Dialogical engagement with voices: A single case study

This paper raises the possibility that a dialogical, or discursive, model of human experience may be useful in helping someone who experiences verbal hallucinations. The model regards verbal hallucinations as a variety of inner speech with dialogical properties. The explication of these properties in the context of a personal narrative allowed the individual to engage in dialogue with the voices, through the medium of a new, supportive and positive voice. This process made it possible to introduce moral responses to distressing and potentially dangerous imperative verbal hallucinations, through the mediation of the new voice. Her dialogical engagement with this voice enabled her to deal effectively with troublesome voices, and was a powerful source of self-esteem. We briefly present the theoretical perspective underlying this approach, and compare and contrast the approach with cognitive-behavioural techniques.