HE.S.T.A.F.T.A. - Scientific Society of Mental Health Professionals

MANY INNER AUTHORS: PRACTICAL COMPREHENSION OF THE “POLYPHONIC SELF” IN PSYCHOTHERAPY TRAINING.

  • Athena AndroutsopoulouPhD. Psychologist-Psychotherapist, Training and Research Institute for Systemic Psychotherapy, Athens, Greece
  • Polyphonic self
  • new voices
  • meta-position
  • training exercise

Summary

In this paper we present an exercise used as part of psychotherapy training to increase practical comprehension of the notion of “polyphonic self”. Trainee therapists learn to identify various voices in autobiographical interviews, diaries and letters based on the methodology that William Stiles applies in analyzing therapy transcripts. Equipped with this knowledge, trainees can help strengthen  ‘new voices’ in clients, and assist in the emergence of at least one reflexive voice or meta-position in their narratives; this is a voice that makes space for inner dialogue and supports the continuous struggle of the many inner authors for narrative coherence.

Key - words : Polyphonic self, new voices, meta-position, training exercise.

“If you hear a voice within you say ‘you cannot paint’, then by all means paint and that voice will be silenced.”
Vincent Van Gogh

Context

Presented is an exercise designed and used in the training of systemic therapists. Its aim is to increase understanding of the notion of polyphony in narratives.[1] A variety of training exercises related to the dialogical and polyphonic self have been proposed by Reed (2010), Straton (2007) and Tseliou (2007), among others.

Polyphony and the dialogical self

Most researchers interested in the notion of dialogical self are inspired by the ideas of Bakhtin, a Russian scholar who studied the literary work of Theodore Dostoevsky (TD). Bakhtin suggested that in TD’s  novels the ‘authors’ are many and not just one (Bakhtin, 1973, 1981). Each of these ‘authors’, the central characters in a story, has his own voice and expresses his own opinions and worldview. Likewise, the client consists of more than one inner authors. Many inner authors are into a dialogical relationship which creates a complex narrative organization of the self. Persons are able to narrate their stories from many different positions in time and space. In terms of time, the self as author “can imagine the future and reconstruct the past” (Sarbin, 1986, p. 18), and therefore occupy different temporal positions. In terms of space, the self consists of many parts or voices that occupy different spatial positions, which are also in a dialogical relationship with the positions of other selves (Hermans, 2004).

The idea that the self is polyphonic has been demonstrated by clinical observations and research in psychopathology, as discussed by Hermans and Dimaggio (2004). The dissociative identity disorder (previously known as multiple personality disorder) is one expression of the pathological side or collapse of a dialogical self. There, different voices do not recognize each other as occupying different spatial positions, they are not in dialogue and there is no collaboration and interaction between them. In a functional dialogical self, voices act as characters in an evolving narrative and each stands up for its own space. The dominance of any voice over others depends also on external voices, on the history of each person, on the collective stories of families, groups and communities, and on the cultural environment a person has been born into and belongs to (Hermans, 2004).

In the wider discipline of systemic and family therapies, contemporary dialogical approaches such as those of Harlene Anderson and Harold Goolishian, Tom Andersen, Karl Tomm, and Jacob Seikkula (see Hoffman, 2002; McNamee & Gergen, 1992) emphasize the importance of dialogue which opens space for the unsaid. They also note the importance of internalizing an external dialogue which offers new perspectives and allows for “new” inner voices to be heard. Most important is the work of Peggy Penn, who talked of the dialogical self inspired mainly by the notion of narrative multiplicity (Penn & Frankfurt, 1994) as discussed by Gergen (Gergen & Kaye, 1992). Penn placed emphasis in the importance of turning a negative inner dialogue, dominated by a critical voice, to a more positive one.

Identifying inner voices

In previous papers we have demonstrated ways to identify various voices, dominant and silenced, using a combination of narrative tools: written self-characterizations of self and family in the present and in the future, discussion about a favorite novel/film/theatre play, narration of childhood recollections (Androutsopoulou, 2014; see also Androutsopoulou, 2001 a,b, 2013). Various voices can also be identified in dreams (Androutsopoulou, 2011). Each voice constitutes a theme that can be tracked through the self-narration. Dominant voices constitute restricting themes whereas ‘new voices’ constitute more liberating themes and support a multiplicity of perspectives.

Research case examples based on transcripts of sessions combined with audio analysis have shown that the inner voices of clients alternate (Stiles, Οsatuke, Glick, Mackay, 2004). In one example, the researchers identified at least two voices in a female client’s narration, a dominant which they named “ the caretaker voice ” (and marked in bold letters) and a weaker voice “ the care for me voice ” (which they marked in italics). In another example, the researchers identified four voices, roughly categorized here as: a victim voice, a self-confident voice, an angry/hostile voice, a need for care/depressed voice (Osatuke, Gray, Glick, Stiles, Barkham, 2004). Stiles and his associates have also monitored and recognized different vocal qualities in the various voices (change of tone and vocabulary). So in their view, “voices are more than a metaphorical description of internal multiplicity: they can be literally heard in a person’s speech” (Osatuke, Gray, Glick, Stiles, Barkham, 2004, p. 252). The identification of different voices and their alternation- inspired by Stile’s methodology – is the subject of the training exercise presented below, designed to increase the understanding of the notion of the polyphonic self.

Training exercise

Autobiographical interviews

In the training of therapists and as part of their familiarization with the notion of the polyphonic self, we use archive material of transcribed autobiographical interviews with clients. Trainees are given the following instruction:

“In the segment transcript of the autobiographical interview found below, ‘Mary’, 45 years old, describes the situation at home and the relationship with her mother, following the separation from her husband. Working in small groups, try to identify at least three different voices of Mary’s. Read the transcript aloud, as if you were rehearsing a play, and change style and tone of voice to match the content. Then, name the voices you have identified”.

Trainees usually identify the following voices: a  passive  voice (in bold letters), which is scared, gives in and justifies others, and a more  _assertive _ voice (in italics) which gets upset and angry. A more detailed analysis supported by audio material, would probably reveal two separate voices (a scared and a giving-in voice) in the place of one passive voice. But for reasons of training and facilitating application to clinical practice, we prefer to analyze texts in a manner that is as simple as possible, naming voices as opposite characters (Hermans, 1996). Trainees usually identify an additional reflexive voice (underlined) of Mary’s, which takes personal responsibility of actions.

  • **“I’ve never had, never felt her [my mother’s] love, never felt any tenderness, never heard a kind word like ‘well done my child what you’ve done was good’. She was always…, I was afraid of her. I’ve always felt fear for this woman…, though I never stopped loving her deep inside… I was afraid of her […].  ** _She really gets to me, because she always says I do not love her, I do not care for her, I do not want her, and I tell her “Fine, if I didn’t want you would you still be here? Wouldn’t I have put you into a nursing home and have my home all to myself?” _ **She doesn’t understand this and it hurts me ** […].  There are times when I think to myself “Couldn’t she just die to give me some peace?” Now my children want to leave home. “We can’t take it anymore”, she says to me, my young daughter especially, “can’t take it anymore mum, can’t bear to have her in the house.” Two days ago I said to her, “mum, you should go to that small apartment and let us live here on our own, my husband has left I won’t bear losing my children too.”  […]  My mum is old, you know, she is 90, she is not well, she is very ill, she’s got some cysts right here, she can’t get up […] so I gave her my bedroom. […]   When I go to sleep at night I say to myself “did I deserve this, not even a room of my own?”

  • […] I believe that if I didn’t have my mum with me, he wouldn’t have got tired, that we shouldn’t have divorced, we should have been together […]. In a way I can understand why he leftOf course I don’t understand his treating me like that, I didn’t deserve this treating … that he found another woman and broke his home. […]  I want others around me to be smiling and happy and I try to make this happen by putting my self aside many times, and I always did this […].  I don’t know though, I don’t know if I would be happy if I changed that, I don’t know.   Sometimes I tell myself If I were ever born again I would rather be mean, take care only of myself,   but… Would I be happy? If I were different, mean, strict with people?...”

** Famous diaries **

For the purposes of training and familiarizing trainees with the identification of various inner voices we use additional material, such as segments from autobiographies and diaries of famous intellectuals. In one such exercise, the following instruction is given:

“The segments below come from the diary of Virginia Woolf (see Bell, 1984). The famous author suffered from manic-depression with a series of psychotic episodes. These segments are from the last days of her life before she committed suicide by drowning herself in a river close to her country home in 28th March 1941. Working in small groups, identify at least two inner voices and note their alternation as the day of her death was nearing.”

Trainees identify one voice they usually name “the  pessimistic  voice of loneliness and resignation from life” (bold letters), and another which they name “the  optimistic  voice of fighting for life” (italics).

_   1.   _ Sunday 26 January 1941

_A battle against depression, rejection […] routed today (I hope) by clearing out kitchen […]. _ § [2]  _This trough of despair shall not, I swear, engulf me. _ The solitude is great […] the house is damp. The house is untidy.  But there is no alternative. Also, days will lengthen. What I need is the old spurt […]. I begin to dislike introspection. Sleep & slackness; musing; reading; cooking; cycling […]. This is my prescription.  §   **Its the cold hour, this, before the lights go up. A few snowdrops in the garden. Yes, I was thinking: we live without a future. Thats whats queer, with our noses pressed to a closed door. ** _Now to write, with a new nib, to Enid Jones _ [a friend of hers] (p. 354-355).

[Three more entries in-between]

  1.    Sunday 8 March 1941 [entry before last]

[Describes joyful scenes from Brighton]. §   _No: I intend no introspection. I mark Henry James’s sentence: Observe perpetually. Observe the oncome of age. Observe greed. _ Observe my own despondency  […].  _By that means it becomes serviceable. _ Or so I hope .  _I insist upon spending this time to the best advantage . I will go down with my colors  flying . This I see verges on introspection; but doesn’t quite fall in. Suppose I bought a ticket at the Museum; biked in daily & read history. Suppose I selected one dominant figure in every age & wrote round & about. Occupation is essential. And now with some pleasure I find that its seven; & must cook dinner […]. _ **§ ** _[…] Oh dear yes, I shall conquer this mood. It’s a question open sleepy, wide eyed at present-letting things come one after another. Now to cook the haddock _ (p. 357-358).

3.   Monday 24 March 1941 (last entry)

[Describes a visit to an old neighbor who has lost her two sons in the war. She was knitting and told them she had taught dressmaking in the past ]. Sitting there I tried to coin a few compliments. But they perished in the icy sea between us. And then there was nothing. § A curious sea side feeling in the air today. It reminds me of lodgings on a parade at Easter. Everyone leaning against the wind, nipped & silenced. All pulp removed. § This windy corner. And Nessa [her sister] is at Brighton, & I imagine how it wd be if we could infuse souls. §   _[To write] Octavia’s story [friend and her doctor]. Could I englobe it somehow? English youth in 1900. _ **§ ** Two long letters from [names of friends].   I cant tackle them , yet enjoy having them.  §   L. [her husband] is doing the rhododendrons…  [last phrase in the diary] (p. 359).

Recognizing the identity of dominant inner voices

A common denominator in various psychotherapy approaches making use of the notion of dialogical self, is the importance placed by therapists in their clients’ negative self-criticism, the dominance of a critical voice in their inner dialogue (Hermans & Dimaggio, 2004). (See also Firestone, 1986, for a connection between a critical inner voice and suicide).

Referring to one of his female clients as an example, Schwartz (1987) has pointed to the existence of inner voices that are in conflict. The client, who had bulimia, described the conflict of inner voices in her head, a “cacophony” which confused her. With the invitation of her therapist, she identified the voices that usually took part in these inner conflicts. One such voice was very critical of her appearance, another was very critical toward her parents, another was the voice of despair, and yet another encouraged her bulimia. Schwartz conceptualized the idea of an Internal Family System, a system which relates and corresponds to the external family system. In this light, therapists and clients can do more than identify various inner voices, they can also recognize their identity.

‘Old’ voices, ‘new’ voices

Our trainees are taught that therapy, irrespective of approach, can be seen as a process of gradual assimilation of silenced or weak voices, as Stiles (1992) has suggested. These ‘new’ voices are initially experienced as problematic, in the sense that a person rejects them because he experiences them as  strange, as a cause of intense emotional pain or tension. These new voices are the positive exceptions, the “unique outcomes” (White & Epston, 1990) or the “innovative moments” (Goncales & Ribeiro, 2012) in a person’s narrative. As they are gradually assimilated, these voices become a conscious part of the self, supporting and enriching inner dialogue.

Peggy Penn had noticed that it is easier for new voices to speak out in writing. By having these voices speak out, a negative inner monologue dominated by a critical voice can be turned into a more positive inner dialogue. Penn encouraged her clients to write letters, mostly to other family members, especially in cases of trauma or chronic illness (Penn, 2001). In our therapy work we find helpful to study spontaneous letters sent to the therapist, especially by those clients who find it difficult to express themselves orally.

Training exercise (continues)

** Letters **

In the following example, 30 year old Peter sent a series of e-mails to his therapist in the course of eight months. In these e-mails he appears to gradually recognize the identity of his inner critical voices, and very hesitantly begin to doubt that he is “insufficient by nature and nothing can be done to change that.”

Analyzing this material, trainees are asked to identify more than two or three voices. They usually come up with the following: The voice of  problematic self  and resignation from life (in lower case bold letters), the voice of  functional self  and commitment to life (in italics), the voice of STRICT SELF-CRITICISM (in upper case), the voice of  **CRITICISM FROM PARENTS ** (in uppercase bold letters), the voice of  _CRITICISM TO PARENTS _ (in uppercase italics), the compassionate reflexive voice of adult Peter toward Peter-as-child (underlined).

1.    **All these thoughts are bothering me again, in fact they’ve never stopped! I was wondering whether I’m crazy and I hear voices that make me think all these things about myself. No matter how much I sleep I feel tired, and so old. […] Yesterday I was all tightened and I burst out on my younger brother. ** I AM SO TERRIBLE! WHY AM I DOING TO HIM WHAT THEY’VE DONE TO ME?   He was working at our store all day and wanted to leave earlier to meet his friends, and I shouted at him and wouldn’t let him go, and I even swore at him. He left and came back five minutes later because his friends had left by then, and he said: Happy now? My friends have gone! Why do you speak to me like that?” I was a wreck!  WHAT HAS HE DONE TO ME, WHY DO I TALK TO HIM IN SUCH MANNER? WHY DO I WANT HIS LIFE TO BE AS MISERABLE AS MINE IS? WHAT SORT OF A BROTHER AM I..?”

2.        **I cannot control myself at all, one moment I am all cool and fine and in a few seconds I feel I’m sinking, these thoughts dominate my mind, the complaints about my life. ** I CANNOT UNDERSTAND WHY I’M DOING THIS TO MYSELF. ONCE I SEE SOMETHING GETTING BETTER, I INSTANTLY MAKE MYSELF FEEL AWFUL. WHY AM I DOING THIS? IS IT THAT I CANNOT BEAR TO SEE MYSELF BEING HAPPY? CAN I ONLY BEAR TO BE UNHAPPY AND FULL OF GUILT?  It seemed odd to me when two nights ago I functioned like a normal person, I went out, had a drink, relaxed, danced, I was with people that accepted me. I wish I could function like this every day.

_3.     _ Lately, some memories come from the past and my childhood and school years. I remember when I was little there were so many nights when I could not sleep. I remember covering up my head, from bottom to toe, legs, arms, nothing left out. I don’t know what frightened me that much, so many nights of fear, I was afraid to open my eyes in case I saw something, the slightest noise scared me. I was holding my breath and tried to breath as quietly as possible. I was afraid to breath. So many nights of agony for such a small kid…I don’t know why. Was it that I was afraid that something was out there beyond my covers or was it that I did not want my parents to hear me and understand I am awake and beat me up. I don’t remember. When I was a bit older, in high school, I don’t remember the exact age, I spent a big part of my life thinking that one of my parents would die, sometimes my dad sometimes my mum. Of course there was the period when I thought I myself would die, and then I remember phases of depression, my heart was aching. My mum took me to some doctors, a cardiologist I think, but that was it, they couldn’t think of anything further than that… What agony! What fear! Since the time I was little. Why? Everything scared me since then. Later, I never studied muchMY PARENTS TOLD ME I SHOULD GO TO A TECHNICAL SCHOOL, I WOULDN’T PASS MY EXAMS OR GET INTO COLLEGE ANYWAY.   GREAT ENCOURAGEMENT, RIGHT???   Well, of course there was no chance I would go anywhere because I was afraid of making any kind of changes and of meeting new people.”

_4.       _ Every time you answer my e-mail you give me courage, I’m fighting inside , OR AT LEAST THIS IS WHAT I SAY I DO,  but today I suffer a lot. Last night I couldn’t sleep. To tell you the truth I have started thinking that I want to die or simply cease to exist.  BUT I DON’T HAVE THE GUTS TO DO SOMETHING, I CAN’T FIND THE COURAGE EVEN TO DO THAT.  Some times when I walk in the street I hope I’ll be hit by a car and be redeemed.

5.    _HOW TERRIBLE MY PARENTS ARE! YOU WERE RIGHT, THEY WILL NEVER CHANGE, NOTHING WILL CHANGE HERE, I AM THE ONE WHO NEEDS TO CHANGE, AND DO SOMETHING FOR MY LIFE. IT WAS NOT SO MUCH MY FATHER’S WORDS AS WAS HIS MANNER WHEN HE ASKED ME TO GET UP FROM BED AND HELP HIM, THE TONE OF HIS VOICE, I CANNOT DESCRIBE HOW IT RINGS IN MY EARS WHENEVER I HEAR HIM SPEAK OR MY MUM. IT’S A WHINING-DEPRESSING-AUTHORITARIAN TONE AND MANNER THAT MAKES YOU FEEL GUILTY FOR BREATHING, WHEN YOU SHOULD HAVE BEEN BURNING IN HELL OR BE WHIPPED OR BE THROWN SALT ON YOUR WOUNDS OR BE PUNISHING YOURSELF SIMPLY FOR LIVING, RESTING OR RELAXING, _ WHEN OTHERS, ALL OTHERS, NOT SO LUCKY AS YOURSELF!!! HAVE NOTHING COMPARED TO YOU!!! AND YET THEY’VE MANAGED TO DO SOMETHING WITH THEIR LIVES, THEY MOVED ON, THEY GOT THROUGH, WORKED HARD, MADE MONEY, STUDIED, HAD FAMILIES, WHEREAS YOU!!! YOU DID NOTHING, A WORTHLESS EGOTIST THAT’S WHO YOU WERE AND WHO YOU STILL ARE, YOU ONLY THINK OF YOURSELF….

These words ring in my ears for so many years…

I GET OUT OF BED MAD WITH ANGER, BUT THE ANGER EVAPORATES AFTER TAKING TWO STEPS. LATER I BEGIN TALKING TO MY MUM, TALKING, TALKING, SAYING THEY MEAN NOTHING TO ME AND THEY SHOULD EXPECT NOTHING FROM ME, ABSOLUTELY NOTHING. MY MUM’S RESPONSE“WE NEVER EXPECTED ANYTHING FROM YOU ANYWAY, WE’VE SEEN WHAT YOU’VE MADE OF YOURSELF ALL THESE YEARS, HOW FAR YOU’VE GONE! YOU CANNOT COME TO TERMS WITH YOURSELF AND BLAME US AND OTHERS FOR IT.”  I COULD NEVER COME TO TERMS WITH MYSELF AND I NEVER WILL COME TO TERMS WITH MY BLOODY LIFE, AND EVEN IF I DIE TOMORROW, I TELL HER, I DON’T GIVE A DAMN…”

It seems that whenever Peter got angry at his parents, they got angry and critical toward him instead of soothing and encouraging him. Peter internalized the parental criticism straight forwardly, and this self-criticism was almost automatically turned into self-destructive thoughts.

Returning to trainees, they are encouraged to apply the idea of identifying various voices to the therapeutic conversation, and help clients recognize the identity of their voices at any given moment. Eventually, clients develop at least one reflexive voice, which creates space for inner dialogue and contributes to the struggle of the many inner authors for narrative coherence.

Emergence of a reflexive voice

Ultimately, in Herman’s view, psychotherapy is not only about helping various inner voices emerge or only about supporting weak or even silenced voices to speak out; it is also about assisting  the client to adopt at least one reflexive voice or meta-position. A meta-position provides an overarching view of other positions and facilitates the creation of dialogical space (see also Goncales & Ribeiro, 2012). It also contributes to the many inner authors’ constant struggle for narrative coherence (see also Androutsopoulou, Thanopoulou, Economou, Bafiti, 2004).

Training exercise (continues)

** Letters (continues) **

Letters written at the closure of a therapeutic process can help trainees, and in fact any therapist, evaluate together with clients any progress made, based on the space that a reflexive voice or meta-position occupies in their letters.

The letter below was written by 70 year old Mark, at the end of a three year collaboration with his therapist (see also Androutsopoulou, 2014). In this letter he mentions his critical voice, calling it “the voice of logic”, but also his more tender voice, calling it “the voice of my heart”. The latter voice emerged in therapy, but he comments that in certain areas his strict voice still dominates contrary to his wishes. That voice, which is aware of the existence of other voices, which notices their presence in various contexts and declares its wishes, is a reflexive voice or meta-position. In the previous example of Peter, a reflexive voice had begun to emerge, but –till that time- it was associated only to Peter-as-child (his temporal position in the past). In Mark’s case, the reflexive voice is compassionate toward all of Mark’s positions in time and space, toward the polyphonic self in its entirety. It is in this reflexive voice (underlined) that Mark narrated his recent history:

“Five years ago, at age 65, I left home and  my wife. I left then because, as my life cycle was coming to a closure and my heart condition was deteriorating, I panicked at the idea of not taking myself and my destiny into my own hands. […]. When I first left home things were hard because I did not know how to take care of myself. But my biggest problem was loneliness and anxiety about my health. I gradually managed to overcome these fears and I even fantasized about a new life, I dreamed of buying a new house , write poems and start a new relationship. Three years have passed since I started therapy. I have not bought the country house I desired, though I still desire it. I have definitely not become a poet. What’s worse, I have never expressed my feelings to the woman I loved.  One voice is saying that I have no right dreaming at this age. In fact, my health has deteriorated and new problems have been added on top of old ones. Now at 70 I am officially an old man. What a shock this is! But during these years I learned ways to feel joy and happiness. I learned to speak with the voice of my heart and say “I love you” to my children, that I had never said before. I learned to love my friends more, and other people, and not to judge them with strictness. But mostly, I learned to love myself more, show myself some compassion and appreciation, even admiration! I am more peaceful now and more satisfied with my life. It’s only that sometimes, when I sit alone at night, I ache for having listened to the voice of logic and for not fighting harder for my dreams. But, I promise, I will not give up trying!”

Conclusion

The training exercise presented here makes use of written material (autobiographical interviews, diaries of known intellectuals, clients’ letters), which is analyzed based on the methodology which Stiles and his associates use in the analysis of therapy transcripts. The aim of the exercise is to help practical comprehend the notion of polyphonic self, as put together mainly by Hermans. Trainees learn to identify different inner voices, old and new, and to evaluate together with clients the progress made in therapy. The evaluation is based on the emergence of reflexive voices, which can be compassionate toward the polyphonic self in its entirety (see also Androutsopoulou, 2014).


FOOTNOTES

[1] This work takes place in the Training and Research Institute for Systemic Psychotherapy (www.logopsychis.gr), Athens, Greece. Mental health professionals are trained in an enriched systemic perspective calledSANE-System Attachment Narrative Encephalon® (see Androutsopoulou, Bafiti, Kalarritis, 2013). The focus of the present paper is on the narrative-dialogical dimension of the enriched perspective (Androutsopoulou, 2003; Androutsopoulou, 2005).

[2] §= paragraph

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ARTICLE 4/ ISSUE 5, October 2014

Systems-Centered Training with Couples: Building Marriages that Work

Susan Gantt, Ph.D., ABPP, CGP, FAGPA, FAPA is the Director of the Systems-Centered Training and Research Institute. She is a psychologist in private practice in Atlanta and works for Emory University School of Medicine where she coordinates group psychotherapy training. She trains, supervises and consults in the practice of SCT in the USA and Europe, Yvonne Agazarian, Ed.D., CGP, DFGAPA, FAPA, developed the Theory of Living Human Systems; she founded the Systems-centered Training and Research Institute and works as a therapist, consultant and trainer in Philadelphia, Pennsylvania where she teaches, trains, and supervises Systems-Centered therapists internationally
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