The Philosophy and Therapy Podcast · John T Maier

#32: Sam Wilkinson on Auditory Verbal Hallucinations and the Philosophy of Psychiatry

·1 hr 13 min·5 clips

From Philosophy in Therapy: The predictive processing approach explains auditory hallucinations as bottom-up...

John T. Meyer introduces Sam Wilkinson and sets the conversation at the intersection of philosophy, therapy, and psychiatry. The discussion opens with auditory hallucinations and the predictive processing framework Wilkinson uses to interpret them. Wilkinson explains the basic idea behind predictive processing in a way that helps orient listeners who are new to the topic. The episode then moves into a narrower question about how to understand voice-hearing as an experience. Wilkinson argues that the relevant cases are heterogeneous and that any good account has to make room for that variety. He suggests that voice-hearing may be more fundamentally communicative than purely auditory. That shift in emphasis changes how the phenomenon is carved up. It also changes what counts as a clinically useful response. The conversation spends time on the idea of the "speaker behind the voice." Wilkinson treats that speaker as something clinicians and hearers may need to engage with, not simply suppress. Meyer presses on the therapeutic implications of not rushing to dismiss the voice as meaningless. Wilkinson connects that view to relational therapies that work with voice-hearing rather than against it. Avatar therapy and relating therapy come up as examples. The episode stresses that taking the voice seriously is not the same as colluding with delusion. Instead, it is a way of asking what emotions, conflicts, or social meanings the experience may express. The discussion also widens to everyday contexts beyond psychiatry, where questions of relating, caregiving, and perspective-taking still matter. Wilkinson links those broader reflections back to the central problem of how minds relate to one another. Meyer keeps restating and refining the questions so Wilkinson can build the argument carefully. The result is a conversation that stays concept-heavy without losing contact with clinical reality. It is as much about how to frame the phenomenon as about the phenomenon itself. By the end, the episode has mapped a view of voice-hearing that is philosophically disciplined and therapeutically attentive. It leaves the listener with a richer sense of why the category is difficult and why that difficulty matters.

As heard by us

A careful look at voice hearing that treats meaning as seriously as symptom.

Sam Wilkinson treats auditory verbal hallucinations as more than a diagnostic curiosity. They are framed as communicative experiences with clinical weight, and that framing gives the material real shape.

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Why you'd press play

For when you want a careful guide to voice-hearing, not a scare story.

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