Polyphony is a word frequently spoken in the dialogical approach.
But how does it look like in practice? Jaako Seikkula wrote more about it in his article „Becoming Dialogical: Psychotherapy or a way of life?“
Here is an excerpt including transcriptions of real conversations with clients.

On 15 pages Jaako Seikkula writes about the dilemma of looking at dialogue as either a way of life or a therapeutic method.

We publish just a part of the original text.
Read the whole article


A First Polyphonic Case Example: Pekka’s Father

Pekka was referred to psychotherapy for his deep depression that had led to a severe suicide attempt. His wife and two adult sons were present.

The richness of the family therapy conversation becomes evident if we focus on those voices that are not seen but are present in each person’s inner dialogues. These voices of the vertical polyphony become ‘switched on’ depending on the themes of the dialogues.

In this case, Pekka was preoccupied by his job as a doctor and difficulties taking care of his duties. He was also preoccupied by his marital problems, by being a father to his two sons and especially by his own father.

The memory of his father was actualised when, after a long break in their relations, Pekka took an initiative to re-start the relationship and the father answered yes, but died soon after. Father’s voice was invited to the dialogue in the first session.

T: When did father die?
M: It was 4 years ago.
T: If he … if the father could hear what we are talking about, what would he say or what kind of advice would he give in a situation like this?
M: Well … yes … I am sure that Dad … Dad would be quite sad about this. He would surely show his compassion and …
T: What would he … how would he show his compassion? What would he say, what words would he use?
M: Well, he … he was a kind of a old folk man who could not show everything …
T: Hmm ….
M: … he would for sure try to encourage me …
T: Yes.
M: … and I think that he would handle this quite nice. That’s all I can say.
T: But what you think is that he would encourage you and he would show his compassion … and … that … or this is what I hear, that he would in a way understand this situation?
M: Yes. I was the only one of us who could handle father, after he was …
T : Yes … yes
M: … old …
T: … that he would encourage you and show his compassion. … What do you think your mother would say, if she still could be with us here?

Important aspects of the polyphony are the voices of each therapist. Therapists participate in the dialogue in the voices of their professional expertise, being a doctor, psychologist, having training as family therapists and so on (see Rober, 2005).

In addition to the professional voices, therapists participate in the dialogue in their personal, intimate voices. If a therapist has experienced the loss of someone near to her, these voices of loss and sadness become a part of the polyphony. Not in the sense that therapists would speak of their own experiences of death, but in the way they adapt themselves to the present moment: how they sit, how they look at the other speakers, how they change their intonation and so on. Inner voices become a part of the present moment, not so much of the stories told.

Therapists’ inner voices of their own personal and intimate experiences become a powerful part of the joint dance of dialogue.


Second Polyphonic Case Example: The Silent, Curing Moment

Mary was a sister of Matt, who had a long history of being hospitalised because of schizophrenia. Mary wanted to have family meetings because their history was unspoken. Mary, Matt and their mother Susan came to see us.

They said that their tragedy started decades ago when their father died suddenly. Her big brother Matt became very important for Mary when she was 10 years of age, but very soon he discontinued school, started to isolate from friends and the family, and used drugs that caused extreme unpredictable outbursts that became a nightmare for Mary.
She was terrified and traumatised when her brother became psychotic, step by step.

At the time, Mary was never invited to any family meetings, and not even her mother could explain what was happening with Matt. After being hospitalised for the first time at 18 years of age, Matt had been in the hospital for about 25 years when we met for the first time.

From the very beginning the dialogues were sensitive in many respects.

First, the mother announced that she did not want a family meeting, because she was afraid that speaking about old and sensitive memories would make Matt become psychotic.

Indeed, while speaking about some emotionally loaded issue, Matt all of a sudden did start to speak about his specific stories, which could be seen as psychotic.

When this happened, I asked him if I had said something wrong for him to speak about those issues. And then I asked if it was possible to go on with the subject we had opened with. Mostly Matt answered that we did not say anything wrong and allowed us to go further.

Step by step, Matt’s psychotic speak episodes decreased and on the whole stopped. After meeting for some 2 years, with about four–five sessions every year, the following sequence of dialogue emerged.

This was the first time when Mary, in the presence of her family, could find words for her terrifying experiences.

M stands for Mary and T1 for the author.

M: I have not been recognised.
T1: You have not been recognised?
M: Throughout my life I’ve been excluded from the family. At last I want to get rid of this symbiotic mess.
T1: You said that ‘Throughout my life I’ve been excluded from the family’. Then you said that ‘At last I want to get rid of this symbiotic mess’. It sounds like you are saying two things at the same time?
M: … yes … that’s what I said … But so far I cannot say anything more about it.
T1: … yeah.

When Mary first said her experience, the therapist repeated her words. This is often very helpful for generating dialogue in emotionally loaded issues. By repeating word for word, the speaker can hear her own words with a slightly different intonation.

Bakhtin (1984) talks of the penetrated word, a word that has been penetrated by the tone of another’s word; such ‘a word is capable of actively and confidently interfering in the interior dialogue of the other person, helping that person to find his own voice’ (p. 242).

This happened in the episode above. When the therapist repeated the words, it was possible for Mary to hear her own words. After repeating the words and saying, ‘It sounds like you are saying two things at the same time’, there was a silent moment, and during this present moment Mary heard her words by notifying that was the thing she said but cannot find words for.

The silence of the therapists seemed also to be very important, since the therapists did not fill this moment with their meaning by giving comments. This was a powerful moment also because Matt and Mary’s mother were there to hear the words for the first time.


How did the stories end?

With Pekka we worked together for 16 months, having most sessions with him alone and with two or three therapists — one of them being a Master’s student in psychology.

Every second month we met together with his wife. Pekka recovered from depression, but difficulties remained in the marital relation.

With Mary and her family we have met for 5 years, three to five times a year. Everyone has improved both in their personal lives and their interactions with each other.

Her brother has not been admitted into hospital during these years and they have learned to speak with each other. He no longer speaks about any psychotic experiences. In our sessions they have started to discuss the father and the memory of his loss; they have become curious about each other and have learned to live as a family after almost 30 years of living in isolation.

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