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Narrative Approach in Family Therapy

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Daniel Palac

on 5 December 2013

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Transcript of Narrative Approach in Family Therapy

Narrative Approach in Family Therapy

Sketches of Leading Figures
Michael White ->
founder of the narrative movement

David Epston ->
family therapist from New Zealand, second most influential leader of narrative movement

Jill Freedman & Gene Combs ->
direct a training center in Evanston, IL and wrote the book,
Narrative Therapy

Jeffrey Zimmerman & Vicki Dickerson ->
pioneered use of narrative therapy with adolescents and with couples

Harlene Anderson & Harry Goolishian ->
developed collaborative, conversational approach to family therapy

Adler School of Professional Psychology*
Dan Palac

Sketches of Leading Figures

Theoretical Formulations

Normal Family Development (What's Normal?)

Development of Behavior Disorders

Goals of Therapy

Conditions for Behavior Change

Family Therapy - Therapeutic Techniques

Summary
Overview of Narrative Therapy Presentation
Narrative Therapy
Narrative therapy approach is a perfect expression of the postmodern revolution because family therapy is concerned with the ways people construct meaning rather than behavior
The underlying premise is that personal experience is fundamentally ambiguous
Theoretical Formulations
Narrative approach was first viewed as a
hermeneutic
tradition in psychoanalysis, or based on an individual's interpretation, similar to Freudian therapy
Revisionists in 1980s shifted the goal of narrative therapy from a historical truth to a narrative intelligibility
Family therapists began to recognize how much narrative accounts affected people's perceptions
Stories just don't mirror life...they shape it
Tim and Kayla example
Instead of having or being a problem, clients are encouraged to to think of themselves as struggling against their problems

The problem is the problem!
Externalization of Problems
Normal Family Development
Therapists avoid judgments about what is normal and also the idea of categorizing people
Therapists avoid labeling someone as normal or abnormal and reject principles about what causes problems or what resolves them
Michael Foucault
Social philosopher who believed those in authoritarian positions not only had the power to subjugate society, but also have the narratives become internalized truths


Influenced White to take the
social constructionist
axiom that there are no absolute truths in a politcal direction. Must deconstruct established truths that oppress people's lives
Collaboration
Therapists situate themselves with clients by disclosing personal beliefs that inform their therapy so clients know what they're getting into

Clients are encouraged to educate therapists regarding their cultural problems and to correct them when they make assumptions that don't fit the client's experience
Development of Behavior Disorders
Problems persist when unhelpful stories remain fixed and obscure other more helpful versions of the events
Single mother example

Narrative approach does not focus on behavior, but rather the stories and how they affect the person and how they interpret the experience

Problem-saturated stories ->
patterns of tunnel vision regarding the demonstrated behavior and response that perpetuates the problem story
Alien Invaders
Closed and rigid narratives that make people vulnerable to being overtaken by destructive emotional states

Externalizing the problem reduces guilt and blame, daughter isn't the problem, rebelliousness is; mother isn't the problem, oversensitivity is

Example of anorexia
Goals of Therapy
Not problem solvers
Therapy transforms identities from flawed to preferred
Unique outcomes -> times when the individual resisted the problem or behaved in ways that contradicted the problem story
To free people from oppressive cultural assumptions and empower them to become active authors of their own lives
Conditions for Behavior Change
Narrative therapists deconstruct unproductive stories in order to reconstruct new and more productive ones

Reconstruction involves creating new, more optimistic stories using externalizing conversations to help separate persons from problems

Therapists ask
effects questions
such as, "How does the problem affect yourself, relationships, attitudes, ideas about yourself?
-These questions aim to broaden the client's sense of his or her problem and notice areas in their lives where the problem has been less powerful
Therapy
Assessment
Narrative assessment begins with getting the family's history, including their experience with the problem as well as their assumptions about the problem

Approach assessment as both anthropologist and hypnotist
Anthropologist in the sense of investigation
Hypnotist in the sense of asking these questions in a process that empowers clients...."Tell me your story. What would you have preferred to happen? What were you hoping to accomplish?"

Mapping the influence of the problem on the family vs. mapping the influence of the family on the problem
Therapy
Therapeutic Techniques
Role of therapist is to continue asking question after question, following the client's lead and repeating their answers

Initial session is to gather information on how the client spends his or her time, without getting into a lengthy history
Therapist acknowledges talents and competencies
Client can ask the therapist any question they would like in order to establish a collaborative atmosphere
Externalizing Conversations
The therapist's questions about the identified problem imply that it isn't possessed by the clients but instead is trying to possess them

The problem is almost always personified...anorexia is a person's problem, "How does anorexia convince you to starve yourself?"
Reading Between the Lines of the Problem Story
The therapist listens for sparkling events or unique outcomes - times when the person was able to avoid the problem's effects
Reauthoring
Therapists ask questions regarding the client's past victories over the problem in order to begin creating a new narrative that has evidence of competence relative to the problem
Summary of Narrative Therapy
The Narrative approach is built on two metaphors:
1) personal narrative
2) social construction

Therapists try to break the grip of unhelpful stories by externalizing the problems
externalize.....find unique outcomes.....recruit support

Instead of looking within families for dysfunctional interactions, therapists look outside for destructive influences or cultural values and institutions
Basic Assumptions of Normal Families
1) Families have good intentions
2) Families are profoundly influenced by the discourses around them
3) Families are not their problems
4) Families can develop alternative, empowering stories once separated from their problems and the cultural myths they have internalized
Example of Alice
Alice sees herself as codependent because of the way she relates to men.
Therapist would explore reasons for this assumption by asking questions about what codependency means
Alice may say codependency allows her to blame herself
Therapist then has Alice highlight times when she related to men in ways she prefers
Also has Alice consider how society's view of women contributed to her self-blame
Reinforcing the New Story
Clients should contact people from their past who can authenticate their new story- who can confirm and add to the examples of their acting capably
Recruiting allies
Joining leagues
Rereading letters
Narrative therapists summarize sessions at end
Deconstructing Destructive Cultural Assumptions
Narrative therapists make the connection to cultural narratives more explicit

Example of violent man never being weak or tender
Example of John-> never cried, no emotion. grew up in Australia being taught not to cry or be "soft" and if so this was unmanly. Deconstruction-> Asking questions about this experience.."Do you think rituals of humiliation alienated you from your own life? Did these practices help or hinder you in recognizing a different way of being male?"
SHAMELESS
Pilot Episode
Full transcript