Trialogue: community dialogue on mental health

When I first heard the term “Trialogue”–   I was at the same time puzzled : why would anyone want a dialogue with only three perspectives? and intrigued : sounds interesting, something like  the dialogues that  I was familiar with and witnessed generating such deep and powerful learning…

So I googled the word and discovered a whole world of middle east trialogue – an ongoing examination of the three religions of the book:  Judaism, Christianity and Islam. That’s not the same trialogue and whilst I was pleased that it exists, it was not the one I was curious about.

Mental Health Trialogue

Mental health Trialogues come from a tradition in German- speaking countries of broader health dialogues and social dialogues: in Germany, Austria and  Switzerland thousands of people participate in community dialogues about health [and other social issues]. Sometimes the groups can be 300 strong and run over a weekend.

Some of the generalised  characteristics of a  dialogue in the broad human tradition of which trialogue is part……

Conversation   a group of people talking, listening, turn-taking:  not about action or agreeing but about sharing – ideas, time and space, bearing witness to different insights and perspectives.

Exploring  surfacing assumptions behind ideas and language; uncovering complexity,  different  perspectives and insights.

Listening   each person in the group spends more time listening – and really listening-  than talking

Circle    – sitting in a circle. This enables everyone to bear witness to each other – also makes turn taking easier and equalises power relations without any overt “control”.

Reflective learning  dialogue    taking time together to reflect on our own ideas and in shared reflection, mopening new possibilities of making sense.

A trialogue has these general characteristics and adds a little more particular to the  setting as a dialogue about mental health. The group coming together has a shared interest in mental health and includes people from [but not representing] three perspectives  : people labelled with diagnoses, carers , professionals.  In the circle people leave their roles behind and simply be themselves: a human being.

So a trialogue is simply a way of and part of a tradition of practising dialogue ?

Ok, so what’s a dialogue?


My own understanding of dialogue is from experience working in the ways described by people like David Bohm, Peter Senge, Otto Scharmer and William Isaacs:, in an organisational learning tradition and especially working with teams learning to practice “team dialogue”: or “team learning” [one of Senge’s five disciplines of organisational lerning]….but also incorporating ideas from Martin Buber and Paolo Freire. So my key mental models around dialogue  look like this :

Discussion, debate, “I’m right you’re wrong”

We can have many different kinds of conversations, though in the west we typically follow the “I’m right – you’re wrong approach modelled so vigorously by politicians, law procedurals and soap operas. This is, by now,  powerfully embedded and unnoticed in our habits of thinking through our  language :

Discussion ….which we often use loosely to mean “conversation” but whose roots actually mean “to strike the winning blow” usually practised in a …

Debate …which we often take to mean a lively exchange of ideas,  has roots that mean ”to kill the other idea” . We can observe this in how it is often practised.

This process might then lead to a vote – the process of assigning support to one side or the other.

This is a great western tradition grown from ancient Greece and we see it in our parliaments modelled on 17th century school debating clubs .

Canadian Parliaments are typically set up on the  “Westminster model” with two sides sat across the aisle from each other- yelling and booing an generally behaving like the pupils at those public school  debating chambers – but less well behaved.

In his model is built on assumptions that there must be a winning argument, there must be a majority to carry through winning arguments. Indeed, our first-past-the-post electoral system sets up a two sided debate where a proposition is put up either to be struck down or to dominate the opposition through force of argument, or numbers – it’s all about power.

And  the US system is an even more extreme example: there are only two parties and they are continually attacking – no longer are they satisfied with attacking each other’s ideas  each other’s ideas but each other’s person, past, even family – and they do this even to others on their own “side”.

Our courts have the same inbuilt assumptions: cross examination of witnesses is often less about examining the evidence presented by a witness than it is about attacking the credibility of the witness or even their right to bear a witness.

In the west we see it everywhere – and we follow the examples so well demonstrated by our politicians, and lawyers and  TV pundits. And there is a place for this kind of conversation – the difficulty is that we’ve become so used to it that we have by now mostly brainwashed ourselves into thinking it is the only way to have a conversation.

Other traditions: different conversations

Yet these traditions are relatively recent and certainly not rooted in all human cultures – and are actually alien to some.  And many times, a different kind of conversation will yield better outcome.

Many cultures around the world, including in North America  have maintained their traditions of  talking circles and listening circles, where people sit sometimes for days with their focus as much on listening as talking…

There is likely no human culture that does not have as part of it’s tradition some form of sitting in a circle and talking.

 Dialogue project

William Isaacs has been working on the Dialogue Project at MIT for a couple of decades. From his work  I learned how the language we use unthinkingly so powerfully shapes the kind  of conversations that we have and how, by being aware of this, we can choose to have very different kinds of conversations for different purposes.


has it’s roots in dia –  “through”, “flow” and logos –  “meaning” so we can think of it as “flow of meaning”.

David Bohm invites us to think of dialogue like a river flowing through a landscape – twisting and turning, being shaped and guided by the landscape but at the same time shaping the landscape as it passes through.

“a  conversation with a centre, not sides”

a process of inquiring and understanding –not a conversation for   agreement,  winning,  or action.

 in these terms   we create space and allow ourselves to access ways of thinking  that are more in tune with the systems we are part of – our own man-made structures and nature: the universe itself.

We also draw on universal human traditions of sitting around in circles and talking , telling stories, often very personal  and heartfelt , making connections with each other.

Dialogue can be a spiritual experience.

Discomfort is part of the process

Practising dialogue, even though it comes from within us,  can be uncomfortable, frustrating – painful experience. And it takes some practise to do well but learning is more about trying, making mistakes and opening ourselves to what is innate – within us already – than it is something that can be taught to us by others.

Who might find it difficult?

  • If you are anxious to see decisive action- maybe you spend much of your life adding to and crossing off your action list -you may find the process slow and frustrating and “too much talking”
  • If you think you already know everything then you may find yourself thinking “but we already know the answer: let’s get on with it!”
  • If you like to move to agreement with gusto you may find it tantalisingly frustrating when the group seems to be moving toward a consensus or agreement of some sort, only to pull back, divert or just go in another direction altogether.
  • If you crave harmony and getting along you may be challenged when people bring out their deepest feelings, values and assumptions challenging the group to not avoid difficult ideas but to intentionally  examine them and understand them: trying inside different and difficult perspectives. Dialogue generates not a sugar coated, feel good,  storefront “greeter”  harmony but one that is trickier  with ups and downs and tensions, and spikes and discomfort and creative tension generates, in time, a deeper, overall  harmony.

Dialogue is a kind of conversation that is not about any of these things – or at least it deals with them in a different way and puts them lower down a list of priorities than it does listening, inquiring, building understanding, making sense. All of this can and will happen in a dialogue.

But so will members of the group supporting each other in very  human ways,  sitting with the discomfort that can arise – and witnessing, sharing and talking about those difficulties is part of the process.

Dialogue is not about “agreeing to disagree”, The word even the idea of “agree” is just not in the vocabulary or thinking practise of a group skilled in dialogue: exploring, even seeking out differences, accepting and finding deeper meaning in them and through them, and making sense are what the group engages in and with.

Innate but almost forgotten

Dialogue is a process or practise that is likely deep within our collective knowing, almost forgotten but we can learn to reawaken it.

And, thanks to the work of Isaacs and many others we have some clues about how we can make it easier to learn, or re-learn.

Bohm, Senge , Isaacs in particular worked to identify some of the keys to successful dialogue and to promote and enable  it’s practice around the world. Including the – Society of Organisational Learning. Early work on systems thinking drew on many emerging practices  in many fields- including family systems therapy and other stuff going on in Europe.

Bohm’s work was rooted in his quantum physics work (he was a colleague of Einstein) and 40 years of conversations with Kirishnamurti.  Senge is interested in how dialogue can be used in organisations and more lately through how it can be used to help bring about a better world. It’s a key component in his five disciplines approach. Isaacs built on Bohm’s work: seeking through The Dialogue Project to identify keys to dialogue and how to help people learn to practise.

It sounds obvious – we all know how to have a conversation, right? But when we try we find out how tricky it is.

Together they identify some key practices that are hard to learn, especially when we are so rooted in discussion, debate and the passive agression of  “agreeing to disagree” .  The key ideas look  like…

  • Creating a “container”…in which to hold the dialogue – if there is no container it can flow anywhere – flow away, dissipate. This “container” can be very loose but includes things like – the circle, some framework of “groundrules”, a starting or framing topic or at least a shared interest; and rituals and norms that allow members to learn how the group works and remind themselves of basic expectations .
  • Suspend  assumptionsdoes not mean ignoring or dismissing, but rather ‘holding up in front ’ ready for exploration, it also refers to holding off judgements and decisions.
  • Participants  view each other as colleagues or peers Dialogue occurs when people appreciate that they are involved in a mutual quest for understanding and insight. ‘A Dialogue is essentially a conversation between equals’ (Bohm et. al. 1991).
  • In the early stages there needs to be a facilitator who ‘holds the context’ of dialogue.  This may be a different form of facilitating than you might have seen where a “trainer” imparts expert knowledge – it is a lightly handled, “soft hands” approach, that is concerned with enablig the process,  and not much concerned with content. You might have a different label but “facilitate” simply means to make easy and here the role is to make easy the process of dialogue- done in the manner of “leading from behind” or, done well,  almost invisible in the room and with the clear intention of making itself redundant so that wisdom is able to emerge from the group.

A conversation for inquiry, and understanding not action

If you want to get a large group of people to agree a course of action then don’t set up a dialogue. Dialogue is not fast and it’s not really about action. It’s a conversation for exploring, expressing, forming complex, contradictory and incoherent ideas. We put all ideas in the centre – and hold them there. An we each take from the centre what works for us and leave the rest.

There is no call to action more a call to witness, hear and to listen, and to explore til we have found, discovered, uncovered the whole.

There can be great tension – some people will think or feel “the answer is obvious” and want to rush to action.

But dialogue is not a conversation for action – though certainly a dialogue group  can be a place from which co-ordinated action is launched. Often, through dialogue the possible courses of action become much clearer and simpler: the actions taken require less energy and are more effective. It’s a paradox that holding from action often makes the action we eventually take easier.

So, this is my  long way to get to..

Trialogue: a community dialogue on mental health

So, “suspending” my own assumptions, I can share my sense of a mental health  trialogue as an exercise in community dialogue – where the container we create  is that we have a shared interest in mental health , and engage together in exploring important ideas from three identifiable key perspectives: survivor, family- carer, and professional.

The aim is to deepen our understanding of each of these three perspectives –out of which we hope will grow a deeper, broader understanding of each other, and how we might eventually together shape better approaches to mental health  ..

A peer support group for everyone

Dialogue is not about talking to, or talking at, but talking with. It is not about medicine or therapy and so might stubbornly resist attempts to build an evidence base to prove otherwise. Dialogue is  not about fixes or solutions and is not itself a solution.

Dialogue is about hearing, and bearing witness and discovering and appreciating new insights.

Simply, dialogue in its many forms can be an opportunity every now and then, to practise and to learn how to be a little more human – a peer group for everyone.

And that can be very healing.

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1 Response to Trialogue: community dialogue on mental health

  1. curiousanalyst says:

    Lots of food for thought here — well done!


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