Voice Awareness in Therapy


The voice is the unappreciated servant, the unsung companion, overlooked, taken for granted at the therapy table. Or there are ghost voices that lie within unspoken from the past or whisper from the social side-lines. This is how to speak; this is how to express feelings and ideas. These are the words to use. This is the tone, the pitch and the preferred prosody.


We are so caught up in saying what we want to say we neglect to notice how we are saying it. The voice is at the heart of how we say things and relate when in conversation. A mutual willingness to be interested in, kind to and surprised by our voices is helpful to any conversation whether creative, business, therapeutic or reflective.


We bring to the conversation a relationship with our voices. Do I know or trust my voice? Does it give me away? Does it sound like it is performing? Is it nervous, shaky or brash? Is my voice different in different roles? We bring to the conversation an awareness of how we co-constructing a sharing of our voices.


Is there a reciprocation between our voices? Does my confident voice make yours more anxious? Does my compassionate voice bring tenderness into your voice to yourself? Does my monotonous account of my stories bring out a monotonous tone from you or do you counter it with a more varied and urgent voice? If I recap with an authoritative voice does that stop your doubtful voice from coming out? These are the questions that might be in the air unspoken between us during the push and pull of turn-taking and control in the conversation and the call and response of our voices.


We hear our voice with our own critical or sympathetic ear. Part of therapy is doing voice work. Just as we may join a choir to develop and practice our singing voice so we can find our conversational voice more freely and with more relational authenticity through compassionate practice.

If we can replace shame with compassion and curiosity, it can help us listen as we speak to the emotional cadence of our own and other voices. The voice may touch thoughts and feelings that lie beyond or beneath what is being read out. Shy words may grow in confidence, words too often loudly repeated may look a little ridiculous and be reined in.

Lucy Cutler and I have been doing Voice Awareness workshops for therapists to show the voice as a therapeutic tool. As Cognitive Analytic Therapists we work relationally and integratively and we have put the voice at the centre of our work. We came to this focus through a psycho-social and plural view of the self in the world and the through the use of more varied and co-creative letter writing and conversational mapping in and between sessions with clients and in supervision. If we make a listening map of the key words of the conversation it leads to a moment of what we have called recapping where therapist and client go around the word map of key patterns and concerns and give voice to it. Sometimes it helps to audio record or video record this with our phones. What is evident is the added awareness of our voices that comes from recapping our thoughts and feelings, memories and responses both out there on paper and in there on our minds and in our bodies simultaneously.

The voice registers the relational process of making connections. The voice falters or strengthens, gives way to emotion and in our jargon shimmers in and between feelings and hovers and zooms in and out of ideas. We found we were more able to turn the voice from a silent companion carrying the stresses and strains of what is being experienced and felt into an active and instructive element in our enquiries. Awareness of our voices: their changing pitch and tone, fullness and authority, their prosody and musicality became part of our recapping with the map. Similarly, we then used letter writing as a form of inner and interpersonal dialogue. Both therapist and client would write a short letter addressing one emotion, incident or aspect of their lives. We called this writing to the map or writing to the moment and its power is enhanced by the spontaneity of giving attention to the voice in the moments of writing and again in the reading out and sharing. Like recapping with the map, reading out from the letter with the freedom to hover and shimmer with words and ideas and feelings called attention to the psycho-social dynamic and wavering presence of the voice. Working with the voice became part of our relational thinking aided by Cognitive analytic concepts of roles, patterns and sequences. These are some of the dimensions of voice work that interest us.


· The emotional voice (feeling, tone, pitch)

· The grammatical voice (active, passive, middle)

· The social voice (accent, status, gender, class, ethnicity, prejudice and power)

· The interpersonal voice (role, intimacy, turn taking, co-authoring and listening

· The addressive voice (inward, outward, targeted, searching)

· The verbal voice (language, words, conversation

· The historical voice (societal voices across generations, family voices, local words and turns of phrase)


We have developed a checklist for voice awareness and the process of combining mapping and writing with voice work has enhanced our versatility as therapists and offers ways of linking with the other therapy approaches drawing upon narrative therapy, systemic thinking and emotionally focused work.


Here is Sam's story of a moment of voice work in therapy. Sam was talking about his experience of a crisis in his life. As he talked his voice went high and low, fast and slow. It was as if he was surfing along the waves of the ups and downs of his emotions as he described and managed how much he relived his experience. He finished talking by saying something definitive and in the process his voice change. He said, as if firmly to me and to himself, "there is no point crying over spilt milk." But his voice wavered over the final words 'spilt milk'. Your voice changed when you went from saying: There is no point crying which I heard you say in a very summing up closing down kind of voice. Like you were saying this is the end of the conversation. Sam agreed and I added that at that moment in the sentence I felt sad because I wanted more between us about the emotions he was describing. Sam agreed and said. "I had trouble saying the words spilt milk. The words took me right back into the messy feelings which I was trying to keep at arm’s length. The words spilt milk are upsetting. Again, the words brought a tremor to his voice. We smiled at the absurdity of words and all the connotations of the word upsetting. We could just sit with the feelings of spilt milk. To borrow freely from the poet William Wordsworth - a feeling recollected through words in the relative tranquillity of revoicing them. We agree there might be a point in crying over spilt milk especially if our voices would allow us to feel the feelings wrapped up in the words.

Therapy is a series of mostly surprising, sometimes unintended (though we are fishing for them) troublesome tricky or divine moments. The voice is the unsung companion and possible the key to working with more self-conscious relational and conversational awareness of feelings and language. So as to work more therapeutically. We draw on the tools and concepts of Cognitive Analytic Therapy and the growing mix of ideas from social therapy, relational psychoanalysis and identity therapy. In particular we draw on the rich work of Bob Hobson still rich and rewarding book Forms of Feeling.

If any of this is of interest and you are curious about combining mapping and writing and talking therapeutically and reflectively in a conversational way then book a place on one of our Therapy with the Voice workshops.

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