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

Abstract

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.