Hearing voices as a form of inner dialogue. Using the dialogical self to turn a critical voice into an ally

ABSTRACT

In Western culture, “hearing voices” is often considered a symptom of mental illness. After reinterpreting this phenomenon from perspectives that emphasise the socio-cultural aspects of the construction of these voices, this paper describes a case report involving a psychological intervention divided into six phases. The aim is to challenge the dominant narratives that stigmatise the experience of hearing voices, and propose alternative meanings that can improve the hearer’s ability to manage the voices by converting them from a disease into a personal and relational resource. Using the metaphor of an “inner dialogue”, we show how changes in the client’s interpretation of the voices, and way of relating to them, can be co-constructed by the client and the therapist. The paper concludes with some critical reflections on the medicalisation of mental distress, highlighting the importance of expanding our understanding of the experience of hearing voices, not only in clinical terms, but also on a social and cultural level.

KEYWORDS:

• Hearing voices
• social construction
• dialogical self
• therapeutic practices
• case report

Acknowledgments

The authors would like to thank Frances for expressing her point of view on the voices and her experience of psychotherapy, which helped writing the present article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. The fourth author conducted the psychotherapy with Frances. The first author devised the present approach and served as supervisor. The second and third authors contributed to the drafting of this article.

Additional information

Notes on contributors

Diego Romaioli

Diego Romaioli, PhD, is Researcher in Social Psychology at the FISPPA Department, and Psychotherapist at the SCUP center, University of Padua. His research interests are in social psychology, focusing on change, motivated irrationality, ageism, volunteerism, qualitative and generative methods, psychotherapy, multiplicity and relational processes in the construction of the self.

Giacomo Chiara

Giacomo Chiara is a psychotherapist, and holds a PhD in Psychological Sciences. He is currently doing his second PhD in Social Sciences at the FISPPA Department, University of Padua. His research interests focus on mental health, counselling and psychotherapy, dialogical-self theory and multi-being, intercultural dialogue, migration, social psychology and literature, qualitative research.

Elena Faccio

Elena Faccio is Associate Professor in Clinical Psychology at the FISPPA Department, University of Padua. She is interested in investigating the issues of identity and change, both from a theoretical and a clinical point of view. She is the author of numerous researches and of three volumes on bodily and alimentary diseases in the perspective of the dialogic self and interactionist approach.

Roberto Miglietta

Roberto Miglietta, psychologist and psychotherapist, is member of the Italian Society of Interactionist Psychology. His interests are in clinical psychology and psychotherapy; he is currently engaged in several projects, also collaborating with the FISPPA Department.