Narrative therapy

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Narrative therapy
Intervention
MeSH D062525

Narrative therapy is a form of psychotherapy using narrative. It was initially developed during the 1970s and 1980s, largely by Australian Michael White and his friend and colleague, David Epston, of New Zealand.

Their approach became prevalent in North America with the 1990 publication of their book, Narrative Means to Therapeutic Ends,[1] followed by numerous books and articles about previously unmanageable cases of anorexia nervosa, ADHD, schizophrenia, and many other problems. In 2007 White published Maps of Narrative Practice,[2] a presentation of six kinds of key conversations.

Overview[edit]

Michael White 2006

The narrative therapist focuses upon narrative in the therapy. The narrative therapist is a collaborator with the client in the process of developing richer (or "thicker") narratives. In this process, narrative therapists ask questions to generate experientially vivid descriptions of life events that are not currently included in the plot of the problematic story.

By conceptualizing a non-essentialized identity, narrative practices separate persons from qualities or attributes that are taken-for-granted essentialisms within modernist and structuralist paradigms. This process of externalization[1] allows people to consider their relationships with problems, thus the narrative motto: “The person is not the problem, the problem is the problem.” So-called strengths or positive attributes are also externalized, allowing people to engage in the construction and performance of preferred identities.

Operationally, narrative therapy involves a process of deconstruction and "meaning making" which are achieved through questioning and collaboration with the client. While narrative work is typically located within the field of family therapy, many authors and practitioners report using these ideas and practices in community work,[3] schools[4][5] and higher education.[6]

Although narrative therapists may work somewhat differently (for example, Epston uses letters and other documents with his clients, though this particular practice is not essential to narrative therapy), there are several common elements that might lead one to decide that a therapist is working "narratively" with clients.

Narrative therapy topics[edit]

Concept[edit]

Narrative therapy holds that our identities are shaped by the accounts of our lives found in our stories or narratives. A narrative therapist is interested in helping others fully describe their rich stories and trajectories, modes of living, and possibilities associated with them. At the same time, this therapist is interested in co-investigating a problem's many influences, including on the person himself and on their chief relationships.

By focusing on problems' effects on people's lives rather than on problems as inside or part of people, distance is created. This externalization or objectification of a problem makes it easier to investigate and evaluate the problem's influences.

Another sort of externalization is likewise possible when people reflect upon and connect with their intentions, values, hopes, and commitments. Once values and hopes have been located in specific life events, they help to “re-author” or “re-story” a person's experience and clearly stand as acts of resistance to problems.

The term “narrative” reflects the multi-storied nature of our identities and related meanings. In particular, re-authoring conversations about values and re-membering conversations about key influential people are powerful ways for people to reclaim their lives from problems. In the end, narrative conversations help people clarify for themselves an alternate direction in life to that of the problem, one that comprises a person's values, hopes, and life commitments.

Narrative approaches[edit]

Briefly, narrative approaches hold that identity is chiefly shaped by narratives or stories, whether uniquely personal or culturally general. Identity conclusions and performances that are problematic for individuals or groups signify the dominance of a problem-saturated story.

Problem-saturated stories gain their dominance at the expense of preferred, alternative stories that often are located in marginalized discourses. These marginalized knowledges and identity performances are disqualified or invisibilized by discourses that have gained hegemonic prominence through their acceptance as guiding cultural narratives. Examples of these subjugating narratives include capitalism; psychiatry/psychology; patriarchy; heterosexism; and Eurocentricity.

Furthermore, binaries such as healthy/unhealthy; normal/abnormal; and functional/dysfunctional ignore both the complexities of peoples’ lived experiences as well as the personal and cultural meanings that may be ascribed to their experiences in context.

Common elements[edit]

Common elements in narrative therapy are:

  • The assumption that narratives or stories shape a person's identity, as when a person assesses a problem in his life for its effects and influences as a "dominant story";
  • An appreciation for the creation and use of documents, as when a person and a counsellor co-author "A Graduation from the Blues Certificate";
  • An "externalizing" emphasis, such as by naming a problem so that a person can assess its effects in his life, come to know how it operates or works in his life, relate his earliest history, evaluate it to take a definite position on its presence, and in the end choose his relationship to it.
  • A focus on "unique outcomes" (a term of Erving Goffman) or exceptions to the problem that wouldn't be predicted by the problem's narrative or story itself.
  • A strong awareness of the impact of power relations in therapeutic conversations, with a commitment to checking back with the client about the effects of therapeutic styles in order to mitigate the possible negative effect of invisible assumptions or beliefs held by the therapist.
  • Responding to personal failure conversations[7]

Method[edit]

In Narrative therapy a person's beliefs, skills, principles, and knowledge in the end help them regain their life from a problem. In practice a narrative therapist helps clients examine, evaluate, and change their relationship to a problem by acting as an “investigative reporter” who is not at the centre of the investigation but is nonetheless influential; that is, this therapist poses questions that help people externalize a problem and then thoroughly investigate it.

Intertwined with this problem investigation is the uncovering of unique outcomes or exceptions to its influences, exceptions that lead to rich accounts of key values and hopes—in short, a platform of values and principles that provide support during problem influences and later an alternate direction in life.

The narrative therapist, as an investigative reporter, has many options for questions and conversations during a person's effort to regain their life from a problem. These questions might examine how exactly the problem has managed to influence that person's life, including its voice and techniques to make itself stronger.

On the other hand, these questions might help restore exceptions to the problem's influences that lead to naming an alternate direction in life. Here the narrative therapist relies on the premise that, though a problem may be prevalent and even severe, it has not yet completely destroyed the person. So, there always remains some space for questions about a person's resilient values and related, nearly forgotten events. To help retrieve these events, the narrative therapist may begin a related re-membering conversation about the people who have contributed new knowledges or skills and the difference that has made to someone and vice-versa for the remembered, influential person.

Outsider witnesses[edit]

In this particular narrative practice or conversation, outsider witnesses are invited listeners to a consultation. Often they are friends of the consulting person or past clients of the therapist who have their own knowledge and experience of the problem at hand. During the first interview, between therapist and consulting person, the outsider listens without comment.

Then the therapist interviews them with the instructions not to critique or evaluate or make a proclamation about what they have just heard, but instead to simply say what phrase or image stood out for them, followed by any resonances between their life struggles and those just witnessed. Lastly, the outsider is asked in what ways they may feel a shift in how they experience themselves from when they first entered the room.[8]

Next, in similar fashion, the therapist turns to the consulting person, who has been listening all the while, and interviews them about what images or phrases stood out in the conversation just heard and what resonances have struck a chord within them.

In the end, an outsider witness conversation is often rewarding for witnesses. But for the consulting person the outcomes are remarkable: they learn they are not the only one with this problem, and they acquire new images and knowledge about it and their chosen alternate direction in life. The main aim of the narrative therapy is to engage in people's problems by providing the alternative best solution.[citation needed]

Criticisms of narrative therapy[edit]

To date, there have been several formal criticisms of narrative therapy over what are viewed as its theoretical and methodological inconsistencies, among various other concerns.[9][10][11]

  • Narrative therapy has been criticised as holding to a social constructionist belief that there are no absolute truths, but only socially sanctioned points of view, and that Narrative therapists therefore privilege their client's concerns over and above "dominating" cultural narratives.[10][12]
  • Several critics have posed concerns that narrative therapy has made gurus of its leaders, particularly in the light that its leading proponents tend to be overly harsh about most other kinds of therapy.[10][12] Others have criticized narrative therapy for failing to acknowledge that the individual Narrative therapist may bring personal opinions and biases into the therapy session.[10]
  • Narrative therapy is also criticized for the lack of clinical and empirical studies to validate its many claims.[13] Etchison & Kleist (2000) state that narrative therapy's focus on qualitative outcomes is not congruent with larger quantitative research and findings which the majority of respected empirical studies employ today. This has led to a lack of research material which can support its claims of efficacy.[13]

See also[edit]

[14] ==References==

  1. ^ a b White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: WW Norton.
  2. ^ White, M. (2007). Maps of narrative practice. NY: W.W. Norton.
  3. ^ Dulwich Centre, 1997, 2000
  4. ^ Winslade, John & Monk, Gerald. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass. ISBN 0-7879-4192-1
  5. ^ (Lewis & Chesire, 1998)
  6. ^ (Nylund and Tilsen, 2006)
  7. ^ Narrative Means to Therapeutic Ends; Maps of Narrative Practice; White, M. (2000). Reflections on Narrative Practice Adelaide, South Australia: Dulwich Centre Publications
  8. ^ White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide: Dulwich Centre Publications. pp 15.
  9. ^ Fish, V., Post Structuralism in Family Therapy: Interrogating the Narrative/Conversational Mode. Journal of Family Therapy 19(3) 221-232 (1993)
  10. ^ a b c d Minuchin, S., Where is the Family in Narrative Family Therapy? Journal of Marital & Family Therapy, 24(4), 397-403 (1998)
  11. ^ Madigan, S., The Politics of Identity: Considering Community Discourse In The Externalizing of Internalized Problem Conversations, Journal of Systemic Therapies, 15(1), 47-62 (1996)
  12. ^ a b Doan, R.E., The King is Dead: Long Live the King: Narrative Therapy and Practicing What We Preach, Family Process 37(3), 379-385 (1998)
  13. ^ a b Etchison, M., & Kleist, D.M, Review of Narrative Therapy: Research and Review, Family Journal 8(1) 61-67 (2000)
  14. ^ Freedman, Jill and, Combs, Gene (1996). Narrative Therapy: The social construction of preferred realities. New York: Norton. ISBN 0-393-70207-3. 

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