Auditory verbal hallucinations and the differential diagnosis of schizophrenia and dissociative disorders: Historical, empirical and clinical perspectives

AVH are common in schizophrenia and posttraumatic disorders, and are not significantly differently manifested in these disorders. We contend that all voices are dissociative in nature, and can be most successfully treated through respectful engagement, which seeks to recognize the underlying purpose/concern of the voices, and transform the person's relationship with their voices. The dissociative etiology of AVH in schizophrenia, however, may be somewhat different from that in other disorders - a 'bursting through' of dissociative parts associated with severe depersonalization, as opposed to a more gradual development through absorption and intense focus on internal states. In concert with Bleuler's original proposal of schizophrenia as 'split mind', it is proposed that schizophrenia might represent a 'low level' dissociative disorder. Research to further explore this proposal is suggested.