Reading B

Submitted by tara.mills@up… on Thu, 12/08/2022 - 17:13

Corey, G. (2017). Narrative therapy. In Theory and practice of counseling and psychotherapy (10 ed.) (pp. 382-392). Cengage Learning.

Sub Topics

Of all the social constructionists, Michael White and David Epston (1990) are best known for their use of narrative in therapy. According to White (1992), individuals construct the meaning of life in interpretive stories, which are then treated as “truth.” Because of the power of dominant culture narratives, individuals tend to internalize the messages from these dominant discourses, which often work against the life opportunity of the individual.

Adopting a postmodern, narrative, social constructionist view sheds light on how power, knowledge, and “truth” are negotiated in families and other social and cultural contexts (Freedman & Combs, 1996). Narrative therapy is a strengths-based approach that emphasizes collaboration between client and therapist to help clients view themselves as empowered and living the way they want (Rice, 2015).

The key concepts and therapeutic process sections are adapted from several different works, but primarily from these sources: 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 in focus from most traditional theories. Therapists are encouraged to establish a collaborative approach with a special interest in listening respectfully to clients’ stories; to search for times in clients’ lives when they were resourceful; to use questions as a way to engage clients and facilitate their exploration; to avoid diagnosing and labelling clients or accepting a totalizing description based on a problem; to assist clients in mapping the influence a problem has had on their lives; and to assist clients in separating themselves from the dominant stories they have internalized so that space can be opened for the creation of alternative life stories (Freedman & Combs, 1996).

The Role of Stories

One of the theoretical underpinnings of narrative therapy is the notion that problems are manufactured in social, cultural, and political contexts. We live our lives by the stories we tell about ourselves and that others tell about us. Our stories shape reality in that they construct and constitute what we see, feel, and do. The stories we live by grow out of conversations in a social and cultural context. Change occurs by exploring how language is used to create and maintain problems (Rice, 2015). Therapy clients have vivid stories to recount. When stories are changed, not only is the person telling the story changed but the therapist who is privileged to be a part of this unfolding process is also changed (Monk, 1997).

Listening With an Open Mind

All social constructionist theories emphasize listening to clients without judgment or blame, affirming and valuing them. Narrative practice goes further in deconstructing the systems of normalizing judgment that are found in medical, psychological, and educational discourse. Normalizing judgment is any kind of judgment that locates a person on a normal curve and is used to assess intelligence, mental health, or normal behavior. Because these kinds of judgments claim to be objective measures, they are difficult for individuals to resist and usually are internalized. Narrative therapists argue that suspending personal judgment is of little value if you participate in normalizing judgment. Deconstruction involves turning the tables and asking what clients think of the judgments they have been assigned. Narrative practitioners might be said to invite people to pass judgment on the judgments that have been working them over. Narrative therapists help clients modify their painful beliefs, values, and interpretations as clients create meaning and new possibilities from the stories they share. Therapists do not impose their value system, and interpretations flow from clients’ stories rather than from a preconceived and ultimately imposed theory of importance and value.

Narrative therapists strive to listen to the problem-saturated story of the client without getting stuck. Therapists stay alert for details that give evidence of the client’s competence in taking stands against oppressive problems. Winslade and Monk (2007) maintain that the therapist believes the client’s abilities, talents, positive intentions, and life experiences can be the catalysts for new possibilities for action. The narrative therapist demonstrates faith that these inner resources and competencies can be identified, even when the client is having difficulty seeing them.

During the narrative conversation, attention is given to avoiding totalizing language, which reduces the complexity of the individual by assigning an all-embracing, single description to the essence of the person. Therapists begin to separate the person from the problem in their mind as they listen and respond (Winslade & Monk, 2007). This is called double listening.

The narrative perspective focuses on the capacity of humans for creative and imaginative thought, which is often found in their resistance to dominant discourse. Narrative practitioners do not assume that they know more about the lives of clients than their clients do. Clients are the primary interpreters of their own experiences. People are viewed as active agents who are able to derive meaning from their experiential world, and they are encouraged to join with others who might share in the development of a counter story.

colanalysing new financial project while working together on office desk

This brief overview of the steps in the narrative therapeutic process illustrates the structure of the narrative approach (O’Hanlon, 1994, pp. 25–26):

  • Collaborate with the client to come up with a mutually acceptable name for the problem.
  • Personify the problem and attribute oppressive intentions and 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 inquiring into 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 counter story. The client needs to live the counter 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 (2007) stress that narrative conversations do not follow the linear progression described here; it is better to think of these steps in terms of cyclical progression containing the following elements:

  • Move problem stories toward externalized descriptions of problems.
  • Map the effects of a problem on the individual.
  • Invite the individual to evaluate the problem and its effects.
  • Listen to signs of strength and competence in an individual’s problem-saturated stories.
  • Build a new story of competence and document these achievements.

Therapy Goals

A general goal of narrative therapy is to invite people to describe their experience in new and fresh language. In doing this, they open new vistas of what is possible. This new language enables clients to develop new meanings for problematic thoughts, feelings, and behaviors (Freedman & Combs, 1996). Narrative therapy almost always includes an awareness of the impact of various aspects of dominant culture on human life. Narrative practitioners seek to enlarge the perspective and facilitate the discovery or creation of new options that are unique to the people they see.

Therapist’s Function and Role

Narrative therapists are active facilitators. The concepts of care, interest, respectful curiosity, openness, empathy, contact, and even fascination are seen as a relational necessity. The not-knowing position, which allows therapists to follow, affirm, and be guided by the stories of their clients, creates participant-observer and process-facilitator roles for the therapist and integrates therapy with a postmodern view of human inquiry.

A main task of the therapist is to help clients construct a preferred story line. The narrative therapist adopts a stance characterized by respectful curiosity and works with clients to explore both the impact of the problem on them and what they are doing to reduce the effects of the problem (Winslade & Monk, 2007). One of the main functions of the therapist is to ask questions of clients and, based on the answers, to generate further questions.

White and Epston (1990) start with an exploration of the client in relation to the presenting problem. It is not uncommon for clients to present initial stories in which they and the problem are fused, as if one and the same. White uses questions aimed at separating the problem from the people affected by the problem. This shift in language begins the deconstruction of the original narrative in which the person and the problem were fused; now the problem is objectified as external to the client.

Like the solution-focused therapist, the narrative therapist assumes the client is the expert when it comes to what he or she wants in life. The narrative therapist tends to avoid using language that embodies diagnosis, assessment, treatment, and intervention. Functions such as diagnosis and assessment often grant priority to the practitioner’s “truth” over clients’ knowledge about their own lives. The narrative approach gives emphasis to understanding clients’ lived experiences and deemphasizes efforts to predict, interpret, and pathologize.

Monk (1997) emphasizes that narrative therapy will vary with each client because each person is unique. For Monk, narrative conversations are based on a way of being, and if narrative counseling “is seen as a formula or used as a recipe, clients will have the experience of having things done to them and feel left out of the conversation” (p. 24).

The Therapeutic Relationship

Narrative therapists place great importance on the values and ethical commitments a therapist brings to the therapy venture. Some of these attitudes include optimism and respect, curiosity and persistence, valuing the client’s knowledge, and creating a special kind of relationship characterized by a real power-sharing dialogue (Winslade & Monk, 2007). Collaboration, compassion, reflection, and discovery characterize the therapeutic relationship. The strengths-based and future-focused nature of narrative therapy lends itself to a more collaborative relationship than problem-based approaches that emphasize the therapist as the expert in the relationship (Rice, 2015). If this relationship is to be truly collaborative, the therapist needs to be aware of how power manifests itself in his or her professional practice. This does not mean that the therapist does not have authority as a professional. He or she uses this authority, however, by treating clients as experts in their own lives.

Winslade, Crocket, and Monk (1997) describe this collaboration as co-authoring or sharing authority. Clients function as authors when they have the authority to speak on their own behalf. In the narrative approach, the therapist-as-expert is replaced by the client-as-expert. This notion challenges the stance of the therapist as being an all-wise and all-knowing expert.

Clients are often stuck in a pattern of living a problem-saturated story that does not work. When a client has a limited perception of his or her capacities due to being saturated in problem thinking, it is the job of the therapist to elicit other strength-related stories to modify the client’s perception. The therapist assists the client in this pursuit by entering into a dialogue and asking questions in an effort to elicit the perspectives, resources, and unique experiences of the client. The past is history, but it sometimes provides a foundation for understanding and discovering news of differences or unique outcomes that will make a difference. The history of the problem often dominates understanding, but there is another history that narrative therapists argue should not be neglected. It is the history of the counter story to the problem story, which is constructed in conversation and becomes the foundation for a different future. The narrative therapist supplies the optimism and sometimes a process, but the client generates what is possible and contributes the movement that actualizes it.

a woman having a consultation session with a young lady

The effective application of narrative therapy is more dependent on therapists’ attitudes or perspectives than on techniques. In the practice of narrative therapy, there is no recipe, no set agenda, and no formula that the therapist can follow to assure positive results (Drewery & Winslade, 1997). When externalizing questions are approached mainly as a technique, the intervention will be shallow, forced, and unlikely to produce significant therapeutic effects (Freedman & Combs, 1996; O’Hanlon, 1994).

Narrative therapists are in agreement with Carl Rogers on the importance of the therapist’s way of being rather than being technique driven. A narrative approach to counseling is more than the application of skills; it is based on the therapist’s personal characteristics that create a climate that encourages clients to see their stories from different perspectives. Narrative therapists emphasize their willingness to see beyond dominant cultural norms and to appreciate clients’ differences. However, a series of “maps” of narrative conversational trajectories can help give structure and direction to a therapeutic conversation (White, 2007).

Questions . . . and More Questions

The questions narrative therapists ask may seem embedded in a unique conversation, part of a dialogue about earlier dialogues, a discovery of unique events, or an exploration of dominant culture processes and imperatives. Whatever the purpose, the questions are often circular, or relational, and they seek to empower clients in new ways. To use Gregory Bateson’s (1972) famous phrase, they are questions in search of a difference that will make a difference.

Narrative therapists use questions as a way to generate experience rather than to gather information. The aim of questioning is to progressively discover or construct the client’s experience so that the client has a sense of a preferred direction. Questions are always asked from a position of respect, curiosity, and openness. Therapists ask questions from a not-knowing position, meaning that they do not pose questions that they think they already know the answers to.

Through the process of asking questions, therapists provide clients with an opportunity to explore various dimensions of their life situations. This questioning process helps bring out the unstated cultural assumptions that contribute to the original construction of the problem. The therapist is interested in finding out how the problems first became evident, and how they have affected clients’ views of themselves (Monk, 1997). Narrative therapists attempt to engage people in deconstructing problem-saturated stories, identifying preferred directions, and creating alternative stories that support these preferred directions. For a more complete discussion of the use of questions in narrative therapy, see Madigan (2011).

Externalization and Deconstruction

Narrative therapists believe it is not the person that is the problem, but the problem that 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 with them. Narrative therapists help clients deconstruct these problematic stories by disassembling the taken-for-granted assumptions that are made about an event, which then opens alternative possibilities for living.

Externalization is one process for deconstructing the power of a narrative. This process separates the person from identification with the problem. When clients view themselves as “being” the problem, they are limited in the ways they can effectively deal 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 and enables clients to take a stand against specific story lines, such as self-blame. By understanding the cultural invitations to blame oneself, clients can deconstruct this story line and generate a more positive, healing story.

The method used to separate the person from the problem is referred to as externalizing conversation, which opens up space for new stories to emerge. This method is particularly useful when people have internalized diagnoses and labels that have not been validating or empowering of the change process (Bertolino & O’Hanlon, 2002). Externalizing conversations counteract oppressive, problem-saturated stories and empower clients to feel competent to handle the problems they face. Two stages of structuring externalizing conversations are (1) to 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 (McKenzie & Monk, 1997).

Mapping the influence of the problem on the person generates a great deal of useful information and often results in people feeling less shamed and blamed. People feel listened to and understood when the problem’s influences are explored in a systematic fashion. A common question is, “When did this problem first appear in your life?” When this mapping is done carefully, it lays the foundation for coauthoring a new story line for the client. Often clients feel outraged when they see for the first time how much the problem is affecting them. The job of the therapist is to assist clients in tracing the problem from when it originated to the present. Therapists may put a future twist on the problem by asking, “If the problem were to continue for a month (or any time period), what would this mean for you?” This question can motivate the client to join with the therapist in combating the impact of the problem’s effects. Other useful questions are “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. This kind of mapping can help the client who is disillusioned by the problem see some hope for a different kind of life. Therapists look for these “sparkling moments” as they engage in externalizing conversations with clients (White & Epston, 1990).

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 it’s too late. I’ve messed up again.” Questions about how his anger occurs, complete with specific examples and events, can help chart the influence of the problem. However, it is questions like the ones that follow that externalize the problem: “What is the mission of the anger, and how does it recruit you into this mission?” “How does the anger get you, and how does it trick you into letting it become so powerful?” “What does the anger require of you, and what happens to you when you meet its requirements?” “What cultural supports (in your family/community/world) have shaped the role that anger plays for you?”

Search for Unique Outcomes

guy having hot drink, working on laptop

In the narrative approach, externalizing questions are followed by questions searching for unique outcomes. The therapist talks to the client about moments of choice or success regarding the problem. This is done by selecting for attention any experience that stands apart from the problem story, regardless of how insignificant it might seem to the client. The therapist may ask: “Was there ever a time in which anger wanted to take you over, and you resisted? What was that like for you? How did you do it?” These questions are aimed at highlighting moments when the problem has not occurred or when the problem has been dealt with successfully. Unique outcomes can often be found in the past or the present, but they can also be hypothesized for the future: “What form would standing up against your anger take?” Exploring questions such as these enables clients to see that change is possible. Linking a series of such unique outcomes together starts to form a counter story. It is within the account of unique outcomes that a gateway is provided for alternative versions of a person’s life (White, 1992).

Following the description of a unique outcome, White (1992) suggests posing questions, both direct and indirect, that lead to the elaboration of preferred identity stories:

  • What do you think this tells me about what you have wanted for your life and about what you have been trying for in your life?
  • How do you think knowing this has affected my view of you as a person?
  • Of all those people who have known you, who would be least surprised that you have been able to take this step in addressing your problem’s influence in your life?
  • What actions might you commit yourself to if you were to more fully embrace this knowledge of who you are? (p. 133)

The development of unique outcome 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?
  • Iguess there are a number of people who have an outdated view of who you are as a person. What ideas do you have about updating these views?
  • If other people seek therapy for the same reasons you did, can I share with them any of the important discoveries you have made? (p. 23)

These questions are not asked in a barrage-like manner. Questioning is an integral part of the context of the narrative conversation, and each question is sensitively attuned to the responses brought out by the previous question (White, 1992).

McKenzie and Monk (1997) suggest that therapists seek permission from the client before asking a series of questions. By letting a client know that they do not have answers to the questions they raise, therapists are putting the client in control of the therapeutic process. Asking permission of the client to use persistent questioning tends to minimize the risk of inadvertently pressuring the client.

Alternative Stories and Reauthoring

Constructing counter stories goes hand in hand with deconstruction, and the narrative therapist listens for openings to counter stories. People can continually and actively reauthor their lives, and narrative therapists invite clients to author alternative stories through “unique outcomes”; these events could not be predicted from listening to the dominant problem-saturated story and are not included in any narrative about the person. The narrative therapist asks for openings: “Have you ever been able to escape the influence of the problem?” The therapist listens for clues to competence in the midst of a problematic story and builds a story of competence around it. Madigan (2011) suggests that a person’s life story is probably much more interesting than the story being told. He maintains a therapist’s main task is “to help people to remember, reclaim and reinvent a richer, thicker, and more meaningful alternative story” (p. 159).

A turning point in the narrative interview comes when clients make the choice of whether to continue to live by a problem-saturated story or to state a preference for an alternative story (Winslade & Monk, 2007). Through the use of unique possibility questions, the therapist moves the focus into the future. For example: “Given what you have learned about yourself, what is the next step you might take?” “When you are acting from your preferred identity, what actions will it lead you to do more of?” Such questions encourage people to reflect upon what they have presently achieved and what their next steps might be.

White and Epston’s (1990) inquiry into unique outcomes is similar to the exception questions of solution-focused therapists. Both seek to build on the competence already present in the person. The development of alternative stories, or narratives, is an enactment of ultimate hope: Today is the first day of the rest of your life. Refer to Case Approach to Counseling and Psychotherapy (Corey, 2013, chap. 11) for two concrete examples of a narrative approach to working with Ruth from the perspectives of Dr. Gerald Monk and Dr. John Winslade.

Documenting the Evidence

Narrative practitioners believe that new stories take hold only when there is an audience to appreciate and support them. Gaining an audience for the news that change is taking place needs to occur if alternative stories are to stay alive, and an appreciative audience to new developments is consciously sought.

One technique for consolidating the gains a client makes involves a therapist writing letters to the person. Narrative therapists have pioneered the development of therapeutic letter writing. These letters that the therapist writes provide a record of the session and may include an externalizing description of the problem and its influence on the client, as well as an account of the client’s strengths and abilities that are identified in a session. Letters can be read again at different times, and the story that they are part of can be reinspired. The letter highlights the struggle the client has had with the problem and draws distinctions between the problem-saturated story and the developing new and preferred story (McKenzie & Monk, 1997).

Epston has developed a special facility for carrying on therapeutic dialogues between sessions through the use of letters (White & Epston, 1990). His letters may be long, chronicling the process of the interview and the agreements reached, or short, highlighting a meaning or understanding reached in the session and asking a question that has occurred to him since the end of the previous therapy visit. Usually they include as many direct quotations from what the client said as possible. These letters are used to encourage clients, noting what they said about their own accomplishments in relation to handling problems or speculating on the meaning of their accomplishments for others in their community. Letters documenting the changes clients have achieved tend to strengthen the significance of the changes, both for the client and for others in the client’s life.

Narrative letters reinforce the importance of carrying what is being learned in the therapy office into everyday life. The message conveyed is that participating fully in the world is more important than being in the therapy office. In an informal survey of the perceptions of the value of narrative letters by past clients, the average worth of a letter was equal to more than three individual sessions (Nylund & Thomas, 1994). This finding is consistent with McKenzie and Monk’s (1997) statement: “Some narrative counselors have suggested that a well-composed letter following a therapy session or preceding another can be equal to about five regular sessions” (p. 113).

Application to Group Counseling

Many of the techniques described in this chapter can be applied to group counseling. Winslade and Monk (2007) claim that the narrative emphasis on creating an appreciative audience for new developments in an individual’s life lends itself to group counseling. They state: “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 into a wider world” (p. 135). They give several examples of working in a narrative way with groups in schools: getting back on track in schoolwork; an adventure-based program; an anger management group; and a grief counseling group. For a detailed description of these narrative groups, see Winslade and Monk (2007, chap. 5).

men sitting by table in office at start-up meeting and brainstorming

Strengths From a Diversity Perspective

Social constructionism is congruent with the philosophy of multiculturalism. One of the problems that culturally diverse clients often experience is the expectation that they should conform their lives to the truths and reality of the dominant society of which they are a part. With the emphasis on multiple realities and the assumption that what is perceived to be a truth is the product of social construction, the postmodern approaches are a good fit with diverse worldviews.

The social constructionist approach to therapy provides clients with a framework to think about their thinking and to determine the impact stories have on what they do. Clients are encouraged to explore how their realities are being constructed out of cultural discourse and the consequences that follow from such constructions. Within the framework of their cultural values and worldview, clients can explore their beliefs and provide their own reinterpretations of significant life events. The practitioner with a social constructionist perspective can guide clients in a manner that respects their underlying values. This dimension is especially important in those cases where counselors are from a different cultural background or do not share the same worldview as their clients.

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 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.

Narrative therapy is a relational and anti-individualistic practice. Michael White believes that to address a person’s struggles in therapy without a relational and contextual understanding of his or her story is entirely absurd (as cited in Madigan, 2011). Narrative therapists concentrate on problem stories that dominate and subjugate at the personal, social, and cultural levels. The sociopolitical conceptualization of problems sheds light on those cultural notions and practices that produce dominant and oppressive narratives. From this orientation, practitioners take apart the cultural assumptions that are a part of a client’s problem situation. People are able to come to an understanding of how oppressive social practices have affected them. This awareness can lead to a new perspective on dominant themes of oppression that have been such an integral part of a client’s story, and with this cultural awareness new stories can be generated.

In their discussion of the multicultural influences on clients, Bertolino and O’Hanlon (2002) approach clients without a preconceived notion about their experience and learn from their clients about their experiential world. Bertolino and O’Hanlon practice multicultural curiosity by listening respectfully to their clients, who become their best teachers. Here are some questions these authors suggest as a way 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 can you share with me about your background that will enable me to more fully understand you?
  • What challenges have you faced growing up in your culture?
  • What, if anything, about your background has been difficult for you?
  • How have you been able to draw on strengths and resources from your culture? What resources can you draw from in times of need?

Questions such as these can shed light on specific cultural influences that have been sources of support or that contributed to a client’s problem.

Shortcomings From a Diversity Perspective

A potential shortcoming of the postmodern approaches pertains to the not-knowing stance the therapist assumes, along with the assumption of the client-as-expert. 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. If the therapist is telling the client, “I am not really an expert; you are the expert; I trust in your resources for you to find solutions to your problems,” then this may engender lack of confidence in the therapist. To avoid this situation, the therapist using a solution-focused or a narrative orientation needs to convey to clients that he or she has expertise in the process of therapy but clients are the experts in knowing what they want in their lives. The postmodern approaches stress being transparent with clients and honoring their hopes and expectations in therapy. This emphasis creates a context for providing culturally responsive services.

Module Linking
Main Topic Image
man looks at the notepad while working on laptop in cafe
Is Study Guide?
Off
Is Assessment Consultation?
Off