Abstract
BACKGROUND AND HYPOTHESIS: Research has found that the content and valence of voices heard by persons with schizophrenia appear to be shaped by local culture. We interviewed twenty participants about their voices in Suan Prung Hospital in Chiang Mai, Thailand to see if, and how, there appeared to be such local influences. STUDY DESIGN: In an ethnographically driven and phenomenological study, we asked participants what their voices said; whether the voices ever told them what to do and if so, what; whether they knew the speakers; whether there were speakers they liked; whether they had hallucinations in other sensory modalities; and other related questions. Interviews lasted between 30 min and 2 h. STUDY RESULTS: Much content of these voice-hearing experiences reflected culturally specific themes. Only one person reported hearing violent commands. There were stories about the power of sacred things and powerful lineages, and cosmological stories about the power of nature. In this cultural context where talk about minds is highly elaborated, participants often said that if they had been more mindful, sati, they would not have heard voices. Most strikingly, many persons described their voices as associated with a kind of uncontrolled wildness of nature spirits. CONCLUSIONS: We find that the felt disruption of the self-world boundary appears to be interpreted in Thailand as a kind of literal wildness, best countered by mindfulness. This seems to be an unusually explicit account of phenomenology of ipseity disorder and suggests that ipseity may be understood and experienced differently in different cultural worlds.