Thought & Speech › Thought Alienation

Thought Broadcasting

Thought broadcasting is the conviction that one's own thoughts are, in some way, no longer private — that as the person thinks, others are aware of the same thoughts, or can access them, or are thinking them too. Different people describe this in somewhat different ways: some feel their thoughts are audibly escaping, others feel that everyone nearby is simply thinking in unison with them, and some describe hearing their own thoughts spoken aloud and believing this means others can hear them.

Because a genuine range of related but distinct experiences are all conventionally described using this one term, it is traditionally considered important, in clinical practice, to establish and record exactly what the person believes is happening to their thoughts, rather than assuming a single fixed definition applies.

Recognition features

• A conviction that one's private thoughts are, in some way, no longer confined to oneself alone
• The exact felt mechanism varies between individuals: thoughts escaping and being accessible to others, others thinking the same thoughts simultaneously, or thoughts being audible and therefore overheard
• Often accompanied by significant distress or self-consciousness in social situations, given the loss of a normally taken-for-granted sense of mental privacy
• Frequently occurs alongside other experiences of thought alienation, such as insertion or withdrawal

Eliciting it at interview

• Ask an open first question: "Do you ever feel that other people can know what you're thinking, or that your thoughts aren't private anymore?"
• If the person confirms this, ask them to describe exactly what they mean in their own words, since the term covers several genuinely different experiences that matter for accurate documentation
• Explore the impact on daily life, such as avoidance of public places or crowds, since the distress caused by this experience can be considerable

Distinguishing features

• Differs from thought insertion and thought withdrawal in the direction of the disturbance: broadcasting concerns other people gaining access to the person's own thoughts, rather than thoughts being added to or removed from the person's mind by an outside force
• The precise felt mechanism (escaping thoughts, shared thinking, or audible thoughts) should be documented specifically, since these are recognised as meaningfully different experiences beneath one umbrella term
• Differs from an auditory hallucination of one's own thoughts being spoken aloud (thought echo), which concerns hearing one's thoughts, whereas broadcasting concerns the belief that others can access them

Common misconceptions

• That thought broadcasting has one single, agreed definition; in practice the term is used to describe several related but distinct experiences, which is why careful, open-ended questioning matters more than simply asking a single yes/no screening question
• That thought broadcasting is exclusively a symptom of schizophrenia; while strongly associated with it historically, the underlying belief that thoughts are not private has also been described in other contexts

Related phenomena

Thought Alienation · Thought Insertion · Thought Echo · Disturbance of the Boundaries of the Self · Passivity Phenomena

Diagnostically relevant to

Schizophrenia (links open the DSM-5 Learning Lab)

Practice this

A patient describes, with obvious distress, that as he thinks something, people around him somehow know exactly what he is thinking at that moment — as though his thoughts are no longer confined to his own head and are somehow accessible to others. He denies that anyone is putting thoughts into his mind or taking them away. What is this? · A patient says that a voice sometimes speaks his thoughts aloud, just after he has thought them, as though echoing them back to him — but he does not believe anyone else can access his thoughts directly, and no one else is mentioned as being aware of his thinking. Before revealing the answer: is this thought broadcasting? · A patient reports a disturbance affecting the privacy or ownership of his own thoughts. Before revealing the answer, decide what distinguishes thought broadcasting from thought insertion. · A patient reports a disturbance in which her private thoughts are somehow no longer entirely her own affair. Before revealing the answer, decide what distinguishes thought echo from thought broadcasting. · A patient describes an unsettling change in the privacy of his thoughts, but you are not yet sure whether this is thought insertion or thought broadcasting. Before revealing the answer, decide what single question separates the two. · A patient has hinted that other people somehow know what he is thinking. Before revealing the answer, decide how you would explore this further. · Explain why thought broadcasting is grouped together with thought insertion and thought withdrawal as "passivity phenomena" despite the disturbance running in the opposite direction.

Illustration

A 35-year-old man stops attending his local shops because he is convinced that everyone around him can hear his thoughts as clearly as if he had spoken them aloud, and describes standing in a queue acutely aware and ashamed that strangers must be following his private train of thought word for word.

References

• Casey, P. & Kelly, B. (2019). Fish's Clinical Psychopathology, 4th ed. Ch. 4, 'Disorders of Thought and Speech'.