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Postmodern Approach: Narrative Therapy

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on 30 November 2014

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Transcript of Postmodern Approach: Narrative Therapy

Michael White (1949 - 2008) was the cofounder, with David Epston, of the narrative therapy movement. He founded the Dulwich Centre in Adelaide, Australia.
Founders of Postmodern Therapies:
Narrative Therapy
Shortcomings From a Diversity Perspective
The postmodern approaches stress being transparent with clients and honoring their hopes and expectations in therapy.
An Introduction
Narrative Therapy
The Postmodern Approach and Social Constructivism
David Epston (1944) is one of the
co-developers of narrative therapy.
He is the co-director of the Family
Therapy Centre in Auckland, NZ. He travels all over the world presenting ectures and workshops.
Individuals construct meaning from interpretive stories which are treated as "truth"
The power of the dominant culture narratives often causes people to internalize the messages from these dominant discourses - some of these narratives work against the life opportunity of the individual.
Therapy works to reestablish personal agency from the oppression of external problems and the dominant stories of the larger culture and system of stories
Key Concepts
The key concepts and therapeutic process
ideas are adapted from the work of Winslade
and Monk (2007), Monk (1997), Winslade,
Crocket and Monk (1997), McKenzie and
Monk (1997) and Freedman and Combs (1996).
Focus of Narrative Therapy
The narrative approach involves adopting a shift from most traditional theories. Therapists establish a collaborative approach listening respectfully to clients' stories searching fora time in the clients' lives when they were resourceful. They seek to avoid diagnosing and labeling or believing story absolutes. Rather they assist the client in mapping the influence a problem has had on their lives, assist them in separating themselves from the dominant stories they have internalized, creating a space for the creation of an alternative life story.
The Role of Stories
We live by the stories we tell about ourselves and that others tell about us. These stories shape reality and construct and constitute what we see, feel and do in our social and cultural context Narrative therapy clients do not assume the role of victims, (hopeless and pathetic), rather they emerge as courageous, victors who have vivid stories to recount. Both the client and therapist are a part of this unfolding process.
Listening With an Open Mind
All social constructionist theories emphasize listening to clients without judgement or blame. Narrative practice goes further in deconstructing the systems of normalizing judgements that are found in medical, psychological, and educational discourse. (Normalizing judgement uses a curve to assess medical, psychological/mental health and behavior. As objective measures they are attractive and easily internalized.) Narrative therapy invites the client to pass judgement on the judgements in one's life. Clients are asked to see both good and bad in situations, modify painful beliefs without imposing values and interpretations, and create meaning and new possibilities from old stories.
The Role of Stories....cont'd
Although narrative therapists bring to the therapy venture certain attitudes such as optimism, respectful curiosity, and persistence, and a valuing for the client's knowledge, they seek to listen to the problem-saturated story of the client without getting stuck. The narrative therapists stays alert for details that give evidence of the client's competence in taking stand against oppressive problems. Winslade and Monk maintain that the therapist believes that clients have abilities, talents, positive intentions, and life experiences that can be the catalysts for new possibilities for action.

The counselor needs to demonstrate faith that these strengths and competencies can be identified, even when the client is having difficulty seeing them. The narrative perspective focuses on the capacity of humans for creative and imaginative thought pushing through the voice of dominant discourse.
The Therapeutic Process - A Brief Overview
Collaborate
with the client to come up with a name for the problem.
Personify
the problem and attribute oppressive tactics to it.
Investigate
how the problem has been disrupting, dominating or discouraging to the client.
Invite
the client to see his or her story from a different perspective by offering alternative meanings for events.
Discover
moments when the client wasn't dominated or discouraged by the problem by searching for exceptions to the problem.
Find
historical evidence to bolster a new view of the client as competent enough to have stood up to, defeated or escaped from the dominance or oppression of the problem.
At this phase the person's identity and life story begin to be rewritten.
Ask
the client to speculate about what kind of future could be expected from the strong, competent person who is emerging. As the client becomes free of problem-saturated stories of the past, he or she can envision and plan for a less problematic future.
Find or create
an audience for perceiving and supporting the new story. It is not enough to recite a new story. The client needs to ilve the new story outside of therapy. Because the person's problem initially developed in a social context, it is essential to involve the social environment in supporting the new life story that has emerged in the conversations with the therapist.
Winslade and Monk stress that narrative conversations are not linear but a cyclical progression with the following elements:
move
problems stories toward externalized descriptions of problems
map
the effects of a problem on the individual
listen
to signs of strength and competence in an individual's problem-saturated stories
build
new story competence and
document
these achievements.
Therapy Goals
Therapist's Function and Role
Narrative therapists are active facilitators where care, interest, respectful curiosity, openness empathy, contact and even fascination are seen as a relational necessity.
Therapists are to follow, affirm, and be guided by the stories of their clients, creating the role of participant-observer and process-facilitator roles that integrates therapy with the postmodern view of human inquiry.
The therapist adopts the stance of respectful curiosity so that he or she can explore both the impact of the problem on them and what they are doing to reduce the effects of the problem (Winslade and Monk, 2007).
At the beginning of therapy, the therapist uses questions aimed at separating the problem from the people affected by the problem. This shift in language begins the deconstruction of the original, problematic narrative where the person and problem were fused and creating a situation where the problem is objectified as external to the client.
Narrative practitioners work to make sure the client sees him or herself as the agent of change.
There are no set formulas in narrative therapy and each client will experience change in his or her own time and way.
Application: Therapeutic Techniques and Procedures
The effective application of narrative therapy is more dependent on the therapists' attitudes than on technique. Narrative therapists are in agreement with Carl Rogers on the notion of the therapist's way-of-being as opposed to being technique driven.
However, a series of "maps" of narrative conversational trajectories can help give structure and direction to a therapeutic conversation and these assist the client in finding new meanings and possibilities.
Questions...And More Questions
The purpose of the questions is to explore the client's dominant cultural processes and imperatives.
The questions are circular and intended to empower the client.
The aim of questions is to progressively discover or construct the client's experience so that the client has a sense of a preferred direction.
Questions are not asked from a position of knowing the answer.
Questioning provides the clients with an opportunity to explore various dimensions of their life situations - identifying preferred directions and creating alternative stories that support thee preferred directions.
Externalization and Deconstruction
Externalization and Deconstruction
Externalization and Deconstruction
Narrative therapists believe it not the person that is the problem, but the problem is the problem (White 1989). These problems often are products of the cultural world or of the power relations in which this world is located. Living life means relating to problems not being fused by them.
To use Gregory Bateson's (1972) famous phrase, they are questions in search of a difference that will make a difference.
Externalization
Externalization is one process for deconstructing the power of a narrative.
This process separates the person from identification with the problem.
When clients experience the problem as being located outside of themselves, they create a relationship with the problem. For example, there is quite a difference between labeling someone an alcoholic and indicating that alcohol has invaded his or her life.
Separating the problem from the individual facilitates hope.
By understanding the cultural invitations to blame oneself, clients can deconstruct this story ine and generate a more positive, healing story.
The method used to separate the person from the problem is referred to as externalizing conversation
.
Externalizing conversations counteract oppressive, problem-saturated stories and empower clients to feel competent to handle the problems they face and they occur in two stages.
Two Stages
1. map the influence of the problem in the
person's life, and,
2. to map the influence of the person's life back
on the problem
Mapping
Mapping the influence of the problem on the person generates a great deal of information. Helpful questions are, "When did this problem first appear in your life? or "If the problem were to continue for a month (insert any time), what would this mean for you?" or "To what extent has this problem influenced your life?" and "How deeply has this problem affected you?"


It is important to identify instances when the problem did not completely dominate a client's life. Therapists look for sparkling moments as they engage in externalizing conversations with clients.
The Case of Brandon
The case of Brandon illustrates an
externalizing conversation
. Brandon says that he gets angry far too much, especially when he feels that his wife is criticizing him unjustly: "I just flare! I pop off, get upset, fight back. Later I wish I hadn't,but its' too late. I've messed up again."

To
externalize
the issue, the therapist asks, "
What
is the mission of the anger and how does it recruit you into this mission?" or "
How
does the anger get you, and how does it trick you into letting it become so powerful?" or "
What
does the anger require of you, and what happens to you when you meet its requirements?" and "
What
cultural supports (family, community/world) have shaped the role that anger plays for you?"
Search for Unique Outcomes
In the narrative approach, externalizing questions are followed by questions searching for
unique outcomes
- those moments of choice or success regarding any problem. This is done by selecting for attention any experience that stands apart from the problem story, regardless of how insignificant it may seem. The therapist may ask, "Was there ever a time in which anger wanted to take you over, and you resister? What was that like for you? How did you do it?"

Unique outcomes
can be found in the past, the present or hypothesized for the future: "What form would standing up against your anger take?" Exploring questions like this gives the client the ability to see change is possible. Linking a series of
unique outcomes
together creates a counter story.

Following the description of a
unique outcome,
White (1992) suggests posing questions, both direct and indirect, that lead to the elaboration of preferred identify stories:
What do you think this tells me about what you have wanted for your life?
What actions might you commit yourself t if you were to more fully embrace this
knowledge of who you are?

The development of
unique outcomes stories
into
solution stories
is facilitated by what Epston and White (1992) call "circulation questions".
Now that you have reached this point in life, who else should know about it?
There are a number of people who have an outdated view of who you are. What ideas do you have
about updating these views?

Questioning
is an important part of the narrative conversation. Questions are sensitive to the situation, and it is best to let the client know that this therapy uses questions; the client can control how many and the extent to which the questions go.
Documenting the Evidence
Narrative practitioners believe that the new stories take hold only when there is an audience to appreciate and support them. One technique for consolidating the gains made by the client is therapeutic letter writing. Letters can be read again at different times and the story they are a part of can be re-inspired. These letters are used to encourage clients, noting their accomplishments and these tend to strengthen the significance of the change.

Some therapist may write letters to their client as a part of their practice (Nyland).

Nyland and Thomas (1994) contend that narrative letters reinforce the importance of carrying what is being learned in the therapy office into everyday life.


"Some narrative counselors have suggested that a well-composed letter...can be equal to about five regular (therapy) sessions."
A general goal of narrative therapy is to invite people to describe their experience in new, fresh language.
They open new vistas of what is possible.
Narrative therapy includes an awareness of the impact of the dominant culture on human life.
Practitioners seek to enlarge the perspective and focus and facilitate the discovery or creation of new options that are unique to the people they see.
Application to Group Counseling
Many of the techniques used in narrative therapy can be applied to group counseling.

"Groups provide a ready-made community of concern and many opportunities for the kind of interaction that opens possibilities for new ways of living. New identities can be rehearsed and tried out in a wider world." (Winslade and Monk 2007)
Strength From a Diversity Perspective
Social constructionism is congruent with the philosophy of multiculturalism. Narrative therapy is grounded in a sociocultural context, which makes this approach especially relevant for counseling culturally diverse clients. Narrative therapists operate on the premise that the problems are identified within social, cultural, political and relational contexts rather than existing within individuals. They are very much concerned with considering the specifications of gender, ethnicity, race, disability, sexual orientation, social class, and spirituality and religion as therapeutic issues. Furthermore, therapy becomes a place to reauthor the social constructions and identity narratives that clients are finding problematic.

Possible questions to more fully understand multicultural influences on a client:
Tell me more about the influence that [some aspect of your culture] has played in your life.
What challenges have you faced growing up in your culture?
What can you tell me about your background/culture that will enable me to more fully understand you?
Individuals from many different cultural groups tend to elevate the professional as the expert who will offer direction and solutions for the person seeking help. To avoid this situation, the therapist using either the solution-focused or narrative orientation needs to convey to clients that he or she has the expertise in the process - that the client is the expert in knowing what they want in his or her life.
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