The Concept of Pseudohallucination: An Attempt at Specificity and Renunciation

Abstract: The concept of pseudohallucination (PH) occupies an awkward position in psychiatry. The concept was deemed overly polysemous and hence unusable a few decades ago by various authors. However, the concept has recently reemerged from the ashes by its inclusion in the International Classification of Diseases , 11th edition, in different places. This warrants another look at this awkward concept. In this paper, I argue that a more specific account of PH can be obtained by returning to especially Kandinsky's but also Jaspers' work. Despite this achieved specificity, because of the polysemy of the concept, I believe that it should be renounced. I start by developing Kandinsky's and Jaspers' accounts of PH as involuntary, intrusive, and vivid imagery, as seen in schizophrenia spectrum disorder. The third section relates this to contemporary research on disturbances of imagination and pseudo-obsessions. In the fourth section, I turn to auditory PHs, which reveals that what ties these prima facie disparate phenomena together is disturbances of the self–world relationship. Based on this achieved specificity, the next section reconsiders the concepts of true hallucination and PH. In the sixth section, I turn to contemporary research on PH and discloses additional issues related to this polysemous concept. In the seventh section, I conclude by asking: what is the added value of the concept of PH and why we insist on retaining it? Given that we have better concepts at our disposal, I argue for its renunciation.