My BF talks with his alters both ways. Sometimes, it's more like thoughts in his head and other times, they are having conversations out loud. It's quite a variety of experiences.

I don't have alters, but I can/do dissociate. But that's not always the same each time, either. Sometimes, the world just gets very dim and far away. Sometimes it's like watching it on TV. Sometimes it's like...reality...gets "replaced bysomething else, although that's harder to describe.