ABSTRACT
A key clinical question within psychiatry has traditionally been whether the patient considers his or her visions and voices originate from inside or from outside. This reflects a distinction between those originating from inside as neurotic, not totally unfamiliar to our ego, and those originating from outside as psychotic. Intensity of feeling usually accompanies such semi-visions, or full hallucinations. Patients frequently experience hearing voices or seeing visions which seem to come to them from outside, take them by surprise, and often lead them in a new direction. The clinical reporting of voices and visions need not be bewildering if the clinician is aware of their history and can think about their meaning. Such phenomena are common in the lives of holy people, as recorded in the main sacred texts over millennia. The therapist consistently tried to establish who was who, what the projections were, what was external, and what was internal, reality.
