Last updated 11/06/2007

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by Dirk Corstens, Eleanor Longden and Rufus May

1.Why Talk With Challenging Voices

Many people who hear challenging voices have found that a turning point in learning to cope with this experience has been finding different ways of talking with and understanding their voices.
Learning to understand the motives of your voices and different ways of talking with them can help the relationship to change between the voice hearer and the voices. Techniques derived from various psychological and dramatic traditions (e.g. Gestalt, Voice Dialogue, Transactional Analysis, Psychodrama) have used chairs to act out different roles and relationships in order to help people resolve conflicts and reclaim power in their lives.
For the last ten years, a growing number of individuals have adapted this method to use with voice-hearing. We came together to write this so that others may try the technique as an aid for coping with challenging voices.

Many people engage and speak with their voices, and stances can vary from:

argumentative:
Voice: “You’re a failure”
Voice hearer: “No I’m not, go away”

To challenging:
Voice: “These people don’t like you”
Voice hearer: “Haven’t you got anything better to say?”

To submissive:
Voice: “You shouldn’t go out tonight”
Voice hearer: “All right then”

Many voice hearers experience their voices as powerfull, as if they have to obey to everything they say. That the voices tell the ultimate truth. Voices can also threaten with “punishment” to the voice hearer or beloved others.
In our approach, that is derived from “Voice Dialogue”, we try to explore the motives of the voices so that the voice hearer can find new strategies to cope with their voices. It can create a more autonomous position in which the voice hearer can make her or his own choices. Some voices even can become supportive.

Why is Voice Dialogue appropriate for voice hearers?

It is not oriented towards pathology nor is it focused upon discovering what is wrong. It offers a neutral but strong attitude to work with voices – acceptance is the core of the work.
It offers a “positive” model for the existence of voices.
It helps to built up more awareness – some distance towards the voices – and a more fruitfull relationship between voices and voicehearer.

2. Basic Principles

The basic principle is that we are not trying to change the voices; we are trying to explore their relationship with the person. Doing this work will help the individual gain a different perspective on what the voices are trying to say.
If the voice hearer can develop a more strong attitude the voices are able to change. Our aim is not to get rid of the voices but help the person take back more control in the relationship they have with the voices.

In the Voice Dialogue model everybody consists of different selves or subpersonalities. Each with its own way of perceiving the world, each with its own personal history, physical characteristics, emotional and physical reactions, and opinions on how we should run our lives. These selves serve to adapt to difficult situations. The dominant selves want to protect us from being hurt, want us to succeed in life, expect us to do what is asked by our environment. This adaptation we learn early in life. Our selves stick to what is learned to survive. Our dominant selves push away our more vulnerable parts and these, what is calles “disowned” selves become hidden and can play a significant role anymore. The selves are organised in opposites.
An example. When you are brought up with the rule: “Children that ask will be forgotten” and this is also practiced in daily life, than you develop a dominant or primary self that wants strongly to please everybody. A self that focuses at doing exactly what you think will be necessary for being liked. The opposite self, e.g. asking questions that can eventually bother other people, asking questions that can be neglected or as a person you can become rejected, will be pushed away by this strong “Pleaser”-self. The “Pleaser” doesn’t want you to take the risk of rejection.
The person with the selves organised like this doesn’t dare to ask questions, is always afraid of being rejected when she or he asks questions. This person doesn’t have a choice anymore between asking something they need or neglecting what their own needs are. The person has adapted to the rule that was prevalent in history.

Originally the organisation of the selves was beneficial to cope with situations in daily life. But in life circumstances change and these selves stay fixated in their originally adaptive roles. So later in life, in other situations, with other people and other needs, the organisation of the selves can prevent you from adaptation. Mostly we are not aware of that.
In the practice of Voice Dialogue, what is called a facilitator, not a “therapist”, helps you to explore these different selves by asking these selves, one after another, simple questions.
The facilitator asks you to concentrate on a self and go into the energy of this particular self in a different place than where you started in the room. So both the facilitator and yourself know and experience that you talk from a different part. This emanating self is questioned.

Questions that are asked are like:
Nice to meet you, can you tell me your name?
How old are you?
How do you look like?
How do you feel at this moment?
How long are you with Jacob (the person who is facilitated is called Jacob)?
Do you remember when you came in the life of Jacob?
What happened then?
What are you caring for?
Do you have a difficult job?
Does Jacob know you are there?
Does he like you?
Does he accept your help?
Do you get space to do your job?
Do the other selves know you?
Do they collaborate with you?
What would happen in the life of Jacob if you weren’t there?
What would you like Jacob would improve in his life?
Etc

All these questions make perfectly clear what the function is of this specific self. It is an exiting experience when this self is questioned in such a respectfull way. The facilitator elaborates no pressure to change, just expresses her or his curiousity and wanting to acknowledge the presence and individuality of this particular self.
There are no bad or good selves. Although some can have a limiting impact on the life of a person, these selves don’t have all knowledge or capacities to exert in situation they don’t know. They selves are “designed” to prevent rejection or danger and are triggered by what they learned early in life. They’re doing the best they can.
During this questioning the facilitator engages with the particular self in an open and committed way. Compliments are exchanged. The presenting self is growing, becoming more open in an energetic way. The facilitator stays in his curious and acknowledging attitude.
The self experiences this acknowledgement and the facilitator stimulates reflection on its role in the life of the person. The self will express feelings and emotions, like a real person. Special attention is drawn to these emotions, what the self is feeling physically when this self is there. It is encouraged to be there, to express herself.
There will be no discussion, no opposing views from the side of the facilitator. The self is expressing without the limitations of its function or tasks. The energy builds up and after a while decreases. When the most urgent expressions have passed the facilitator asks if the self has some advice for the person, based on what is said. After that the facilitator thanks the self and asks the person to return to the original place where the person started.
Then the person, in this position, is asked to reflect on what happend and how it feels. Mostly people express surprise and that they now understand more about how this aspect of themselves works in daily life. They feel a little bit more distance and closeness together to this part. This self now has become a bit different to the person. In the future they can physically feel when this particular self is active.

Often, when a dominant self has presented itself in this way, a hidden or disowned self will pop up. The same procedure will be followed. Also the physical appearance of this side is very important to focus on, because that will be an anchor for the person to identify this self. When the disowned self will be able to express itself it means that it is no longer hidden and that the dominant and opposite self permitted this pushed away aspect of the person to come on stage. It enriches the person.
After such a repeated scenery, where different selves have presented themselves and the person has reflected on feelings and opnions, the person is asked to stand next to the facilitator who summarizes briefly in a neutral way what he saw and experienced himself.
This helps the person to become aware of the processes that played a role in the scenery. Mostly these facilitation processes have a great impact and automatically work through in daily life in a smooth way.
That is called transformation. The person will know and feel when a certain self is operating and wil learn to use it or to lessen its impact in daily life. This process of transformation is predicted and stimulated by the facilitator.

Usually such a session takes one and a half or two hours. Voice Dialogue isn’t repeated too frequently, because of the time these experiences take to ground in daily life. Transformation takes time. Mostly a few sessions are enough to give thorough transformation a chance.
So change is an aim but that is viewed as an autonomous process if the person gets aware of the selves that play important roles in their lives and if the awareness of the aspects that are pushed away, mostly beautifull qualities, increases.

What does this all have to do with the voices voice hearers hear?
These voices are not experienced as “ parts”! They are other people that speak to me, they have nothing to do with me! They can attack, they ruine my life. They forbid me things. I am afraid of them. They challenge everything I want. They tell me to do what I don’t want. They have full power of me! This “Voice Dialogue” is another therapeutic trick to convince me that my opinions are wrong. I want to get rid of my voices! They are my enemies.

You can’t deny that your voices are yours. You own them. You have a relationship with them. They came in your life at a difficult moment. There is no magical trick that you can get rid of them.You live with them. That is a reality. It is like a partner that will not disappear. You dislike him, but you can’t divorce. You didn’t ask for it. But it stays a pain in the ass. You want to fight it but it is too strong. So you better find ways that you can stand it, that you can improve your skills to relate to it.
In our experience voices want to be heard. To be listened to. They want to express themselves. Many voices are angry or even malevolent. Angry people want to vent their anger, to express why they are angry. Mostly anger connects to repression. You don’t get what you want. Angry people exaggerate. They were not able or permitted to express what they wanted. They were limited. Voices are ordinary people. They have feelings, motives, shortcomings, possibilities and opinions. They don’t use rational strategies but react out of frustrations.

An example from real life. Paul heard one voice. A very destructive voice. He told Paul to jump in front of the train. He commented all day on everything Paul did and thought. This voice was limiting Paul’s life extremely. Paul was very afraid of the voice. This voice was someone elses. Paul wanted it to disappear.
When the facilitator started to talk to this voice, he wasn’t nice. He expressed his anger and frustration with Paul. He told the facilitator that Paul deserved to die. He, Paul, was a whimp, the voice told. The voice was very frustrated with Paul who never stood up against injustice done to himself. Everybody played with Paul. He always, in every situation, stayed this anxious rabbit.
The voice told that he was angry at Paul all day. That had to be very tiring, the facilitator remarked. Indeed, the voice told he was fed up with this. He wanted Paul to be stronger but all his comments made Paul more anxious and avoiding. The facilitator mentioned that he understood the voice wanted Paul to become stronger. Was that correct? Yes, it was. Is the way you want to help Paul effective? No, Paul became weaker and weaker. When Paul becomes less anxious? If you support him, the voice said. Do you know how to do this? No. So the facilitator told about how he had learned to support anxious people. The voice was interested. Do you want to become his “Teacher”? Much less tiresome! This idea attracted the voice and from that time on he was changed from a destructive bullying voice to a supportive companion that tried to positively help him to express what he needed.
In the following sessions the facilitator helped the voice to improve his supportive qualities. Untill this day this voice didn’t return to his old nagging and criticizing attitude. Paul acquiered a true mate.

So in talking to the voices we essentially use the same non-judgemental attitude that is asked for in the Voice Dialogue practice. Of course we disagree with destructive attitudes! We don’t want people to being hurt.
But mostly there is ground for such an attitude, we want to explore these motives.
What happend in the life of the voice hearer that the voices appeared in such a negative way. We want to talk about what made the voice frustrated, we want to support the voice hearer to become more equal to the voices. We support the voice and the voice hearer they are both not happy in their entanglement. We aim at a better understanding between eachother and strive for improving the positive qualities of the voice hearer to cope better with life.

If there are positive voices too, we encourage support from them.

3. How does a session looks like?

The facilitator starts by asking the voice hearer how he and the the voices would feel about talking to them directly. She asks why the voice hearer and the voices find it a good idea or not.
The facilitator gives an extensive explanation about the method and its purposes. She informs the voice hearer that the voices need to agree to talk. If the voices don’t want than it is important to explain what the advantages can be.
The facilitator never forces the voice hearer or the voices to do this work.
All three parties: the facilitator, the voice hearer and the voices must agree and feel feel safe with it. If not we don’t do this kind of work. There are also other ways to work together and achieve a better relationship with the voices.
The facilitator gives examples of positive experiences with the method to stimulate the interest of voice hearer and voices. The facilitator acts as if she is talking to individual members of a continually present group, the whole group must give consent. Some voices don’t want and other do, then the facilitator asks what the consequenses can be.
The advantage we want to go for is that they understand each other better, that there will be a better relationship with the voices.
If the voice hearer wants to stay in control, the therapist can speak indirectly to the voices, asking questions that are formulated by the voice hearer as an interpreter. This can be a warming up or the only practice the voice hearer wants.

Before the start the facilitator initiates a discussion with the voice hearer about which voice he/she wants to speak first. Preferably start with a familiar but not too threatening one.

Then the facilitator asks the voice hearer to concentrate on the particular voice. When there is proper contact with this voice the voice hearer is asked to take another place in the room. The chair is placed there where the voice hearer thinks the voice is at the right distance, in the right position.
The facilitator welcomes the voice and tries to find a suitable attitude towards the prevalent voice that now has taken over the conversation.

Then the following questions will be asked:
Who are you? Do you have a name?
How old are you?
Does the voice hearer know you?
When did you come in the life of (name of voice hearer)?
(Directly adressing to the voice and talk about the person as another stimulates the voice to be present.)
What was the reason or your motive for you to come to (name)?
What were the circumstances at that time in the life of (name)?
What happened in the life of (name)?
What did you have to care for or do for (name) ?
What do you want to achieve for (name)?
What would happen with (name) if you would not be there?
How does (name of voice hearer) relates to you?
How is it to take care for (name)?
Would you like something to change in your relationship with (name)?

When these kind of questions are answered the facilitator thanks the voice for his explanations.
The common last question is:
is there anything you want to advice / suggest to (name)?

When the facilitator wants to finish the dialogue, she asks if the voice does not mind to close the talk and perhaps wants to have another talk another time. After the permission the facilitator greets the voice in the sense of saying goodbye to the voice, and can make another compliment.

We then return to the voice hearer in the beginning position. Back to the middle position.

The facilitator encourages reflecting on what happened. Often the voice hearer is surprised by what happened and starts to feel some distance to that particular voice.
The facilitator and voice hearer discuss how it feels having had this inetrview with the voice and what the voice hearer thinks about what the voice said. Probably another voice will come up. Then the same procedure is repeated, if the voice hearer wants this and dependent on the time that is left.

At closure the “Awareness” phase is initiated. The facilitator asks the voice hearer to stand next to her. Together viewing at the scene and the facilitator summarizes what she saw happening. Most voice hearers appreciate this. Thus they become (more) aware of the process that was going on. The facilitator is not judging what happened but merely tells what she saw.

The facilitator encourages the voice hearer to continue to make contact with the voices at home. And to think about other potentials for changing the relationship.
In advance questions to the voices for next session can be scheduled.

We trust that after such a process is initiated voice hearer and voices work things further out themselves. It is helpful to keep a diary of what happens. Sessions can also be summarized on paper afterwards by the voice hearer. Sometimes a voice hearer wants the session (video-) taped.

4. Attitudes

The voice-hearer is the owner.
At any moment the voice hearer can interfere in the ongoing process. The facilitator states that it is preferable (obligatory?) for the voice hearer not to disappear completely during the session. It is important to remember and to learn from it. He must stay in charge and take responsibility for that.

The facilitator is not the enemy of the voices.
In traditional psychiatry the approach that prevails is that one should get rid of the voices. You should not listen to the voices and distract yourself. The experience of voice hearing is often not positively acknowledged. Of course, it should be convenient that the voices’ influence on you will diminish. But sending them away is not our goal. Probably you come in a situation where the voice withdraw if they have “done their work”. If the underlying problem is solved.

Non-judgemental, relaxed:
Facilitators are trained not to judge, not to go in discussion with the voices. The facilitator won’t work with your voices if he is afraid of them. The facilitator must feel confident and relaxed, although it is an exiting endeavour to talk with voices.

The facilitator wants to get to know the voices.
The facilitator expresses curiousness in how you and the voices are doing together. Often the voices are not happy with the entanglement they are trapped in. The facilitator expresses empathy.

Respectful, but not submissive.
The facilitator has a respectful attitude towards what and who are presented. But they are firmly opposed to hurting someone. The facilitator wants to stimulate autonomy, not an obeying or destructive life style.

Match the energy of the voice.
The facilitator has some experience with her own selves. During facilitation she finds support from her selves that match best with the voice that is presented. E.g. when an anxious voice is in action, the facilitator seeks support from her own anxious selves, but stays in a neutral and aware attitude. In this way the contact with the voice can improve through empathy.

Assertive stance when challenging the voices, not argumentative.
The facilitator is capable of not being challenged into arguments. She stays firm but doesn’t take a moral standpoint.
Respect is the ethical principle.

5. When the Technique can be of Use

The technique will be particularly beneficial for those with prior experience of communicating with their voices.
Some voice hearers don’t know that they can communicate with their voices. They are too afraid for them or didn’t even think of the idea. Communication first has to become established, the facilitator can give advice. Some voice hearers can’t or don’t want to communicate with their voices. For those this method is not of use.
The person has to feel safe enough to do the exercise.
Again, the facilitator tries to help you at feeling at ease with this exciting and often new exercise. You stay in control, the facilitator focuses on that. You are responsible for staying present, the facilitator encourages it.
Time should be spent collaboratively with the voice-hearer for planning suitable questions to put to the voices.
It is fine if you know what you can expect. It is important that you plan what you want to achieve, that you express what your concerns are. What you want to learn or know.
The voice-hearer should be given the opportunity to use the chairs appropriately in response to what the voices have said; this may become easier over time.

6. When the Technique can be Dangerous

When the voice-hearer feels they may be unable to maintain control during the interview.
If the facilitator senses that, she asks you to return to the beginning position. She will not proceed with the talking to the voice. The importance of having some form of control is stressed. If you can’t stay in control the reasons ought to be discussed.
It is necessary that the voice hearer and the facilitator have confidence that the voice hearer can take over at any moment. If necessary the facilitator doesn’t proceed the talking to the voices untill both the voice hearer and the facilitator are convinced that control is possible next time. Other work should be done beforehand to pave the way.

If there is a poor understanding between the interviewer and the voice-hearer. If this is the case it should be put on the agenda immediately.
Doing this kind of work together demands proper understanding. Things that hinder understanding must be discussed and cleared, in order to be able to proceed. Both facilitator and voice hearer are equally responsible for that. The most hindering aspect on the side of the facilitator is when she aims too much in the direction of change.

When the interviewer responds inappropriately to the voices, in either tone or content.
This seems obvious, but if the facilitator isn’t aware (facilitators are human beings, not perfect) the voice hearer should mention that. If a voice expresses anger towards the facilitator it must be dealt with properly. Often there is a good reason for it and that needs to be explored.
The facilitator shouldn’t take remarks too personally.

When debriefing does not take place.
The voice hearer must leave the room at ease, debriefing is for checking that. If the influence of the voice is still too strong when time is up, time should be taken in order to make the voice hearer at ease.

When the chair is not clearly used.
Sometimes voices are competing with eachother in order to get space. The facilitator must pay attention to that, negotiate and set a proper agenda for all of them.

When talking to the voices becomes a goal in itself
Some voice hearers become so fascinated with this procedure that it becomes a game instead of a mean to achieve certain goal (e.g. autonomy, better relationship).

7. Goals

Exploration of the voices’ underlying motives.
To help the individual feel more detached from the voice-hearing experience.
Enhancing a more healthy dialogue.
Solving conflicts.
Gather information about the voices and the role they play in actual life and in the life history.
Discover what kind of action is required.
Start an internal process of change.

8. Examples

Karen is a 28 year old woman.
She had been in psychiatric hospital for 4 years. Most of the time in the seclusion room, to prevent her from hurting herself. The voices told her to do so. She was heavily medicated but it didn’t make the voices go away or diminish their impact on her. At a certain moment she decided not to hurt herself anymore. Then she could come out of the hospital and live on her own. She married. Although she lived independently the voices restricted her life. Almost all day they were talking to her. Criticising, commenting and telling her to hurt herself, which she didn’t. It costed Karen a lot of energy.
In the first interview it appeared that Karen heard four male voices. They all where negative towards her and her actions. Karen agreed that the facilitator talked to the voices.
The facilitator followed the above mentioned procedure. The voices subsequently vented their anger with Karen and all four told about the history of their relationship with Karen.
The story that came out was the following. The voices came in the life of Karen when she was approximately 4 years old. Karen was lonely and had experienced awfull things. The voices than supported Karen. They helped her to survive. As a child and adolescent she accepted the support of the voices. They had a good relationship with Karen.
When Karen was 20 years old she became member of a religious sect. She felt happy and safe in that community and at a certain moment she told about her voices. The other members of the sect expressed their opinion that the voices were instruments of the devil and urged Karen to get rid of these voices. A fight between Karen and the voices was initiated and the voices transformed in very negative ones.
This was the beginning of Karen’s journey in psychiatry.
The relational history that was depicted Karen had forgotten. She wasn’t aware anymore of what happened, so absorbed she was by the negativity of the voices. Nobody discussed the history of the voices with Karen. In the psychiatric clinic professionals were also trying to help Karen to get rid of the voices, which didn’t succeed.
Once the voices expressed their frustration it became obvious that their original intent was to support Karen. They expressed this frustration and Karen could grasp this. After the session Karen started intensive dialogues with the voices at home. In a more constructive way.
At the next session a month later two voices had disappeared.
Two voice dialogue sessions were enough to restore the relationship between Karen and her two remaining but now positive voices. It appeared that Karen developed to a autonomous person who wasn’t needing that much support anymore.
The voices disappeared and stayed away untill now, years later. Karen dared to taper down the medication. She wrote that she now hears only one supportive voice that she doesn’t want to leave and leads a happy life with almost no medication.
So the talking to the voices gave way to transformation of the voices back into the original supportive voices. At last Karen didn’t need them anymore and they could withdraw.

For more information about the voice dialogue method we recommend the following sites:
Institute for Transformational Psychology (Netherlands)
The objective of the Institute for is to bring Transformational Psychology to the attention of more people and to advance its use. To achieve these goals the ITP organises lectures, training’s, and an educational program. The methods and techniques the ITP uses are not a target in itself, but instruments to achieve awareness and integration of a number of important principles of transformation.

Voice Dialogue International
The website of the originators of Voice Dialogue, Hal and Sidra Stone. Voice Dialogue, Relationship, and the Psychology of Selves can be used by individuals for their own personal growth or by professionals in the fields of psychotherapy, counseling, personal coaching, and business and organizational consulting. Their psychospiritual approach to consciousness and transformation includes an in-depth study of the many selves or subpersonalities that make up the psyche, as well as work with dreams, archetypal bonding patterns, and body energy fields.