using narrative therapy in my practice….

Posted by: bailey on May 27th, 2014

As I am using Narrative Therapy in my practice these days I thought I would let you know a little bit about it…the_white_tree_by_druckhelm

Narrative Therapy

Narrative Therapy is different from traditional therapies and psychological perspectives as it is one of the therapies that stems from the postmodern approach of social constructivism (Corey, 2009). Grown out of opposition to modernist views that believe that there is an objective reality, postmodernism believes in multiple and conflicting truths and realities (Corey, 2009).  The essential function of language is one of creating meaning and in creating realities (Corey, 2009). This is due to the central role it plays in human interaction (Gersie & King, 1990). The words story and narrative have etymological roots linked to the Greek word meaning to know (Gersie & King, 1990).  This reflects how language contributes to the process of accumulating knowledge and communicating inquiry and outcome of knowledge (Gersie & King, 1990). People use stories in fundamental ways throughout their lives to make sense of their experience through the existence of multiple stories (Morgan, 2000). Telling a story allows others to know and enables each of us to “know ourselves as someone who has a voice which is worth listening to, someone who can be heard and understood” (Gersie & King, 1990). It therefore also leads to social inclusion (White & Epston, 2000).

These dimensions are reflected in Micheal White’s and David Epston’s approach to narrative therapy (White & Epston, 2000). Their approach to narrative therapy provides a theoretical framework to deconstruct the problem and re-author the client’s story. This framework includes externalization of the problem, identifying unique outcomes, and altering the relationship the client has with the problem. It can be applied practically to individuals in therapy.

The Problem

         A problem arises for the individual when the story that she is telling is unrepresentative of her lived experience and the perception she has of herself is incongruent with her total experience (White & Epston, 2000). From the narrative perspective, these dominant stories people have of themselves and their problems are seen as restraining narratives. Dominant stories negatively influence a person’s existence as new possibilities become limited due to the uncritical acceptance of assumptions about a problem (McKenzie & Monk, 2007). In the exploration of the problem, the client is considered to be the expert (Morgan, 2000). By acknowledging this, the therapist takes a de-centered approach. Given the therapist’s specialized knowledge of the counseling process they are considered active facilitators of this process.

Externalization

In facilitating narrative therapy, the therapist assists the client to approach these dominant stories so as to deconstruct them (Munroe, 2002; Russel, & Maggie, 2004). Deconstruction facilitates the process of disassembling the unitary knowledge that may be oppressing the individual. This is done by its externalizing the problem. Externalization is the process of clearly delineating the problem as outside the individual. This is an approach that enables the client to objectify and, at times, personify the problem (White & Epston, 2000). These practices involve recognizing that the problem does not reside within the individual but outside of them within the social and political context (Munroe, 2002). This allows the individual and the therapist to really look at how the context contributes to the problem (Munroe, 2002). It opens the conversation to the possibility of a non-problem saturated perspective (White & Epston, 2000). Through this process, the individual’s strengths and values come to light and are applied in creation of the preferred narrative (Munroe, 2002).

Once the problem is externalized questions can be introduced to question the relative influence of the problem (White & Epston, 2000).  This can be done in two ways; mapping the influence of the problem and mapping the influence of the person.  When mapping the influence of the problem the individual is asked questions that assist her in visualizing how the problem is affecting the behavioral, emotional, physical, interactional, and attitudinal domains of the person. This usually involves a problem-saturated description of life and a description of the problem across various interfaces. On the other hand, when mapping the influence of the person, the therapist wants to highlight how the person and her relationships influence the problem. These questions usually bring forth information that contradicts the problem-saturated description of life and help to identify resources and competence in the face of their problems.

Unique Outcomes

Throughout the journey of therapy the therapist is searching for unique outcomes. These are moments where choice and success dominate the problem (Corey, 2009). This is done by drawing attention to any lived experience that stands up against the problem story (White, 2005). By identifying these moments, the therapist and the client can together look at the resources that were brought to those moments and build on them. There is an assumption that there are always examples of unique personal outcomes (Morgan, 2000). Once identified, they begin the process of re-authoring the client’s life (White, 2005).

Preferred Narratives

Once problems are externalized and unique outcomes are identified, individuals can then engage in the process of writing preferred narratives (White, 2005). This means that according to a theme and plot that one asks the client to link events in non-problem saturated way. As the protagonist in his world, the client takes an active role shaping his life and relationships (White & Epston, 2000).  By emphasizing lived experience and capitalizing on the resources of unique outcomes, meaning emerges. Preferred narratives also allow the clients to recruit social support from their family and friends as the problem is separate from their identity. This process is meant to empower clients.

There is great diversity of ways in which one may create narratives within our societies (Gergen, 1991). Not only are there oral narratives, but television, music, movies, novels, and others exist (Gergen, 1991). Traditionally letter writing has played a large role in narrative therapy according to Micheal White and David Epston (2000). Due to this diversity, client and therapist may also be creative in their approach to writing these narratives and choosing tasks for clients to engage it.

Metaphor

Metaphor in narrative therapy can be a useful tool to use with clients (Howell, 2009). It serves a function of elucidating meaning throughout the process of creating a preferred narrative. It provides a scaffold between experience and the construction of meaning as it speaks to the person in a way that they can understand. In this way it facilitates the process of meaning making.

Outsider Witnessing

The audience is an essential component of this narrative theory in that stories only exist in the realm of social interaction (Sween, 1998). This is associated with the postmodern belief that reality is co-constructed in relation to interactions with others, history, and culture.  In these social interactions clients allow others access to their preferred narrative. Narrative therapy has created the explicit possibility of a special therapeutic social interaction through the outsider witnessing. In cases where this is utilized, outsider witnesses are invited to therapy to listen for and acknowledge the preferred stories of the grieving couples.

Outsider witnessing occurs within the context of definitional ceremony. Barabara Myerhoff describes this as the process of actively constructing identity in which one is seen for one’s own worth, for who one is, and for the vitality that one has (Carey & Russel, 2003). Micheal White brought this to narrative therapy in specially convened definitional ceremonies (Carey & Russel, 2003). In practice the therapist interviews the client with the outsider witness observing the interview. Once finished this interview, the therapist interviews the outsider witness in front of the client. Thereafter the positions are changed again and client is asked about what it meant to hear from the outsider witness. This process is then debriefed. Through this practice, the isolating and individualizing effects of problems are challenged as the individual’s identity claims are validated and he shares what is important to him through this practice. (Carey& Russel, 2003).

Strengths and Limitations

Embracing Diversity

Diverse clients often experience the expectations to conform to the cultural narratives of the dominant culture (Corey, 2009). Due to narrative therapy’s social constructivist philosophy, it accepts diversity openly as it looks for multiple realities and identifies that truth is the product of social construction.  Through the stories that people tell the therapist, the therapist will learn about the specific cultural narratives that are oppressing a specific individual. This work is all down within the cultural values and worldview of the client. This is more appropriate than traditional therapies in which people tell their stories and have their stories redefined in terms of the theoretical constructs that the therapist uses (McLeod, 2004). Those theoretical constructs may not necessarily be appropriate or sensitive to the client’s values.

References

Carey, M. & Russel, S. (2003). Outsider-witness practices: Some answers to commonly asked questions. The International Journal of Narrative Therapy and Community Work, 1, 3-16.

Corey, G. (2009). Theory and practice of counseling and psychotherapy (8th ed. ) Belmont, CA: Brooks/Cole, Cengage Learning.

Freedman, J., & Coombs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: W.W. Norton.

Gergen, K. J. (1991). The saturated self: Dilemmas of identity in contemporary life. New York: Basic Books.

Gersie, A., & King, N. (1990). Story making in education and therapy. London: Stockholm Institute of Education Press.

Howells, K. (2009) Narrative work and the metaphor of ‘home’. The International Journal of Narrative Therapy and Community Work, 4, 32-43.

Mc Leod, J. (2004). The significance of narrative and storytelling in postpsychological counseling and psychotherapy. In Lieblich, A., McAdams, D. P., Josselson, R. (Eds.) Healing Plots: The narrative basis of psychotherapy (pp.11-27). Washington, DC: American Psychological Association.

McKenzie, W., & Monk, G. (1997). Learning and teaching narrative ideas. In G. Monk, J. Winslade, K., Crocket, & D. Epston, (Eds.), Narrative therapy in practice: The archaeology of hope (pp. 82-117. San Fransico: Jossey-Bass.

Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Adelaide: Dulwich Center.

Morgan, A. (2002). Beginning to use a narrative approach in therapy. The International Journal of Narrative Therapy and Community Work, 2, 85-90.

Russell, S. & Carey, M. (2002). Externalizing – commonly asked questions. The International Journal of Narrative Therapy and Community Work, 2, 1-17.

Sween, E. (1998). The one-minute question: What is narrative therapy? Some working answers. Gecko, 2, 3-6.

Whitaker, R. (2009). Narrative explorations in clinical health psychology. The International Journal of Narrative Therapy, 2, 48-57.

White, M., & Epston, D. (2000). Narrative means to therapeutic ends. New York, NY : W.W. Norton & Company.

White, M. (2005). Workshop Notes. Adelaide: Dulwich Center.

 

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