Dialogues in Philosophy
Mental and Neuro Sciences

Dialogues in Philosophy, Mental and Neuro Sciences

The official journal of Crossing Dialogues
Volume 14, Issue 2 (December 2021)

Hallucinations in schizophrenia and PTSD. Idealtypical psychopathological differences
Matteo Maggiora, Stefano Naim & Massimiliano Aragona
The aim of the present study is to investigate whether dissociative hallucinations differ from psychotic hallucinations.
In order to emphasize the phenomenal differences, we use an idealtypical approach to compare several psychopathological features of hallucinations in post-traumatic flashbacks and in schizophrenia. Ideal types are general ideas useful to exemplify the phenomena in their more complete and typical presentation at a purely phenomenal level, irrespective of partial similarities and overlapping of some of their features.
Hallucinations occurring within post-traumatic flashbacks are experienced in a clearly altered state of consciousness, are usually vivid highly personalized multisensorial scenes, are often realistic echoes of the original traumatic experiences, and the patient’s emotional reaction is coherent with their content. Moreover, when the patient remembers them or is told about what happened, he/she clearly views them as pathological intrusive phenomena originating from own mind.
On the other side, typical schizophrenic hallucinations are experienced in a somehow lucid state of consciousness, are usually bizarre, partial, less vivid, scarcely personalized and localized. Their internal coherence as well the congruousness with the emotional reaction is lower. The “position-taking” is also more complex: at one side their implicit interpretation is intertwined with a delusional lived-world, at the other side the patient usually asserts explicitly (when investigated) that even the most elusive experiences are real.
Indeed, despite their inconsistencies the schizophrenic are, as passively experienced without putting in question their plausibility, and consequently the “awareness of their 
In conclusion, our study suggests that the most typical PTSD and schizophrenic hallucinations can be sharply distinguished at the phenomenal level.
Hallucinations, AVHs, Flashbacks, Schizophrenia, Psychosis, PTSD, Phenomenology, Psychopathology
Dial Phil Ment Neuro Sci 2021; 14(2): 46-59
Received on December 20, 2021
Accepted on February 13, 2022
Firstly published online on May 23, 2022