Neuroscience of the "voice in the head/inner dialogue" and audio hallucinations

[Cotcha Yankinov]

Neuroscience of the "voice in the head/inner dialogue" and audio hallucinations

Some people are acutely aware of this "inner dialogue/monologue" that is occurring almost constantly during the day, and it seems that it might be pathological in some mental disorders such as anxiety, and then possibly separate (but then again possibly similar) in biological origins you have audio hallucinations. I was wondering if we knew much about the biological origins of the voice in the head, such as perhaps if there is a particular neurotransmitter or brain region that is especially responsible. Some people report profound peace and silence of the voice in the head with NMDA antagonists (I can attest personally that they help with silencing both the inner dialogue and musical hallucinations), so is NMDA a suspect for being largely responsible for the voice in the head?

There are also audio hallucinations which seem to be related to excess dopamine/arousal. Is there any research on why excess dopamine leads to audio hallucinations? Can you extract from the mechanisms behind working memory and assume that excess dopamine/arousal decreases the signal to noise ratio resulting in excess noise or an over active brain region?

 

[Zilpe]

Unfortunately I can't answer your question (I'm not sure anyone can give you a definitive answer at this point) but I've often wondered if certain mental disorders do not exhibit auditory hallucinations but rather a failure to correctly "identify" the inner monologue. What I mean by this is that people are simply unable to recognize the standard voice in their head as their own thoughts and are erroneously attributing them to an outside source. There are cases of "alien limb" syndrome where patients feel like their arm or leg does not belong to them and is acting on it's own, maybe certain dissociative identity disorders are similar but rather than an alien body part it's alien thoughts.

 

[Cotcha Yankinov]

That's very interesting. I don't think 100% of people are even aware of the inner monologue, at least my grandma didn't seem to be. So it makes sense that it's possible that someone could believe it was not under their conscious control (many thoughts don't seem to be under conscious control, not to get into a free-will discussion here though haha). It would appear as though someone was controlling them from the outside to a person who could not recognize their own inner dialogue.

I wonder if the people who are more likely to come down with those related disorders tend not to "read aloud in the head", apparently it's possible for some people to read without hearing the words in their head.

 

[belligerent drunk]

Interesting question, I've never actually given it a serious thought. As someone who has this "dialog" all the time in their head, I can't imagine thinking or reading any other way. Although what Zilpe says is certainly an interesting thought. I know my mother, who is a schizophrenic, hears all kinds of voices, but they're most often voices of people she knows, such as her children or some other close people. I am adamant that it is actually her thoughts, because, without getting into much detail, it just follows from my observations - the stuff she "hears" is exactly the stuff she would be thinking on her own; so it's as if her (often bad) thoughts are "disguised" as voices of people she knows.

I believe many people can "think" with not their standard voice, but with someone else's voice. I've seen many people say something along the lines of "I read this in Morgan Freeman's voice". Perhaps connected to this phenomenon?

 

[Cotcha Yankinov]

Have you guys heard of these "columns" of neurons in the neocortex? Incredible stuff... Apparently there are over 100 million microcolumns with 100 neurons each... At one time Wikipedia said that each hypercolumn appears to be dedicated to a specific sensory region and such, and also it appears that the primary auditory cortex is inside of the neocortex. So I wonder what might be going wrong in the brains of schizophrenics regarding these columns.

I normally have an extremely overactive inner dialogue that can take the form of any voice I've ever heard, but in my experiences with sleep deprivation I can get voice hallucinations (of people I know and whose voices I have heard recently) - one thing I notice in particular is that they seem to be "direction wise" coming from "outside", rather than being localized to the same sort of central vicinity as the normal voice in the head. The localization is to the point where I will actually think someone is behind me or in a certain area of the room. I wonder if schizophrenics experience this difference in localization concerning their actual voice in the head and their hallucinations.

I wonder on a biological level what is going on, what exactly is the difference between the voice in the head and audio hallucinations, even if it's only a difference between how we perceive the voices and our voice in the head?

 

[Zilpe]

The thing is, I don't think this is really a question that can be answered on a biological level. It's likely happening at a higher level of abstraction. If a program has a bug in it you don't ask what's happening in the hardware. Fundamentally you can trace everything back to the hardware but that's not really whats going wrong. Most mental illness I suspect is similar. We can look at the brain but what we really need to know is the functionality rather than the physiology.

 

[Zilpe]

Interesting question, I've never actually given it a serious thought. As someone who has this "dialog" all the time in their head, I can't imagine thinking or reading any other way. Although what Zilpe says is certainly an interesting thought. I know my mother, who is a schizophrenic, hears all kinds of voices, but they're most often voices of people she knows, such as her children or some other close people. I am adamant that it is actually her thoughts, because, without getting into much detail, it just follows from my observations - the stuff she "hears" is exactly the stuff she would be thinking on her own; so it's as if her (often bad) thoughts are "disguised" as voices of people she knows.

I believe many people can "think" with not their standard voice, but with someone else's voice. I've seen many people say something along the lines of "I read this in Morgan Freeman's voice". Perhaps connected to this phenomenon?

This is exactly what makes me think this. So often the thoughts of schizophrenics seem to be expressing anxieties and self-doubts. The only difference is that they've become "external" to the person. If there was a problem with the sensory input itself you might expect more random gibberish than coherent and personal thoughts.

 

[dopamimetic]

This topic is becoming very interesting. Somehow I believe there is still so much unknown about our inner world, things we don't even have words for - everybody knows just his own way of perception and consciousness, and has to use that as a base to imagine how other people could think like, but nobody will actually ever know how it would look and feel to be in someone else's mind ... people are so different, and things like voices in the head have a completely different meaning for everyone. This is what I truly dislike about psychiatry ... they ask you some silly questions, do you hear voices? Okay, you're schizophrenic. And so on.

 

[Ligaturd]

Interesting question, I wonder how excess activity at the D2 receptor site caused by dopaminergic stimulants actually causes this phenomenon. The way I experienced hearing voices and paranoia is much like I am starting to experience it now. It's kind of disturbing but realizing that I am in fact starting to experience this gives me some comfort as I can ensure to make a point to differentiate from what is real and what is not, I feel as if not losing the plot and not giving into delusions will allow some control in the future. Hopefully it's just a temporary state induced by stress and anxiety. You can't reliably diagnose anything while using drugs or from 6 months to a year after stopping all drug use.

I recently went on suboxone, my anxiety got insanely crazy and I have been hearing voices. I thought it was nust a manifestation of my anxiety but a friend who has schizophrenia described exactly the same thing. I thought it was anxiety because these "voices" are pretty much the product of the same things that I always thought people were judging me on before which are pretty much a projection of my own insecurities which actually come from things people have said about me in the past. I also used to feel as if people could read my thoughts as a child and it would cause me so much distress. When I walk by certain houses the "voices" sound like they are coming from the house but it makes no sense that it would be, and that people would be talking about me every time I walk by their house in a way that I could hear them. The voices are always female as well, which isn't my own internal voice as I am male. It isn't always negative things that I hear and it's rarely ever clearly audible but I know what it means.

 

[neversickanymore]

Its a conversation between the conscious and unconscious. When there is a significant disagreement and resultant struggle like with the addiction the whole thing gets really heated and addicts struggling in early recovery have a never ending full blown brawl to deal with.
The Brain and Addiction

The dialogue is only a relatively small portion of the complex interaction between these two bedfellows.

NSA's Location:
babysitting the argument in my head

 

[Cotcha Yankinov]

I know my mother, who is a schizophrenic, hears all kinds of voices, but they're most often voices of people she knows, such as her children or some other close people. I am adamant that it is actually her thoughts, because, without getting into much detail, it just follows from my observations - the stuff she "hears" is exactly the stuff she would be thinking on her own; so it's as if her (often bad) thoughts are "disguised" as voices of people she knows.

From the wiki on the dopamine theory of schizophrenia - "Eventually, the cingulate gyrus becomes atrophied towards the anterior, due to long-Term Depression (LTD) and Long-Term Potentiation (LTP) from the abnormally strong signals transversely across the brain.^[3] This, combined with a relative deficit in GABAergic input to Wernicke's area, shifts the balance of bilateral communication across the corpus callosum posteriorly.^[4] Through this mechanism, hemispherical communication becomes highly shifted towards the left/dominant posterior. As such, spontaneous language from Broca's can propagate through the limbic system to the tertiary auditory cortex. This retrograde signaling to the temporal lobes, results in the parietal lobes not recognizing it as internal, resulting in the auditory hallucinations typical of chronic schizophrenia.<sup>["

So here is a mechanism that explains how the voices may appear to come from the outside...</sup>

 

[neversickanymore]

From the wiki on the dopamine theory of schizophrenia - "Eventually, the cingulate gyrus becomes atrophied towards the anterior, due to long-Term Depression (LTD) and Long-Term Potentiation (LTP) from the abnormally strong signals transversely across the brain.

What allows the abnormally strong signals? There are two general "destinations" of the mesolimbic pathway. Striatum being one. What does this area actually do and whats the big picture of the system and process?

Edit: How many different types of auditory hallucinations are there? Simplified way down, could the same chemical root cause them both/all? How?

Dopamine has so many functions. Are you a musician?

 

[Cotcha Yankinov]

Hey NSA sorry I didn't quote the rest of the wiki on the dopamine theory of schizophrenia but the rest of it is there.

I actually am a lifelong musician, and I have horrible music stuck in my head/musical hallucinations (the only other kind of audio hallucination I can think of) and most nights music in my dreams, I think my tendency towards hearing voices has something to do with having an over developed audio cortex. I always thought that there is a dopamine component to music as well.

 

[tantric]

i was under the impression that most people identify the 'voice' of their thoughts as their self. one of the things one learns with meditation is to let that go and move one's 'self' to being the person who hears the thoughts, not the one who creates them.

 

[MyDoorsAreOpen]

This is indeed an interesting topic that I've thought about a lot. My understanding of the fundamental mindstate of schizophrenia is that the world feels fake, and you feel fake. Depersonalization and derealization. So I'm very much in agreement that the auditory hallucinations are probably the person's inner monologue seen as not one's own.

I have an inner monologue that goes nonstop. I have trouble imagining a human being, other than someone profoundly retarded or brain damaged, not having one. I've done all kinds of experiments with drugs and other consciousness-bending techniques in an attempt to replicate what a schizophrenic feels. But not once on any of these have I experienced voices that probably came from my head but felt like they didn't.

 

[neurotic]

If there was a problem with the sensory input itself you might expect more random gibberish than coherent and personal thoughts.

definitely. but then, i think "schizophrenia" is more of a social concept than anything else. i have met one diagnosed schizophrenic kid which would act and be very incoherent. then another schizophrenic old lady which was coherent and would always talk about aliens and be overall weird. the impression that i have is that if you start to act really fucking weird in a way that you get sent to a doctor, you're just lumped into schizophrenia. the two persons i mentioned have the same diagnosis but the neurological differences they have from the average human brain might be completely unrelated.

this and i think we're still very, very far from knowing anything appreciably precise about the physical bases of phenomenological events. i would even guess that it might be beyond our intellectual scope. i for one always get amazed at how complex things our brain does and we take for granted are.

 

[belligerent drunk]

My understanding of the fundamental mindstate of schizophrenia is that the world feels fake, and you feel fake.

Really? That is interesting to hear, because I would imagine it being the other way around. To me it seems that the world and especially the hallucinations feel real, which is really the root of the problem. The person cannot distinguish reality from products of their own mind. But then again my opinion is mainly based on anecdotal second-hand experience, I'm not well-read on the topic.