Book Review: The Dialogical Self in Psychotherapy

The Dialogical Self in Psychotherapy, which gathers together formulations of self, psychopathology, and clinical practices for children and adults. Their book is practical because it gives many concrete clinical examples and provides suggestions for alternative psychotherapeutic techniques. Their book also raises some philosophical questions, since its premise is to move away from presuppositions of dominant biological theories of psychopathology and talk therapies i.e., cognitive-behavioral, neo-Freudian drive and ego therapies, that reduce the self in mechanistic functions and dichotomies: adaptive vs. maladaptive, normal vs. abnormal, dependent vs. independent, and so on.

One of the main tasks of Dialogical Self in Psychotherapy is the sufficient description of self as a multiplicity of I-positions in which, as Hermans writes, 'The I fluctuates among different and even opposed positions' (p.19). The multivoiced self is structured in various dialogical positions and characters. Self-narrative is not linear with beginning, middle, and end, but is 'continuously structured and restructured by two or more voiced positions that in their dialogical interchange endorse, revise, restructure and develop any existing story' (Hermans & Dimaggio, pp.1-2). Temporal organized and dominant stories are constantly challenged by spatially tensed, and even opposed, narrative variations. Since the dialogical self is 'a dynamic multiplicity of relatively autonomous I-positions' (p.19) one can move from one position to another—from 'I as a father' to 'I as a piano player' to 'my father,' to 'my friend,' and so on. This multiplicity involves power differences in the self and asymmetry among the positions. The self is either in negotiation or conflict of its positions. Following the Bakhtinian theory of utterance, Leiman formulates the idea that speech does not happen in a vacuum. Every utterance emerges in a social practice, has an addressee, and expects a response. When the individual speaks, he or she is, in the listener's eyes, into a certain position. The speaker always faces the challenge of an 'internalized judge.' Thus, an utterance involves multiple positions and shifts. As Bakhtin contends, 'The word is bottomless'" (p.259). Behaviors have multiple meanings; they are acts of expression in relation to both addressees and referential objects. Lewis and Todd also provide the thesis that the self is the gestalt of mind and body, since the brain is dialogical. Coherent activities between the orbitofrontal cortex (for emotions) and the anterior cingulated cortex (for information processing) depend on the individual's awareness of voiced positions.

What does it mean to say that the self is multivoiced? One might think that the multivoiced self is pathological i.e., dissociative or multiple personality disorder. Contrary to this notion, all contributors of this book develop the thesis that the disowning of multivoicedness within the self deprives the individual to function at his or her full potential. The authors conceptualize psychopathology as the constraining of vocal interactions and the inflexibility to move from one part to another. Each chapter asserts that realizing ourselves as multivoiced—as individuals who are dominated by some voices (discourses) and deprived from others—we maintain personal continuity and coherence. As Dimaggio, Salvatore, and Catania argue, psychopathology means impoverished narratives and limitation of self-positions. The impoverished narrative involves disorganized content, monotony, stereotypes, absence of multiple characters, or absence of positional shifts.

A more relevant chapter to existential philosophy is Cooper's 'Encountering Self-Otherness.' Following Buber, Cooper distinguishes between an I-I and I-It mode of self-relating. The I-I mode is an active agency and confirms the alternate I-position. In contrast, the I-It relational mode criticizes, dismisses, and derides the alternate I-position. The I-It mode fails to accept the other as Other; it demands totalization and homogeneity; it negates alterity and difference of the other voice.

The editors' Introduction and the 16 essays contained in the book, written by authors from varied theoretical and clinical backgrounds, draw on both contemporary and historical philosophical sources in existentialism, social phenomenology, neo-Freudianism, pragmatism, and humanism. Organized in four sections—(1) General theory (chapters 1-4), (2) Theory and Clinical Practice (chapters 5-10), (3) Reconstructing Dialogical Processes in Severely Affected Patients (chapters 11-14), and (4) Methodological Issues in the Psychotherapeutic Process (chapters 15-16)—Hermans and Dimaggio's volume covers the theoretical foundation of the dialogical self, the clinical issues in the treatment of clients, and the methodological issues related to dialogical issues of psychotherapy.

Although the book is a valuable source for psychotherapists, I find it limiting when authors refer to self only as consciousness -negate, in other words, the existence of the unconscious desire- and when they do not provide a more rigorous theoretical description of what they mean when they say that the goal of dialogical therapy is to help the self becoming 'whole' and 'integrated.' Contributors provide many clinical examples and describe well their experiences in the therapeutic process, techniques, and interventions.

The Dialogical Self in Psychotherapy should enjoy a wide readership. It is relevant to psychotherapists who want to incorporate anti-essentialist approaches to psychopathology and unique treatment modalities as well as faculty who teach courses that are relevant to dialogical psychology.

Katerina Daniel