Making meaning through storytelling:

Working with Asylum Seekers

in South Australia

Teresa Puvimanasinghe, PhD, MAPS,

Counsellor

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1st Australia and New Zealand Refugee Trauma

Recovery in Resettlement Conference

29th, 30th & 31st March 2017

Overview Kumar’s Story

Fragmentation of Trauma Narratives

Dilemmas of an Asylum Seeker

Narrative & Exposure Methods

4 Narrative Principles

Working with Narratives

Benefits & Challenges

Conclusion & References

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Kumar’s Story

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Fragmentation of Trauma Narratives

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Continuum of Narrative Types Reflecting Trauma Disclosure

Avoiding

narratives

Struggling

narrativesPrompted

narratives Narrative

exceeding

boundaries of

disclosure Returning

narratives

Complete silence Complete narrative

From: Narrative and Silence:

How former Refugees talk about

Loss and Past Trauma (2014)

Dilemmas of an Asylum Seeker

Past, multiple traumatic events.

Ongoing stressors.

Interaction between

Past trauma & ongoing stressors.

Daily battle with psychological symptoms.

Loss of meaning in life.

No proper legal representation.

Social stigma, shame and mistrust.

Forced to talk about the unspeakable.

Loss of language, whether to disclose or not;

and how much to disclose ????

Fragmented and emotionless stories often not

believed, and dismissed as fiction???

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Narrative Based Therapies

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Despite criticism, Narrative based therapies for trauma survivors have the most evidence.

Not without problems: high dropout rates; too

painful; unmanageable emotional upheaval.

People are not ready to disclose; some never will.

Adaptations: CA-CBT incorporating culturally

conducive ways to manage symptoms

(Hinton et al., 2012)

Other therapies: Narrative Exposure Therapy (NET)—Neuner et al. (2004).

Testimonial Therapy (TT)—Agger et al. (2012).

Writing therapy—Pennebakar (1993).

NET

The Narrative Method

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Storytelling is an inherently human

activity, helping people to find

meaning in life.

Eventually people will try to live the

stories they tell in keeping with the

meanings they construct.

[Bruner, 1990; Reissman, 2007, Squire, 2007]

Narrative Therapy: 4 Principles

Re-authoring

Re-membering

Outsider witnessing

Externalizing 9

Counselling

room

Re-authoring

Identification and co-creation of

alternative storylines of identity e.g.

victim to survivor. Via curiosity and inquiry

Alternative storylines are not inventions.

Looking for alternative moments, events,

stories to the ‘problem storyline’. E.g. ‘I am a victim’ ‘I am a survivor’

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Re-membering

If identity is shaped by relationships with others, then, re-

organising the relationships and memberships of one’s

‘club of life’.

Identities shaped by many voices—‘multi-voiced’.

Involves: (i) significant others; (ii) particular skill or

knowledge; (iii) antidote to negative self identity.

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Outsider Witnessing

Bearing witness to one’s story, within the

counselling room.

Extending to: family, community, other survivors, or outsiders.

Preferred responses: Curiosity & mystery.

Acknowledgement, resonance, and transport.

Celebrating resilience and survival.

Ceremonies. 12

Externalizing

Alternative to internalizing.

Basis: belief that one’s problems are

not located within; but shaped by

history, culture, sexuality etc.

Prompting the realisation that: ‘they’

and ‘the problem’ is not the same thing.

Via language, but goes beyond.

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‘how long have you been

depressed?’

‘For how long has depression

influenced you?’

Vs.

The Work We Do…..

Information about counselling.

Assessment / Brief history.

Advocacy: Establishing safety and trust.

Immigration process: Information & clarifications.

Introduction to storytelling: Discussion of benefits & challenges (Psychoeducation.)

Preparing for storytelling.

Psychoeducation continued.

Agreement to write story / note taking (if

possible).14

Working with

Narratives

Working with Narratives cont.

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Storytelling over several sessions.

Including:

Re-authoring: Transformation from victim to survivor.

Re-membering & Reconnection: e.g. learning about unique

strengths and coping strategies.

Outsider witnessing—within counselling room.

Sometimes externalizing.

Reading and editing stories.

Continued advocacy: connecting with lawyers,

preparing for immigration application and interview, etc.

Facilitatingimmigration process

Therapeutic benefits:

symptoms, functionality, meaning,

hope.

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Conclusion

Narrative Work: Revisiting Benefits

Helping clients’ journey through the

immigration process.

Improving symptoms & functionality.

Reinforcing client-therapist relationship.

Familiarity with storytelling.

Flexibility of approach.

Discovering unique strengths & coping

strategies.

Meaning making & maintaining hope.17

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References AGGER, I., Igreja, V., Kiehle, R., & Polatin, P. (2012). Testimony therapies in Asia: Integrating spirituality in

testimonial therapy for torture survivors in India, Sri Lanka, Cambodia, and the Philippines. Transcultural Psychiatry, 49, 568–589.

BRUNER, J. S. (1990). Acts of Meaning. Harvard University Press.

HERMAN, J. (2015). “Trauma and Recovery: The aftermath of Violence – from Domestic Abuse to PoliticalTerror”: Basic Books.

NICKERSON, A., Bryant, R.A., Silove, D., & Steel., Z. (2011). A critical review of psychological treatments ofposttraumatic stress disorder in refugees. Clinical Psychology review, 31(3), 399-417.

NEUNER, F., Schauer, M., Klaschik, C., Karunakara, U., & Elbert, T. (2004). A comparison of narrative exposure therapy, supportive counselling, and psychoeducation for treating posttraumatic stress disorder in an African refugee settlement. Journal of Consulting and Clinical Psychology, 72(4), 579–587.

PENNEBAKER, J. W. (1993). Putting stress into words: Health, linguistic, and therapeutic

implications. Behavior, Research & Therapy, 31, 539–548.

PUVIMANASINGHE, T., Denson, L.A., Augoustinos, M., & Somasundaram, D. (2014). Narrative and Silence: How former Refugees talk about Loss and Past Trauma. Journal of Refugee Studies, (2014) 28(1), 69-92.

RIESSMAN, C.K. (2008). Narrative Methods for the Human Sciences. Los Angeles: Sage Publications.

RUSSEL, S. & CAREY, M. (2004). Narrative Therapy. Adelaide: Dulwich Centre Publications.

SCHAUER, M., Neuner, F., & Ebert, T. (2005). Narrative Exposure Therapy. A short-term intervention fortraumatic stress disorder after war, terror or torture. Hogrefe, Cambridge (Massachusetts)/Bern/Gottingen.

SQUIRE, C. (2008). ‘Experience-centred and Culturally-oriented Approaches to Narrative’. In Andrews, M.,Squire, C. and Tamboukou, M. (eds) Doing Narrative Research. Sage Publications, pp. 41–63.

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Thank you

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