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There is uncertainty about what the source of these internal sentences are in some conditions. Attribution for a recently produced internal sentence may lead to concerns over schizophrenia, hallucinations, or hearing voices.

The religious practice of Zen attempts to quiet the internal voice by various means.

The person creating the inner speech is also the sole consumer of the monologue. Propositions once created allow a person to consider their implications and formulate logical correlates.

Over a period of time the topic of a stream of conscious will wander. How the stream changes can be described as the flow. Various internal and external causes may affect the flow, including smells, music, and memories. Changes in the flow of consciousness can be logical or seemingly quite random. In the latter case, the subconscious may be at work.

If a sentence is assembled every couple of seconds, then critical events associated with the production and consumption of the subunits of the internal monologue should be on a 10 or 100 millisecond timescale. On the other hand, with the ability to place certain topics on hold and reassess them later, the timescale associated with thought trains could be as long as years.

• In printed English-language books, an internal monologue is often signified by placing the monologue in italics.
• In the film Austin Powers: International Man of Mystery, Austin loses his ability to use internal monologue, leading him to say, "How do I tell them that [because of the unfreezing process] I have no inner monologue? [pause] I hope I didn't say that out loud just now."
• In the series Peep Show and Scrubs, the main characters’ internal monologue is heard by the viewer and forms an important part of the plot.

• Subvocalization
• Introspection
• Talk aloud protocol
• Telepathy
• Cognitive linguistics
• Philosophy of mind
• Mind-wandering
• Self-awareness
• William James
• Visual thinking
• Human self-reflection
• Consciousness
• Language of thought
• Language and thought
• Wikibook on consciousness