Narrative therapy

Narrative therapy is a form of psychotherapy that seeks to help patients identify their values and the skills associated with them. It provides the patient with knowledge of their ability to live these values so they can effectively confront current and future problems. The therapist seeks to help the patient co-author a new narrative about themselves by investigating the history of those values. Narrative therapy claims to be a social justice approach to therapeutic conversations, seeking to challenge dominant discourses that it claims shape people's lives in destructive ways. 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, schools and higher education.[1][2][3][4]

Michael White
Narrative therapy
MeSHD062525

History

Drawing on the work of Michel Foucault, the approach was developed during the 1970s and 1980s, largely by Australian social worker Michael White and David Epston of New Zealand.[5]

Conversation maps

Re-authoring Identity

The narrative therapist focuses upon assisting people to create stories about themselves, about their identities, that are helpful to them. This work of "re-authoring identity" claims to help people identify their own values and identify the skills and knowledge they have to live these values. Through the process of identifying the history of values in people's lives, the therapist is able to co-author a new story about the person.[6]

The story people tell about themselves and that is told about them is important in this approach which asserts that the story of person's identity determines what they think is possible for themselves. The narrative process allows people to identify what values are important to them and how they might use their own skills and knowledge to live these values.[7]

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.

Externalizing conversations

The concept of identity is important in narrative therapy. The approach aims not to conflate people's identities with the problems they may face or the mistakes they have made. Rather, the approach seeks to avoid modernist, essentialist notions of the self that lead people to believe there is a biologically determined "true self" or "true nature". Instead, identity, seen as primarily social, can be changed according to the choices people make.[8]

To separate people's identities from the problems they face, narrative therapy employs externalizing conversations. The process of externalization allows people to consider their relationships with problems; thus the narrative motto: "The person is not the problem, the problem is the problem."[5] So-called strengths or positive attributes also are externalized, allowing people to engage in the construction and performance of preferred identities.

An "externalizing" emphasis, such as by naming a problem so that a person can assess its effects in his or her life, come to know how it operates or works in their life, relate their earliest history, evaluate it to take a definite position on its presence, and in the end choose their relationship to it.

Statement of Position Map

In a narrative approach, the therapist aims to adopt a collaborative therapeutic posture rather than imposing ideas on people by giving them advice. Michael White developed a conversation map called a 'Statement of Position Map' designed to elicit the clients own evaluation of the problems and developments in their lives. Both the therapist and the people who consult them are seen as having valuable information both in terms of the process of therapeutic conversation and in terms of the content of these conversations. By adopting a posture of curiosity and collaboration instead, the therapist aims to give the implicit message to people that they have already knowledge and skills to solve the problems they face. When people develop solutions to their own problems on the basis of their own values, they become much more committed to implementing these solutions.[9]

Re-membering practice

Narrative therapy identifies that identities are social achievements and the practice of re-membering draws closer those who support a person's preferred story about themselves and dis-engages those that do not support the person.

Absent but implicit

Drawing the work of Jacques Derrida, Michael White was curious about the values that were implicit in people's pain, sense of failure and actions. Often people only feel pain or failure in relation to their values, how they would prefer their relationships or life to be. Further, often there are stalled initiatives that people take in life that also are guided by implicit values.

Outsider witnesses map

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.[10]

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.

Therapeutic documents

An appreciation for the creation and use of documents, as when a person and a counselor co-author "A Graduation from the Blues Certificate"; Often casenotes are often created collaboratively with clients so they have input in how they are documented.

Social-political therapeutic approach

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. There is also an awareness of how social narratives such as femininity and masculinity can be corrupted and negatively influence peoples identities.

Eating disorders

Narrative Therapy has made numerous contributions to the field of eating disorders. David Epston, Stephen Madigan and Catrina Brown have made the most significant contribution to bringing a depathologizing approach to this issue.[11]

Men and domestic violence

Narrative Therapy has also been applied to work with men who abuse their female partners. Alan Jenkins and Tod Augusta-Scott have been the most prolific in this field. They integrated a social-political analysis of the violence, while at the same time engaging men in a respectful, collaborative manner.[12][13]

Community work

Narrative Therapy has also been used in a variety of community settings. In particular, an exercise called "Tree of Life" has been used to mobilize communities to act according to their own values.

Criticisms
See also: Psychotherapy § General critiques

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.[14][15][16]

  • Stories empower people to self-prescribe narrative therapy. Not only do people know which story they like, but they also know which narrative they need to escape from reality as well as transform it.[17]
  • 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 simply privilege their client's concerns over and above "dominating" cultural narratives.[15][18]
  • 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.[15][18]
  • Narrative therapy is also criticized for the lack of clinical and empirical studies to validate its many claims.[19] 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.[19]

See also
Theoretical foundations
Related types of therapy
Other related concepts

Notes
  1. (Nylund and Tilsen, 2006)
  2. Dulwich Centre, 1997, 2000
  3. Winslade, John & Monk, Gerald. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass. ISBN 0-7879-4192-1
  4. (Lewis & Cheshire, 1998)
  5. White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York: W. W. Norton. ISBN 978-0393700985
  6. Brown & Augusta-Scott, Narrative Therapy, 2007, p. 24
  7. Brown & Augusta-Scott, Narrative Therapy, 2007, p. 36
  8. Michael White, Maps of Narrative Practice, 2007, p. 139
  9. Michael White. De-Centered Practice. Re-authoring Lives##. 2001. p. 39
  10. White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide: Dulwich Centre Publications. pp 15.
  11. Catrina Brown and Tod Augusta-Scott. Narrative Therapy: Making Meaning, Making Lives. Sage Publications. 2007
  12. Catrina Brown and Tod Augusta-Scott. Narrative Therapy: Making Meaning, Making Lives. Sage Publications. 2007
  13. Tod Augusta-Scott (ed.). Innovations in Interventions to Address Intimate Partner Violence: Research and Practice. (Routledge Press, 2017)
  14. Fish, V., Post Structuralism in Family Therapy: Interrogating the Narrative/Conversational Mode. Journal of Family Therapy 19(3) 221-232 (1993)
  15. Minuchin, S., Where is the Family in Narrative Family Therapy? Journal of Marital & Family Therapy, 24(4), 397-403 (1998)
  16. 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)
  17. Van Laer, T., Visconti, L. M., & Feiereisen, S. (2017). "Need for narrative." Journal of Marketing Management. Available at SSRN: https://ssrn.com/abstract=2831991, doi: https://www.tandfonline.com/doi/full/10.1080/0267257X.2018.1477817, or Vimeo: https://vimeo.com/99623579
  18. 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)
  19. Etchison, M., & Kleist, D.M, Review of Narrative Therapy: Research and Review, Family Journal 8(1) 61-67 (2000)

Further reading
  • Catrina Brown and Tod Augusta-Scott. Narrative Therapy: Making Meaning, Making Lives. Sage Publications. 2007.
  • Winslade, John & Monk, Gerald. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass. ISBN 0-7879-4192-1
  • White, M. (2005). Narrative practice and exotic lives: Resurrecting diversity in everyday life. Adelaide: Dulwich Centre Publications. pp 15.
  • Etchison, M., & Kleist, D.M, Review of Narrative Therapy: Research and Review, Family Journal 8(1) 61-67 (2000)
  • Freedman, Jill and, Combs, Gene (1996). Narrative Therapy: The social construction of preferred realities. New York: Norton. ISBN 0-393-70207-3.
  • Grimwade, Jolyon (2009). "In Praise of Sneaky Poo: A Case, Four Whites, and a Missing Narrative." Australian and New Zealand Journal of Family Therapy 30.02: 109-121.
  • White, M. (2007). Maps of narrative practice. NY: W.W. Norton. ISBN 978-0-393-70516-4
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Narrative therapy
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