Family Therapy paper
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NarrativeTherapySpring20191.pptxNarrative therapy: restorying lives
Michelle Washburn-Busk MS, LMFT
Key figures
Michael White
Co-director of Dulwich Center in Australia with Cheryl White
Attended David Epston’s workshop in 1981 which sparked the partnership
David Epston
Trained as anthropologist & social worker
Co-director of the Family Therapy Center in New Zealand
Influences
Gregory Bateson
Michael Focult
Feminism
Narrative therapy
Post-modern revolution
Concerned with ways people interpret their behavior rather than how they behave
There are multiple ways of interpreting experiences therefore, multiple beliefs, ways to make meaning of life, and narratives
Theoretical Assumptions
Narrative therapists believe that strategic reframes won’t land unless they fit people’s stories
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We organize our lives through stories.
Many experiences have not been storied – potential for alternative stories
Many different meanings can be made of the same event
Stories are how humans create meaning over time.
Theoretical Assumptions
Our lives are socially constructed.
Stories are created in relationship to others.
Theoretical Assumptions
The dominant discourses in society influence what gets storied and how.
The interpretation of an event is determined by its receiving context.
Group membership (family, friends, race, gender, religion, etc.) influences our stories.
Discourses are systems of words, actions, rules, beliefs, and institutions that share common values and are often invisible and taken for granted.
In-class journal #7
Think about Harry Potter.
What is his dominant narrative (from Voldemort)?
Think about beliefs, values, insecurities
What is his preferred narrative (from parents, supportive friends, professors, self)?
Beliefs, values, strengths
In-Class Journal #7 *(4/24)
Group membership (family, friends, race, gender, religion, etc.) influences our stories.
How has your group membership(s) influenced your personal story (beliefs you hold about yourself, personal rules, behaviors, etc.)
Theoretical assumptions
Events that do not fit the existing plot are often omitted from the storyline.
Locating problems in discourses helps us see people as separate from their problems and choose alternative preferred discourses.
Connecting the dots – Need a Volunteer
Draw lots of dots on the board, connect dots that represent the narrative one has
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In-class journal
Identify a negative belief you have had about yourself. Now plot 3-5 instances that confirm that belief.
Connect the dots.
Then, add more plots that add other experiences totally unrelated to this belief, and some experiences that are CONTRARY to this belief.
Now connect THOSE dots.
How linear is it?
View of family & client
Families possess a rich history
Resists labelling of people- past meanings are the problem
Issue Development
Current stories have narrow plot lines that are constricting options and not sufficiently representing a person’s lived experience.
The person is not the problem, the problem is the problem and the person’s relationship with the problem is the problem.
The problem is dependent on its effects for survival.
Rather than focusing on self-defeating behavior patterns, narrative focuses on self-defeating cognitions - the stories people tell themselves about their problems.
Change
Deconstruct unhelpful dominant discourses
Locate unique outcomes to construct alternative plot lines = reauthoring
By altering language, meanings are also altered, which instigates new actions.
If the person refuses to cooperate with the requirements of the problem, then they are undermining it; refusing to submit to the effects of the problem renders the problem less effective.
Role of Therapist
Not knowing stance = no assumptions about peoples current situation, values, or preferences.
Therapist is not expert, but someone who is interested, curious, and intrigued by the success in people’s lives
Labels are avoided, so “person” is preferred over “client”
Assist people in discovering events that contribute to the preferred story
Role of Therapist
Collaborates with people to rewrite problematic stories
Not neutral- therapist takes the side of people’s preferred stories
Decentered- focus more on client’s words than the therapist’s
BUT - therapist internally acknowledges that their own work is influential.
Assessment
No formal assessment phase since no idea of “normal.”
The therapist begins by hearing each person’s view of the problem, the influence of the problem on their life, and begins deconstructing the assumptions surrounding the problem to understand how the dominant discourse is empowered.
The therapist also tracks key words to use in externalizing and goal setting.
Assessment continued
Once problems have been personified as alien entities, the therapist first maps the influence of the problem on the family and then maps the influence of the family on the problem.
Therapist explores distressing impact of problem on lives
Client’s responses to this usually highlight their own sense of inadequacy.
Goals of Therapy
In Narrative terms, not a goal, but a “project” or direction in life
Overall- help people deconstruct problems in a manner that robs the problem of power and influence in the person’s life.
Co-constructed by family and therapist – identifying the problem and how the family perceives life will be when the problem is no longer dominant (SFBT)
Key Practices (Interventions)
Externalizing Problems
Deconstructive Questioning
Internalizing Other questions
Telling & Witnessing
Reauthoring
Extending the Conversation
Externalizing problems
Externalizing Problems = separate the person from the problem
Removes guilt of being the problem, but not people’s responsibility for the extent to which they participate in the survival of the problem.
Enables people to assume responsibility for the problem.
Allows people to unite together against the problem
Externalize eating disorders, addictions, depression, anxiety, shame, inner-critic & self-compassion
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Externalize the inner-critic
In-Class Journal
1. Think of a behavior in your life that is causing some problem(s)
2. When your inner-critic responds to this behavior, what do you feel?
3. Turn toward your inner-critic and be curious about what’s motivating it?
4. Write words of thanks to your inner-critic.
5. Write words of love and encouragement to yourself about this problem
In-class Journal: Extend the conversation
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Think
Now think of this problem or another part of yourself or your life that makes your inner-critic criticize you.
Write
Write a screen-play where there is a dialogue between your inner-critic and your self-compassion about this issue.
Write
Write at least 15 lines of dialogue.
Externalizing problems cont.
Defining the Problem to Externalize
Therapist can offer suggestions
Violence and abuse are not externalized, but the beliefs and values associated with them are
Definitions should be relevant to their own experience rather than professional definitions
May need to help client broaden problem to find unique outcomes
Help families establish a shared definition of the problem- can be accomplished through externalizing
Relative influence questioning
Helps people recognize the way the problem has influenced them and vice versa (mapping the influence).
Contradicts the problem-saturated narrative = unique outcomes arise as evidence of a person’s influence over the problem but are only unique if considered significant to the person
Increases personal agency.
Each family member can map their influence (both how they keep the problem alive and how they rob it of power)
Unique Outcomes
Aspects of one’s lived experience that fall outside the dominant story. Build hope and self-efficacy.
Only need one to begin creating new meaning
Historical unique outcomes can be identified by a review of the person’s influence in relation to the problem prior to therapy, between therapy sessions, or over the course of therapy.
Current unique outcomes occur in session and usually are brought to the person’s attention by the therapist’s curiosity
Future unique outcomes exist in a person’s plans and hopes to escape the influence of the problem = a present act of defiance towards the problem
Deconstructive Questioning
Deconstructive Questioning = questions that help the client question the values and beliefs that support the problem and ways to keep the problem from interfering in the future. Places assumptions and reality under scrutiny.
Internalizing Other Questions
Internalizing Other Questions = perspective taking. Asks people to view themselves or the situation through another person’s eyes. E.g. “How would your teachers describe your reputation at school?” “What would your husband say if I asked him about..?”
Telling & Witnessing
Within a family = one family member tells their story while the others listen and then are asked to reflect on what they heard. Then switch.
Reflecting teams or outsider witness groups = reflecting team observes families and then discussed in front of the family what they saw and heard, potentially arriving at a new understanding of the family’s experience to present to the family for consideration. The family then has an audience for their new narrative.
reauthoring
Reauthoring = Ascribing meaning to unique outcomes and creating an alternative story line. Inviting new co-authors of the new story.
Extending the Conversation
Letter Writing = an extension of the conversation between sessions. Celebrates new stories created by families and promotes ongoing “performance” of these new stories. May also include certificates of merit.
Definitional Ceremonies = Rituals to commemorate, communicate, and celebrate meaningful changes.
Effectiveness & Criticisms
Some indications of effectiveness
Not a very large research base
Quite abstract and cognitive
Does not focus on system dynamics that may impact the problem- people find it more challenging to adapt to families than more systemically oriented models.
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