narrative therapy edited by kim-final

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NARRATIVE THERAPY PSYC703-COUNSELLING AND THERAPEUTICS BY: KIM TALIA PILLAY (215080580) LEANTHA RAJAH (215080577) SHERNICE SINGH (211514000) SIYABONGA MBAMBO (210519548) THEMBELIHLE NKOSI (212526662) POONAM PATEL (215077920) SHENAY HARRILAL (215056505) THABO BLOSE (200201664) KHETHIWE THUSI (212515507) NAKITA I. BOOYSEN (212520571) BHEKISISA MASILELA (215078700) 1

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Page 1: NARRATIVE THERAPY Edited by KIM-FINAL

NARRATIVE THERAPYPSYC703-COUNSELLING AND THERAPEUTICS

BY:

KIM TALIA PILLAY (215080580)

LEANTHA RAJAH (215080577)

SHERNICE SINGH (211514000)

SIYABONGA MBAMBO (210519548)

THEMBELIHLE NKOSI (212526662)

POONAM PATEL (215077920)

SHENAY HARRILAL (215056505)

THABO BLOSE (200201664)

KHETHIWE THUSI (212515507)

NAKITA I. BOOYSEN (212520571)

BHEKISISA MASILELA (215078700)

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Introduction

Narrative Therapy can be viewed as a non-diagnostic, empowering and collaborative form of

therapy which effectively identifies the competencies, skills and expertise that a client

postulates which serves as an effective tool that guides the client in changing their life.

Hence, the client is viewed as a separate entity away from the problems that he or she

encounters, this helps the therapists to externalize the sensitive issues that the client has

encountered. This objectifications dissipates resistance and defences and allows the client to

address these issues in a more productive and creative manner. Narrative Therapy can be

utilised for individuals, couples or families. In light of these settings the technique of

externalising problems sets the stage for fostering creating positive interactions and

transforming negative communication or responses into a more accepting , non-judgmental

and meaningful exchanges. Hence, viewing the problem in an objective manner would assist

these individuals to reconnect with the heart of their relationship and address the ways in

which the problem has challenged that particular core strength (White & Epston, 1990).

A Brief History of Narrative Therapy

Narrative Therapy was the brainchild of Family Therapists Michael White and David Epston.

This partnership was formed in the late 1970s. At this time, White was already a renowned

and respected psychologist in Australia. He was an editor of the Australian Family Therapy

Journal and he was conducting Family Therapy training and workshops throughout Australia,

however David Epston was relatively unknown at this point. He later rose to acclaim after

many attended the second Australian Family Therapy conference. He was a non-conformist

sporting an afro and exhibiting many quirky traits (White, 2009). This section will briefly

reflect on the significant relationship between Michael White and David Epston and how

their intellectual collaboration led to the birth of Narrative Therapy. This section will also

discuss the past, current and potential future developments of this form of therapy.

The humble beginnings of Narrative Therapy emerged as Michael White and David Epston

were influenced by the ideas of Michel Foucault. A French post-modern philosopher who

was interested in the significance of language and meaning to counselling taking cues from

post-modernism and post-structuralism, which was profound and had been immensely

unexplored until White and Epston gave rise to Narrative Therapy (Besley, 2001). The initial

modes of thought of White and Epston embarked on the Family Systems Therapy, which held

the view that people are “best understood through assessing the interactions among and

between family members. The development and behaviour of one family member is

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interconnected with others in the family” (Corey, 2013, 435). However, Michael White and

David Epston were further interested in the significance of language and meaning which was

where Narrative Therapy emerged. The language and how it is used is pertinent as it can alter

or distort ones experiences as they narrate their stories (White, 1995).

These two scholars identified limitations to Family Therapy and therefore developed

Narrative Therapy in order to combat these. Unlike traditional therapies, that suggests that the

problem dwells in one’s subconscious, White and Epston recognized that in relation to

language and how an individual tells their story, moulds how one perceives and feels about

the presenting problem and their ability to solve it. It also provided therapy to those

individuals who did not have a strong family background or family relations but rather

focused on the individual’s issues and experiences. These family therapists were previously

focusing on families as an interrelated unit but found that Narrative therapy offered a person

focused approach. This new born approach abandoned the traditional psychological lingo

such as ‘cases’, ‘case histories’ and had replaced the term ‘client’ with ‘person’ (Payne,

2000). Patients were now ‘speaking’ and their `voices’ were used to describe their

experiences, narrating their stories (Drewery & Winslade, 1997).With regards to a

postmodernism or poststructuralist view, it can be noted that linguistics contributed not only

to how one frames the notions of the ‘self’ and ‘identity’ but also how therapists and or

counsellors help people identify meaning in their words and of the world they occupy

(Besley, 2002). In essence, these revolutionary scholars were now interested in this non-

directive approach which centred people as the experts of their own lives and empowered

individuals to seek and find their own voice and meaning in Narrative Therapy.

The therapists Michael White and David Epston observed and believed that the way people

disclose stories directly correlates to their emotions and state of mind. They also suggested

that it was not the therapist’s responsibility to point out problems and provide advice on how

to mend them, instead to be curious about the context in which the problems arise (White,

1995).Therefore, this non-blaming and respectful approach encourages individuals to be the

change in therapy, mitigating the limiting factors that shackled their previous school of

thought. Narrative therapy allows rehabilitation and growth to individuals, focussing on their

experiences and issues and not solely on their family background and relations.

Narrative Therapy is presently well established into practices of many clinicians and is

extensively used as a basis for various interventions such as, personal, families and

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communities, facilitating treatment all over the world. However, there is limited scientific

evidence that attests to the effectiveness of Narrative Therapy. It is a substantial form of

therapy, providing a means of supporting individuals from various frames of references. For

example, Narrative Therapy has aided in treating a range of issues, including anorexia,

depression, asthma and other pathologies (Murdoch, 2009). Although Narrative Therapy has

had its successes, there is a greater need for further research to quantify the effectiveness of

this therapy. Many aspects of the therapy remain as theoretical constructs but further

development of this therapy will turn these theories into therapeutic practices, assisting in

providing clear treatment plans and guidelines when practising this form of therapy. By re-

authoring a few key elements of this form of therapy’s official story, the therapy alone will be

able to offer new and boundless possibilities for the development and rehabilitation of

individuals undergoing treatment.

Key Concepts

Stories in a ‘Narrative Therapy’ context compromise of events that the client encounters

which are connected by a theme, which occurs over time and is according to a plot. A story

develops as particular events are privileged and selected over other events as being more

important or true. As the story takes shape, it invites the client to choose only certain

information while other events then become neglected hence resulting in the same story being

continually told. Stories provide a description of the lives that individuals lead and shape

their life accordingly with regards to their perspectives, past encounters and their future

aspirations. When a client comes to therapy the stories that they have to depict have been

dominated by the problems that they encounter (White & Epston, 1990). These are the

following elements of stories which are vital in Narrative Therapy:

Problem saturated story: This story takes form when a client is not overwhelmed the

problem being encountered; hence the therapist effectively helps the client to understand that

they do not have to reduce their identity by totalising their descriptions.

Re-authoring: This is an important concept and depicts the joint partnership of the therapists

and client to create an alternate life story this relates to stories about the ways in which the

client views their life, hence the therapists has a vested interest in seeking out and creating

stories that pertain to identity this would assist the client in not being influenced by the

problem that he or she is facing.

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Dominant stories: These types of stories are developed through conversations in social and

cultural contexts and helps in shaping the ways in which people construct and constitute what

they are able to see and feel.

Deconstruction and externalisation: These vital concepts that is important to employ in

Narrative Therapy. Deconstruction consists of exploring meaning, and effectively unpacking

or taking for granted categories and assumptions which underlie social practises which are

guised as truths. Deconstruction helps the therapists to resolve problems in an effective

manner by deconstructing the meaning of reality of their lives and relationships, and depict a

difference between reality and the internalised status of the self. Besley (2001) affirms that

externalising a situation relates to openly speaking of a problem as an entity which is separate

from the client; this approach is useful as it transfers the location of a problem to an internal

characteristic of the client. The therapeutic conversation centres on the problems which are

viewed as an external barrier. (Besley, 2001).

Building conversations and collaboration: These are integral aspects in Narrative Therapy.

Conversations between the therapists and client open the way for new directions and journeys

to be explored by the client, thus the client chooses which problems to go to and which to

leave behind. Collaboration this process entails the process in which the individual seeking

help plays a significant role in mapping the direction of this journey. Hence, these

conversations are interactive. Objectivity is a vital concept to employed in this form of

therapy as it permits the client to address their problems in a creative and productive manner

and helps the counsellor to view the problem in an objective manner and help the individual

reconnect with the heart of their relationship and highlight the ways in which the problem has

challenged their strengths (Besley, 2001).

Language and the utilisation of question: These are key aspects that should be considered

in this form of therapy. Language can be viewed as a profound element in Narrative Therapy

as it does not only impact on the ways in which we frame the notions of the self but assist

counsellors in helping clients acquire meaning to their life . Socially constructed realities are

an imperative element in Narrative Therapy which denotes that reality is constructed through

language and this form of therapy effectively helps in organizing and maintain reality. The

utilisation of questions is effective in narrative therapy. A series of questions are posed at the

client about the problem that he or she is encountering this helps them in internalizing and

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understanding the relationship between the client and the problem and helps in separating the

person from the problem (Besley, 2001).

Listening with an open mind: Lindsley (2001), as cited in Corey (2014) explains that it is

imperative for therapists to suspend their personal judgment when listening to a client and its

of paramount for the therapists to listen in an efficient manner to the stories that the client is

narrating as this would assist the therapists in ascertaining important information of the

clients competencies and to effectively help in forming barriers to their problems.

View of Emotional Disturbance

Narrative Therapy views each client as possessing their own story. Each client comes to

therapy with their own story, their own perception on how things are happening in their lives,

how things happened in the past and how they are going to happen in the future. The client

arrives at therapy as a living, breathing, dynamic culture, a human being whose story has

been moulded by the various influences around him or her. According to (Monk et.al, 1997,

3), “narrative approaches to counselling invite clients to begin a journey of co-exploration in

search of talents and abilities that are hidden or veiled by a life problem”. The term co-

exploration here is very important as it indicates exactly how the therapeutic relationship will

be expected to be in Narrative Therapy. With the therapist maintaining a partnership with the

client helping him explore his story further so as to uncover things that were previously

obscure.

Narrative Therapy understands that there is power in language, in the way we speak of things,

the way we word and phrase things, the way we tell our story can change our reality. “The

problems we encounter are multi-sourced, they are developed over a long period of time, and

they come together through the medium of human language to construct and produce our

experience” (Monk et.al, 1997, 27). From the time we are born, we are immersed in culture;

we are changed by various levels of influence in society. Emotional disturbances arise from

our perceptions of the problem, and our view that the problem is intricately linked to who we

are. We commonly see the problem as our personal creation, and often we take ownership of

this problem. Clients commonly view the problem from a one dimensional perspective, and

this is how anxieties about the problem arise. Language and the mediums in which we

communicate contribute to how we understand the world around us and play a vital role in

how our problems are constructed. Language and the way we speak about a problem can

breathe life into a problem or situation, and make it more threatening than it actually is.

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“Through story and language, cultures send powerful messages to their members about the

meaning of important concepts that sustain the culture, including gender, race, class, and of

course, health” (Shapiro & Ross, 2002, 6). The therapist introduces this power of language to

the client, and shows them how they can use language to change the nature of the problem,

from something debilitating into something manageable.

Narrative Therapy focuses on showing the client that the problem stems from external factors

and situations, however not denying that the client has been affected by the problem.

Narrative therapy aims to separate the problem from the client and to show the client how

they have been looking at the problem with a narrow perspective. And finally focuses on

showing the client their power over their own story and how they can change the effects the

problem has been inflicting on them. The client is not made to feel guilt or shame when

revealing stories. The exploration of his story with the therapist helps him bypass the problem

that has hindered his progress on his journey. According to (Monk, 1997, 4), “The main

character in the plot is frequently positioned in the therapeutic conversation as the courageous

victor rather than the pathologized victim, as a colourful individual who has vivid stories to

recount rather than a hopeless individual leading a pathetic life”. This means that clients are

not labelled with certain pathologies. They are seen as distressed individuals. Payne (2011)

explains that narrative therapists move away from analysing and diagnosing clients with

symptoms and disorders. Rather, they see therapeutic sessions as a way of moving towards

problem resolution.

According to Narrative Therapy principles, the problem is something that can be “altered,

changed and renegotiated” (Morgan, 2002, 88). In Narrative Therapy, the client is

encouraged to see his story from a positive perspective, and to recognize the power in his

story and his ability to use his story as a tool to reorganize and reconstruct his world so as to

overcome obstacles. Narrative Therapy focuses on understanding client’s identities,

understanding problems and how they impact the client’s life.

Therapeutic Goals

Narrative Therapy, according to Corey (2011) is more about encouraging a therapist to create

an approach of working together with clients for different purposes. Some of these purposes

involve paying special attention to the stories told by the clients; searching and recognising

moments in a client’s life showing their strengths or resourcefulness; asking questions in a

manner of engaging clients and facilitating their exploration; averting the tendency to

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diagnose or label clients or to accept a totalising description based on their problems; helping

clients and showing the influence imposed by the problem on their lives; and helping clients

to separate themselves from the dominant stories they believed and internalised about

themselves with the aim of creating new alternative stories about themselves to replace the

old ones.

In an attempt to achieve the above mentioned purposes, these writers in the field of

psychotherapy and Narrative Therapy mentioned, have illustrated their understanding of the

goals of Narrative Therapy, as presented below:

Corey (2011) understood the goals of Narrative Therapy to be divided into two separate

schools of thought namely a general goal of having people describing their new experiences,

and a second goal or raising the awareness. Firstly, the general goal, that is people describing

their new experiences. This involves inviting people to describe their experiences in a new

and different language. Therefore, this will allow for the creation of new ways to see what is

possible. This new language therefore allows clients to give new meanings to their

problematic thoughts, feelings and behaviours. Secondly, awareness raising that involves

raising the awareness of the impact made by the dominant culture on a client’s life. Therefore

Narrative therapist attempt to enlarge the perspective and focus and facilitate creation of new

options which appear to be unique to the individuals they see.

In addition, Angus (2008) understands narrative therapy as focusing on the client’s

understanding of his or her own story and how the client emotions, actions, and problems fit

into the context of the story leading into the emergence of three therapeutic goals namely

putting the "untold" aspects of the client's past into the life narrative; helping clients

emotionally enter and re-author their own stories; and helping clients construct new meanings

in relation to stories that may emerge in therapy. Therefore, according to this understanding,

therefore it appears that a basic goal of narrative therapy not to be derived from solving a

problem but will be to create a different reality of an unconsidered influence. Therefore, this

will involve creating a new story which is not supporting the problem. In creating a new

story, the client is seen as a person with a problem but also a person with a potential for

change.

This means that a client is allowed to tell a story, while in the same process of story-telling,

the therapist searches and recognises time where the client shows an element of strength or of

having resources. The therapist then avoid judging a client with his or her problem but rather

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tries to show the client the impact or influence contributed by the dominant stories on the

client’s presented problem. This is then referred as raising the awareness. The therapist then

encourages the client to reauthorize his or her story in a new way that is not oppressive to the

client.

By summarising these goals, for instance, a student might have failed all his semester tests

this semester in all the modules, and therefore accepting that he is a failure he is not supposed

to be at the honours level. However, the student might have not realised the impact and

influence caused by his loss of both his parents this semester due to a car accident which

contributed into a student’s lack of concentration or poor memory when studying. Therefore

the therapist can tell the student that the fact that he was able to pass his undergraduate

studies up to the honours level shows that he is a good, hard-working student with a potential.

The student was unfortunate to lose both his parents unexpectedly or accidentally which

negatively affected memory/concentration when studying he could not remember things he

studied. In essence, Narrative Therapy goal can be summarised as having people describing

their new experiences by helping them to emotionally enter and re-author their own stories;

and constructing new meanings in relation to stories that may emerge in therapy.

Therapist’s role

Active listener role: The therapist in narrative therapy assumes a role of active listening,

simply because the therapy is about story telling. It is essential for the therapist to understand

and show interest to what the client is narrating. However, this includes the therapist

monitoring the client’s non-verbal (body) language, because it will give some insight and

meaning to what the client is saying.

Collaborator and consultant role: According to Murdock (2009), a Narrative Therapist

enables their clients to be “true experts” in their sessions and storytelling. This is because the

client will be encouraged to reveal their neglected stories to the therapist since they own their

stories or life experiences. The therapist is seen as a curious learner as the client narrates their

story (Sharf, 2004). Therapists in narrative therapy create an atmosphere that will ensure that

the client is feeling free to disclose whatever story they have and the therapist will assume the

consultant role.

Respect and non-blaming is essential: The therapist is expected to respect the client and

their stories no matter how provoking or shocking it may be. Therapists help clients re-author

their life stories. The Therapist should not express shame or blame towards the client as they

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narrate their stories as this will discourage the client from opening up. Therapists should

work together with clients towards finding preferred outcomes of their stories (Murdock,

2009).

Probing and questioning: Since therapy focuses on client’s narratives, it is the therapist’s

role to probe in order to gain more insight into stories and encourage clients to reveal more

information for better understanding of the underlying influences of a client’s behaviour.

Probing will reassure clients that the therapist is listening and interested in their stories as

they narrate. For example, the therapist might ask questions like: “How did you make sense

of? Or what were your reactions afterwards?”

Empowering the client: The client is empowered and this role is pivotal to Narrative

Therapy. It helps the client to notice their skills, competencies and accomplishments beyond

their problems or difficulties they may face. The therapist is expected to de-center themselves

and assume a “not-knowing role” in therapeutic sessions. The therapist should make the

client the center and not burden the client with their own issues. This will allow client to feel

welcome to further elaborate on their stories and experiences. One argues that the therapist

does not need to disclose themselves because the therapy is positioning a client at the center

and be an expert of their own life and stories, in this way, the client gains sense of

independence and control.

Moreover, the narrative therapist assists the client to externalize problems and life events and

finding out possible points to emphasize so that client takes stand against undesired life or

behavior. Sharf (2004) asserted that it is a duty of the therapist to work in collaboration with

client in reducing the influences that go against client’s preferences and wishes.

Client’s role

Payne (2011, 471) explains that “self-stories have emotional resonance” which “influence

people’s attitudes, actions, relationships and sense of identity”. Untold (repressed) and

neglected self-stories are a “pre-existing framework of time-structured memories” (Payne,

2011, 475). They have the potential to negatively affect our behaviours and attitudes, which

in turn, affect our relationships. Corey (2014) mentions a lens as an example of the way in

which self-stories can change the way an individual perceives the world. Lenses are created

through different experiences, and impacts whether self-stories are repressed or neglected.

This resonates into ones sense of identity, relationships, behaviours and actions. Payne (2011)

explains that by exploring untold stories, clients are able to explore the sources of certain

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behaviours and attitudes. Therefore, clients need to actively participate in the therapeutic

relationship.

Narrative Therapy focuses on helping the client through a transitory phase (Ribeiro, Bento,

Goncalves & Salgado, 2010). The authors explain an example of a client that has problematic

narratives centred on pleasing others under all circumstances and expresses anger towards

those who neglected his needs (Ribeiro et.al, 2010). Clients need to actively participate in

sessions and in homework exercises in order to move from a sense of “resentment” towards

“acceptance”, “accepting that others did the best they could and try to establish a new kind of

relationship with them by asserting his or her own needs” (Ribeiro et.al, 2010, 202).

Clients willingness and curiosity to reveal and explore untold or neglected stories will

determine the pace and depth of sessions. Clients can be sensitive in revealing certain stories

which could impact the pace and depth of therapeutic sessions. Narrative therapy explains

that untold stories have the potential to allow movement towards change. Therapists

encourage clients to participate in conversations and story-telling with others, as well as the

therapist. Narrative therapy is focused on the clients’ memories and self-stories, therefore the

client is seen as the expert in his or her own life.

Techniques used in Narrative Therapy

According to Drewery & Winslade (1997), an effective application of Narrative Therapy is

more dependent on the therapist’s personal attitudes and perspectives, rather than a set list of

techniques used. Furthermore, there is no recipe, set agenda and formula in which a therapist

can use to ensure successful therapy. It is important for the therapist to firstly ask open-ended

questions in order to gather enough information so that a sufficient description of the

relationship between the client and the problem is obtained.

Externalization of the problem- when the client comes to understand that the problem can

be separated from his identity or sense of self can be removed or changed. The belief behind

this is that when your label yourself as being the problem it becomes extraordinarily difficult

to encourage change. If you believe that you are living with a problem which is separate from

your sense of self, it becomes significantly easier to initiate the change process. For example,

if you say that you are a selfish person then you have to change who you are in order to not

be selfish. If you say that you are a person who engages in selfish behavior then you can

simply change the behavior without needing to change your fundamental sense of self.

Michael White spoke out against diagnostic labels as he saw them as being damaging. He

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suggested that labels encourage people to over identify with their diagnosis thereby hindering

the change process. It can be very empowering for a client to see that they are separate from,

and have a degree of control over, the “problem” in which they are facing. The therapist

should encourage clients to add a preposition to the characteristic or behavior that they would

like to change.

Deconstruct the problem – It is difficult to solve problems when those problems are over

generalized. This method is used to make the issue specific and manageable for the client and

is meant to help the therapist understand what the problem means to the client. When

practicing deconstruction, Therapists should ask questions such as “Tell me what you see…

what is going on when the problem is present. Tell me what we will see when the problem

has gone away".

Unique outcomes– Changing the dominant negative storyline. The therapist will help the

client to focus on life stories which are contrary to the problem-saturated narrative. Narrative

Therapy would suggest that you create a negative reality by focusing your attention and

perceptions on story-lines which fit in with your self-created negative reality. This means that

story-lines which are contrary to the dominant negative storyline are not perceived (though

they are available) or they are not given. The therapist should encourage the client to talk

about storylines that are different or contrary to the dominant negative storyline. Because the

therapist believes in this alternate storyline, the new storyline, the new reality is validated and

can be integrated. Example: “tell me about when the problem was not able to influence your

relationship…I would like to hear about how you fell in love…tell me what you love so much

about your partner”.

Alternative stories and re-authoring - the therapist should find historical evidence to

strengthen a new view of the person as being competent enough to have "stood up to,

defeated or escaped" from the dominance of the problem. This is the part in which the

person's identity and life story begin to get rewritten. This is seen as the narrative part.

Narrative therapists ask for stories and evidence from the past to prove that the person was

actually competent and strong but did not always realize this.

Documenting the evidence- a technique in which a therapist writes letters. Which helps

consolidate the gains in which a client has made, these letters provide a record of the session,

may include the client’s externalized description of the problem, identified strengths and

abilities of the client, which can be identified through the session. The letter is used to

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highlight the struggles the client has had with the problem and helps to distinct the client’s

distinction between a negative and problematic story to a developing new and preferred story.

Applying Narrative Therapy to Disorders

According to Polkinghorne (1991), the narrative approach can be used to treat a broad range

of psychological conditions, such as anxiety and depression. These moods are seen as

resulting from events experienced by the person that assault the self-identity, which is the

core focus of narrative approach. Since its aim is to assist the client develops a new self-

identity in a form of alternate story, because it strongly believes that people are resourceful,

in a sense that they can deconstruct the dominant story while also constructing a new one if

they are guided by the therapist in doing that. It is further stated that narrative therapy can

work well with a lot of clients, such as those suffering from childhood conduct problems,

anorexia, delinquency, bullying, child abuse, grief reaction, marital conflict, substance

addiction, adjustment to HIV/Aids and Schizophrenia to name a few, however, we will only

focus on the application of narrative approach to older adults suffering from the Substance

Addiction Disorder.

Literature reveals that when it comes to substance use addiction, younger people have

different challenges compared to older adults. There are various factors, which include social

and financial concern which result in older individuals who are more prone to become

victims of addiction on medication, drugs and alcohol. Hence, the narrative approach offers a

viable therapeutic alternative, because it unearths problems in people’s life, in this case

addiction and assist patients to retell them in more empowering ways. One begins to say to

themselves, “I am not a bad person…I am just a person with the problem”. It can be deduced

from this statement that the person with addiction problem is not the problem; however the

addiction problem is the problem. This is a drastic shift from traditional therapies that often

view the mental illness as from the within the individual, and somehow imply that people are

responsible for their problems (Gardner & Poole, 2009).

The Narrative approach is most suitable for people which Substance Abuse condition because

it is an epitome of a socially constructed problem. On one hand, people start using substance

simple because they want to fit in social groups, or want to appear cool and unfortunately end

up being addicted due to peer pressure. Furthermore, individuals at the spectrum are mostly

in touch with reality; hence have the ability to tell their narrative or story, unlike people who

are out of touch with reality who might struggle narrating their story. The Narrative approach

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might even be more helpful to deal with addiction among older beings because it can

effectively deal with social stigma attached to substance addiction. Most people may shy

away from help simple because they avoid negative social labels such as “addicts” and

“junkies”. The Narrative approach counteracts traditional assumption by looking at problems

as being cultural, family and social created. The Narrative approach further challenges the

DSM as an objective truth of illness. In this approach, the DSM is seen as another way of

oppressing people with problems, by pathologizing them and making them helpless and some

Narrative Therapists prefer not to use DSM to diagnose a client who possesses pathologies.

In Narrative Therapy, all therapeutic conversations aim to explore multiple constructions of

reality rather than trying to find facts which constitute a single truth. It is through this

endeavour that alternative stories of self-identity can be discovered, therefore, replacing

dominant maladaptive ones (Carr, 1998).

A Narrative Therapist will apply a few set of techniques when dealing with people suffering

from addictions. Externalising the problem is the central therapeutic technique which was

used by Michael White, to help clients begin to define their problems as separate entities.

There is a particular style of questioning that is used to help the client begin to view their

problems as separate from themselves. In applying this technique the therapist also questions

how the problem affects the person’s life and relationship with others. This technique applies

an externalised metaphor of the problem, where the problem is perceived as the third person,

with evil intention to the client, it is given a name e.g. in this case the addiction. The therapist

may ask a set of questions from the client such as: “Are you happy what the addiction is

doing to your life? How did the addiction come to oppress you in this way?” By doing so,

this way of posing questions helps in separating the person from the problem and may begin

to assist the clients externalise the problem. This may interrupt and challenge the saturated

story of the person’s identity. Individuals will most likely begin to view themselves not as

“addicts” and “junkies” but as having a problem of excessive substance use (Carr, 1998).

Furthermore, Carr (1998) proposed the excavating unique outcome as another technique

used in narrative approach. When excavating unique outcomes, the therapist ask clients

particular instances in which the client avoided being oppressed by the problem or disallowed

the problem from having a major negative influence on their live. The therapist may ask the

following set of questions: “Can you tell me about the time when you prevented addiction

from oppressing you? What does this success in resisting the influence of addiction tell us

about you as a person? Can you tell me how despite the powerful influence of alcohol you

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made the decision to come here today and ask for help?” The Narrative approach capitalises

on small achievement people have made in their lives. By bringing these achievements into

light or by making people aware, it somehow produces an improved self-concept. This is a

good foundation for the development of a new narrative as it allows one to reclaim their lives

and clarify their direction in the near future. Hence, people may begin to see themselves as

more powerful than the problem, and may be in a better position to manage it.

Once all the above techniques have been established on the client’s story, there is a need to

draw the audience or witnesses in order to maintain the new narrative. The outside witness

group involve members of the client’s social network who may form a support system for the

client and may coach him or her with relevant skills and knowledge to manage the addiction

problem. Witness group may be significant others such as family or friends that are directly

or indirectly affected by a person’s addiction and are determined to support him/her come

clean. Moreover the therapist may also include therapeutic documents, in the form of letters

of predictions, letters of reference, letters of special occasion, self-stories, certificates for

work well done, etc. The therapist does this in order to keep records of therapeutic progress

and future projections (Carr, 1998). For instance, it can be kept on record that the client has

committed himself that he or she wishes to drop his or her monthly up take of substances to

zero, and if this goal is reviewed later and the clients have achieved it, the therapist may

reward him or her with a well done certificate. Hence encouraging good behaviour and

promoting the development of a new self-identity.

Multiculturalism and Narrative Therapy

Counselling therapies and concepts are richly rooted in Euro-American context and this

causes lots of controversies when applied in a context such as South Africa (Sue, 2001).

Practicing in a country such as South Africa requires every therapist to consider the

multicultural perspective because it’s diverse in culture. This write up will view the

multicultural application in narrative therapy. Narrative therapy requires the client to be the

author of their book, because they are the owner of individual knowledge and they construct

their own realities through narrating their stories (Kerl, 2002). In essence, Narrative Therapy

holds the belief that clients create their own reality and meaning and they make that their

“truth” about lives.

The Multicultural perspective is a universal scope that considers life experience, cultural

values, beliefs and diversity. The multicultural approach requires counsellors to be aware,

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have knowledge and be skilled enough to respect the perspective of every culture (Yoon,

Jeremie- Brink & Kardesh, 2014). Therefore, culture is defined as the way of life, beliefs, art,

values and customs. Culture can be defined in many ways (Turnbull, Lea. Parkinson, Phillips,

Francis, Webb, Bull & Ashby, 2010). We all belong to a certain culture, it is what grooms us

and makes us who we are. The Health Professional Council of South Africa (HPCSA, 2008)

regards cultural diversity and human rights as important components in therapy. A Narrative

Therapist must be aware of their cultural beliefs by always acquiring knowledge and

depicting a nature of willingness to learn and by doing so; one will gain experience and skills

in treating a culturally diverse population. When a client narrates their story in therapy, their

constructed reality becomes dominant and this socially constructed reality is deeply rooted in

culture. It is pertinent to note that a clinician should fully understand and explain cultural

implications when applying Narrative Therapy in a counselling setting.

According to Corey (2011), the problem with culturally diverse clients is that, they believe

they should conform to the reality and truth of the society, because they have been raised that

way. Narrative therapy examines the meaning of stories, therapist take a journey with the

client and listen to their stories and explore the themes and richness of meaning behind every

told story (Semmler & Williams, 2000). Stories are planted in culture, the way we are told to

live, and how reality is constructed for us becomes the primary target of narrative therapy.

According to Semmler &Williams (2000), Narrative Therapy is about understanding the

cultural assumptions that influence client’s stories. When narrating a story, language becomes

an important aspect. We all feel comfortable with our own language; we tell our stories better

if we believe that the therapist speaks the same language, which is pertinent in Narrative

Therapy, however this form of therapy is relevant for culturally diverse clients. Narrative

therapist’s are also curious and there to discover and to listen to the meaning instead of the

language. The client is the owner of knowledge therefore, if the therapist does not understand

what is being communicated, they can pause and ask, for instance, “What does this story

mean for you?” and the client will most likely expand on what they meant. Stories are

defined in a client’s individual language and gender, ethnicity, disability, sexual orientation,

social class and religion are highly respected in Narrative Therapy because the client is the

owner of the “truth” and narrative therapy is built on socio-cultural context (Corey, 2011).

According to Corey (2011), in Narrative Therapy, the therapist concentrates on problem

stories which cause the client to feel subjugate at the personal, social, and cultural levels.

Client dilemmas are manifested in their social context, however, once the therapist has helped

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the client to investigate the meaning of their stories by means of cultural awareness, new

stories can be generated (Corey, 2009). In order for the therapist to consider a multicultural

perspective here are some of the questions that Corey (2011) suggested, as an example of

what the narrative therapist might ask in therapy: What can you share with me about your

background that will enable me to know you more or will enable me to fully understand

you?; What challenges have you faced growing up in your culture?; What, if anything, about

your background has been difficult for you?; How have you been able to draw on strengths

and resources from your culture?; What resources can you draw from in times of need?

Issues and Controversies

There are many advantages and disadvantages of using Narrative therapy. Narrative Therapy

has been most commonly criticised for its’ use of language that is difficult to read and

understand (Murdock, 2009). The challenge in reading and understanding Narrative Therapy

may be accounted for by the difficult language and terms used such as dominant story,

alternate story, cultural discourse, dominant discourse, and problem-saturated stories

(Murdock, 2009). In Narrative Therapy, clients are viewed as the experts in knowing they

want in life and the narrative therapist depends on the clients and his or her resources to solve

their problem (Corey, 2014). This creates a problem and may risk doubt or lack of confidence

in the therapist knowledge and expertise as many individuals from different cultural groups

view professionals as the expert who provides direction and solutions to their problem

(Corey, 2014). It is argued that to prevent this from occurring, the therapist should convey to

clients that they have the expertise however, the clients know best about what they want in

their lives, in that way they are seen as the expert (Corey, 2014). Narrative Therapists believe

that reality only exists to human kind in a language based way and that language is socially

constructed in society (Ridgway, 2007). This constructionist view reduces human kinds

experience of reality to its language nested within its’ social context (Ridgway, 2007). This

would mean that for a Narrative Therapist to be able to understand client’s life experiences

they would have to understand and speak the language of the client, which is highly

contradictory to practice in counselling. In Narrative Therapy, constructionism does not take

into consideration the possibility and capability of individuals creating their own reality, their

versions of a meaningful life (Alto, 1996). A Narrative Therapist believes problems arise

when humans begin to oppose cultural and dominant discourses which are described as

culturally and socially accepted truths in a society (Murdock, 2009). They believe that

problems are external oppressions to human beings. In this way the theory has been criticised

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for being relativistic, this means that knowledge, truth and morality exist in relation to culture

and society, that is problems only exist through the influence of the environment on us, which

is falsely. Therefore, the goal of Narrative Therapy is to assist clients resist external

oppression and dominant discourses, however the therapy has also been criticised for being

too nihilistic in this light. The therapy encourages human being to disconnect socially with

society, to ignore norms in society and to marginalise. Narrative therapists are said to hold a

very limited perspective of agency (Lee, 2004). Agency is seen as a movement away or out of

subjugating cultural and dominant discourses, more than intentional movement towards

preferred goals (Lee, 2004). Narrative therapy has further been criticised for “losing the

family”. The theory “ignores the relationships between people because they do not attend to

the relationships patterns and structures in their client’s families” (Murdock, 2009, 509).

Lastly, the Narrative Therapist’s view of the problems being external to the individual creates

the contradictory perception of the client as being irresponsible and completely blameless for

their life experiences and the problems they encounter.

Case Study Application

Narrative Therapy is a suitable therapy approach to Kai because this form of therapy is about

narration of stories, therefore the therapist will help him come with a problem saturated story.

Narrative Therapy holds the belief that problems are social constructed and therefore the

individual lives in that story. Since the client is the expected to live in his experience, the

therapist will then follow the client to identify his new story and maintain it. Although there

are no specific systematic steps to follow, the therapist will be guided by some techniques

which he is not obligated to follow them in a systematic order (Corey, 2013).The therapist

will engage in a narrative conversation with Kai and the therapist will listen carefully with

the aim of identifying gaps and a problem saturated story. The therapist will pose questions

such as “Can you please tell me more about what is happening in your life right now?” and

Kai will follow by narrating his tale of adversary.

Firstly, the therapist will externalize the problem and the aim is to change Kai from viewing

himself as the problem rather he should see it as outside from himself (Neal, 1996).

Therefore, the problem is metaphorical and by doing so he will come to a realization of his

issues through the narration of his life experiences. The therapist will pose an externalizing

question, for instance, “How do you feel with the lack of communication between you and

your spouse?” By externalizing the problem the therapist will invite Kai to explore a name he

thinks is suitable for the problem and that name they have agreed on will be maintained

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throughout the course of therapy. For example he might come with a name as Mr. Fear, since

is fear that is stopping him from speaking to his wife openly about his thoughts. By mapping

the effect of the problem, the therapist will ask questions that may assist Kai to see the

influence the problem may have on him. The therapist may pose a question such as “Tell me

how great your fear is presently, on a scale from 1 to 10, with 10 being fear in total control”.

However, the therapist should identify instances where Kai was able to mitigate the problem.

This will aid Kai to reflect on moments where he was able to combat this issue. According to

Corey (2013), this is known as search for unique outcomes. Since he is now motivated to

confront the problem, the therapist will invite him into authoring a new story. According to

Corey (2013), the Narrative Therapy perspective holds the notion that people live in stories

therefore the narrative possessing the problem should be replaced by an alternate storyline

that is less problematic. This challenges the client to maintain the storyline, for example, Kai

may say the new story will be one that defeats Mr. Fear, therefore he will be motivated to

defeat Mr. Fear.

Narrative Therapy holds a belief that a person does not live as a separate individual but with

other people. Therefore, it is important to seek a person or people who are optimistic and

have faith in the client, believing that he is able to change and lead a normal life without

having to be constantly rehabilitated. Inviting an audience enables the client to invite

supportive acquaintances, friends and family to witness the rehabilitated and renewed Kai

who is attempting to make the change for his life in the near future. The therapist also writes

letters in every session which are summary of the client’s progression through the process of

therapy. This is given to the client to read and remind himself of what he promised himself to

do and how he will maintain the story and achieve his goal (Besley 1996).

Conclusion:

In essence, the importance of Narrative Therapy used in the psychological setting is to uplift

society, create a different perspective, change one’s thoughts, and get rid of bias, prejudice

and discrimination. Although, there is now access, there needs to be professional people

applying Narrative Therapy. Clinicians employed must be competent which will benefit

society, in the counselling sessions which are carried out in more comfortable and

approachable settings. Narrative Therapy has advanced in leaps and bounds globally. The

access and exposure of this form of psychotherapy has increased drastically from the past to

the present day. However, a greater need for further research is required into the efficiency

and development of this form of therapy. The only way to combat this is to equip more

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clinicians with background, experience and knowledge to implement these theories and make

it more widely accessible to various factions of society, so everyone may add to the

community in order for them to thrive and grow. Narrative Therapy has grown substantially

and has treated numerous individuals throughout the world and further research and

application will only serve to improve countless more lives.

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