Dialogical interplay between voices during therapy fosters the increase of self-reflective skills. Most patients come to therapy because they do not understand their symptoms, cannot control them and are frightened of them. The patient's partly disowned experiences lie buried in these symptoms that can be regarded as meaning-laden signs. They "want to be heard", to use Bakhtin's expression. They act like muffled voices in situations that stir up past dialogic and internalized events, usually adverse or traumatic. This active, polyphonic nature of symptoms can be employed in psychotherapeutic dialogue. The therapist's responsive understanding singles out some of these 'voices', bringing them into the focus of joint attention and reflection. Thus, the self-reflective processes in psychotherapy have a dialogical origin. Giancarlo Dimaggio presents a clinical case, combining Hermans' Self-Investigation and microanalysis of patient diaries in order to demonstrate how self-reflective skills develop in psychotherapy, thanks to the patient's writing activity and the therapist's intervention. Mikael Leiman discusses the developmental path of the 'observing I' as a semiotic position, i.e. a jointly created I-position that emerges in psychotherapeutic discourse. Katerine Osatuke describes the development of a method for distinguishing clients' internal voices based on vocal cues. William B. Stiles describes a sequence of emotional experience generated as the voices of the symptoms or problems encounter and build meaning bridges with the person's dominant voices or I-positions.


Giancarlo Dimaggio, Giampaolo Salvatore, Cristina Azzara & Dario Catania, Centro di Psicoterapia Cognitiva, Rome, Italy
Rewriting self-narratives, change in dialogical patterns, and increase in metacognitive monitoring:
A single-case analysis


Mikael Leiman, University of Joensuu, Finland
The observing I as a semiotic position


Katerine Osatuke, Meredith J. Glick, Carol L. Humphreys, William B. Stiles, David A. Shapiro & Michael Barkham, Miami University, USA
Hearing voices: Methods for detecting internal multiplicity in psychotherapy clients


William B. Stiles, Katerine Osatuke, Meredith J. Glick & Hannah Mackay, Miami University, USA
Encounters between internal voices generate emotion:
An elaboration of the assimilation model