Voice dialog is a therapeutic technique devised by the psychologist Hal Stone and his wife Sidra Stone. They elaborated on a theory of interpersonal relationships originally developed by Eric Berne. The basic principle of voice dialog is a person may have several different “selves,” one of which is “primary.” The subordinate selves comprise different aspects of the person’s whole personality and thus may be considered a kind of “internal family” of different outlooks and perspectives. While to some extent this community is democratic the “primary self’ remains the one in control. Voice dialog is an experiential therapy. It aims for shifts and changes in the client’s concept of self through a process of discovery, not introspection or intellectualization.
I recently participated in a voice dialog session. The purpose of this note is to describe that experience from a practical and operational standpoint, not to elaborate on the theory of voice dialog or transactional analysis. The session began with the client declaring a part of his/her self the client would like to enact. The part might conceal an aspect of the client’s personality, which has been the subject of therapy. The therapist invites the client to physically move his/her chair to a different location in the room. The purpose of doing so is to emphasize the client’s transition into inhabiting a different role. The therapist starts by asking questions to the effect: “Who will we hear from?” “Whom am I speaking with?” “Who are you; what part of (insert client’s name) are you?”
The client then responds as if the role the client inhabits was the client’s entire personality interacting with the therapist. The client does not relate previous historical incidents experienced by the client (or by the part) from the client’s past. Rather the client becomes the part in the present and relates the part’s current sensations and feelings. The client must disconnect from his/her whole personality and assume that of the part. The client might go so far as to match words and tone of voice that would be appropriate for the part, thus enacting the past, not just narrating or describing it. This is a tricky distinction and may take some practice to do correctly.
The therapist has a reciprocal burden. The therapist must address the part directly, typically by using the pronoun “you.” The therapist does not address the client. Rather the therapist addresses the part as if it was the client’s entire personality. For example, if the part is a 10-year old child, then the therapist might imagine he/she was talking to that person on an airplane. The therapist encourages the part to share its point-of-view by asking questions and making paraphrases. The therapist can ask about the part’s role; its relationship to other parts inhabiting the client’s personality; and which other parts the client has, which support it. Another technique the therapist might use is to ask a “history question” of the form, “When did you first appear?” or “when did you join (insert client’s name) personality?” The client should stay with the part during the entire session, which may last from 10 to 15 minutes. The therapist does not show bias or try to change the person inhabiting the part.
The therapist should conclude by asking the part, “is there anything else you’d like to say?” The therapist then directs the part to move his/her chair back to its original position, and the client assumes his/her original identity. The therapist then solicits the client’s reaction and invites the client to comment on the experience. The client might assume an “awareness position” by standing behind the therapist as the therapist describes what just happened. The client then goes back to the center and reacts to what the therapist said. At this point the therapist can repeat the exercise and hear from another part, or resume regular therapy with the client.
Here are some thoughts I had at the conclusion o the exercise. First, voice dialog clearly would be inappropriate for persons with dissociative identity disorder as it might exacerbate the pathological separation of their various parts. Second, as I observed it is difficult for the client to say in role and for the therapist to address the client in role. Third, it is unclear where the part comes from. Does it derive from an issue currently being experienced by the client, or is it just descriptive of some aspect of the client’s experience? In order to be effective it seems as though the former should pertain. There must be something in the part that is expressive of the client’s current mental status and issues. Then, however, it seems the therapist and the client are skirting around them rather than addressing them directly, which may lack as much therapeutic benefit.
Interestingly voice dialog is different from gestalt therapy as developed by Fritz Perls because the parts do not engage in dialog with each other, which is the hallmark of Perls’ technique. Rather the outcome goal is for the client to become intimate with his/her internal parts and explore their relationship to the “primary self.”