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Narrative Therapy – Writing Your Way to Wellness

Posted by on Dec 20, 2009 in Psychology
Barbara Kennedy asked:


Imagine yourself back in time a long time ago. You are a child sitting cross-legged near the central village fire. Firelight dances on the faces of those seated around you. Your eyes are wide with excitement! Your little heart pounds like thunder! Your tiny hands clutch bits of grass as the old and wise storyteller recounts stories of the heroic acts of courage and history. The storyteller’s ancient hands rise up toward the night sky as sparkling embers spiral upwards to join the stars. Through the careful weaving of these stories, the storyteller brings the past, present and future together. You listen. You learn. You remember. –Excerpt from The Wisdom Tree

Storytelling is as old as the first homosapien who picked up a stick and scribbled in the dirt. Native Americans chisel on the walls of caves; Nanas all over the world–with a gaggle of grandchildren at their feet–spin yarns passed down from prior generations; teenagers lock their diaries and hide them.  So why have first-person narratives ranked on best seller lists and in book reviews with so much fervor? Well, it goes something like this, Once upon a time…

Narrative therapy proposes that people use certain stories about themselves like the lens on a camera. These stories are selected and framed memories and information that are repeated over and over. But stories don’t mirror life, they shape it.  Stories organize the information from a person’s life. They guide how people think, feel, act, and make sense of their experiences, thus have the power to control people’s perspectives of their lives, their histories and their futures.  Because people tend to become these stories they tell about themselves, whether inspiring or oppressive, narrative therapy focuses on how these important stories can get written and re-written. It provides a means to refocus the lens on this camera and help reshape a person’s self-image, self-esteem and relationships.

However, often by the time a person or family comes to therapy, they feel isolated, defective and depressed. Their lives have become completely dominated by ‘problem-saturated’ stories that work to oppress them, divide them, hinder wellness, and sometimes actually make them ill.

Problem-saturated stories can also become identities—for example, if someone calls himself or herself “a failure” or “a victim” or “a depressive,” there is really one story and it’s a devastating one.

First draft: When I was four, I remember my mother was screaming and it was pitch black outside and I felt helpless. Then she pushed me out of a second story window.

Thousands of vignettes and criss-crossed story lines make up lives. Narrative therapy involves the process of drawing out and amplifying these story lines, focusing on the most meaningful intentions, influential relationships, turning points, treasured memories and how they all connect. Part of the process is helping patients and clients understand their experiences.  What was most meaningful? What choices, intentions, relationships have been most important? It’s more about poetry and prose than it is about archeology.

Second draft: My mother was shaking me. It was dark and I smelled smoke. A black man in a big coat appeared at the window and my mother handed me over to him.

Narrative therapy works by helping people ‘deconstruct’ unproductive stories in order to ‘reconstruct’ positive ones. In the process of re-storying experiences, especially where unhappy emotions such as anger, fear, anxiety and depression dominate, new and more empowering events can restore lives. It operates from the view that most people don’t want problems in their lives. By stepping away from problem saturated and oppressive stories, they can discover the ‘untold,’ preferred account by exploring the turning-points, the key relationships, and those particular memories not dimmed by time, and focus on the intentions, dreams, and values that have guided their life, despite the set-backs. Oftentimes, the very process of writing brings back memories that have been overlooked–surprising stories that speak of forgotten competence, strengths and even heroism.

Third draft: There were a couple of times in my life when I was really scared.  One time was when our house caught on fire in the middle of the night.  My mother and I waited for the fire engine together. “Be brave,” she instructed me, as she wrapped me in a blanket and led me to safety, and I was.

Discovering through new stories, the hopeful, preferred, and previously unrecognized and hidden possibilities and strengths contained within patients’ lives is referred to as ‘re-authoring.’ By listening to patients and helping them to externalize problems, deconstruct pessimistic life stories, and convey unswerving confidence in their ability to re-champion certain events, we have a powerful tool for change, healing and personal satisfaction.


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The Use of Narrative Therapy in the Transformative Work of Grief

Posted by on Nov 11, 2009 in Psychology
Beth Patterson asked:


Helen Keller has said that “the only way to get to the other side is to go through the door.”  This is certainly true in the work of transforming grief into healing and growth. This process involves allowing ourselves to feel the intense emotions of grief – sadness, anger, despair and other difficult emotions, as well as tapping into our internal strengths and external sources of support and ultimately finding new ways to stay connected to our departed loved ones.

Narrative therapy and has been used with a wide variety of difficulties and issues, including grief reactions.  The role of the narrative therapist is as collaborator or co-author with the client.  As such, the narrative therapist partners with the client to explore the stories that give meaning to the client’s life (White, 1995).  Carr (1998) describes the context of narrative therapy as follows:

Within a narrative frame, human problems are viewed as arising from and being maintained by oppressive stories which dominate the person’s life….Developing therapeutic solutions to problems, within the narrative frame, involves opening space for the authoring of alternative stories, the possibility of which have previously been marginalized by the dominant oppressive narrative which maintains the problem (p. 468).

Narrative therapy is thus an empowering vehicle for “re-authoring lives” (Carr, 1998, p. 468; White, 1995), in which the therapist takes the role of a partner or collaborator with the client, rather than an authority figure (Angell, Dennis & Dumain, 1999).. The narrative therapist partners with the client to create a safe place to feel the emotions of grief, and to explore the stories that give meaning to the client’s life. The use of narrative or story is a useful vehicle for making meaning and sense of difficult experiences in our lives, by allowing us to access alternative cognitions and gain self-knowledge… 

A narrative therapy tool that is often used in grief work is the use of written expression, such as journaling and letter writing.  This can be a powerful vehicle for expressing the emotions of grief and accessing the individual’s unique internal resources and strength, as well as a means of enforcing continuing bonds with the deceased and keeping him or her in the bereaved person’s life as an internalized source of strength and guidance. 

Accessing Spiritual Beliefs and Strengths through Narrative Therapy

The collaborative approach of the narrative therapist can be useful for accessing the client’s spiritual strengths by respectful inquiry into the client’s worldviews, including his or her beliefs before the loss, and how they may have changed since the loss, and discussing spiritual and existential issues that arise in this context. (Calhoun & Tedeschi, 2000, p. 167).

As one gets in touch on a deep level with his or her own suffering and resiliency in the face of that suffering, he or she can begin to get a panoramic view of the human condition and tap into his or her spiritual strength. Religious and spiritual beliefs have been observed to be one way in which individuals create meaning and a sense of order and purpose to the human condition, life and death, as well as creating an ongoing relationship with the deceased (Golsworthy & Coyne, 1999; Calhoun & Tedeschi 2000).

My Theoretical Perspective

The strength-based and holistic approach I use with my grieving clients, through the use of techniques of narrative and solution-focused therapy, is informed by my Buddhist practice.  In particular, I come to each session with my clients with the ground that each human being possesses inherent wisdom, or Buddha Nature, and that this wisdom can be called upon to access the individual’s strengths and resilience in times of suffering.  As Stephen Levine (1982) notes, grief fully experienced allows us to “plumb the depths” of our souls and to “touch something essential in [our] being….[W]hat is often called tragedy holds the seeds of grace” (pp. 85-86). Those “seeds of grace” are the basic goodness and inherent wisdom possessed by all, and it is my job as a collaborator or partner in the journey of grief to support my clients to get in touch with the strengths that they possess, but which may be obscured by the intensity of their feelings of helplessness and loss.  Through narrative therapy, including the use of literary and other creative forms of expression, clients are able to create some space around that intensity, which in turn gives them some perspective and hope for change and transformation. 

The broader perspective that can be reached through narrative therapy techniques can put the client in touch with both the uniqueness of his or her own loss, and the universality of grief and suffering.  Paradoxically, contemplating the universal truth of suffering can open us to acceptance and peace.  As His Holiness the Dalai Lama (1998) observes, “if we can transform our attitude towards suffering, adopt an attitude that allows us greater tolerance of it, then this can do much to help counteract feelings of mental unhappiness, dissatisfaction, and discontent” (p. 140).

Through allowing ourselves to experience and express our suffering, we can find a meaningful way to grow, transforming hopelessness into hope and possibility.  The use of journaling and other narrative therapy techniques can foster the realization that grief is an integral component of the human condition.  Through experiencing our own unique grief, we can tap into its universality, lessening our hopelessness and isolation, and deepening our connection with others and the human condition.  This is the transpersonal and transformative work of healing grief.

Clinical Application and Discussion

“Peggy”:  A Story of Abuse and Resilience

“Peggy” came to therapy to deal with her conflicting feelings after the recent death of her mother.  Peggy had been her mother’s caregiver in the last months of her mother’s life.  In our first session, Peggy recounted that her mother was an alcoholic, and that she has a history of alcohol abuse as well.  She also told me of the emotional abuse she experienced at the hands of her father, and her mother’s failure to protect her from that abuse. In addition, Peggy was experiencing distress about her conflicted relationship with her siblings – which is often exacerbated and magnified by the death of a key family member.

During our next session, I encouraged Peggy to tell me the story of her relationship with her mother, and how that relationship transformed from one of recrimination over her mother’s failure to protect Peggy from her father’s abuse to one of forgiveness and intimacy.  I was able to get Peggy in touch with the knowledge that her mother’s death does not mean she is no longer a source of support and strength for her. Peggy agreed with my suggestion, as her therapeutic partner, to write a letter to her mother to reinforce her continued attachment to her mother as a source of spiritual strength.

The process of writing the letter to her mother yielded some unexpected rewards for Peggy.  She surprised herself by her ability to not only acknowledge her continued love for her mother, but also to finally express anger toward her mother for her mother’s role in perpetuating the alcohol-fueled dysfunction in her family, and thus to let go of her family role of being the “good girl”.  Peggy was empowered by this newfound ability to express herself more authentically. 

A key narrative therapy intervention is to affirm the availability of the client’s social network to support his or her grief work.  Part of this process is learning who is a source of support, and who is not.  Peggy has excellent support from friends at her church who share her spirituality, and she realized that it would be far better to turn to them for support at this time, rather than to her family.  At the same time, I acknowledged and validated that giving up the hope that her family can be a source of support at this time was a secondary loss resulting in another experience of grief.  My acknowledgement of this fact was reassuring to Peggy and helped normalize her process.   In addition, I worked with Peggy to link her use of this strength and self-awareness in the past to her current circumstances.  She was thus able to see that she is not a victim of her family of origin, but rather, has some control over the course of her life and the process of her grief.

Peggy now has some tools for healing.  She knows on a core level the strengths she has to move forward.  She feels empowered by her mother’s continued supportive presence in her life and has a renewed faith in her spiritual strength and resiliency. 

Considerations for the use of Narrative Therapy

Despite my successful experience with the use of narrative therapy in accessing continued attachment as a source of strength in grief, other interventions may first need to be used before certain clients have the ability to fully experience the feelings of grief and transform them into healing and growth.   

My work with “Frank”, an eighty year old widower, is illustrative.  Frank’s wife “Paula” died after a long bout with dementia.  Frank reported that, despite a long and loving marriage, a byproduct of Paula’s dementia was extreme anger toward him. I attempted to do a life review with Frank to see if he could gain some perspective, but in telling the story of his life with Paula, he consistently berated himself.   I realized that a narrative therapy life review would have been counterproductive at that point, and that narrative therapy interventions would only be useful with Frank if he were able to let go of some of his distress and internalized self-blame.  I therefore used Gestalt techniques to work with Frank to release the power of his wife’s anger, and cognitive behavioral approaches to foster Frank’s self-care and self-esteem and to help him realize that he did not have to hold on to the blame and shame his wife had instilled in him.  I also helped Frank access other avenues of support, such as emotional support from his son, social support at the local senior center and a grief support group.   

As a result of continued work with Frank’s feelings of blame and shame and Frank’s availing himself of his sources of support, Frank became less distressed about feeling Paula’s presence.  He found that he was now able to tell the story of his life with Paula without internalizing her anger.  It was only after the use of other interventions that Frank was able to re-author his story, and he came to feel Paula’s presence in his life as his guardian angel.

Conclusion

Narrative therapy can be an effective tool for working with the emotions and grief and finding new meaning in one’s life.  The process of expression literally takes deep feelings out of the body, externalizing them so that they become workable. Through this process, grieving clients are able to see that they have some control over their lives, and can tap into their strengths and their inherent wisdom.  With my guidance as a partner on the path of healing grief, my clients can discover their unique strengths, resources and resiliency, deepen their spiritual beliefs, and enhance the meaning of their lives in the context of the human condition.


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