© The Author(s) 2025. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com. Schizophrenia Bulletin vol. 51 no. S3 pp. S253–S260, 2025 https://doi.org/10.1093/schbul/sbaf137 SUPPLEMENT ARTICLE Wildness, Mindfulness, and the Phenomenology of Voice-Hearing in Thailand Julia Cassaniti 1, *; Chaiyun Sakulsriprasert 2 ; T.M. Luhrmann 3 1 Department of Religious Studies, University of Virginia, Charlottesville, VA 22904, United States; 2 Department of Psychology, Chiang Mai University, Chiang Mai, 50220, Thailand; 3 Department of Anthropology, Stanford University, Stanford, CA, 94305, United States *To whom correspondence should be addressed: Julia Cassaniti, University of Virginia, Charlottesville, VA, United States (tsc4wg@virginia.edu) 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 inuences. Study Design: In an ethnographically driven and phe- nomenological 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 expe- riences reected culturally specic themes. Only one per- son 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 cul- tural 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 nd 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 phenomenol- ogy of ipseity disorder and suggests that ipseity may be understood and experienced differently in different cultural worlds. Key words: voices; anthropology; ipseity; mindfulness; identity; religion; Buddhism; Thailand. Introduction and Background We use the word “voice” to describe the experience of hearing someone speak when no one is there to have spoken. Voices are the most striking symptoms of the condition we identify as “schizophrenia,” although voices also appear in other forms of serious psychotic disorder, psychosis being the state in which someone’s thoughts and perceptions seem radically different from consensual reality. 1 People who hear voices report that they hear someone else speaking when no one else is there. Yet the experience is more subtle and more strange than the word “voice” suggests. The event can feel thought-like but does not feel like one’s own thought; it can feel neither inside or outside; often there is a quality of insistence and com- mand. People sometimes say that the voice “feels real” even when they know that the experience is a symptom of an illness. 2 The use of the word “voice” can blind us to how complex these events are for those who experience them. Another thing that can blind us is that these symp- toms seem so closely associated with serious psychotic disorder that clinicians, upon hearing that someone has heard a voice, can move quickly to treatment options without exploring what the person is reporting in more detail. In recent years, scholars and scientists have begun to realize that careful attention to the phenomenology of voice-hearing can teach us much about these disorders which standard biomedical research cannot. In this enter- prise, cultural comparison—of the sort anthropologists do well—is crucial. Cultural comparison can show us what features of these events respond to local shaping, and thus whether there are features presumed to be uni- versal which in fact are not. For example, many observers presume that violent commands are a simple organic byproduct of psychotic disease, the way a sore throat is a byproduct of a cold. The work we present here adds to the mounting evidence that violent commands associated with psychosis are more common in the west: it may be the feeling of negative command, rather than a com- mand to do violence, which is basic to the condition of psychosis. 3, 4 S253 Downloaded from https://academic.oup.com/schizophreniabulletin/article/51/Supplement_3/S253/8275885 by guest on 07 October 2025