Narrative Therapy

Martin Payne

• Publisher: SAGE Publications Ltd
• Year: 2006
• ISBN:
  9781446233900
• Edition: 2
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

`A thought provoking and interesting book that will be of interest to nurses and others supporting patients? - Accident and Emergency Nursing

`It is a relevant and timely book that will remind therapists of the importance of the telling of client?s stories as an important component of the therapeutic process. Whatever approach we use, the client?s story will be a part of what we work with, so a sophisticated questioning of what ?stories/narratives? are will benefit our work. This book is a good starting point for such an exploration. It?s an interesting book that will appeal to counsellors ready to challenge or add to their existing approach? - Therapy Today

Narrative Therapy: An Introduction for Counsellors, Second Edition, offers a clear and concise overview of this way of working without oversimplifying its theoretical underpinnings and practices.

Narrative therapy places peoples? accounts of their lives and relationships at the heart of the therapeutic process. Its main premise is that the telling and re-telling of experience by means of guided questioning can facilitate changed, more realistic perspectives, and open up possibilities for the person seeking assistance to position him- or herself more helpfully in relation to the issues brought to therapy.

Drawing on the ideas of Michael White and David Epston, this fully revised, extended and updated second edition incorporates recent developments in narrative theory and practice, and introduces developments initiated by other narrative therapists worldwide. New material has been added around counselling for post-traumatic reactions, couples conflict and a sense of personal failure.

The book is illustrated with extensive examples of practice with individuals and couples. It is ideal for anyone on training courses in narrative therapy, and also for counsellors who wish to consider common ground between narrative ideas and their current approach.

Martin Payne is an independent therapist and trainer in Norwich, UK.

ONE

An Overview of Narrative Therapy

Narrative Therapy and traditional therapies

Narrative therapy is radical in many ways, as it embodies ideas, assumptions, aims and methods which may be unfamiliar and challenging for counsellors familiar with traditional counselling approaches. However, there are common factors with traditional therapies which may provide entry points to understanding. These common elements are not very much emphasized in the narrative therapy literature, which has led some commentators to see it as élitist despite (for example) Michael White’s insistence that his ideas and ways of working are a contrast to those of traditional approaches, with no implication that these ideas are ‘mistaken’ or ‘wrong’ (2000: 19–20, 2004a: 132).

Person-centred counsellors will recognize common ground with narrative therapy in that both therapies aim to encourage knowledge, skills and capacities for living to become consciously recognized, and transformative. Both therapies aim to create a context of respect and acceptance where these elements, not initially very much part of the person’s self-perception, may be recognized, spoken, reinforced and drawn upon for positive change. The counsellor’s role in both therapies is to facilitate this process rather than to impose assumed expert professional knowledge about the person’s motives or needs. Both therapies assume a co-operative and egalitarian stance between the counsellor and the person, with the counsellor following slightly behind the person as she develops her discoveries and decides how these discoveries may be called on.

Counsellors who use cognitive approaches believe that illogical thinking is the main element preventing persons from overcoming their practical and emotional difficulties. Narrative therapy also encourages a re-structuring of existing perceptions through the close examination of existing conceptual limitations. Both approaches see the therapist’s task as assisting the person to engage more fully with his ability to re-frame his experience.

Psychoanalytic theorists such as Donald Spence emphasize that therapists do not and cannot address the raw, actual past experience of the person seeking help, but are limited in therapeutic material to persons’ accounts of what brings them to therapy. The narratives by which these accounts are told by the person are partial, selective, inconsistent, and influenced by conceptual assumptions derived from wider society. The embedded professional assumptions and interpretative biases through which the therapist understands the account also contribute to its remoteness from the past actuality being selectively described, and socially inherited linguistic forms and conventions add their own shaping and moulding (Spence 1982: 321–37). Narrative therapists would agree with all these observations.

A few more examples may be helpful. Neuro-Linguistic Programming has in common with narrative therapy its close attention to the language of therapy and its recent focus on the nature of the stories told by the person to the counsellor (Young 2004). Adlerian recognition of the centrality of power relations between individuals and in society is also a central concern of narrative therapy, as are the focus on the importance of social context, and on persons’ interactions as more appropriate than analysis of assumed pathology (Carlson J. in ed. Madigan 2004: 76). Counsellors whose work is based on Kelly’s Personal Construct Psychology see it, like narrative therapy, as a hopeful approach which emphasizes the person’s interpretation of the world as the material for therapy, and like narrative therapists they believe that examining persons’ constructs of reality can be the starting point for the person’s escaping the limitations of restrictive autobiographical schemas (Fransella and Jones 1996: 37–8). Solution-focused brief therapy is similar to narrative therapy in many respects, in particular in the refusal to pathologize, and the technique of identifying instances when the problem has not been present, discussing the significance of these instances, and using them as a basis for working towards change (de Shazer 1985, 1991). Narrative therapy emerged from Systemic Family Therapy and shares many of its methods, including the extensive use of questioning, attention to social and familial influences on persons’ perceptions, and the use of reflecting teams.

In suggesting entry points to narrative therapy for readers who work in other counselling models I am not advocating eclecticism, or suggesting that these therapies are essentially the same:

running together of distinct traditions of thought and practice … leads to the false representation of the positions of different thinkers … when these distinctions are blurred we cannot find a place in which we might sit together, regardless of our different persuasions, and engage in conversations with each other in which we might all extend the limits of what we already think. (White 2000: 103–4)

Nevertheless it can be argued that the concept of ‘narrative’ does provide a place where therapeutic minds can meet (Angus and McLeod eds: 2004a: 367–404). And some practices developed by White and other narrative therapists, when properly understood, can productively be introduced into other ways of working. Person-centred counsellors taking part in a workshop on narrative approaches to couples work told me that the concept of ‘exceptions’ (another word for ‘unique outcomes’ – see explanation below) struck a chord with them, and helped them to identify with more precision occasions when their clients were finding a way forward.

Different but equally valid descriptions

Adams and Hooper’s delightful book Nature Through the Seasons (1975/1976) describes the changing seasons in the English countryside in two ways. One description is scientific, covering topics such as atmosphere, temperature changes brought about by the earth’s journey round the sun, chemical changes in the soil, biochemical aspects of plant growth, and the mating and migration patterns of birds. The other description is evocative, describing the misty beauty of autumn fields, the starry carpeting of ditch banks by primroses, the distant call of a cuckoo. Each description of the same time of year is valid and yet they are utterly different. Taken together they give a dual perspective, a more complete overall description. Two disparate narratives combined to make a richer overall narrative.

Narrative therapy encourages richer, combined narratives to emerge from disparate descriptions of experience.

The book has illustrations, two for each season. One portrays open landscape, and the other woodland. David Goddard’s illustrations show each animal, bird, plant or tree in meticulous detail. Yet one aspect is far from realistic: crowded into each scene is almost every tree, flower, plant, insect, fungus, bird, animal and reptile associated with the season! The illustrations follow a convention – the reader knows that she would never see all this wildlife gathered together in one landscape, but it is convenient for the book to show them all at once in one picture. Even so, there are missing elements: in an actual landscape there are possibilities for surprise (once, in Kent, I saw an osprey diving – a bird native to Scotland). No portrayal of the typical can include variants and yet it can be the variants that make experience uniquely memorable.

Narrative therapists encourage a focus on the untypical – untypical, that is, as perceived by the person. They encourage the untypical to be considered in great detail because it is through the untypical that people can escape from the dominant stories that influence their perceptions and therefore their lives. Stereotyped descriptions of experience become less fixed and influential when methods of therapy assist these stereotyped descriptions to be more complete.

The outline of narrative practices which follows in this chapter uses a convention similar to the illustrations in Adams and Hooper’s book. It offers an overview, not implying that all of these elements are necessarily found in any one session or indeed in any sequence of sessions. Certain practices are often found in narrative therapy sessions, but the priority is a sensitive response to the person. I have taken part in narrative counselling in which almost exactly the sequence of practices I describe was followed; where few of the practices were used; and where these particular practices were not used at all.

The language of narrative therapy

The use of specific terminology is important in narrative therapy. Michael White sees his use of precisely chosen but sometimes unfamiliar language as inevitable when he describes ideas outside the mainstream of traditional therapy: ‘Although some readers may consider some of these terms to be jargon, I would ask that they avoid re-translating these into more familiar words and phrases of the conventional discourses of counselling/psychotherapy, for to do so will change their meaning’ (2004a: x). A consciousness of language usage is seen by White and Epston as a central responsibility of therapists:

We have to be very sensitive to the issue of language. Words are so important. In so many ways, words are the world. So, I hope that a sensitivity to language shows up in my work with persons and, as well, in my writing (White 1995a: 30).

The powerful associations triggered by evocative language can be called on in therapeutic conversations to increase vividness and immediacy, and I give examples of this in later chapters. But there is a down side. Narrative therapists try to remain aware that language is fraught with possible ambiguity, misinterpretation, and unthinking assumptions. By its very nature language is saturated with historically and culturally derived meanings, often unrecognized as such, which may influence or distort what the person and the therapist characterize and how they communicate. ‘Masculine’ and ‘feminine’ are good examples: even to the most thinking person these words are likely to trigger rooted associative overtones of ‘tough, active and decisive’ contrasted with ‘soft, vulnerable and passive’, and both imply an absolute gender distinction which biology and social psychology deny. It takes a conscious effort to escape from these meanings. Words are not representations of clearly distinguishable realities, but generalized symbols inviting the reader to supply meaning and definition from her own store of associative linkages. These associations are powerfully imbued with assumptions derived from their usage in a social and linguistic community. Slippery definitions apply even to the words we use to describe our profession. To the general public the word ‘counselling’ has perhaps begun to lose its original meaning of advice-giving, but ‘therapy’ certainly retains its medically-derived meaning of an expert-based cure.

The point is well expressed by Adrienne Chambonne and her colleagues:

language is constitutive of people’s lives. One cannot stand outside language. Language is evocative and brings forth realities. Therefore, vigilant attention must be paid to the use of language from the very beginning and throughout the therapeutic conversation. Our concern is not only how people interpret language and circumstances, but how we interpret their interpretations. (ed. Madigan 2004: 152)

White’s and Epston’s written language is often vivid and engaging:

Nick had a very long history of encopresis, which had resisted all attempts to resolve it, including those instituted by various therapists. Rarely did a day go by without an ‘accident’ or ‘incident’, which usually meant the ‘full works’ in his underwear. To make matters worse, Nick had befriended the ‘poo’. The poo had become his playmate. He would ‘streak’ it down walls, smear it in drawers, roll it into balls and flick it behind cupboards and wardrobes, and even taken to plastering it under the kitchen table … the poo had even developed the habit of accompanying Nick in the bath. (White 1989:9)

I purposefully mis-heard the few responses that she gave me to my questions. I often do this with nervous, shy or unwilling adolescents:

Neolene:	[mumbling inaudibly in response to DE’s question.]
DE:	[incredulously] You want to buy a pumpkin?
Neolene:	[looking at me in amazement] What do you mean pumpkin?
DE:	I thought you said you wanted to buy a pumpkin?
Neolene:	[laughing, but now perfectly audible and responsive] No … what I said was…
(Epston and White 1992:39)

However, as White implies in the passage quoted earlier, the reader new to narrative therapy may well find some of its language puzzling or obscure, and discover that familiar terms are used in unfamiliar ways. White’s exposition of concepts in the writings of Michel Foucault, themselves derived from Ancient Greek originals, is daunting:

The second aspect of the constitution of the self as a moral agent is the ‘mode of subjectification’ (not ‘subjugation)’. It is the mode of subjectification that provides the mechanism through which people are encouraged or required to recognize their moral obligations in regard to the management of the relevant ethical substances. (2004a:189)

On other occasions narrative therapy language carries clear, specific meanings familiar to those who have read publications where the terms are defined, but which may puzzle readers new to these terms:

I will present candidate questions that assist family members to select out unique outcomes, place these unique outcomes in the context of a pattern across time, ascribe significance to unique accounts, and speculate about new possibilities. These are all questions that invite, from family members, a ‘performance of meaning’. (White 1989: 41)

In the following pages I explain terms used in narrative therapy when describing their place in practice. Their strange quality should evaporate with familiarity.

White is scrupulous to maintain gender- and ethnic-neutral vocabulary, but his concern goes further...

Table of contents

• Cover Page
• Title Page
• Copyright Page
• Contents
• Foreword by John McLeod
• Acknowledgements
• Preface to the Second Edition
• Introduction
• 1 An Overview of Narrative Therapy
• 2 Ideas Informing Narrative Therapy
• 3 Assisting the Person to Describe the Problem
• 4 Encouraging a Wider Perspective on the Problem
• 5 Asking Questions
• 6 Therapeutic Documents
• 7 Telling and Re-telling
• 8 Examples of Narrative Practice I: Counselling for Depression, and for Recovery from Abuse
• 9 A Fresh Look at Assumptions in the Therapy Culture
• 10 Examples of Narrative Practice II: Counselling for Post-traumatic Reactions, and in Working with Couples
• Postscript
• Appendix: An Exercise in Co-supervision using Narrative Therapy Practices
• References
• Index