Dissecting Auditory Verbal Hallucinations into Two Components: Audibility (Gedankenlautwerden) and Alienation (Thought Insertion)

Iris E. C. Sommer*, Jean-Paul Selten, Kelly M. Diederen, Jan Dirk Blom

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


This study proposes a theoretical framework which dissects auditory verbal hallucinations (AVH) into 2 essential components: audibility and alienation. Audibility, the perceptual aspect of AVH, may result from a disinhibition of the auditory cortex in response to self-generated speech. In isolation, this aspect leads to audible thoughts: Gedankenlautwerden. The second component is alienation, which is the failure to recognize the content of AVH as self-generated. This failure may be related to the fact that cerebral activity associated with AVH is predominantly present in the speech production area of the right hemisphere. Since normal inner speech is derived from the left speech area, an aberrant source may lead to confusion about the origin of the language fragments. When alienation is not accompanied by audibility, it will result in the experience of thought insertion. The 2 hypothesized components are illustrated using case vignettes.
Original languageEnglish
Pages (from-to)137-140
Issue number2
Publication statusPublished - 2010


  • Auditory verbal hallucinations
  • Alienation
  • Audibility
  • Schizophrenia
  • Gedankenlautwerden
  • Audible thoughts
  • Thought insertion
  • Inner speech
  • Voices

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