Social Constructionism in Family Therapy

1.      Suspicious of search for ultimate truths

2.      Meanings are developed through social interaction and social consensus.

3.      There is an emphasis on the criss-crossing of ideas and meanings in our conversations with one another.

4.      Meanings are transitory.

5.      Value is placed on the adoption of the “not knowing” approach to understanding human problems.

6.      Therapy is a creative process rather than a discovery process. A <-> B <-> mutually influence each other.

7.      Uses the generative approach.

8.      Uses narratives and cultural framework.

9.      Uses language and meaning (i.e., Hoffman-Friendly Editor).

 

Narrative Family Therapy: A Social Constructionist-Postmodernist Therapy (e.g., Michael White, David Epston, Jill Freedman, Gene Combs, and Others)

BASIC ASSUMPTIONS

1.         Human beings are interpretive beings, we are all active in the interpretation of, in giving meaning to, our experience as we live our lives. An act of interpretation is an achievement.

2.         It is not possible for us to interpret our experience in a vacuum. A frame of intelligibility is necessary for any interpretation of lived experience.

3.         Such frames provide a context for our experience, and make the attribution of meaning possible.

4.         The meanings that we derive in the process of interpretation have real effects on the shape of our lives, on the steps we take in life. Thus, such meanings are not neutral in their effects on our lives.

5.         The personal story or self-narrative provides the principal frame of intelligibility for our lived experience.

6.         The personal story or self-narrative is not radically invented inside our heads. Rather, it is something that is negotiated and distributed within various communities of persons and in the institutions of our culture.

7.         The personal story, or self-narrative, structures our experience. It is the personal story, or self-narrative, that determines which aspects of our stock of lived-experience are selected for expression.

8.         It is the personal story, or self-narrative, that determines the specific shape of the expression or particular aspects of our lived experience.

9.         It is the stories that we have about our lives that actually shape or constitute our lives.

10.       Our lives are multi-storied. No single story of life can be free of ambiguity and contradiction. No sole personal story or self-narrative can handle all of the contingencies of life.

11.       The act of living requires that we be engaged in the meditation of the dominant stories and of the sub-stories of our life.

12.       Narratives follow a sequence of events across time and have a plot.

13.       A storied life is multiverse and there are many stories that have not been told. Life is richly complex and there are always counterplots to be found and new stories to develop.

 

Contrasting Post-Modernist and Modernist Theories

 

Attempt to discover, to map, and to know the objective truth consistent with empirical science.

Suspicious of search for the ultimate truths. Few, if any ultimate truths.

Searches for characteristics of healthy vs. unhealthy

Non-normative. Narratives that people tell themselves.

Therapist as expert. Takes charge of and sets the goals for therapy. Goals dictated by one’s theory of therapy.

Therapist as learner. Is collaborative. Constructs new stories and deconstructs old ones. Develops a story that is more helpful.

Role of therapist is that of director, choreographer, coach.

Role of therapist as participant-observer with the client.

Treats the “real” problem. The underlying structural flaw in the system that leads to symptoms, e.g., covert parental conflicts, low self-esteem, personality flaw, etc.

No such thing as “real” problem. There are only problems that people describe.

Therapy as a discovery process

Therapy as a creative process.

 


 

Contrasting Narrative/Collaboratric Language

with Solution-Focused Models

 

Anderson & Goolishian

O’Hanlon & Weiner-Davis

Human systems are language-generating and, simultaneously, meaning-generating systems.

Clients have resources and strengths to resolve complaints.

Meaning and understanding are socially constructed.

Change is constant

Any system in therapy is one that has dialogically coalesced around some “problem.”

The therapist’s job is to identify and amplify change.

Therapy is a linguistic event that takes place in what we call a therapeutic conversation.

It is usually unnecessary to know a great deal about the complaint in order to resolve it.

The role of the therapist is that of a conversational artist. Therapist is a participant-observer and a participant-facilitator of the therapeutic conversation.

It is not necessary to know the cause or function of a complaint to resolve it.

The therapist exercises this therapeutic art through the use of conversational or therapeutic questions.

A small change is all that is necessary; a change in one part of the system can affect change in another part of the system.

Problems we deal with in therapy are actions that express our human narratives in such a way that they diminish our sense of agency and personal liberation.

 

Change in therapy is the dialogical creation of new narrative, and therefore the opening of opportunity for new agency.

 

 

Other important assumptions about the therapeutic process.

·    The therapeutic context does not have a privileged location outside of the culture at large.

·    The therapeutic context is not exempt from the structures and from the ideology of the dominant culture.

·    The therapeutic context is not exempt from the politics of gender, class, race, and culture.

·    The therapeutic context is not exempt from the politics associated with the hierarchies of knowledge and the politics of marginalization.

·    It is never a matter of whether or not we bring politics into the therapy room, but it is a matter of whether we are prepared to acknowledge the existence of these politics, and it is a matter of the degree to which we are prepared to be complicit in the reproduction of these politics.

·    When people walk into the therapy room, they bring with them the politics of their relationships. When people walk into the therapy room they walk into a context that is structured by politics.

·    The unquestioned acceptance of the assumption that therapy has some privileged location guarantees that the practices of therapy will be more complicit in the reproduction of the dominant culture.

·    The unquestioned acceptance of this assumption ensures the duplication, in therapy, of the very context that is constitutive of many of the problems that person’s actually bring to therapy.

·    These considerations will assist us to acknowledge that, as therapy is of this culture, as therapists we will inevitably be playing a role in the reproduction of the dominant culture.

·    And we will be faced with new questions:

— What can we build into the therapeutic context that might contribute to our awareness of the politics of relationship?

— How do we propose to deal with the political dilemmas raised in this work?

— What steps can we take to avoid being wholly complicit in the reproduction of the dominant social order?

— What are some of the necessary conditions of a therapy that is sensitive to the politics of gender (including the politics of heterosexual dominance), race, culture and class?

— How might we go about interacting with persons in ways that assist them to identify, to embrace, and to honor their resistance to those acts of self-government that they are incited to engage in by the dominant knowledges and practices of power of this modern culture?

— How might we go about subverting the hierarchies of knowledge that privilege professional knowledge claims, and open up new possibilities for descent?

— What options are available to us for transgressing the property boundaries of the professional knowledges?

— What possibilities are available to us for the privileging of alternate knowledges and the knowledgeableness of those persons who seek our help?

— How might we successfully confront ourselves with the moral and ethical responsibilities that we have for the real effects of, or consequences of, our interactions with those persons who seek our help?

— What choices do we have in establishing structures that make our work accountable to those persons who seek our help, structures of accountability that expose the real and the potential abuses in the practice of therapy?

— What are the appropriate ways for us to acknowledge the imbalance of power that is inherent in the therapeutic relationship?

— What actions can we take to mitigate the toxic effects of the imbalance of power that is inherent in the therapeutic relationship?

— How might we go about acknowledging our own location in the worlds of gender, race, class and culture?

— And how might we go about acknowledging the implications of this location?

 

Therapeutic Roles of Social Construction/Narrative Therapy

1.      Therapist as learner.

2.      Therapists entertain all ideas.

3.      Therapeutic stance is on of taking a position of curiosity.

4.      Therapist focus on Collaborative and co-constructive relationship between client and therapist.

5.      Therapists maintain a focus on the client’s presenting problem.

6.      Therapists understandings are “grist for the mill.” Ideas are held only as hypothesis or possibilities.

7.      Therapists focus on what beliefs are restraining clients from acting in more appropriate ways. Invitations to responsibility.

Constitution of Therapists’ Lives

·    A critical review of the one-way account of therapy exposes the workings and reinforcement of the subject/object dualism that is so pervasive in the structuring of relations in Western culture.

·    The one-way representation of this process is marginalizing of those persons who would seek help.

·    There is a politics associated with this dominant conception as a one-way process, one that is associated with the construction and preservation of hierarchies of knowledge.

·    If we proceed to break from this subject/dualism, we will be able to take seriously the notion that there can be no detached, autonomous position.

·    We will be able to acknowledge the extent to which therapeutic interaction in constitutive of the lives of all parties to this interaction.

·    We will be able to acknowledge that what is shaping of the lives of these persons who seek our help is also constitutive of our work, and that what is constitutive of our work is also shaping of our lives in general.

·    We will be able to realize that it is an act of marginalization, an act that defines those persons who seek our help as “other,” not to make it our business to identify, to acknowledge, and to articulate the ways in which this work is changing of our lives.

·    This would include acknowledgment of:

— the privilege that we experience as persons invite us into their lives in various ways, and of the real effects of this privilege;

— the inspiration that we experience in this work as we witness persons changing their lives despite formidable odds, and as we experience the real effects of this in our lives;

— the experience of new and special associations that are enriching of our lives;

— the joy that we experience as we are privy to the extent to which persons are able to intervene in their lives to bring about preferred changes, and as we join with persons in the celebration of this;

— the special metaphors that person introduce us to that provide us with thinking tools in other situations;

— how this interaction has enabled us to extend on the limits of our thinking, and to fill some of the gaps in our own self-narratives;

— the contribution that others make to the sustenance of our vision, and of our commitment to this work.

·    This plays a significant role in dismantling the hierarchies of knowledge and the hierarchies of knowledgeableness.

·    This is not a cost. but is sustaining of us and our work.

 

 

 

Responsibility of the Therapist

·    A version of responsibility that emphasizes accountability to those persons who seek our help.

·    This is not a version of responsibility in which therapists are guided by the assumption that they can transcend their ways of being and thinking that are culture, class, race, and gender informed.

·    Instead it is a context of accountability that encourages

— therapists to render visible certain aspects of their taken for granted ways of being and thinking, to expand the consciousness of their biases;

— therapists to acknowledge their location in the social world, and the privileges and the limits of understanding that are associated with this location;

— persons to confront the limits of the therapists understandings, and to express their experience of these limits;

— persons to honor the unique understandings and experiences of life that pertain to their location in the world of gender, race, class and culture;

— therapists to transgress the limits of their thought by stepping into alternative sites of culture;

— therapists to name the assumptions and the perspectives that are associated with those metaphors that guide their work.

·    It is a version of responsibility that includes a refusal to engage in the politics of totalization and in the marginalization of peoples lives.

·    It is a version of responsibility that require therapists to take direct action to dismantle the structures of power that ensure their privilege in their interaction with those persons who seek their help.

·    It is a version of responsibility that enjoins therapists to hold themselves to account for the real effects of, or the consequences of, their interactions with those persons who seek their help.

 

THE THERAPIST’S WORK

·    Deconstruction of meanings and behavioral practices.

— Deconstructive listening — Listen for other possible meanings

— Deconstructive questioning — Helps see stories from different perspectives. See that stories are constructed and how they got to be constructed. Help clients question assumptions and beliefs. Bringing forth problematic beliefs, practices, feelings and attitudes. Questions: What is their relationship with the belief, practice, attitude or feeling?

— What are the effects of the results of the belief, etc.?

— Interrelationships with other beliefs, etc.?

— The tactics of strategy of the belief, etc.

·    Building on strengths.

·    Understanding internalized conversations.

·    Internalizing Conversations

A.  Internalizing conversations that introduce ways of speaking and thinking about life that erase context.

B.   Internalizing conversations that spit experience from the politics of relationship.

C.  Internalizing conversations that are pathologizing of lives and relationships (those are associated with the fabrication of the “disorders,” the “psychopathologies,” the “dysfunctions,” and so on, and with the production of relationship “dynamics”).

D.  Internalizing conversations that are totalizing of lives and relationships (those propose that the “disorders,” “pathologies,” and “dysfunctions” speak the truth of a person’s identity, and that “dynamics” speak of the nature of a person’s relationship).

E.   Internalizing conversations that are associated with certain techniques of power and techniques of self that have to do with modern technologies of the government of persons.

F.   Internalizing conversations that are isolating of personas from each other.

·    Externalizing conversations

A.  Externalizing conversations that introduce ways of speaking about life that emphasize context.

B.   Externalizing conversations that re-politicize experience.

C.  Externalizing conversations that deconstruct the “disorders,” the “psychopathologies,” and the “dysfunctions,” and that deconstruct relational dynamics.

D.  Externalizing conversations that assist persons to identify and to name the techniques of power and the techniques of self to which they have been subject.

E.   Externalizing conversations that facilitate the re-naming of the dominant plot.

F.   Externalizing conversations that encourage persons to map the real effects of certain “truths,” and the practices that are associated with these “truths,” on their lives and relationships.

G.  Externalizing conversations that assist persons to evaluate the real effects of these “truths” and “practices” on their lives and relationships.

H.  Externalizing conversations that assist persons to identify alternative and preferred purposes and commitments, and alternative and preferred practices of self and of relationship.

Power and the culture of therapy

1.         The culture of therapy does not have some privileged location outside of culture at large.

2.         The culture of therapy is not exempt from the structures and ideologies of dominant culture.

3.         The culture of therapy is not exempt from the politics of gender, race, and class.

4.         The culture of therapy is not exempt from the politics associated with the hierarchies of knowledge and politics of marginalization.

5.         A review of the history of the culture of therapy suggests that it has played a significant role in the production and reproduction of dominant culture.

Power and the culture of therapy: Some considerations for practice

Some awareness of the extent to which the culture of therapy reproduces the dominant culture can assist us in our search for a therapeutic posture that is not wholly complicit with this. This posture can include a determination:

1.         To assist persons to explore the real effects, on their lives and relationships, of some of the privileged knowledges and practices of power of dominant culture.

2.         To encourage persons to honor and embrace their resistance to the incitements of these dominant knowledges and practices of power.

3.         To privilege alternative knowledges and frames of intelligibility

4.         To establish the sort of structures of accountability that might expose the real and potential abuses of power in the practices of therapy.

5.         To subvert hierarchies of knowledge

6.         To acknowledge one’s location in the social world-gender, race, class, organization, sexual preference, etc.,and the implications of this location.

7.         To acknowledge the contribution of therapeutic interaction in the shaping of one’s own life.

8.         To consistently interview families about their experience of therapy.

9.         To recognize and respect the fact that it is not possible for the therapeutic context to be an entirely egalitarian context, but to strive to render it more so.

Values

This constitutionalist perspective is accompanied by a commitment to:

1.         Challenge values that are what might be referred to as normalizing values-values that are based on foundational premises and on universal notions of the “good.”

2.         Develop a clarity about those values-perhaps small “v” values-that assist us to a) challenge cruelty, domination, abuse, neglect, and so on, and b) respond to what persons say about the particularities of their experience.

3.         Take responsibility for the shape of the expression of these values within the therapeutic context-to develop certain necessary skills in the expression of these values, skills in expression that opens space for new possibilities for action in person’s lives, rather than close down this space.

Representationalism

(often the constitutionalist perspective is mistaken for representationalism)

Propositions

1.         The personal story or self-narrative is a description of life as lived.

2.         The personal story or self-narrative is a mirror or reflection of life as it is lived.

3.         The personal story or self-narrative is a map of the territory of life

4.         A personal story or self-narrative provides just one of many equally valid perspectives on life. Thus, one story is as good as another.

5.         For this reason, there can be no “solid” basis for making decisions about different actions.

The constitutionalist position

(as associated with the narrative metaphor)

1.         The personal story or self-narrative actually provides the structure for life.

2.         The personal story or self-narrative shapes life; it is constitutive of life.

3.         The personal story or self-narrative is not neutral in its effects.

4.         Different personal stories or self-narratives are anything but equal in their real effects.

5.         The narrative metaphor is associated with a tradition of thought that rules out the possibility of an “anything goes” moral relativism.

6.         This tradition of thought prioritize considerations of values and personal ethics.

7.         This tradition of thought encourages therapists to assume responsibility for the real effects or the consequences of his/her interaction with those persons who seek help.

Structure of the story

1.         Landscape of action

Events linked together in

Particular sequences

Through time, and according to

2.         Plot

3.         Landscape of consciousness

Desires

Preferences

Qualities

Characteristics

Motives

Purposes

Goals

Values

Beliefs

Commitments

·    Externalizing the problem

1.   Mapping the influence of the problem

2.   Mapping the influence of relationships to problems

3.   Constructing unique outcomes.

·    Naming the plot — Putting a name on experiences for the purpose of exploration and understanding.

·    Track contextual influences of the problem — What feeds the problem or starves it? Who supports certain problems? Who benefits from this way of doing things?

Adapted from Michael White, David Epston, Jill Freedman & Gene Combs

M.        Relative influence questions

1.         Mapping the influence of the problem

2.         Mapping the influence of relationships to problems

 

Case example

            Nick, aged six years, was brought to see me by his parents, Sue and Ron. 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 the walls, smear it in drawers, roll it into balls and flick it behind cupboards and wardrobes, and had even taken to plastering it under the kitchen table. In addition, it was not uncommon for Ron and Sue to find soiled clothes been hidden in different locations around the house, and to discover poo pushed into various corners and squeezed into the shower and sink drains. The poo had even developed the habit of accompanying Nick in the bath.

A.        In this case it is not clear whether the euphemism “poo” is a common one in Australia, or a common one for White to use in working with children. This creates a situation where the client can then change his or her relationship with the problem.

B.         In describing how the poo was affecting this family, the specific instances cited are all descriptions of social choreography.

1.         The poo was making a mess of Nick’s life by isolating him from other children and by interfering with his school work. By coating his life, the poo was taking the shine off his future and making it impossible for him and others to see what he was really like as a person.

2.         The poo was driving Sue into misery, forcing her to question her capacity to be a good parent and her general capability as a person.

3.         The ongoing intransigence of the poo was deeply embarrassing to Ron. This embarrassment had the effect of isolating him from friends and relatives. It wasn’t the sort of problem that he could feel comfortable talking about to workmates. Also, the family lived in a relatively distant and small farming community, and visits of friends and relatives usually required that they stay overnight. These overnight stays had become a tradition. As Nick’s “accidents” and “incidents” were so likely to feature in any such stay, Ron felt constrained in the pursuit of this tradition.

4.         The poo was affecting all the relationships in the family in various ways. For example, it was wedged between Nick and his parents. The relationship between him and Sue had become somewhat stressed, and much of the fun had been driven out of it. And the relationship between Nick and Ron had suffered considerably under the reign of tyranny perpetuated by the poo. Also, since their frustrations with Nick’s problems had always taken center stage in their discussion, the poo had been highly influential in the relationship focus between Sue and Ron, making it difficult for them to focus their attention on each other.

C.        After determining the pattern of influence of the problem, White then ascertains what influence the clients and their relationship with one another have over the problem. This is similar to the technique that solution-focused therapists use to determine exceptions. In this case,

1.         Although Sneaky Poo always tried to trick Nick into being his playmate, Nick could recall a number of occasions during which he had not allowed Sneaky Poo to “outsmart” him.

2.         There was a recent occasion during which Sneaky Poo could have driven Sue into a heightened sense of misery, but she resisted and turned on the stereo instead. Also on this occasion, she refused to question her competence as a parent and as a person.

3.         Ron could not recall an occasion during which he had not allowed the embarrassment caused by Sneaky Poo to isolate him from others. However, after Sneaky Poo’s requirements of him were identified, he did seem interested in defying these requirements. In response to my curiosity about how he might protest against Sneaky Poo’s requirements of him, he said that he might try disclosing the “terrible” secret to a workmate.

4.         Some difficulty was experienced in the identification of the influence of family relationship in the life of Sneaky Poo. However, after some discussion, it was established that there was an aspect to Sue’s relationship with Nick that she thought she could still enjoy, that Ron was still making some attempts to persevere in his relationship with Nick, and that Nick had an idea that Sneaky Poo had not destroyed all of the love in his relationship with his parents.

D.        At this point, then, White introduces questions that . . . “encouraged them to perform meaning in relationship to these examples, so that they might “reauthor” their lives and relationships.”

1.         How had they managed to be effective against the problem in this way?

2.         How did this reflect on them as people and on their relationships?

3.         What personal and relationship attributes were they relying on in these achievements?

4.         Did this success give them any ideas about further steps they might take to reclaim their lives from the problem?

5.         What difference would knowing what they now knew about themselves make to their future relationship with the problem?

E.         Resolution

1.         Nick thought that he was ready to stop Sneaky Poo from outsmarting him so much, and decided that he would not be tricked into being its playmate anymore.

2.         Sue had some new ideas for refusing to let Sneaky Poo push her into misery, and

3.         Ron thought that he just might be ready to take a risk and follow up with his idea of telling a workmate of his struggle with Sneaky Poo.

F.         Follow up

1.         Two weeks later

a.         Nick had only one minor accident

b.         Nick had not given into Sneaky Poo, had taught Sneaky Poo a lesson. He would not allow it to mess up his life anymore.

c.         Ron and Sue had also “gotten serious” in their decision not to cooperate with the requirements of Sneaky Poo.

i.          Sue had started treating herself and putting her foot down.

ii.          Ron had taken a risk and talked to a workmate about the problem. Discovered that the workmate had a similar problem with his son.

2.         Three weeks after that

a.         Nick had taken further steps to outrun Sneaky Poo.

b.         Nick had made new friends and caught up on his homework.

c.         Family had visited overnight with friends and relatives.

3.         Six month follow-up still going well.

Sources

White, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: Norton.

White, M. (1994). Therapeutic conversation as collaborative inquiry, a workshop presented in Austin, Texas, March 25, 1994.


 

Collaborative Language Systems

A Postmodern Approach to Therapy

Harlene Anderson Approach

 

Three Components of Therapy

Therapy Systems

1.         Human systems are language, meaning-generating systems.

2.         A therapy system is a meaning-generating systems in which a client and a therapist create meaning with each other.

3.         Any system in therapy is one that has coalesced around a relevance usually thought of as a “problem” (problem-organizing, problem dis-solving systems).

4.         The members of a therapy system, client and therapist, mutually determine the membership of each session and the topics of conversation.

 

Therapy Process

1.         The process of therapy is a dialogical conversation, a “talking with.”

2.         In this process, therapist and client engage in a mutual puzzling and search for understanding of a “problem” and its solution as a client defines it.

3.         We talk with a client about his or her concerns, learn about his or her narratives, and create through talking-learning, an “in there together” process that leads to new meaning, new narrative, and new agency.

4.         A central element of a therapeutic conversation is conversational questions.

5.         Conversational questions always come from a position of “not knowing,” from a need to know more about what has been said and what has not yet been said.

 

Therapist Stance

1.         A therapist’s expertise and responsibility is to create a space in which a therapeutic process, a dialogical conversation, can occur and to facilitate that process.

2.         This is a collaborative, non-interventionist position, a philosophical stance.

3.         This is a relationship in which a therapist also changes.

 


 

Along a Continuum Toward a Relational Emphasis

 

FROM

TO

Social systems defined by role and structure

Language systems

Individuals, couples, and families

Individuals in language

Therapist-driven hierarchical organization and process

Client-driven collaborative organization and process

Content

Process

Certainty

Uncertainty

Therapist position of “knower”

Therapist position of “not knower” about client’s reality

Seeking causality

Generating possibilities for courses of action or solutions

Therapist operates from “private” assumptions and thoughts

Therapist is “public” about assumptions and thoughts

Focus on therapy informed by interpretive understanding

Focus on maintaining coherence within client’s experience

Interventionist and strategic expertise of therapist

A mutuality that relies on expertise of all persons participating in the conversation

Core self

Multiple, linguistically constructed relational selves

Researcher as investigator of others

Research as co-investigation

 

CHALLENGES

·          Objective reality

·          Knowledge as independent

·          Language as representational

·          Therapist as “knower” (dominant, privileged voice)

 

OFFERS

·          Knowledge as relational

·          Language as generative

·          Client as “knower” (legitimizes all voices)

·          Multiplicity of possibilities

 

VALUES

·          A “philosophical stance”

·          Speculative inquiry

 

References

Anderson, H. (1996). A reflection on client-professional collaboration. Families, Systems, & Health, 4 (2), 193-206.

Anderson, H. (1995). Collaborative language systems: Toward a postmodern therapy.

 

Creating Successful Relationships with Couples

·    Validation: Have respect for, be humble, listen, and maintain coherence with each person’s story; promote self-confirmation.

·    Client’s story takes center stage: Be curious; ask questions that lead to other questions, not answers.

·    Self identity: Foster the development of self-identities that free and allow for multiple, contradicting, and simultaneously existing selves; a new sense of self leads to self-agency.

·    Client authors his or her own story: Create and safeguard room for each person to develop his or her own views and rewrite his or her own stories.

·    Pacing: Work within each person’s rhythm and timing, not yours.

·    Information: Each client and therapist together create knowledge, knowledge that is unique and specific to the client. Behave differently from his or her expectations of therapist as expert.

·    Choices: Let each person determine what is important.

·    Intervention: Avoid across-the-board diagnoses, goals, and strategies for reaching those goals. Consider the uniqueness of each person, the multiplicity of possibilities for each person, context, and situation.

·    Familiar: Explore the known in a way that allows for doors to be created where there were walls.

·    Public: Make invisible therapist ideas and prejudices visible; keep them open to question and change.

·    Understanding: Don’t know, assume, or fill in the blanks too quickly.

·    Believe: Try to make sense out of what appears non-sense.

 

Adapted by Diana Carleton, Ed.D.

Therapeutic Conversation III Conference, June 1996


 

Guidelines for Reflecting Teams

General Guidelines:

We organize our therapy around the story metaphor. (People make sense of their lives by situating them in stories. Therapy is a context in which people can reauthor their own lives by highlighting different events and making new meanings. New stories tend to lead to new futures.) In keeping with this metaphor, members of the reflecting team focus on differences and events that do not fit the old story and wonder about their meaning and how they occurred. We believe that this opens space for the family to author a new story. We may also focus on beliefs and ideas that perpetuate the old story and ask questions to open space for its deconstruction.

 

Specific Guidelines:

1.  We base our comments on what actually occurs in the room, wondering about and giving our personal responses to what happens in the session.

 

2.  We situate our ideas in our own experience believing that this invites family members to adapt what we say to fit their personal experience.

 

3.  We strive to keep our comments nonevaluative. We wonder about or focus on differences or new occurrences around which family members may choose to perform meaning.

 

4.  We have a conversation to develop ideas rather than a competition for the best idea.

 

5.  We address ourselves to other team members rather than through the mirror to the family.

 

6.  We try to respond to everyone in the family.

 

7.  We don’t talk behind the mirror, believing that this keeps our conversations fresher and more multifaceted.

 

8.  We aim for brevity, especially if there are small children in the family.

 

9.  We try not to instruct or lead the family, striving instead to bring forth many perceptions and constructions, so that family members can choose what is interesting or helpful to them.

 

 

by Jill Freedman and Gene Combs

 


 

Types of Questions in White’s Narrative Therapy

 

In the narrative approach, questions are designed both to get information and give information. Michael White and his colleagues want to discover and highlight for the person and his or her social system alternative stories and views of the person who has been seen as having a problem. White provides this typology of the questions he uses and their purposes. Here, minus some jargon, is a summary.

 

Unique Outcome Questions

 

Designed to elicit descriptions of times when things went differently from the usual problem activities (akin to solution-focused exception questions).

·    Direct Unique Outcome Questions ask the person or family members about times when the problem didn’t happen.

Example: Can you recall a time when you thought you would be dominated by the urge to binge, but instead you stood up to the urge?

Example: Can you tell me about a time when John was able to sit quietly and surprised you or himself?

·    Indirect Unique Outcome Questions ask someone to speculate about the perceptions of others about the exceptions.

Example: Can you understand how I might be surprised by your strength in standing up to the urge to binge?

Example: What things that you told me about not giving in to your temper do you think would shock your previous therapist?

 

Unique Account Questions

 

Designed to elicit the internal experience or explanations about how the unique outcome came about.

·    Direct Unique Outcome Questions ask the person to explain the exceptions reported.

Example: How did you manage to stop the urge to binge?

Example: If this were a new trend in your relationship, what do you think made it possible for you two to take this new direction?

·    Indirect Unique Account Questions ask someone to speculate about how others would explain the exceptions reported.

Example: What do you think your parents are making of the fact that you stopped bingeing?

Example: How do you think I see your decision to take a new path in your life?

 

Unique Redescription Questions

 

Designed to get people to rethink and reevaluate themselves and others based on the answers to the unique outcome and account questions.

·    Direct Unique Redescription Questions ask people to rethink their ideas about the identities or qualities of the person who has been having the problem based on the exceptions and explanations about the exceptions that have been offered.

Example: What does your decision to stop bingeing tell you about yourself?

Example: What do you think John’s decision to ignore the whispers of paranoia tell you about him that you wouldn’t otherwise have known?

·    Indirect Unique Redescription Questions ask the person who has been having the problem to speculate about how others might be reevaluating their ideas about the “problem person’s” identity or qualities based on the exceptions and explanations about the exceptions that have been offered.

Example: What do you think your friends would think about you since you have come to think of yourself as able to stand up for yourself?

Example: How do you think my view of you has changed since hearing you describe yourself as incredible?

·    Relationship to Self Unique Redescription Questions ask the person who has been having the problem to talk about the effect of the previous discussion in the session on his or her relationship to him or herself.

Example: What’s it like for you to hear yourself describe yourself as incredible?

Example: What effect does knowing that you’re resolved not to cut yourself anymore have upon your view of yourself?

·    Relationship to Others Unique Redescription Questions ask someone to talk about the effect of the previous discussion in the session on their current sense of their relationship with someone else.

Example: Can you speculate about how this view of yourself as incredible is changing how you’re relating to me right now?

Example: What affect is hearing that Patrice views herself as incredible having on your relationship with her?

·    Historicizing the Unique Redescription Questions asks someone to talk about people or events in the past that provide evidence that the unique outcome could have been predicted or is not so surprising.

Example: Is there someone who knew you growing up who wouldn’t be surprised by the fact that you’ve been able to stand up to the alcoholism bully?

Example: What incidents from your past would help me understand how you’ve been able to take the extraordinary steps you’ve taken despite hallucinations whispering in your ear?

 

Adapted by Bill O’Hanlon


 

THE DECONSTRUCTION PHASE OF NARRATIVE THERAPY

 

Goals:

To analyze and externalize the client’s problem.

 

Tasks:

1. Get the client to tell his/her story

Maintaining the therapeutic stances presented in Franklin and Jordan (1999), the therapist should allow the clients to tell their whole story before attempting to deconstruct it.

Tell me about the problems that brought you here today.

 

2. Externalizing

Getting the client and those involved to externalize the problem rather than internalize it. The problem will then be viewed as distinct, or as existing outside the client.

What name might you give this problem?

 

3. Mapping

Clients are invited to map the influences of these problems on their lives.

How is the problem affecting your attitudes toward yourself?

How is the problem affecting the lives of significant others in your life?

To what extent do these problems interfere with your interpersonal relationships?

 

4. Identifying Discourses

The therapist and client should explore how the client perceives his or her roles in society. What societal messages has the client internalized which influence his/her thoughts and behaviors.

What life experiences have played an important role in shaping your attitudes?

 

5. Determining if the client favors the present situation

Although it might seem obvious, therapists should ask questions to determine if the clients really want to overcome the problem.

Are you interested in examining further solutions to the problem, or would you rather just live with the problem?

 

6. Aligning the client and those involved against the externalized problem.

By verbally stating their desire to change, the client, therapist, and involved individuals become aligned against the externalized problem. Furthermore, such verbal statements make the commitment more real, serving as a type of contract.

 

THE RECONSTRUCTION PHASE OF NARRATIVE THERAPY

 

Goals:

To create alternative story in client’s life

 

Tasks:

1. Identify unique events

The aim of this technique is to enlist the client’s concentration and effort to isolate positive events that contradict the problem-saturated story. Since linking these events into a coherent sequence creates the alternative story, the counselor will need to work hard with the client to assemble as many unique events as possible.

 

2. Exploring abilities that have contributed to desirable events

Landscape-of-action questions allow clients to identify the history of unique outcomes by locating them within particular sequences of events that unfold through time.

How did you get yourself ready to take this kind of step? What preparations led up to it?

Landscape-of-consciousness questions allow clients to reflect on the qualities, commitments, preferences, and desires that have contributed to the development of unique outcomes.

It seems that we are both now more in touch with how you prepared yourself for this step. What does this reveal about your motives, or about the purposes you have for your life?

 

3. Seeking an audience to witness favored developments

An audience that can bear witness to and acknowledge the changes a client is making validates the client’s new description of himself and verifies the changes as real and not imagined.

Who would be least surprised to learn of the changes you are making?

Who would be most surprised?

What would they say or do if you told them about these changes?

 

4. Building awareness of how changes affect self-description

As the client reflects on new reevaluations, distinctions are made between the client’s place in the old story and the ascribed role in the new story. This reflection helps the client strengthen and anchor a preferred self-definition.

Have you always seen yourself as someone with courage when you get to a really hard place in life? (experience of experience questions)

 

5. Considering the possible effects of new discoveries

The counselor assists the client in bridging past competencies with the present so that these abilities are available for future uses when difficulties arise.

Having developed these abilities, what new possibilities might they open up for you in the future?

 

Readings for Week 6

Videos for Week 6

   

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