About Voice Therapy

What is Voice Therapy?

Voice Therapy is a powerful technique that quickly taps into clients’ core negative beliefs.  It is a process of identifying and eliciting negative thought patterns (“critical inner voices“) that are driving a person’s maladaptive behavior. It is called Voice Therapy because clients learn to verbalize the negative thoughts they are aware of in the second person, as though another person were talking to them.  Shifting to this second person format brings to the surface the emotional content of these negative thoughts.  This also helps clients to separate their own point of view from the hostile point of view toward themselves.  It allows them to “take their own side” and identify the sources of these destructive cognitions which originated in traumatic attachment experiences.  Therapist and client then collaborate on suggestions for behavioral change.

The principal technique of Voice Therapy involves an individual’s verbalization of their negative thoughts as though another person were addressing them, for example, “You’re stupid. You’re a failure,” instead of “I think I’m stupid. I feel like a failure.” This methodology is important for two reasons: (1) this is the form in which most people think critically about themselves or experience negative internal dialogue (2) this technique usually brings out considerable affect, leading to meaningful emotional and intellectual insight.
What are the steps in the therapeutic process in Voice Therapy?

Voice Therapy involves a five-step procedure in which the client and therapist collaborate in understanding the client’s destructive ways of thinking.

Step 1. Identifying the contents of the client’s negative thoughts as voices by verbalizing them in the second person format as described earlier. This can be approached in an intellectual manner (i.e., focusing on their cognitions), or by using a more dramatic, cathartic method (i.e., expressing the emotion associated with the thoughts). In the more cathartic approach, clients are encouraged to say the voices louder or to use the tone in which they experience the voices and to express the emotions behind the voices, which often consist of strong anger and sadness. The therapist might instruct the client to “say it louder,” “really feel that,” or “let go and blurt out anything that comes to mind.”

Step 2.The emotional expression of the first step leads spontaneously to the second step which involves developing insights into the sources of the voice attacks. During this step, the client often will make statements such as “That’s what my father used to say to me,” “That’s the feeling I got from my mother,” or “That was the atmosphere in our home.” The therapist can encourage this process by asking, “Where do you think those thoughts came from?” or “Where have you heard those thoughts before?” In Voice Therapy, the therapist refrains from interpreting aloud to the client, but instead attempts to elicit insight from the client. Insights have the most impact when they originate from the client and when they are combined with a full expression of feelings. As clients develop insight, they experience a sense of compassion for themselves and gain a clearer sense of their true identities. In turn, they develop more compassion and empathy for others.

Step 3. The third step in Voice Therapy consists of the client responding to the voice. Often, this is a cathartic experience, particularly when the client feels the full impact of taking his or her side against the voice. In the process of responding, clients often reveal a great deal of information regarding their childhood and the way that they experience attachment relationships. It then is important for them to make a rational statement about how they really are, how other people really are, and what is true about their social world.

Step 4. Clients develop insight into the relationship between their voice attacks and their self-limiting and self-destructive behavioral patterns. They begin to understand how limitations they impose on themselves in their everyday life functions, along with destructive behavior patterns they act out, are governed by the voice. They identify specific thoughts that are influencing behaviors that are self-destructive, such as addictions, as well as those that trigger aggressive, violent behaviors toward other people. They recognize negative thoughts that have made them fearful, guilty, or too ashamed to engage in constructive behaviors that represent the self system.

Step 5. The fifth step in Voice Therapy involves changing the behaviors that are based on the destructive ways of thinking, thereby altering clients’ basic self-concept, their view of others, their perspective on their social world, and their core defenses. The corrective suggestions for behavioral change are chosen through collaboration between the therapist and the client, and are designed to challenge the client’s misconceptions and misperceptions of self and others. Collaborative interventions that effect changes in an individual’s behavior are a necessary part of a successful therapeutic procedure. These suggestions should be in line with the client’s personal goals, ambitions, and interests (i.e., the things that matter to them, the things that light them up). These suggestions also involve the client refraining from self- and other-destructive behavior that the voice is encouraging. In either case, the goal is for clients to follow the suggestions, resist the voice attacks, go through the anxiety, and expand their boundaries and positive sense of self.

However, because acting on corrective suggestions involves breaking with the psychological defenses that warded off painful emotions and that were originally necessary, this step always involves personal risk and feelings of increased vulnerability. It is important for the therapist to prepare clients for the anxiety that they are likely to experience when they implement suggestions that are counter to the dictates of the voice.

As clients act against their voices, their destructive thoughts may become more intense, almost like a parent who yells at them to get back in line. However, if they can endure the anxiety and maintain the behavior change, the voice attacks become less intense and eventually fade into the background, almost like a parent who becomes tired of nagging. This is not to imply that these voice attacks may not resurface, but when and if they do, they will not have as much influence over the individual’s behavior. If clients take small steps to change their behavior, and deal with the level of anxiety that arises with each step, it is less likely that they will become overwhelmed with anxiety and run back to their defenses.
How Was Voice Therapy Developed?

Voice Therapy was originally developed as a laboratory procedure to investigate how people defend themselves and to understand the structure and function of the negative thought process that underlies defensive, maladaptive behavior. It has also been used as a psychotherapeutic methodology that combines cognitive, affective, and behavioral components into an integrated treatment strategy, and has been applied in individual, group, and couples therapy.

Voice Therapy Resources







If you are interested in receiving training in voice therapy, please contact [email protected].