Prof. Joseph Levine

Senior Psychiatrist




Fifth Conversation: Comparing the "Voice Dialog" Method to Our "Reference Group Focused Therapy"

By Prof. Levine & Dr. Salganik

Hello to our dear readers,

In this conversation we will look at the method known as "Voice Dialogue" (VD) and compare it to our method "Reference Group Focused Therapy” (RGFT) while focusing on the similarities and differences between the two methods.

VD (a method developed by American Jungian psychologists Hal and the Sidra Stone) sees the human psyche as naturally composed of many characters which they call 'sub-characters, sub-personalities, plural selves”, and more. Each character has its own distinct sub-personality that includes desires, impulses, needs, abilities, point of view and sensitivities.

According to this approach, all figures exist in all human beings, however in different people, these figures will be expressed in different ways and intensities. In general, this is a method that helps the patient to be aware of his variety of sub-personalities and how to consciously choose between those who will be effective in his development and those who will be counter-productive. The theoretical basis of VD is therefore related to the psychology of the Self and in addition to the “Aware Ego Process” concept that we describe further on.

The authors identified two main types of sub-personalities – “primary selves” and “disowned selves”. Primary selves refer to the dominant group of selves that define the personality of the individual and control the life of that person. This group is called the “operating ego”. The “disowned self” is the group of “sub-personalities” that are equal in some respects and opposite to the primary self. Although there are conflicting values, both the primary selves and the disowned selves are considered to contribute to the individual's survival, social skills and general well-being. The authors of the method emphasize the importance of treating each self with respect during treatment.

Hal and Sidra Stone

Hal and Sidra Stone

During the course of their work, the authors of the method realized that there is likely to be an advantage in harnessing the experiences of the primary selves and the disowned selves at the same time. In order to achieve this, the person in therapy needs to distance himself from the primary selves and reach a central space – away from the operating ego – in order to observe both the primary selves and the opposing disowned selves. Such a framework – in which the individual can step back, observe from "distance", evaluate the experiences of the primary selves and the disowned selves, and be more able to make conscious and focused choices – is called the “Aware Ego Process”.

Illustration of the relationship between the aware ego process and the primary and disowned self

Illustration of the relationship between the aware ego process and the primary and disowned self

When a patient meets a pair of opposing characters along a particular axis in his character (such as stingy versus generous or brave versus apprehensive) he understands the benefits and values that each one has, and the contribution of both to his life, both on their own and in their balance. From the experience of the dynamic tension between the two poles, the growing non-identification with the two polarized figures and the acceptance of both, there arise a state of consciousness that can be called the 'conscious aware self'. This state of awareness allows for more adaptive choices and a growing experience of 'being integral entity'.

The "conscious aware self" is not considered to be a character. It can be regarded as a state of consciousness and as a process that allows for the seemingly paradoxical state of receiving all the characters without identifying with any of them. The "conscious aware self" is not only a state of non-judgmental observation but a state from which the conscious person navigates his life and acts through it.

VD is especially a method of separating from the Primary Selves. In working with this method of treatment the patient has a feeling that certain parts of his personality are incomplete and he is looking for a kind of wholeness and uniformity. Note that in this method people are not experienced as damaged or sick or in need of repair. VD's goal is to develop an "AWARE EGO" which is the ability to separate from the Primary Ego processes and adopt the disowned selves that the person is not connected to. This ability to consciously choose between the selves that we are connected to initially, recognizing their limitations, will give us benefits. Note that in VD there is no attempt to fix or change the various selves. Instead, you are encouraged to go through a conscious ego process, learning about the skills and limitations of each self and how to use or not to use it.

VD gives a person a hope to get to know the internal map of his selves, to experience and learn about the primary and disowned selves and get awareness and understanding of the Aware Ego process.

In order to promote the expression and understanding of the individual’s selves, each self is given its own chair or space in the room. The facilitator will encourage the person under the treatment to move from one chair to another while each self speaks out the patient's mouth. The Aware Ego process is also assigned its own chair so that the person in treatment can observe, analyze and act on what is revealed. After the presenting self has spoken, the person in treatment stands next to the facilitator, who gives an unbiased summary of what happened.

During a typical therapy session, the facilitator will invite the different selves of the person to talk about their own life experience. The role of the facilitator is to listen to and encourage the interviewed self to provide as much information as possible about his or her views. There is no attempt to negotiate between different selves, to change the self currently activated in the therapy or to encourage it to agree on something. The facilitator may ask questions as part of this process in an attempt to allow both the patient and the facilitator to learn more about each of the selves.

Questions may include:

• What is your name?

• Can you describe your appearance?

• Can you describe your feelings now?

• How long have you been with the person in treatment?

• Do you remember when you first met the person in therapy?

• Can you please tell me about this meeting?

• What role or job do you perform for the person in therapy?

• Is your job difficult to perform?

• Does the person in care know you are there?

• How does the person in treatment feel about you?

• Does the other opposing self work with you and support you?

• What would happen to a person in treatment if you were not present to help him?

Note that when a facilitator encounters a pair of opposing self-figures on a particular character axis (such as stinginess versus generosity or courage versus apprehension) he should understand the benefits and values of each, and the contribution of both to the patient's life, both individually and in their balance.

A state of consciousness that arises out the experience of the dynamic tension between these two poles of self-figures, the growing non-identification with the two polarized figures and the acceptance of both, is called the 'Aware Ego process’.

At the end of the treatment session, the patient returns to a place known as the "conscious ego" and makes his conclusions together with the facilitator. Finally, we note that many variations of the work have been developed in individual, group or self-work format.

If we sum up, then, according to the model developed by Dr. Hal Stone and Dr. Sidra Stone, the ego is a group of primary selves that operate and activate our lives (Operating Egos). The main therapy tool is the Aware Ago Process that implies dis-identification with the primary and/or disowned selves that have previously appeared at random and without our control or desire thus allowing a person to be aware of his inner motivations increasing person’s freedom of choice and ability to make more informed decisions.

This Aware Ego process allows us to choose only those primary and disowned selves that suit us in any given situation.

  • ISBN 965-7304-07-5 אורה גבריאלי, השד, הנזירה והילד הקסום – מסע אל הדמויות שבתוכנו, ספרים, 2006 – על גישת ווייס דיאלוג

Stone, H., Stone, S., Embracing Our Selves: The Voice Dialogue Manual. Nataraj Publishing, 1993. – ISBN 1-882591-06-2

Stone, H., Stone S., Embracing Your Inner Critic: Turning Self-Criticism into a Creative Asset. San Francisco: HarperSanFrancisco, 1993. – ISBN 0-06-250757-5

Stone, H., & Stone, S. (n.d.). The basic elements of voice dialogue, relationship, and the psychology of selves. Retrieved from

Stone, H., & Stone, S. (n.d.). Voice dialogue: An introduction to the use of voice dialogue. Retrieved from

The question now is what is the difference between VD and RGFT?

We will first note similarities between these two treatment methods:

1] Both theories claim that man is composed of a variety of different selves or sub-personalities.

2] Both theories see the importance of one [RGFT] or more selves [VD] as a possible cause of a variety of mental disorders.

3] Both theories see reduction or disengagement from identification with the dominant self as the goal of treatment.

4] Both theories consider the strengthening of the reflective self [RGFT] or the aware ego [VD] as one of the cornerstones of treatment.

The following are the main differences between the two methods:

1] VD focuses on the person himself or the interpersonal dyad with another person, RGFT embodies a complex approach that sees the person as an integral part of the social matrix.

2] In VD the source of the selves is innate and archetypal and subject to external influences, in RGFT, origin of Selves – completely through external (social) influences – internalizations of Real Persons/ Reference Groups

3] In VD the primary self has mostly a defensive function, in RGFT the Dictator Self has no defensive function a priori, it emerged only out of attachment needs.

4] In VD inner Selves (Primary, Disowned) have schematic, even caricaturistic character (Pusher, Controller, Critic, Pleaser), they don’t differ much in different people. In RGFT inner (Secondary) Selves have their REAL origins in personal history and are complex and differentiated images -(internalizates).

5] In VD for every Primary Self there is a counterpart – Disowned, Denied, Underdeveloped Self (Pusher – Relaxer; Perfectionist – Imperfect Self; Pleaser – Rebel). In RGFT There is no dichotomy among Secondary Selves – every Secondary Self is a result of its specific internalization, thus – no obligatory counterparts.

6] In VD There is no distinction between Inner Selves as in relation to impact of social influence, in RGFT Concept of Primary Self as a structure emerged prior to socialization and Secondary Selves emerged as a result of socialization.

7] In VD there is the Concept of Bonding Pattern Analysis – positive vs. negative bonding pattern, in RGFT there is the Concept of Idealized and Defensive Selves – serving defensive purposes, based on Trigger Event Analysis.

8] In VD therapeutic work comprises mainly “disidentification” from Primary and Disowned Selves, in RGFT therapeutic Work concentrates on Secondary Self modification and Insertion of new Secondary Selves.

We would like to mention that some of the above mentioned definitions are still not described. We will explain them fully in the following conversations.

See you in our next conversation,

Dr. Igor Salganik & Prof. Joseph Levine

Leave a comment