Addiction A-Z

Narrative therapy

A narrative is a story comprised of a collection of events. Every person has a story; for some, it’s essentially positive sprinkled with negative events throughout. But for others, the negative elements or problems are front and center, overshadowing anything positive. Many people go through life defining themselves by their problems. This often makes them feel stuck, hopeless, fearful, or empty.

For example, individuals who’ve struggled with anxiety for many years often describe themselves as “an anxious person.” The more that becomes their “story,” the more they see themselves as fearful and incapable of handling challenges. Similarly, those whose stories center around past mistakes or failures regard themselves as “losers” or “total failures”, while those who struggle with depression define their lives as “hopeless.” Needless to say, these stories exert a powerfully negative impact on the course their lives – unless and until they change the story.

Narrative therapy helps people see themselves as separate from their problems and to use their own inherent strengths and abilities to change their lives. The goal of this therapeutic approach is to help them rewrite the negative story – the problem-saturated narrative – that has been dominating their lives for so long. They learn to regard problems as something they have, not something they are.

In narrative therapy, the therapist isn’t the expert; the client is. This shift in perspective from more traditional forms of therapy can be especially empowering for individuals who seek treatment. It’s not uncommon for therapy clients to regard themselves – at least to some degree – as weak, inferior, or even damaged because of their depression, anxiety, relationship struggles, unresolved grief, or whatever disorder or challenge that caused them to seek professional help in the first place. Narrative therapists work in collaboration with clients to help them achieve their therapeutic goals in a respectful, non-judgmental, and non-blaming manner.

As clients learn to externalize their problems or challenges and deconstruct the problematic story, they can then begin the process of reconstructing it. They use positive alternatives to create a winning story. It’s akin to a writer going back through a novel he’s written – one that was rejected by potential publishers due to flaws in the storyline. Building upon the strengths and most interesting aspects of the original story, he rewrites the novel and turns it into a bestseller.

Narrative Therapy Techniques

Following are some of the techniques often used in narrative therapy:

Externalizing the problem – As mentioned above, in narrative therapy, problems are viewed as something people have, not something they are. In other words, people’s problems don’t define them, nor does their story need to limit or confine them to an undesirable reality. Externalization may involve objectifying, personifying, or labeling the problem – making it a separate or external entity. For example, a person with OCD could personify the intrusive thoughts as an annoying bully.

Mapping the problem – This narrative technique involves the therapist’s use of questions that help people identify how a problem is impacting their life. For example, the therapist might ask someone who’s feeling stuck in unresolved grief, “What sorts of problems does this grief cause in your life?” Such a question can help him consider things he can do – ways to change the grief narrative – to exert control and reduce its impact. 

Identifying unique outcomesWhen clients tell their stories, they typically emphasize all the things that support it. For example, the middle-aged man who perceives himself as a failure in life will tell a story that supports his negative story. He’ll inevitably gloss over or omit all the successes he’s had over the years. The therapist, however, will ask him about exceptions to his narrative. The exceptions, or “unique outcomes,” refer to times when the problem wasn’t so bad or noticeable. Unique outcomes reveal clients’ strengths and skills. Clients can then incorporate these into their new, more positive, narrative.

Deconstructing the story/Identifying alternative narrativesAs clients begin to tell their story, the narrative therapist will point out certain things, such as exceptions (mentioned above) to the dominant story, hidden meanings, and potential alternatives to the current storyline. The therapist’s observations help clients deconstruct their story and consider ways it can be changed.

Exploring and considering alternative plots or endings helps clients begin the process of rewriting – or reconstructing the current, problematic narrative. The new story – which is a more positive perspective of the problem – helps the client begin to overcome it. This process helps clients discover solutions they may not have considered before.

A Brief History of Narrative Therapy

Narrative therapy was developed back in the 1980s by two family therapists with backgrounds in psychiatric social work: Michael White, from South Australia, and David Epston, from New Zealand. Rather than adhering to more traditional approaches to psychotherapy that pathologized people’s problems and / or viewed them as buried in the unconscious mind, White and Epston developed a different approach based on the power of language and stories.

They recognized the powerful role that people’s personal stories – their “narratives” – played in their individual lives. People came into therapy with a story that was “problem saturated.” The presenting problem (e.g. depression, anxiety, posttraumatic stress, grief, or being a victim) not only dominated their life; it also often defined them. White and Epston focused on helping their clients make positive changes and improve their lives by having them essentially rewrite their own stories.

What to Expect in Narrative Therapy

Narrative therapy, like most other types of psychotherapy, usually involves weekly sessions with the therapist. Although the therapist will facilitate the process, it is a collaborative effort between client and therapist. Since clients are regarded as the expert in their own lives in narrative therapy, they – and not the therapist – identify their problems. During sessions, narrative therapists guide the conversation in a way that fosters discovery, and allows and encourages new stories – and new meanings – to emerge. They help their clients rewrite the dominant story – the one that led them to seek therapy – and create one that is much more positive, desirable and empowering.

Disorders, Problems, and Conditions That Can Benefit from Narrative Therapy

Narrative therapy can be used to help children, adolescents, adults, and seniors. It can be a very beneficial form of therapy for couples and families. It’s also been used effectively in group settings.

The problems and disorders that may benefit from this particular therapeutic approach include, but aren’t necessarily limited to, the following:

  • Family conflict
  • Marital problems
  • Relationship issues
  • Anxiety
  • Depression
  • Bipolar disorder
  • PTSD
  • Recovery from abuse and other types of trauma
  • Grief and loss
  • OCD
  • ADHD
  • Substance abuse and addiction
  • Anger issues
  • Aggressive behavior
  • Acting out/tantrums
  • Problems at school
  • Specific phobias
  • Social anxiety
  • Lack of confidence
  • Low self-esteem
  • Sexual identity issues
  • Poor coping skills in children and teens
  • Eating disorders
  • Domestic violence issues
  • Chronic illness

Benefits and Advantages of Narrative Therapy

Following are just a few of the many potential benefits and advantages of narrative therapy:

  • It’s a non-pathological, non-blaming, non-judgmental approach to therapy that separates the problem from the person.
  • It regards the client – rather than the therapist – as the expert in his or her own life. This can be very empowering to therapy clients, as many people seek therapy regarding themselves as “broken” or “disordered” and perceiving the therapist as the person who (hopefully) can “fix” them.
  • It focuses on the client’s strengths, skills, and knowledge rather than on his or her weaknesses and past failures.
  • It helps clients look at their problem(s) from a more objective perspective. This objectivity enables them to consider alternative interpretations of their story.
  • It can be used to enhance other types of therapy, such as art therapy, play therapy with children. Or family systems therapy.
  • The process of externalizing problems and viewing them as separate from the client, therapy clients often feel less guarded and defensive. This enables them to engage more openly and proactively in the therapy process.
  • The approach is very optimistic and even playful at times, making it an appealing therapy for anyone who’s been in therapy in the past and left feeling disillusioned or discouraged by the process.

Potential Disadvantages of Narrative Therapy

No approach to psychotherapy is perfect or without limitations. Following are some of the potential disadvantages or limitations to narrative therapy:

  • Compared to more traditional types of psychotherapy, narrative therapy is relatively new. As such, there isn’t a substantial amount of scientific research that supports this as an effective therapeutic approach.
  • Another potential disadvantage of narrative therapy is that some individuals feel uncomfortable being the “expert” and driving the therapy process. This can be especially problematic for therapy clients who aren’t particularly articulate.
  • Narrative therapy also isn’t appropriate for all types of clients, for obvious reasons in many cases. For example, individuals who are psychotic or have limited cognitive, intellectual, or language skills would not be good candidates for this particular type of therapy.

Finding a Qualified Narrative Therapist

Many types of mental health professionals, including psychologists, clinical social workers, and marriage and family therapists, use narrative therapy in their clinical practice. When looking for a qualified therapist, make sure he or she has received appropriate training and certification from an established narrative therapy training program. The Dulwich Centre in Adelaide, Australia, (co-founded by Michael White) currently offers narrative therapy training programs (including online training) all over the world via members of its staff. There are also several independent narrative training programs in the U.S. and other countries. An online search for “narrative therapy [your city]” is one of the quickest ways to find a narrative therapist in your area.

Narrative therapy is a wonderfully optimistic, respectful, and non-judgmental approach to therapy. If you are struggling with mental health issues or other life challenges that are negatively impacting your life, it might be worthwhile to consider narrative therapy. If you’ve been in therapy before and felt it was too one-sided or unhelpful in other ways, narrative therapy can provide a different perspective, as well as an opportunity to work in a collaborative, highly interactive manner with a therapist. By rewriting the “story” that dominates your life, you can begin to create a future that aligns with your desires and goals.

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