Third-person auditory hallucinations
A third-person auditory hallucination is a voice, heard when no one is speaking, that talks about the person, often as a running commentary on what they are doing.
Remember
Voices that talk about the person, often as a running commentary on their actions, are third-person auditory hallucinations, whereas second-person voices talk to the person. The symptom can be seen in schizophrenia (a condition in which patients interpret reality abnormally) but is not specific to it.
Memory aid
third-person voices talk about you; second-person voices talk to you
Use it to tell the two kinds of voice apart by whether they talk about the person or to the person.
A hallucination is a perception with no real stimulus, for example a voice that is heard clearly although no one is speaking. An auditory hallucination is a perception of sound, most often voices. A delusion is a fixed false belief, so the two should not be confused.
In a third-person auditory hallucination, the voices are heard as coming from outside the person and refer to the individual in the third person. They often form a running commentary on what the person is doing, as in "he is opening the laptop". The voices are not recognised as the person's own thoughts.
Second-person voices are different, because they address the person directly, with "you", often giving commands. Third-person voices talk about you; second-person voices talk to you.
The symptom is one of Schneider's first-rank symptoms, a group of symptoms described by Dr Kurt Schneider. These symptoms can be seen in schizophrenia, a condition in which patients interpret reality abnormally, but they are not specific and may occur in other psychotic illnesses. Third-person auditory hallucinations are a positive symptom, because positive symptoms of schizophrenia add abnormal experiences, such as hallucinations and delusions.
Key facts
- What it is
- voices that talk about the person in the third person, often as a running commentary on what the person is doing.
- Where the voice seems to come from
- outside the person, and it is not recognised as the person's own thoughts.
- Second-person voices
- these address the person directly, with "you", often giving commands.
- Group
- it is one of Schneider's first-rank symptoms, a group of symptoms described by Dr Kurt Schneider.
- Specificity
- first-rank symptoms can be seen in schizophrenia but are not specific and may occur in other psychotic illnesses.
- Positive or negative
- it is a positive symptom, because positive symptoms add abnormal experiences, such as hallucinations and delusions.
Exam traps
- A loss of normal emotional expression is a negative symptom, not a positive one, because positive symptoms add abnormal experiences whereas negative symptoms take normal functions away.
- Hearing one's own thoughts spoken aloud just after thinking them is thought echo, not a voice that talks about the person, because the voice is the person's own thinking being heard rather than a commentary on their actions.
- Mishearing the words of a real conversation is an auditory illusion, not a hallucination, because it distorts an existing stimulus, whereas third-person auditory hallucinations involve voices without someone actually speaking.
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