The paper will present an overview of narrative therapy as a popular and important practice that is used nowadays to assist people in overcoming their past traumatic experiences and developing effective strategies to function in the family and broader social contexts.
The narrative framework of counseling is highly influenced by the findings of Michael White, Australian psychologist from Dulwich Centre, and his colleague David Epston from New Zealand. Researchers of narrative therapy developed a perspective to view “persons’ lives [as] shaped by the meanings that they ascribe to their experience … and by the language practices of self that these lives are recruited into” (White 1993, p. 35). Narrative counseling is a patient-oriented, flexibly structured and longitudinal process which employs an array of methods to help clients in externalizing problems and living life to the fullest.
The paper will be organized as follows. First, an overview of an approach will be presented with a focus on its philosophical implications. Second, the conceptual framework of narrative therapy will be delineated. Third, the most popular tools of externalization of problems through narratives will be described. Finally, the link between narrative therapy and social work will be established. Conclusion section will summarize facts and ideas pertaining to the approach under study.
Narrative therapy: overview of philosophical implications
France and Uhlin define the narrative therapy approach as “an eclectic and evolving set of practices” (2006, p. 54) which relies on the philosophic principles of post-modernism, social constructionism, and constructivism (see White & Epston 1993; White 1990; Riley 1999; Neimeyer 2006; Frankel & Levitt 2006). In other words, the current therapeutic framework is characterized in terms of flexibility, relativism, subjectivism, and active construction of knowledge in a social context.
Narrative therapy borrows a conceptualization of the self from post-modernism as opposed to modernism. The simplistic modernist notion of personality is placed within the context of objective reality. An individual is treated as a passive element obeying to the conformities of external environments. Contrary to modernism, post-modernism claims that there is no single and absolutely correct reality that would be valid for all agents. From this perspective, an individual becomes a holder of “multiplistic, shifting, and interpenetrated by the social world” identity (Neimeyer 2006, p. 106). Narrative therapy sticks to the post-modernist assumption that there are multiple realities which are constructed subjectively by each human individual, and which co-exist so that an interchange of individual knowledge is made possible.
This counseling approach shares certain epistemological (i.e., related to knowledge and the means of its acquisition) features with constructivism. Both assert that there is no absolute knowledge as being imposed from outside. Everybody derives multiple knowledges from the three realms of experience: intrapersonal (constructed within a person in a life course), intrapersonal (constructed during the interaction between people), and communal (constructed collectively by the members of a given community who share specific cultural and social concepts). Appraising the value of the former two types of experience, narrative therapy is far from denying the importance of socially acquired experience, thus standing on similar positions with social constructionism.
What unifies the aforementioned three philosophical perspectives and makes their elements essential for narrative therapy is the assumption that a human being is “essentially a story-telling animal” (Smith and Sparkes 2006, p. 170). Putting it differently, it is natural for an individual to express oneself through language either in oral or written mode. Products of linguistic self-expression are called narratives.
Individually constructed narratives are “semantic systems,” each having a plot, personages and settings, which are interrelated with other narratives “to connect past to future, link affect and cognition, and internalize self-representations and the expectations that accompany them” (France and Uhlin 2006, p. 55). The process of creating narratives, in which an individual functions both as an author and a personage, is aimed at breaching the gap between various forms of a person’s identification.
People normally adjust themselves to varying circumstances and possess psychological elasticity to match their internal desires, beliefs, and concepts with external codes that are imposed by society. However, it is possible that due to the lack of resilience some individuals may suffer from the incompatibilities between their internal systems of beliefs/values/ideas and the external environments. The goal of narrative therapy is to separate clients from problems and train people in the art of active self-construction.
To summarize, narrative therapy is grounded on the philosophical principles of post-modernism, social constructionism, and constructivism. It is relational, subjective, and focusing on social nature of human interaction. The approach rejects the outdated labeling of people in dualities such as “normal” versus “abnormal,” “good” versus “bad,” “sane” versus “insane.” Narrative therapists respect the right of each individual to see the world from his or her own perspective. A narrative therapist or counselor is far from enjoying any privilege over a patient. The practitioner steps into other people’s narrative and invites clients to depart from dominant stories of their victimization towards alternative stories of success.
This school of therapy heals problems and not people. The key method of eliminating the conflict between internal and external conceptualizations of reality is to engage a client into a dialogue with a therapist. The problem is separated from a person through `re-authoring` or `re-narrating` one’s life experiences. The term is borrowed from the anthropologist Myerhoff (1982, 1986) to denote the process of self-reframing. This is achieved at various stages of a multilayered and complex procedure called narrative therapy which is after all an exchange of narratives or `stories` which are developed individually or communally to make life meaningful.
Narrative therapy: Conceptual framework
After reviewing narrative therapy in general terms, it is time to denote the key concepts and processes which back up this approach: dialogue, deconstruction, transparency, externalization, re-authoring, resistance, and unique outcomes.
Counseling through an exchange of narratives between a therapist and a client is performed in a dialogic context. The concept of dialogue as an effective therapeutic tool and medium is called important by many scholars (Marsten & Howard 2006; McLeod 2006; Neimeyer 2006). McLeod (2006) define therapeutic dialogue as follows:
… narrative therapists position clients not as bounded, autonomous individuals, but as members of networks and communities, and are curious about the role of other people in a person’s struggle with a problem such as anger. Clients are positioned as “consultants”, who can teach their therapists about how certain problems can be overcome, rather than as clients expected to adopt a supplicant role. Groups of people struggling to combat dominant cultural discourses are encouraged to join together in collective action. (p. 206)
It is evident that dialogue implies equality and trust. One should be able not merely to speak but to listen as well. Marsten and Howard (2006) similarly describe narrative therapy as a dialogic process of story-telling interchange in which the participants are open for conversation. Dialogic nature of narrative therapy is manifested through coherent techniques which enable both a therapist and a client to relate each other to multiple realities and traumatic experiences.
Narrative therapy pursues many important goals. Keeling and Bermudez (2006) named the three most important of then which are: “to separate the person from the problem, to permit the problem to be viewed from a variety of perspectives and contexts, and to foster client agency over the problem” (p. 406). As one can see, a client’s counseling is organized as a sequence of processes.
First of all, participants locate the so-called dominant story or target events and experiences that have caused psychological trauma to a client. It is believed by therapists that society is organized as multiple hierarchies that are sustained by specific power relations. Each hierarchical system or culture imposes a set of rules and norms which are accepted as truths by those who function in a given social context. Within each culture, there are social agents that acknowledge the primacy of privileged knowledges and those who deny it. The latter are forced onto the margins of the social system. The reason for marginalization or the conflict between the external and internal knowledges is searched in a process of deconstruction.
Marsten and Howard (2006) view deconstruction as manifestation of a client’s growing eagerness to name and acknowledge those cultural, social and other biases which corrupt his/her conceptualizations of the self and others. The same group of researchers introduces the concept of transparency which means flexibility and situatedness. Marsten and Howard (2006) argue that “we occupy relational space in a given moment that makes us contingent witnesses to our own lives, with shifting awarenesses” (p. 104). It means that deconstruction of traumatic experiences is based on the assumption that none of the realities discussed between a therapist and a client is fixed and static. Subsequently, each narrative is treated not as a finished product but as a story to be retold, continued, and refocused.
The agent of therapeutic intervention is encouraged to re-discover or reframe his/her relation to dominant knowledges and painful experiences. This is achieved through externalization which is the fundamental principle and driving force of the narrative approach. The pioneers of narrative therapy White and Epston (1990) referred to externalization as “an approach … that encourages persons to objectify and, at times, to personify the problems that they experience as oppressive” (p. 38). White (1993) described it as follows:
Deconstruction has to do with procedures that subvert taken-for-granted realities and practices: those so-called truths that are split off from the conditions and the context of their production; those disembodied ways of speaking that hide their biases and prejudices; and those familiar practices of self and of relationship that are subjugating of persons’ ‘lives.’ (p. 34)
The concept of externalization is permeated by the assumption that people are affected by language as a media of power interchange. Narratives as tools of power transmittance are also useful tools of setting the client free of external authoritarian knowledges and of his/her subsequent concentration on internal resources.
Externalization provides the victim with a variety of ways to re-construct his knowledge of previous traumatic experiences and separate the self from the problem. As White (1993) puts it, through externalization clients “might become aware of the extent to which certain modes of life and thought shape our existence, and that we might then be in a position to choose to live by other modes of life and thought” (p. 35). According to the scholar, the procedure helps the client to expand the framing of his/her own life and of multiple realities surrounding this person.
As it is clear now, externalization is the process of putting the problem to the centre of therapeutic narrative construction. When a client succeeds in separating himself from the stressor, a therapist invites him to the next stage of creative re-construction of past experiences through re-authoring. To put it in simpler words, a person stops viewing himself as a marginalized victim of external authorship and starts perceiving himself as an active agent of change. Upon departing from the dominant story, the client is eager to compose the alternative story as a story of strength and self-assuredness.
However, there are situations when patients “act against improvement in their lives” (Frankel and Levitt, 2006, p. 220). The narrative school of therapy treats problems as conflicts between the two belief systems: one is constructed inside the client and the other is imposed by the external reality. Facing such acts of resistance, therapists understand that a traumatized person still associates himself with a problem. Resistance is therefore “the client’s old point of view, which cannot be relinquished because a more viable one has yet to fill its place” (Frankel and Levitt 2006, p. 228). To overcome negative reactions, the narrative therapist suggests the patient working collaboratively towards location of unique outcomes.
Unique outcomes are aimed at helping the client to concentrate on “seemingly inconsequential events that imply or demonstrate clients’ otherwise overlooked abilities and resources” (Frankel and Levitt 2006, p. 228). Carlson (1997) delineates the two goals of excavating unique outcomes. One of it is achieved when people recall and acknowledge situations when there were aware of the conflict produced by the external and internal realities. Another possible goal is fulfilled when clients restore previously ignored experiences of them being able to resist to dominant knowledges.
Narrative therapy is especially helpful in family contexts when family members start viewing their relations as devoid of affection, love, understanding, and empathy. The approach is useful when parents cannot cope with children’s problems. The broad goal of narrative therapy in these cases is to enable family members to target sources of trouble, separate themselves from problems, and create new life stories with an emphasis on positive feelings and attitudes.
Tools and practices of narrative therapy
The present section will describe the key tools of narrative therapy such as externalization exercises, art therapy, genograms, and letter writing.
A: Externalization exercises
There are the four most common tools of externalization: externalized personification of a problem, relative influence questioning, contextual influences questioning, and internalized other interviewing.
Externalized personification of a client’s problem was employed by White during sessions with a minor client who experienced soiling problems. Inquiry about the traumatic experience was wrapped around the imaginary figure of ‘Mr. Mischief’ or ‘Sneaky Poo.’
Another well-known strategy used by White and his associates is relative influence questioning. As Carr (1998) emphasized, those procedures are practiced to “interrupt the habitual enactment of the dominant problem-saturated story of the person’s identity” (p. 492). This is a two-stage process, in which a client first maps out the effect of a problem on his or her life, and second maps out his or her personal strategies to overcome a traumatic issue. In other words, the agent is helped to separate himself from the problem and treat it as relative to his identity.
The classicist of the narrative approach White utilized contextual influences questioning when facing clients’ resistant reactions. This is an effective tool for both the therapist and the client to understand the sources of problematic experiences and reflect over possible ways of re-framing troublesome emotions and affections, to eliminate a client’s fixatedness on a problem, and to trace negative effects of external circumstances (corrupted family relationships, religious, cultural, educational, social, and other) on a person’s self-assessment.
Hurley (2006) mentioned a more recent practice of externalization that is called internalized other interviewing. The client is assisted to view himself as consisting of the ‘self’ and the ‘other.’ The latter part embodies people that either positively or negatively influenced the client in the past. An individual is encouraged by a therapist “to more fully appreciate not only the other person’s perspective but also how the thoughts, feelings, and attitudes of another person can be part of who they are” (Hurley 2006, p. 55). The other can be either an emotionally influential personage or a family representative.
Hurley (2006) highly appraises the practice of internalized other interviewing for several reasons:
Internalized other interviewing is a form of re-authoring conversation aimed at uncovering the subjugated stories of children whose lives are saturated by violence. It empowers children to define self narratives that are free from the constraints imposed by traumatic events and their aftermath. It makes room for an alternative self narrative to emerge in response to internalized other questions that engage inactive parts of the self. (p. 55)
The therapist suggests the client answering questions in order to distinguish his own narrative from the life story of the other. Practitioners using this technique employ the so-called Narrative Process Model of counseling. It consists of three stages. The first stage is known as “external” or “storytelling” one. There the patient is motivated to construct autobiographical memoirs or micro narratives. At the second stage, which is known as “internal” or “emotion-focused,” an individual voices out his sorrows, troubles, phobias, i.e. traumatic experiences. Finally, there is a stage of “reflexive/conceptual meaning-making,” at which micro narratives are synthesized with emotional elicitations to shape the new life story and denote the paths of change.
To clarify the technique, Hurley (2006) describes the case of Justine, an 8 year-old minor, who suffered from attention deficit and conduct disorders. It was hypothesized that the cause of trauma for Justin were multiple cases of domestic violence performed by the boy’s father. The client tried to internalize the problem which resulted in seeing nightmares and drawing scenes of violence, as well as multiple cases of misbehavior.
Justine and his mother Sandra were invited to an interview with a therapist who utilized the internal other interviewing technique. The therapeutic session was videotaped and transcribed. The practitioner encouraged the client first to speak for himself and then to imagine how his parents would view the situation by speaking for them. Justine and Sandra went though the follow-up sessions to train in the externalization technique. The multiple-lens perspective helped both the boy and his mother to overcome trauma survived in the past and employ cooperative strategies so that they could change their lives’ conceptualizations.
B: Art therapy
Art therapy is favored by therapists who work with young children and adolescents. At earlier stages of development, individuals perceive their internal selves as constantly changing. Their identities are especially fragile and susceptible to external influences. In result, young people are often left voiceless under the weight of imposed experiences.
Riley (1999) defines the art therapy approach as based on assumption that “structured pre-designed assessment and art directives can be relied upon to achieve therapeutic goals” (p. 37). Art is believed to add excitement and freshness to externalization experiences of the youth, to help them in manifesting their innate creativity and originality of thinking. Carlson (1997) argues that “[t]he very personal nature of the art enhances ability of clients to express hidden aspects of themselves that they might not otherwise reveal” (p. 274). He mentions the two interesting opinions belonging to Wadison (1973) who believed that the client can honestly portray himself through the means of art and use art products as visual reminders of their experiences.
Art therapy stands on the same theoretical positions as purely narrative therapy. Both approaches view clients as being blinded by their past experiences and seeking for self-actualization. Both methodologies employ various media to excavate hidden aspects of clients’ identities and make them visible and audible. Both forms of therapy posit a practitioner and a client within a cooperative dialogical framework as struggling towards the shared positive outcomes.
Carlson (1997) describes how a 14-year-old Misty, who was assigned to both individual and family therapy because of her uncontrollable behavior, was motivated to overcome the problems through drawing self-portraits.
At the stage of internalizing the trouble, she honestly depicted herself as being torn apart by mutually contradicting emotions. The figure on her picture had two faces: the one was smiling and the other one was in tears. Then each family member was asked to explain on the example of Misty’s self-portrait what effects anger produced on their lives. Art helped the participants of the counseling process to understand hidden aspects of the girl’s personality and understand some covert drives behind her abusive behavior. At the stage of externalizing the problem, the dual face was discussed between Misty and a therapist. They collaboratively analyzed the ways, in which anger disrupted the girl’s life in various environments. The client started noting and controlling for the outbursts of negative emotions that had been caused by misunderstandings with her parents.
Art therapy is efficient with both children and adults. Various media are employed within the paradigm including sculpture, music, drawing, acting, and so on. Art intervention mat be accompanied by traditional narrative techniques when clients are engaged in journal writing after externalizing their problems through drawing pictures or making figures of clay. Art forms may also serve to portray how people overcome traumatic experiences and embody positive emotions.
Huber (1996) defines a genogram as “a primary means of identifying the manner in which symptoms (i.e. pathology) are transmitted across generations” (p. 152). The scholar emphasizes that genograms allow practitioners and their clients to apply both individual and intergenerational analysis of relationships and affections. Excavation of traumatic experience tackles upon the lives of minimum three generations of the given nuclear family.
The tool is used as part of different approaches to family counseling including the intergenerational-oriented one and the Solution-Oriented Therapy one. The two approaches differ from each other in the following way. The former concentrates on negative instances in the past, whereas the latter brings to the foreground the client’s positive feelings and attachments.
Huber (1996) states that genograms help both to identify critical areas and seek for possible alternatives to the critical situation not only in clients’ lives but also in the experiences of their relatives, both close and distant. Externalization via genograms is “a method of taking the problem from inside the family and reframing it as an ‘outside intruder’” (Huber, 1996, p. 154). Clients learn to distance themselves from the trauma and think how their relatives would overcome the same difficulty.
Butler and Joyce (1998) compare genograms to family trees because the scheme portrays family relations (parents, siblings, and previous relationships). The specific characteristic of genograms is that they also specify actions and emotions associated with the people mentioned in the chart. The researchers describe how genograms can be employed in family therapy. For example, young married couples may apply to therapists because they suffer from mutual unrealistic and exaggerated expectations. The implications for possible trauma in the future can be searched in the past by researching the patterns of attachment and power as they existed in the clients’ families of origin through genograms.
Jordan (2004) describes genograms as “a widely-used comprehensive systemic assessment device for gathering large amounts of information in a relatively concise and time-effective way” (p. 57). The researcher also mentions the focused genogram which specify the topic of counseling as the recent modification of the classical type.
Genograms are classified on the principle of their orientation. There are theory-oriented ones (the solution-focused genograms which focus on positive elements of past experiences and future positive outcomes), topic-oriented (e.g. the spiritual genogram, the cultural genogram), foci-oriented (the anger genogram, the attachment genogram, the emotional genogram), and population-oriented (the genogram with GLBT or spinal cord injured patients).
Jordan (2004) herself introduces another variation of the genogram that is named color-coded timeline trauma genogram (CCTTG). The scholar defines it as follows:
[This is] a systemic clinical tool that is used to assess the larger effect of trauma, both currently and historically, on the structure, relation, and function of the family as a whole and in terms of family subsystems and individual family members. (Jordan, 2004, p. 61)
Traumatic events are listed chronologically, and the severity of trauma is shown through color. As Jordan (2004) indicates, color can point at minimum the four kinds of traumatic experiences: 1) multitrauma events, 2) family patterns of traumatization, 3) dual couple trauma (mischief happened to the two members of the family), and 4) multifamily trauma in result of natural or human-made disasters.
Overall, the tool of genograms can be used in the individual, couple, and family contexts, horizontally (across the family) and vertically (through generations). It is especially valuable for reframing post-traumatic experiences, emotions, and attachments. Drawing a scheme is accompanied by a therapist asking a series of specially designed questions in order to define the scope of family resources.
D: Letter Writing
The technique was brought into practice by White and Epston (1989-1990). They named several types of therapeutic documentation including letters of invitation, redundancy letters, letters of prediction, counterreferral letters, letters of reference, letters of special occasions, self-stories, certificates, declarations, and self-declarations. Initially, White and Epston (1990) suggested using weekly letters as an alternative for process notes (i.e. the notes taken by a therapist during a session) to establish collaborative relationships with patients. The stage at which letter writing was extensively utilized was called circulation.
Andrews, Clark and Baird (1998) explain that the importance of letter writing derives from the very notion of language as an instrument of power:
As therapy progresses, personal meanings shift, and if alternative stories are to be supported, then circulation of the news that change is occurring must happen for the changes to be incorporated into the life stories of the clients. Gaining an audience for this news is an important part of the re-authoring work. If these “counterplots” are not supported, then the new behaviors will not survive. (p. 150)
The researchers furthermore state that letter writing as being initiated by therapists can be used as a kind of pre-treatment assessment and therefore be employed in counseling of individuals, married couples, and extended families. It should be stressed here that therapeutic letters are not the same thing as case notes. The latter are designed for exclusively professional use, whereas the former serve an effective medium of communication between a therapist and a client, a therapist and other practitioners, and a client and his or her relatives and friends.
As Merscham (2000) observes, letter writing may be used throughout the therapeutic process for the sake of facilitation, and at the end of it as a form of acknowledgement of clients’ achievements. Keeling and Bermudez (2006) list some other possible functions of therapeutic writing. They mention that exercises in exchanging letters on either traumatic or positive issues bring joy to clients, serve the goals of recording and exploring problematic or recovery stories, assist in developing alternative stories that emerge in the process, keep the memory of the narratives of success, and delineate possible strands of change in the future.
Vidgen and Williams (2001) note that in some situation written accounts of therapeutic sessions are more preferable than verbal reminiscences because of their greater permanence and clarity for both a therapist and a client. Upon qualitative analysis of the five interviews with therapists, who eagerly practiced letter writing, Vidgen and Williams (2001) compiled a list of possible usages of this technique among professionals. It appeared that therapists often viewed letters as “an aide-mémoir” (Vidgen and Williams, 2001, p. 321) or a supporting materials to register the details of counseling such as counselors’ and clients’ remarks, particularities of clients’ problems, and ideas for the next sessions as devised by both counselors and clients in collaborative efforts.
The participants of Vidgen and Williams’ study withdrew from using this technique only when they dealt with children whose safety might be abused. Overall, the scholars acknowledge that the main characteristic of letter writing is therapists’ respect for the recipients of the letters and openness of communication. When there are three or more parties involved in a process (e.g. a therapist, a client, and a referral), clients are informed about the content of those letters which are addressed to other stakeholders. All participants of communication are viewed as possessing knowledge, expertise, and responsibilities.
Baker, Eash, Schuette, and Uhlmann (2002) examine the utility of letters from patients’ perspective. Their concern with patient-orientedness is evident in the very choice of the term which is “patient letters.” The patient letters are treated as a means that “reinforces the relationship between the patient’s own circumstances and specific genetic and medical information” (Baker et al. 2002, p. 401). The scholars pay special attention to the understanding of letter-writing skills and propose important guidelines on how to structure the process of therapeutic documentation.
Baker et al. (2002) recommend composing patient letters keeping in mind the issues of conciseness and careful structuring. Documents are organized as recordings of facts taken from medical and family history records, as well as from summaries of the medically relevant information gathered during the client’s visit. Letters should be written in a clear manner so that clients are able to understand them. In the researchers’ opinion, the length of patient letters should not exceed two pages.
Agents involved in a letter exchange should be aware of the issues related to privacy and confidentiality. The content of letters should be discussed with clients if documents are address to the third parties (i.e. medical specialists other than the practicing therapist, family members, representatives of medical and social institutions, and so on). Baker et al. (2002) argue that clients’ educational and cultural level should be taken into account when decision is made about the content of letters. Medical terms should be explained, and paragraphs should run in a clear logical sequence.
There are also stylistic implications for composing patient letters including the issues of distance as manifested through style, tone, use of active and passive voice, as well as specific (definitive) and noncommittal (nondefinitive) statements. Baker et al. (2002) stress that patients’ narrative are highly emotional and value-burdened, whereas patient letters should avoid emotional attributives, slang, and words with strongly negative meaning.
Couper and Harari (2004) admit the dual function of therapeutic letters. They state that,
… this approach best addresses the problems of an increasingly litigious medicolegal environment by clarifying with the patient the formulation of their problems at the earliest practical opportunity and also by clarifying problems in the doctor–patient relationship that may need to be addressed. (p. 365)
So far as patients’ respect for written word exceeds their trust in verbal discourses, letters project certain power onto people’s minds. On the other hand, writing letters is not an imposition of external authority on patients. Contrastingly to such a hypothesis, clients feel themselves more secure when sharing their painful experiences in written mode.
Couper and Harari (2004) delineate the four principles to organize letter composition. These documents usually start with a summary of patients’ traumatic and painful experiences that serve the target for externalization. Next, the letters proceed to the account of clients’ reactions (emotional, cognitive, behavioral, and interpersonal). The next section of a therapeutic letter is usually dedicated to the analysis of social, cultural, and other contexts which may either negatively or positively influence clients. Finally, letters suggest possible solutions for clients to cope with problems.
Narrative therapy and social work
Narrative therapy is not a mere clinical intervention or a discussion of issues relevant to the client’s life. This is an aid to social workers who deal with marginalized victims of traumatic experiences in the communal context. Both narrative therapy and the best social work projects derive their main principles from the post-modernist philosophies. It has been already stated that narrative therapy is a collaborative critical re-assessment of dominant realities, environments, and knowledges. The same critical stance is present in the recent social work policy.
Fraser (2004) explains that the critical social work approach utilizes therapeutic narratives as tools “to reinforce but also contest dominant social practices” (p. 180). Reliance on narrative dialogue is essential for both therapists and social workers who are “a story-telling lot” (Wilks 2005, p. 1249). As Hall and White (2005) acknowledge, language is a powerful means and environment to create modalities which can be perceived as either positive or negative by the agents of therapeutic and social interventions.
However, it seems that social workers encounter difficulties while employing narrative techniques in their practice. They are literally torn between the two conceptual paradigms which imply research on social work. As Wilks (2005) hypothesizes, on the one hand, there are ethical norms which are based on objectivity, authority of mental and behavioral codes, and strictly causal logic; on the other hand, there is a growing impetus towards the new belief system which declares anti-discriminatory and anti-oppressive principles. The conflict observed between these two conceptual frameworks position social workers as “slightly uneasy bedfellows” (Wilks 2005, p. 1250) who have to bridge the gap between the overtly subjective philosophy of narrative counseling and the objective principles of construction of their professional ethics.
Both narrative therapy and social work are respectful of clients’ individual (as well as collective) identities and their right for self-determination. However, whereas therapists are primarily focused on healing psychological traumas of an individual as opposed to and oppressed by the external environment, social workers need to integrate victims of oppression back into to the communal context so that he or she would obey to a universal and conventional code of rules and norms.
As Wilks (2005) observes, some conventional practices of social work are “infused with an atomistic perspective on the moral subject, for whom moral decision making relies upon the application of an independent gaze, separated from social contexts” (p. 1251-1252). Contrastingly, therapists sticking to the post-modernist principles regard ethics as internally constructed, consisting of flexible knowledges which enable people to care for each other in the process of interaction. Differences in professional ethics of therapists and social workers standing on conventional positions sometimes place the agent of interventions into an uncomfortable position marked by problem internalization and silencing of traumatic experiences.
Kohli (2006) provides an example of such internalization in unaccompanied asylum-seeking individuals under 18 years of age who are abandoned by their parents or other adult care-givers in a course of refuge. Such minors are left unattended in the airports or train stations and are targeted by social institutions of a hosting country as needing help. As Kohli (2006) observes, these minor refugees “appear to present their stories to practitioners, while keeping a careful watch on the ways their experiences are interpreted and understood before decisions are made to offer them the type of assistance they hope for” (p. 708). They prefer either to keep silence about their origins and past experiences or invent some tales in order to manipulate adult social workers.
Facing resistance reactions and dominant narratives of underage refugees, social workers may act as narrative therapists in sense that they may separate a problem from an individual. These are not “bad” or problematic children who deny telling truth to “good” social practitioners and subsequently deserve punishment. There is a general problem of silence as a post-traumatic reaction to challenging social circumstances that becomes the target of professional intervention. Here one can see that both therapists and social workers start their practices with locating and externalizing a client’s problem.
Furthermore, whereas conventionally thinking social authorities are often satisfied with the so-called “thin stories,” the hyperbolized accounts of imagined traumatic experiences, narrative therapists and advanced social workers attempt to establish trusting and cooperative relationships with a victim to elicit “thick stories,” or an account of multiple true-to-life experiences that have forced the child into the underprivileged position.
Both therapeutic and social practitioners should use the constructionist lens to understand how “the way people use and tell thicker, perhaps more capable stories about themselves can help in reconstructing their lives, particularly when they have become trapped in thin narratives of victimhood” (Kohli 2006, p. 712-713). Both social workers of the new wave and narrative therapists are interested in initiating the collaborative, trustful and inspiring relationships with the client. They are eager to listen to and analyze the client’s thin stories, enable him or her to share thick stories, and explore possible unique outcomes for the client to reframe himself against the problem. Keeling and Bermudez (2006) define these stages as “relative influence, search for unique outcomes, and thickening of the emerging story” (p. 408). It should be noted here that clients should be always given time to reflect over the whole process of therapeutic or social intervention.
Narrative therapy may become a useful approach within the social work paradigm due to its extensive use of interviewing as being “a creative process in which ideas and beliefs are created not just collected” (Hall ; White 2005, p. 384). When being used appropriately, interviews step out methods of capturing and analyzing the multiplicity of experiences as they are faced by clients. However, in-depth, thick and open-ended interviewing is not enough for externalization of a problem which is required of both a narrative therapist and a social worker.
Riessman and Quinney (2005) name the five principles of an authentic and systematized intervention (be it a therapeutic session or a social work project). Practitioners should rely on valid and detailed transcripts of their interactions with clients. They should concentrate on language as being produced and functioning in changing social contexts. They should aware of the dialogic essence of any narrative, i.e. to listen to a client and try to understand his or her viewpoint. When possible, practitioners should conduct a comparative analysis of agents’ stories to trace similarities and differences among them.
Narrative therapy is an approach to counseling that received development in the 1970s-80s and is widely practiced nowadays. It borrows philosophical concepts from post-modernism, social constructionism, constructivism, feminism, post-structuralism, and other modern schools of thought. The multiplicity of theoretical perspectives embedded into narrative counseling provides it with many opportunities to help clients suffering from various problems such as childhood conduct problems, delinquency, bullying, anorexia nervosa, child abuse, violence, marital conflict, grief reactions, adjustment to AIDS, and schizophrenia. It is used in treatment of individuals and families.
The proponents of this useful approach – White and Epston (1990) – formulated the motto of narrative therapy as follows: “the problem is the problem” (p. 39). It is believed by narrative therapy practitioners that clients are not the same as their troubles. They avoid viewing people as misbehaving against commonly shared norms and beliefs. Quite on the contrary, those therapists, who employ narrative techniques, respect their clients as holders of unique knowledges. The paradigm assumes that a problem in a person is produced by a conflict between an individual’s system of knowledges and the external system of knowledges and rules.
Sharing the post-modernists, narrative therapists claim that knowledge and language are closely interrelated. Socially constructed realities such as culture, religion, ethics, and so on speak to people through languages of authority and domination. Life in the social environment can be viewed as listening to the monologues of dominant knowledges. Narrative therapists suggest turning to dialogical forms of conversation. They acknowledge that clients are experts in their own lives and therefore have the right to speak in their own voices.
The main principle of narrative therapy is externalization of a client’s traumatic experience. This is a complex process of freeing an individual from the negative feelings of guilt, grief, anger and similar painful emotions that are rooted in his or her past experiences. Marsten and Howard (2006) call this ancestry of the past “norms, desired objects, goals, or the fixed conditions” (p. 101). Externalization occurs as part of a therapeutic process organized as a meaningful sequence of longitudinal practices.
Keeling and Bermudez (2006) describe the narrative therapeutic process as a collaborative quest of both a client and a therapist starting from self-discovery and proceeding through the stages of “insight” and “recovery” towards the outcome of “growth” (p. 406). To be able to externalize a problem, a client needs to critically analyze his or her past experiences and beliefs. Then an individual is ready to make a transition to the next stage of therapy which is reflection over positive and non-oppressive life experiences that are called unique outcomes. They are integrated into the client’s alternative life story.
By exercising in narrative therapy a person learns to perceive himself as able to control for the problem. As proponents of narrative approach acknowledge the power of language and human interaction, they invite outsider groups (i.e. people who share the client’s social contexts) to witness the production of the alternative life story. Finally, therapeutic effect is secured at the last three stages of intervention. The client trains in remembering and coping strategies through addressing positive experiences. The therapist utilizes various means of appraisal to raise the client’s self-esteem. Finally, the client in invited to participate in the so-called bringing-it-back practices or to share his or her alternative narratives with people who suffer from similar problems.
There are many techniques which belong to the category of narrative therapy. The most popular are externalized personification of a problem, relative influence questioning, contextual influences questioning, and internalized other interviewing; art therapy methods; genograms; and letter writing. The therapist chooses a mode of intervention upon analysis of the client’s social and education background, family relations, emotional reactivity, age, gender, social status, and many other factors.
Narrative therapy has several limitations. The most important of them is explained by the approach extensively relying on language. It is hypothesized that people restricted in their language capabilities (deaf, mute, dyslexics, and so on) may experience problems with going through narrative sessions. Those individuals who experience problems with writing or coordination (in case of art therapy) may also choose another method of counseling.
It should be stressed one more time here that narrative therapy is used in both individual and family contexts. The post-modernist era with its moral relativity, expansion of social and cultural frameworks brought in many novel trends regarding family relations. Therapists employing narrative methods are aware of the complex nature of family relationships and types. They are able to establish dialogue not only with members of full families but also with representative of divorced families, as well as of the incomplete, GLBT, inter-racial, cohabitating, and other ones. These challenging settings are a promising ground for therapists to mediate family problems and help family members to survive through traumatic experiences.
To put it in a nut-shell, the key to success in narrative therapy is to turn the victim into the active agent of change, to motivate the client for re-constructing his or her life, and to assist any person regardless of backgrounds in voicing fears and aspirations. In result of narrative-oriented therapy, an individual stops being just a passive recipient of external knowledges and learns instead how to function as mediator and negotiator of his or her internal ideas, goals, wishes, and beliefs. Reflexivity and creativeness of this approach to therapy helped many people to eliminate traumatic experiences from their life story and construct the new account of their improved self-actualization in varying social contexts.
Andrews, J., Clark, D. J. ; Baird, F. 1997, ‘Therapeutic letter writing: creating relational case notes,’ The Family Journal, vol. 5, no. 2, pp. 149-158.
Baker, D. L., Eash, T., Schuette, J. L. ; Uhlmann, W. R. 2002, ‘Guidelines for writing letters to patients,’ Journal of Genetic Counseling, vol. 11, no. 5, pp. 399-418.
Butler, C. ; Joyce, V. 1998, Counselling Couples in Relationships: An Introduction to the RELATE Approach, John Wiley ; Sons, Ltd., Chichester ; New York.
Carlson, T. D. 1997, ‘Using art in narrative therapy: enhancing therapeutic possibilities,’ American Journal of Family Therapy, vol. 25, no. 3, pp. 271-283.
Carr, A. 1998, ‘Michael White’s narrative therapy,’ Contemporary Family Therapy: An International Journal, vol. 20, no. 4, pp. 485-503.
Couper, J. & Harari, E. 2004, ‘Use of the psychiatric consultation letter as a therapeutic tool,’ Australasian Psychiatry, vol. 12, no. 4, pp. 365-368.
France, C. M. & Uhlin, B. D. 2006, ‘Narrative as an outcome domain in psychosis,’ Psychology & Psychotherapy: Theory, Research & Practice, vol. 79, no. 1, pp. 53-67.
Frankel, Z. & Levitt, H. M. 2006, ‘Postmodern strategies for working with resistance: problem resolution or self-revolution?,’ Journal of Constructivist Psychology, vol. 19, no. 3, pp. 219-250.
Fraser, H. 2004, ‘Doing narrative research: analysing personal stories line by line,’ Qualitative Social Work, vol. 3, no. 2, pp. 179-201.
Hall, C. & White, S. 2005. ‘Looking inside professional practice: discourse, narrative and ethnographic approaches to social work and counseling,’ Qualitative Social Work, vol. 4, no. 4, pp. 379-390.
Huber, C. H. 1996, ‘Taking an evolutionary perspective: the solution-oriented genogram,’ Family Journal, vol. 4, no. 2, pp. 152-154.
Hurley, D. 2006, ‘Internalized other interviewing of children exposed to violence,’ Journal of Systemic Therapies, vol. 25, no. 2, pp. 50-63.
Jordan, K. 2004, ‘The color-coded timeline trauma genogram,’ Brief Treatment and Crisis Intervention, vol. 4, no. 1, pp. 57-70.
Keeling, M. L. & Bermudez, M. 2006, ‘Externalizing problems through art and writing: experience of process and helpfulness,’ Journal of Marital & Family Therapy, vol. 32, no. 4, pp. 405-419.
Kohli, R. K. S. 2006, ‘The sound of silence: listening to what unaccompanied asylum-seeking children say and do not say,’ The British Journal of Social Work, vol. 36, no. 5, pp. 707-721.
Marsten, D. & Howard, G. 2006, ‘Shared influence: a narrative approach to teaching narrative therapy,’ Journal of Systemic Therapies, vol. 25, no. 4, pp. 97-110.
McLeod, J. 2006, ‘Narrative thinking and the emergence of postpsychological therapies,’ Narrative Inquiry, vol. 16, no. 1, pp. 201-210.
Merscham, C. 2000, ‘Restorying trauma with narrative therapy: Using the phantom family,’ Family Journal, vol. 8, no. 3, pp. 282-286.
Mills, S. & Sprenkle, D. H. 1995, ‘Family therapy in the postmodern era,’ Family Relations, vol. 44, no. 4, pp. 368-376.
Myerhoff, B. 1982, ‘Life history among the elderly: performance, visibility and remembering’ in A Crack in the Mirror: Reflexive Perspectives on Anthropology, ed. J. Ruby, University of Pennsylvania Press, Philadelphia.
Myerhoff, B. 1986, ‘Life not death in Venice: its second life,’ in The Anthropology of Experience, eds. V. Turner & E. Bruner, University of Illinois Press, Chicago.
Neimeyer, R. A. 2006, ‘Narrating the dialogical self: toward an expanded toolbox for the counselling psychologist,’ Counselling Psychology Quarterly, vol. 19, no. 1, pp. 105-120.
Riessman, C. K. & Quinney, L. 2005, ‘Narrative in social work: a critical review,’ Qualitative Social Work, vol. 4, no. 4, pp. 391-412.
Riley, S. 1999, Contemporary Art Therapy with Adolescents, Philadelphia Jessica Kingsley, London.
Smith, B. & Sparkes, A. C. 2006, ‘Narrative inquiry in psychology: exploring the tensions within,’ Qualitative Research in Psychology, vol. 3, no. 3, pp. 169-192.
Vidgen, A. & Williams, R. 2001, ‘Letter-writing practices in a child and family service,’ Journal of Family Therapy, vol. 23, no. 3, pp. 317-326.
Wadison, H. 1973, ‘Art techniques used in conjoint marital therapy,’ American Journal of Art Therapy, vol. 12, pp. 147-164.
White, M. 1993, ‘Deconstruction and therapy’ in Therapeutic Conversations, eds. S. Gilligan & R. Price, W. W. Norton, New York.
White, M. & Epston, D. 1990, Narrative Means to Therapeutic Ends, W. W. Norton, New York.
Wilks, T. 2005, ‘Social work and narrative ethic,’ The British Journal of Social Work, vol. 35, no. 8, pp. 1249-1264.