenarios was associated with a widespread bilateral network including left and right superior temporal gyri, precuneus, posterior cingulate and left inferior and medial frontal gyri. Activation associated with dialogic scenarios and ToM reasoning overlapped in areas of right posterior temporal cortex previously linked to mental state representation. Implications for understanding verbal cognition in typical and atypical populations are discussed.

Despite the recent proliferation of scientific, clinical, and narrative accounts of auditory verbal hallucinations (AVHs), the phenomenology of voice hearing remains opaque and undertheorized. In this article, we outline an interdisciplinary approach to understanding hallucinatory experiences which seeks to demonstrate the value of the humanities and social sciences to advancing knowledge in clinical research and practice. We argue that an interdisciplinary approach to the phenomenology of AVH utilizes rigorous and context-appropriate methodologies to analyze a wider range of first-person accounts of AVH at 3 contextual levels: (1) cultural, social, and historical; (2) experiential; and (3) biographical. We go on to show that there are significant potential benefits for voice hearers, clinicians, and researchers. These include (1) informing the development and refinement of subtypes of hallucinations within and across diagnostic categories; (2) “front-loading” research in cognitive neuroscience; and (3) suggesting new possibilities for therapeutic intervention. In conclusion, we argue that an interdisciplinary approach to the phenomenology of AVH can nourish the ethical core of scientific enquiry by challenging its interpretive paradigms, and offer voice hearers richer, potentially more empowering ways to make sense of their experiences.