Multiple voices versus meta-cognition: an attachment theory perspective

This paper considers the problem of multiple voices as closely related to the clinical problem of dissociation. It is suggested that the capacity to reflect upon mental states in self and other; the capacity for meta-cognition, can be undermined by experiences of childhood trauma in the context of attachment relationships Internal working models of interpersonal relationships come to be established that are barren of representations of mental states in self and other Such models are hard to integrate and give rise to the appearance of multiple voices, even multiple personality, within a psychotherapeutic exchange. A generic aspect of therapy is the enhancement of meta-cognition and the bringing about of integration of unmentalized internal working models.