Narrative Therapy

SOW6425
Professor Nan Van Den Bergh
 NARRATIVE THEORY

• All people are engaged in an ongoing process of constructing a

life story, or personal narrative, that determines their self-
understanding and their positions in the world

• It is the words we use, and the stories we learn to tell about

ourselves and others, that create our psychological and social
realities

• Our life narratives are co-constructed with the narratives of

significant other people in the family, community, and culture

• The way we speak, and the things we speak about, are

determined (and limited) by our cultural heritage
 NARRATIVE THERAPY
• A journey of co-exploration with a client in search of potentials that
are hidden by a life problem, or subject position, and that can
contribute to an alternative life narrative

• Problems, or conditions of emotional or material suffering, result

from personal narratives that keep the person in a subjugated position
and exclude certain possibilities for future action

• Many problems are (at least in part) by-products of cultural practices

that are oppressive to the development of functional life narratives

• The goals of therapy are to awaken clients from problematic patterns

of living, liberate them from externally imposed constraints, and help
them author new stories of dignity and competence.

• This is a therapy of advocacy.

NARRATIVE THEORY VS. OBJECT RELATIONS
THEORY

•In object relations theory, clients are encouraged to explore their

interpersonal patterns (interactions with significant others in the
past) that may either facilitate or impair current functioning.

•Focus is on the interpersonal

•In narrative theory, clients are encouraged to explore their

interpersonal and inter-cultural patterns (the ways and extent to
which they have adopted “arbitrary” cultural beliefs and practices)
that may either facilitate or impair current functioning.

•Focus is on the inter-cultural

 KNOWLEDGE

• Knowledge represents socially situated beliefs that influence what

people understand, see, and say

• It is not “objective” but reflects the values of certain people at a

certain place in time

• It is embedded in all cultural institutions and relationships

• Any generalizations about people serve to reinforce positions of

power among groups rather than represent objective truth

• The prevailing ways in which a society is “understood” gives some

groups privilege and downgrades the positions of others.
 DISCOURSE

• A set of “coherent” stories or statements about the way the world

should be
– conversations about ideas that are based on prevailing cultural
ideologies

• Discourses include prescriptive functions

– how we should think and behave

• We live in a “cultural soup” of social contexts where many different,

potentially conflicting discourses operate.
– Some are dominant while others are subjugated, depending on who is in
power.
• Our social positions are largely determined by prevailing discourses

• We create our worlds with the ideas and terms available to us

 IDENTITY

• “Identity” is how we define ourselves at particular points in time

– Our “standpoint”

• Who we are is a matter of constant contradiction, change, and

ongoing struggle
– Identity is a dynamic process of being rather than something essential or
continuous

• Subjectivities – our identities/positions in relationship to others (like

a role)
– The subjectivities we live with are not necessarily of our own making
– They are products of social interactions and power relations
 DECONSTRUCTION

• Uncovering the hidden relationships in claims to knowledge

• Uncovering and challenging assumptions about the way the world

should be, and thereby opening up new possibilities

• Exploring previously unstated cultural assumptions that contribute

to the construction of a problem

• Deconstruction questions:
– Who has said that?
– Where are they in the power structure?
– Who benefits from this belief?
 Reconstruction

• Formulating a new “story” based on our actual accrued

experience
 ACTIVITIES OF THE SOCIAL WORKER
IN NARRATIVE THERAPY

• Do not “diagnose”, “treat”, seek “solutions”

• Assume an investigative, exploratory, “archaeological” position

• Attend closely to the ways clients use language

• Listen for opportunities to promote the emergence of a “counterplot”

to the dominating problem story,
– give the client’s hinted-at competencies the acknowledgement they
deserve

• Attend equally to the client’s past, present, and future

 THE SOCIAL WORKER-CLIENT
RELATIONSHIP
• Critically analyze the impact of the “preferred
description” of yourself as an “expert”
– What impact does that have on the “helping relationship” and
engagement?
• Create a connection
– orient the client to how you work
– ask for his or her opinion (continue this practice regularly)
• Maintain a stance of persistent and genuine curiosity
• Engage client in share responsibility for the shaping of
the counseling conversation
• Align against the problem, with the person
 THE SOCIAL WORKER-CLIENT RELATIONSHIP
(cont.)

• Validate
– Avoid deficit talk
– Use language of the client’s experience ( “Experience-near”
terminology vs. professional terminology)
– Underscore client's willingness and ability to take
– Offer your own stories (similar to self-disclosure) if appropriate

• Attend to alternative stories of protest, resistance and resourcefulness

• Attend to transference
– not a characteristic of the client, but as a representation of “internalized
social positions”
– How is client responding to you based on possible cultural scripts?
 THERAPEUTIC POSSIBILITIES IN NARRATIVE
CONVERSATIONS

• Separate the person from the problem: use externalizing

conversations
– Move the problem story away from the client
– “The person is the person and the problem is the problem”
– “Sorry syndrome”

• Map the effects the problem story has had on the client’s lifestyle
and on others
– Assess the damage problem story has had on intentions, purposes,
values, believes, hopes and dreams

• Map the effects of the person on the problem

– Address client’s involvement with creation and maintenance of the
“story” problem
– Also address strengths and competencies of client
 THERAPEUTIC POSSIBILITES IN NARRATIVE
CONVERSATIONS (cont.)

• Identify unique events that stand apart from the problem

– Exceptions

– Explore abilities that have contributed to desirable events

• Undertake an archeological excavation of historical origins

of deeply held beliefs and knowledge that provide a context
for understanding the client’s story
– Dig down to the culture of where the story began

– Uncover subjugated knowledge and strengths that may have been

hidden by the power of the problem’s story
 THERAPEUTIC POSSIBILITIES IN
NARRATIVE CONVERSATIONS (cont.)
• Facilitate “outsider witnesses” and reflecting team
practices
– Seek an audience to witness the favored developments; people
who will notice, acknowledge, and respond
– Send letters
– Ask “Who would be most surprised? Least surprised?”

• Construct new narratives that reflect alternative views of

problem and the client
– These are more coherent with values, beliefs and practices of
engagement with people in client’s support system
 DOCUMENTING THE CHANGE PROCESS

• Writing letters:
– To client
– Client to others
• A good letter = five regular sessions!

• Audiotapes, videotapes

• “Certificates” for children

• Encourage the client to give guidance to others

• Ask the client if you can use his or her story to help others
 THE FUNCTIONS OF
EXTERNALIZING CONVERSATIONS
• Creates “space” for a different understanding of a
personal narrative, personal identity

• Client can see herself as separate from the problem story

– Consider the problem story as a kind of “false self”
– Distancing enables to explore the “true self”

• Externalizing can parody or make fun of introjections

client has taken in from dominant culture, and others
 AUDIENCE

• People who can be recruited to bear witness to the

emergence of the client’s new description of him or
herself

• This is necessary in order for the client to make a

departure from the identity offered by the problem
account

• These may include living and deceased persons (who are

“alive” in the client’s heart and mind)
ONE MODEL FOR CLINICAL PRACTICE BASED ON
NARRATIVE THERAPY

Prior to the first meeting send the client a letter of introduction:

• try to allay any anxieties about the meeting
•show respect for the client’s feelings
•affirm the client’s dignity
•give choices about what happens

At the first meeting: If there has been a written referral - Read it (or
portions of it) to the client:
•describe any diagnostic terms used
•consider re-naming the problem
• discuss the reason for referral,
•get the client’s feedback
 ONE MODEL FOR CLINICAL PRACTICE
BASED ON NARRATIVE THERAPY (cont.)

• The presenting problem - Explore this in depth from the

client’s perspective:
– How does the client describe her/his concerns?
– How have they dealt with challenges?

• Personal and family history - This is where the narrative

conversation begins; it is intervention as well as assessment:
– Inquire about strengths, talents and accomplishments

• Previous treatment history - Get the facts but more

importantly:
– assess the client’s reactions, meanings, and effects of these experiences
on the client’s identity
 ONE MODEL FOR CLINICAL PRACTICE
BASED ON NARRATIVE THERAPY (cont.)
• After the meeting - Promote a “reflexive alliance” by
writing an account of the conversation after the client
leaves:
– including new questions that have occurred to you since the
meeting
– Send this to the client and ask for his or her reactions at the next
meeting.
 NARRATIVE THERAPY VS OTHER APPROACHES

• A set of “simple and accessible ideas”, not a set of strict

procedures

Metaphoric Comparisons with Other Therapies

• Mechanistic therapies (cognitive, behavioral, structural):
– Repairing the faulty machine
• Romantic therapies (ego, object, self, family emotional
systems):
– Peeling the onion
• Postmodern “Hippie” therapies (includes solution focused):
– The Story: “What’s your story?”
– How people construct truth about themselves
– Problems as located in a problem story line
Examples of Use of Narrative Therapy
 Considerations When Working With Alcohol-affected
Clients in Narrative Approach
• Avoid using the “jargon” of the medical model
• Avoid using or reinforcing “totalizing” descriptions (such
as, “I am an alcoholic”)
• Recognize and respect the social prominence of alcohol
discourses
• Educate the client about the “blinding power” of alcohol
discourses (“I can’t be an alcoholic because I can limit
my use”)
• Personify the alcohol lifestyle (“AL”)
• Reframe the challenge to “Getting a divorce from AL”
• Help the client reclaim agency (the capacity to act) and
competence (by recognizing and building on strengths,
exceptions)
• Build an audience for the new story
SOME INTERVENTION THEMES FROM “THERAPY
WITH MALE SEXUAL ABUSE SURVIVORS”

• Deconstruction - Taking apart and looking beyond the

taken-for-granted meanings and “common sense”
explanations in male survivor stories, such as:
– The myth of the “he-man”
– Myths of masculinity
– Fears of homosexuality
– Sexual identity

• Reconstruction of a new story of worth, via:

– Recognizing achievements, attributes, and capabilities
– Resisting the tendency to be defined by others (or by prevailing
discourses
 SOME THEMES FROM “APPRECIATING
INDIGENOUS KNOWLEDGE” IN GROUPS

• Assumption: Participants have knowledge and skills in

their lived experience that can be constructively shared
for the mutual development of new narratives

• The group leader’s expertise: A curious, “not-knowing”

style of communication:
– using members’ own language to understand their meanings
– listen for alternative meanings, and help them externalize
 SOME THEMES FROM “APPRECIATING
INDIGENOUS KNOWLEDGE” IN GROUPS

• “Skills” Training Groups (Assertiveness):

• Leader acknowledges his or her strengths but also limitations
• Asks for help from the group
• Let the group set rules
• Ask questions to affirm members’ existing power
• Brainstorm about what assertiveness means
• Tap into social inequities about having the power to be
assertive
• Ask for feedback at the end of each session
 SOME THEMES FROM “APPRECIATING
INDIGENOUS KNOWLEDGE IN GROUPS”
(Cont.)

A Women’s Assertiveness Group (more structured)

•The group is an audience for members’ preferred

descriptions of themselves
•Let members choose their own preferred self-descriptions
•Ask a set of questions each week about member
experiences during the previous week
•Ask about messages received about how women are
supposed to behave
•Ask how have they overcome the effects of these
constraints
NARRATIVE APPROACHES IN MEDIATION

• Mediation is a process for resolving conflict

• Conflict is the inevitable result of the articulation of differences.
– It is emergent and malleable, not fixed.
• Points of view are always related to social discourses and one’s
cultural position
• In mediation, mutual understanding is as important as resolution

A Mediation Process
• Two mediators are preferable, to model cooperation and to broaden
each other’s, and the clients’, understanding

• Pre-mediation discussion is held to plan for safety and to consider the

effects of participants’ prevailing social discourses in this situation
NARRATIVE APPROACHES IN MEDIATION (Cont.)

Separate sessions with each client - To develop rapport, promote free

discussion, suggest new understandings, develop an externalizing mode
of conversation, examine the effects of the person on the problem and
the problem on the person

Joint session - The agenda includes a mutual establishment of rules,

summarizing the process of individual sessions, promoting mutual
understanding (vs. solution), deconstructing the dominant problem,
promoting a mutual problem definition, developing alternative stories of
the relationship of the participants, developing new ways of cooperating

Develop a written agreement - Show caution about the future, ask “what
if” questions
 HEALTH PROMOTING CONVERSATIONS

• The problem of “disconnect” between health professionals and

indigenous people
• Relationships between the two can be enhanced by listening

Step 1: Make contact with representatives of the indigenous people

Step 2: The day-long program
Begin with lots of time for informal conversation
Use the language of the people
Highlight indigenous wisdom
Emphasize alternative knowledge about the health issue
Include presentations by health professionals
Preserve the dignity of all participants in the process
Promote various social groups getting together after the program
 HEALTH PROMOTING CONVERSATIONS
(Cont.)

• Hold follow-up meetings for participants

– With affirmation, the indigenous people can be encouraged to
take greater responsibility for health
– Hold community demonstrations