Banovic I, Gilibert D, Jebrane A
Laboratoire IPSE-Paris-X-Nanterre, université de Bourgogne, pôle AAFE, esplanade Erasme, Dijon, France.
Encephale. 2008 Dec;34(6):589-96. doi: 10.1016/j.encep.2007.09.008. Epub 2008 Jan 11.
Hallucinations are often defined as perceptions when there is no object to perceive. However, clinical practitioners only have access to what their patients tell them about their hallucinations. By cooperating in the construction of a meaning for the hallucination, practitioner and patient can reach a common ground. This "co-construction" produces "hallucinatory stories" that are narratives, which revolve around this phenomenon. This raises the question of where the voices are temporally and spatially in the structure of the narrative.
Fourteen patients meeting the DSM-IV schizophrenia criteria were included and took part in a filmed standardized interview. The markers of temporal and spatial localization were listed and their occurrence in the narrative calculated (Student t test and Wilcoxon test).
The results revealed that: a significant difference between the present perfect tenses. There is a distinction between what is happening now and what has happened in the past; a significant difference between the markers of temporal localization such as accomplishment and position. The hallucinatory phenomena repeat themselves. Furthermore, the subjects' judgements concerning the moment at which the hallucinatory phenomenon arises are objective and are accompanied by a temporal reference associated with their story; a significant difference between the markers of spatial localization, with relative positions being preferred. The voices constitute a distinct, autonomous spatial reference for hallucination subjects.
The narrative makes it possible to give the hallucinatory voices a place in the subject's story. The "hallucinatory stories" represent a transition from the private to the intersubjective world, a way for subjects to appropriate these experiences. When articulated in words, this experience is a product distinct from the self. This distinction between self and non-self, the hallucinating patient and his/her voices, seems to be conveyed in part by the markers of temporal and spatial position.
幻觉通常被定义为在没有可感知对象时产生的知觉。然而，临床医生只能了解患者所讲述的关于其幻觉的情况。通过共同构建幻觉的意义，医生和患者能够达成共识。这种“共同构建”产生了围绕这一现象的叙事性“幻觉故事”。这就引出了一个问题，即在叙事结构中，这些声音在时间和空间上处于何处。
纳入14名符合《精神疾病诊断与统计手册》第四版精神分裂症标准的患者，并让他们参加一次拍摄的标准化访谈。列出时间和空间定位的标记，并计算它们在叙事中的出现情况（学生t检验和威尔科克森检验）。
结果显示：现在完成时态之间存在显著差异。现在正在发生的事情与过去发生的事情之间存在区别；时间定位标记（如完成和位置）之间存在显著差异。幻觉现象会重复出现。此外，受试者对幻觉现象出现时刻的判断是客观的，并且伴随着与他们故事相关的时间参照；空间定位标记之间存在显著差异，相对位置更受青睐。这些声音为幻觉受试者构成了一个独特的、自主的空间参照。
叙事使得能够在受试者的故事中为幻觉声音找到一个位置。“幻觉故事”代表了从私人世界到主体间世界的转变，是受试者接纳这些经历的一种方式。当用言语表达时，这种经历是一种与自我不同的产物。自我与非自我、幻觉患者与其声音之间这种区别，似乎部分是由时间和空间位置的标记来传达的。
