Narrative therapy summary

Share

Narrative therapy summary

Quick summary: My intention is to tell you what techniques can be used in narrative therapy, and why you would use them.

Narrative therapy was developed by Michael White and David Epston.

Narrative therapy is based on post modernism which essentially says that there is no set objectivity… we create reality based on agreed upon beliefs that we transmit through language.

  • Language enables us to have a degree of conformity in what we perceive… we agree to structure chaos to look like the reality that we live within.
  • If everyone claims that the world is flat then that is the agreed upon reality until a new idea is communicated and accepted.

Narrative therapy is not telling people, “If you perceived your life different you would not suffer… your suffering is do to you collaborating with or choosing to believe in a negative storyline!”

Narrative therapy is telling people, “Suffering and Bliss both enter into our lived experience… I would like to help you to live a life in which multiple story-lines can be used to narrate your life. I would like to help you to see that opposites can exist at the same time… you can hold love and hate for a person… a vacation can bring both fantastic and awful feelings… let us promote the positive story-lines so that you can choose to live within a positive constructed reality while seeking appropriate nurturance for the suffering which sometimes comes to visit.”

Sample Scenarios in family therapy: following the explanations of techniques, try and visualize how you might handle the following situations differently.

* Two parents walk into your therapy office with their 15 year old and tell you that their son is a pot head and a mess-up at school.

* a couple walks into your office and states that the problem is that one of them is stubborn and the other one in controlling.

* a man and wife come asking for your services saying that their marriage is falling apart as the male is an alcoholic.

*a family comes into your office and informs you that the children are all ADHD at home but not at school.

* A woman comes into your office and says that she will file for a divorce if her husband doesn’t start making her feel important.

Techniques – Narrative therapy helps clients to:

Externalize the problem – the client will see that the problem can be separated from their identity or sense of self (ego) and therefore can be removed or changed.

  • The belief is that when your label yourself as literally being the problem it becomes extraordinarily difficult to encourage change.
  • If you believe that you live with a problem which is separate from your sense of self, it is significantly easier to initiate the change process.
  • Example: if you say that you are a stubborn person then you have to change who you are in order to not be stubborn. If you say that you are a person who engages in stubborn 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 counter productive. He 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”.

 

Externalization technique – encourage clients to add a preposition to the characteristic or behavior that they would like to change.

  • Example: instead of “I am depressed,” the person would be encouraged to say, “I am currently living with depression. The therapist will then ask a question such as, “when did you notice that depression first entered into your life?”
  • The therapist will then continue to speak about the externalized concern as a separate entity with statements such as, “what have you already done to encourage depression to leave?” or “tell me about a time when depression was not allowed to influence you?”
  • The therapist will use externalization as a means of fostering a collaborative effort. Once the ‘problem’ is separated from the individual the whole family can collaborate in the solution.
  • in my opinion, Externalization is one of the most effective means of eliminating defensiveness and resistance in MFT.

 

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.

  • Example: If a person were to say, “My wife is messy and I’m pissed,” there is no clear solution nor is it clear what emotion needs empathy. The therapist would help the client to be more specific, “when my wife doesn’t put her dishes away I feel unimportant and as it is really important to me to have the kitchen clean… I have a difficult time with my stress and her putting the dishes away would really help me to feel like she understands the stress I am carrying.” the therapist could then say something like, “ so you are looking for your wife to empathize with the stress you are carrying so that stress might give you a break?”

 

Deconstruction technique – help us to understand what the problem means to you.

  • “Tell me what you see… what is going on when the problem is present. Tell us what we will see when the problem has gone away. Tell us what emotions you tend to experience when you think about these examples of the problem. If your family members where able to understand how this all affects you, what would they understand?”

Unique outcomes – Changing the dominant negative storyline. The therapist will help clients to focus on life stories which are contrary to the problem-saturated narrative.

  • This is where the whole postmodernism bit becomes relevant. Narrative therapy would suggest that you create a negative reality by focusing your attention and perceptions on story-lines which substantiate your self-created negative reality… (Neurological studies concerning brain function and structure as related to mindfulness seem to substantiate this).
  • 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 attention.
  • ‘rewrite self defeating narratives’… which means that clients will begin to allow positive story-lines into their life (the premise is that if you have a negative story about your life you unconsciously will ‘look for’ negatives to substantiate the ‘truth’ of the dominant story about your life that you tell yourself… by doing so you unintentionally miss many of the positive stories that are ‘contrary’ to the dominant story.)
  • This can sound blaming so let me clarify… our brain project our beliefs onto our perceptions. This means we unintentionally see things the way that we have been educated to see them. We take information from our senses and try to make sense of that information with what we already believe to be true… narrative therapy allows people to apply new positive narratives to their perceptions… this is different than CBT in that you are free to create your own ‘truth’ as ‘truth’ doesn’t actually exist (cognitive therapy can involve disputing irrational beliefs… ration is a modernist principle. Narrative therapy allows you to focus your attention on alternate beliefs… their is no truth according to postmodernism and therefor nothing would ever need to be disputed.

 

Unique outcomes technique – encourage people 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.”

The Family narrates a new story for the the system to live within – Once the above techniques are used it is important that the  family collaboratively creates a new positive story line. “We are aware of how the ‘problem’ impacted our system and we will use the following ‘solutions’ as we move forward. Solution Focused and Narrative therapy are both postmodern theories and they compliment each other perfectly (I personally use the two in conjunction.)

Existentialism – I very commonly use existential interventions in conjunction with narrative therapy. Existentialism is concerned with meaning and narrative therapy allows for that meaning to be entirely subjective. I will ask questions such as, “what was the positive reason that alcohol chose to enter into your life.” or “What are some of the good reasons that your allow yourself to be taken over by stubbornness?” or “what is the meaning that that you give for this suffering that were are talking about?”

 

Letter, support groups, definitional ceremonies, reflection team… encourage the system and people in the larger community system to validate the new positive story line.

  • Family members, the therapist, people in a support group, therapist colleagues and supervisors etc will listen to the new story and will talk openly to the clients about how they can see this new narrative alive and well in the client’s life.

 

Collaborating with new story Techniques:

  • A therapist will write a letter or a group will say to the client something like, “Ben, I was impressed to see how you allowed the nurturance of your partner to enter into your life to help you to combat the anxiety which sometimes arrives when you go to work. I see that you have called upon personal strength to engage in an exercise routine which greatly impacts anxieties’ ability to gain influence over you.”

 

Reflecting upon our life increases our reflective ability – With reflection we allow ourselves to observe our lived experience and we are then less likely to go through life on autopilot. In this way narrative therapy is a mindfulness tool which enables you to be free to live in the moment… and free to live within the story-lines that you reflect upon.

You are not the story you are the observer and the creator of the story… you can observe yourself in any story you wish to create.

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Narrative therapy: the externalization of perception

Share

Quick summary: By talking with a therapist and re-experiencing emotions, thoughts and emotionally significant experiences, a client can show his/herself that occurrences can be narrated and therefore separated from the concept of self… narration is freedom as we find ourselves to be the author of our own reality. Resiliency naturally emerges as our identity ceases to be determined by the plot of our lives… we are no longer automatically controlled by the plot… instead we are the author… we choose the conclusions of our conflicts.

Typically narrative therapists use externalization to separate a specific attribute or symptom etc from a client. I am realizing now that perhaps Michael White and David Eptson where suggesting that narrative therapy is a means to help clients externalize their perception of reality so that their sense of self is no longer determined by the perceived plot line of their life.

A simple way to externalize – add a preposition or a verb…

  • Example: ‘I am depressed’ – becomes – ‘I am a person with depression’ or ‘I am currently experiencing depression’.
  • Example: ‘my life sucks’ – becomes – ‘currently, the way that I perceive my reality and the conclusions that I draw from the perceptions about my reality encourage me to hold negativity.’

 

Justice – it is very easy to perceive narrative therapy as suggesting that acts of injustice are simply a matter of the victim’s negative perception…

  • Narrative therapy does not condone acts of injustice… instead it offers a freedom of emotional and existential resolve following an experience of injustice of oppression.
  • This freedom enables resiliency.
  • It is the existential conclusion and the emotional response that is under the control of a person.

 

The result – “I perceive my reality this way and this perception has this emotional impact on me. Through externalization I have found my freedom to perceive my reality a different way so that I now hold this more agreeable emotional disposition in relation to the life I live.”

 

Example – ‘Losing or Failing’ – you have the freedom to perceive a loss as ‘a wonderful opportunity to grow from challenge,’ or ‘ an example of incompetence which should make you feel inadequate and hopeless’ … neither perception is more true than the other – you have the freedom of perception

Often misery is the result of colluding with a constructed way of perceiving that was or is being perpetuated by those in privileged positions that hold the power to persuade the masses that their subjectivity is objectivity.

  • The offensive push of objectivity leads people into deterministic thinking which is a form of mental slavery.
  • Example of a thought/feeling from internalizing the narratives of certain media– “I do not the hold the attributes which have been marketed as ideal and I should feel ________ about the ways in which I am different than the defined ideal.”

 

Michael White often spoke of the oppressive power of knowledge… knowledge can be used to oppress people.

  • Knowledge can be used to convince a person that there is a correct and incorrect way of perceiving reality
  • Knowledge tells us what we should do… how we should feel… how we should think…
  • Suffering often arises when we follow a ‘should’ that our intuition or our core self was not or is not in favor of.

 

Euphemisms and reframes are devices for people to take back control of their perceptions… perhaps it is the notion that any perception is objectively more accurate than another which persuades us into determinism.

 

Externalization is a process used in Narrative therapy by which the therapist helps a client to see that they are separate from their perceived character traits.

  • This is useful in solving problems as it is easier to offer assistance in changing an attribute when a client stops believing that that attribute is an inseparable aspect of his/her core self.
  • The client will learn that symptoms such as depression, low self esteem, or lack of ambition etc are separate entities that can be altered with the self as opposed to being altered by altering the self
    • The therapist will suggest that a client is ‘with depression’ or ‘holds depression’ as opposed to promoting that a client ‘is depressed’. If a client is depressed then you must change the actual client… if the client is with depression than you can help to change the client’s relationship with depression… depression is removable without asking a client to change their core self.

 

I am suggesting that all of perception can be externalized – ‘this is a perception I hold of reality’ as opposed to ‘this is reality’.

Once perception is externalized the now separated core self can re-write the impact of the perceived plot line.

I am the Author and the Observer of my perceived reality… I will no longer allow myself to be oppressed by the forced conclusions that I chose to hold… I am free.

 

Suffering is the water which grows the seeds of my spiritual potential… suffering is no longer the walls of objectivity that holds me in determinism.

In this way Narrative therapy becomes an experiential engagement with the process of mindfulness.

Mindfulness allows you to be the observer of existence – the core self is asked to simply notice the emotions of the body, the thoughts and perception of the mind, and the information that the senses retrieve from the environment. These observation are experienced without judgment and without trying to change or alter anything (If you are sad… notice sad… if your thoughts won’t stop… notice this occurrence… if you can’t help but to judge your thoughts… notice this as well).

Narrative therapy is a way of assisting healthy Detachment!

Mindfulness is my favorite and I have always loved narrative therapy – now I see why – the potential of narrative therapy is growing in the emancipated perceptions that I hold.

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

A subtle difference between Narrative and Cognitive psychotherapy

Share

Quick Summary: Narrative and Cognitive therapy both help people to think about their world a bit differently. Cognitive therapy helps people to look at and to change disruptive beliefs and Narrative therapy helps people to put more attention on the positive storylines that make up their reality. Both hold that positive thoughts and a positive self-narratives tend to have a positive or advantageous impact on a person’s behaviors and emotions.

 

A cognitive intervention rests on the idea that we humans tend to have many negative and self-defeating thoughts and beliefs which have a detrimental impact on our behaviors, emotions and overall quality of life.

  • Cognitive psychotherapeutic interventions help people to focus their attention on these disruptive thoughts and beliefs so that those thoughts and beliefs can be adjusted so as to not have such a significant negative impact on a person’s life.
  • Often these thoughts and beliefs are somewhat unconscious or at least beyond our control (this means that the beliefs and thoughts were accepted as ‘true’ without the person making a conscious choice about the validity of those thoughts and beliefs).
  • Cognitive therapy is based on modernism. Modernism theory is the basis for scientific investigation… modernism believe that there is an objective, measurable and consistent reality.
  • Therefore cognitive therapy deals with the removal of ‘false’ thoughts and beliefs… cognitive theory would feel justified in objectively labeling thoughts and beliefs as true or false.

 

There is significant overlap between many psychotherapy theories…

On the surface, Narrative therapy looks very similar to cognitive therapy.

Narrative therapy states that we live within the stories that we tell our selves and the stories which people tell regarding us. This means that according to narrative therapy your reality is determined by the beliefs that you choose to hold regarding your life.

  • A narrative intervention would help people to ‘rewrite’ their personal life story so that their reality could be filled with greater positivity.
  • Narrative therapy is based in postmodernism – in this theory, reality does not exist objectively, truth is simply what you believe to be true. If you believe that events in your life should make you unhappy than ‘unhappy’ will be your self-created reality.
  • Narrative interventions are not concerned with true or false beliefs – as nothing is objectively true you can believe anything that you want to.
  • Narrative therapy helps people to live within more positive and life enhancing narratives.
  • Every day good and bad things happen – narrative therapy helps people to see that they choose which perceptions… which narratives… take the majority of their consciousness.

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

‘narrative means to theraputic ends’ – book summary and review

Share

Quick summary: Below is a book review for ‘Narrative means to therapeutic ends’ written by Michael White and David Epston. I use this opportunity to highlight the major themes of Narrative therapy in general. This is a great book!

For more information about David and Michael you may visit http://www.dulwichcentre.com.au/ (this is a center in Australia which is dedicated to helping people through narrative therapy (Epston and White were co-founders I believe) – the book I am reviewing is a must read for the philosophically inclined – you can get this book at any major online retailer or by clicking the web site above.

Review of White and Epston’s

Narrative means to therapeutic ends

Summary of the basic content of the book

 

            This book starts out very philosophical. White lays out his reasoning for his narrative view and compares that view point against other widely known theories concerning the way we perceive and organize our existence. He explains why he disagrees with certain aspects of the more objective sciences and educates us on some of the current themes in the social sciences. In his philosophical discussions he briefly explains some of his techniques used in narrative therapy. The last two thirds of the book are devoted to helpful examples of how to help clients by offering written narratives. The letters are real and the authors offer their reasoning behind each different type of letter.

What this book is not- this book does not focus on the actual therapy sessions and the way that those sessions could be conducted by a narrative therapist. Instead this book was primarily written to explain the philosophical tenets that led to the narrative therapy model and an in depth explanation on how to use written letters to help your clients.

The Philosophical beginning

 

Power- White fist talks about the two opposing views on the concept of power. One theory being that power is a construct maintained through language and the other theory being that that power actually exists and can be utilized to oppress others. 

Text analogy-The narrative view point is related to the social scientist’s text analogy which suggests that given objectivity doesn’t exist and we cannot actually know a true reality, we then make up stories, which serve as our interpretations of our subjective perceptions.  In this way White extrapolates that change can occur by “re-authoring” or telling a different story about the same perception.

Positivist physical sciences and biological sciences- To understand the text analogy it is nice to compare it to other leading theories on how change occurs. The two theories above believe in a degree of objectivity and therefore look at change in more definite terms. In short, a problem cannot be altered by changing the way we perceive it; instead a problem must be isolated, diagnosed and then removed as if it were tangible. Essentially the problem actually does have an objective existence, which is in contrast to the text analogy which would suggest that a problem is only a problem if one chooses to perceive it that way.

The inherent shortcoming of using narratives as a means of organizing our lived experience– White suggests that we do not in fact offer a story to all aspects of our lived experience; instead we tend to focus on stories that fit nicely into our dominant story and perhaps into that story which is most pervasive in our society at large. White uses this belief as the starting point for many of his narrative techniques. Essentially he suggests that we can offer precedence to un or under-narrated aspects of our lived experience to offer a change in the way we perceive our lives. This flows right into the concept of unique outcomes, which is a technique used to find an exception to the dominant “problem saturated” narrative.

Foucault and his view that power and knowledge are essentially the same thing- White references this man quite often and uses some of his philosophies to explain the many dimensions of the narrative perspective. It is suggested that power is knowledge because when we push an ‘objective truth’ onto a society the individuals in that society will align their own narratives around the dimensions outlined in the ‘truth’. In this way knowledge is power as knowledge can be used to direct the narratives of individuals in the direction of agreed upon truths. This has many Multi-Cultural themes as the dominant cultures have historically suppressed the subjective narratives of individuals in minority groups by forcing them to align with oppressive narratives. In simple terms, when an individual believes a stereotype to be true they might write their own story in a way that ignores authoring their experiences that are contrary to the stereotype.

Brief overview of Narrative techniques (extremely simplified) – White and Epston include these in their theoretical discussions and they use these concepts in their letters to their patients.

            Deconstruction – The therapist asks question to get to the specifics of a stated experience. So instead of saying,” I am sad,” the client would specify that ,” when my child’s incontinence came into our life I have noticed that a heightened sense of irritability towards my spouse came with it.” This is used to show that an event can be interpreted many different ways and the idea that there is solely one meaning to a perception or narrative is what some authors have described as an illusion. This technique has dialectic attributes as the therapist might ask questions such as what is good about that event and what is bad about that event. When a client can see an experience with greater dialectic maturity she/he is more able to re-author that experience in a way which will best serve her/him.

            Externalizations – This is used to help the client to separate the problem they are facing from their identity. Often this simply involves the addition of a preposition such as ‘I am with depression’ in stead of ‘I am depressed’. White and Epston will ask their clients question such as,” and when did this depression enter into your life?”

            Therapeutic questions – Are used to decipher the client’s narrative. They are used to help the therapist to understand the client’s perceived reality. As objectivity does not exist it is important for the therapist to get an idea as to how the client perceives their lived experience and how the client authors what he/she perceives. White enjoys asking question with words that suggest the inevitability of the new narrative coming to fruition. He will say “when this happens” instead of “if this happens”.

            Unique outcomes – The therapist tries to help the client to give examples of instances where the problem was resolved or viewed differently. The therapist tries to get the client to tap into un-authored aspects of their lived experience. The un-authored experiences are unique or different from the dominant story, which the client might be having trouble living within.

            Definitional ceremonies – out-side observers re-tell the new narrative of the client to “thicken“the new narrative.

            Therapeutic letter – (from the therapist) helps in displaying the advancement of new narratives, and to give positive feedback and encouragement. This is the main concept of the book and will be described in great detail below.

            Supportive leagues – this is essentially a gathering of people who have separated a problem from their identity and can work together to co-create narratives to stay successful. If a group was being oppressed by a socially constructed truth, they can band together to author a different interpretation.

Goals of therapy – The goals of therapy are to separate the client form the problem and to re-write self defeating narratives.

Written tradition vs. oral tradition – White gives us the argument in favor of writing letters containing alternative narratives. White supports his idea of writing letter by offering some points on the advantages of the written language. For one, our culture tends to put more emphasis on the sense of sight than any of the other senses. Therefore it is easier for us to accept a new story when we can see it. Second, a written story offers a sense of time which then aids the reader in making meaning from the temporarily relevant narrative. In other words it allows us to see our story in a timely context so that we might make meaning from the linear conglomerate of perceived experiences.

Panopticon- White ends his philosophical discussion with a jab at the current systems in place for oppressing the populace by quantifying existence and allowing it to be constantly evaluated based on the constructed variables of those in dominant positions. The Panopticon was literally an architectural design that would maximize the efficiency of those people working within its boundaries. The inhabitants were all classified and then were measured on set variables. All the inhabitants were made to believe that they were constantly being watched though the architecture was actually designed so as to create the illusion of constant observation. The example was mostly a metaphor used to display how fear can be used to get a populace to adhere to dogma so that they can be controlled. With a freedom from dogma, which is essential if one is to adhere to postmodern principles, our authentic self in free to narrate our perceptions towards our existential growth.

Letters written to clients and people relevant to the clients- White and Epston believe that it is important for people around you to share in your new narrative. Sometimes letters are written to people other than the client so that a new narrative can be shared with significant others; this is especially important given the systemic nature of this theory’s base. Often the process of letter writing is a collaborative effort between the therapist and the client/s.

Types of letter (I will try and be brief) he calls them Narrative Modes

 

           

            Letters of invitation – Given narrative therapy is a systems theory it is desirable to involve multiple members of that system.  There are often times when a member of the system is not present at a therapy session though their presence could be of benefit. These letters are sent to encourage a person or people to attend a session by sharing some of the new narratives of the attending people with the absent person or people.

 

            Redundancy letters – in this case redundancy is related to the jobs or familial roles that people perform within a given system. These letters are often written by the client with the help of the therapist to inform someone that they have been relieved of their job. As the client re-authors his/her life, the resulting independence might lead them to relieving a person from a care giving role. In this example a letter would be written to the caregiver so that the caregiver can accept the new independent narrative of the client.

            Letters of prediction – In these letters the therapist writes a new narrative which encompasses the goals and hopes of the client. The premise is that the client will believe the story and the belief in the new story will result in the prophesy coming true. Essentially the therapist writes what will happen and the client then makes it happen.

            Counter-referral letters – In these letters the new narrative is sent to the person who referred the family to the therapist. This is a way of spreading the new narrative and offering a follow up to a potentially concerned person.

 

            Letters of reference – In certain situation clients are found to believe a troublesome narrative because it has been pushed on them from an important person in the client’s life.  In Epston’s example he was meeting with a couple who were constantly told that they were bad parents by the husband’s parents. The clients ended up believing the narrative which suggested they were bad parents despite the overwhelming amount of evidence to the contrary. In this situation a letter that was filled with lived experiences in support of a new narrative (that they were good parents) was written to the husband’s parents. Again this is an attempt to get more people to participate in an alternative narrative.

            Letters for special occasions – These letters are written to help a client prepare for a potentially stressful occasion by writing down how the client would like the occasion to proceed. All pertinent information that is necessary for the other members of the system to perceive the client accurately during this special occasion is included. These letters are pre-emptive in that the purpose is often to explain how the client perceives the situation so that other members of the system can interact with the client with insight.

            Brief letters – There is a vast array of content that might be included in brief letters, and there seems to be one consistent theme. The theme is to let the client know that you are thinking about them and that you genuinely care. Often times these letter offer a brief summary of the new narratives of the last session. Other times brief letter might be sent to an old isolated client to simply let them know that you are thinking about them. The act of receiving mail tends to make people feel important. Brief letter are very often used to offer a quick reminder that the client can use the above techniques to re-author aspects of their lived experience.

            Letters as Narrative – These letters essentially encompass all the aspects of the narrative theory. They are used to depict the linear nature of the client’s story while showing that that story can progress forward without the detriments of inevitability. The process allows the client to first externalize the troublesome variable and then choose how they intend to author their story. Often a letter will be offered by the therapist in which unique outcomes and other progress will be summarized. The client will then write back a letter including the advancement to their new narrative. Again, seeing your story on paper helps you believe it. This has a lot of over lap with the secret, which is very popular these days. In a sense you can create your own truth as you are the author of your own life.

Self stories – these are letters written by the client once they have successfully authored their story in a way that fits their liking. Once the therapeutic process has been successful and the client feels great within her/his new narrative these letters offer significant others the opportunity to read the new story of the client. This new story can include a re-authoring of the past present and the future to anyone the client so desires. The letters are the client’s authentic autobiography.

Counter Documents – These are awards or diplomas for the successful completion of a goal. They are a visual reminder of success.

 

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.

Externalization – you are with the problem… you are separate from the problem

Share

Quick summary – externalization is a technique from Narrative therapy which uses language to separate a person from their problem so that the person is better able to manage that problem. The basic idea is that it is easier to fix a concern if the concern is not rigidly attached to the person’s identity or personality (you are not stubborn… you use stubborn behavior). In this way the therapist would help a person to see that they are not a depressed person… but rather they are a person living with depression. This process offers perceptual freedom to a person… If they no longer view themselves as innately depressed then they can choose what to do with the depression which is with them (as it never was truly part of them). Narrative theory tends to view diagnosis as counter productive as a diagnosis encourages a person to over identify with the label… this takes away the person’s freedom and hope.

Let me start with some quick examples: the first quote will use over-identification language and the second quote will use externalization. Which wording seems more solvable?

I am a cancer patient – I am living with cancer

I am an anxious person – I am person who carries anxiety

I’m fat – I hold extra weight

I’m a bad parent – I am a person with underdeveloped parenting techniques

Are these just euphemisms? (Nicer ways of saying the same thing)

Yes and No

–         The secondary benefits of this technique are based on positive psychology principles.

  • Narrative therapists believe that you create your own reality through the stories that you tell yourself… and with the stories that we agree upon collectively.
  • Yes – if you tell yourself more positive stories then you will live within the reality of those more positive storylines. This is one of the more controversial aspects of positive psychology, narrative therapy and other constructionist and postmodern views.

 

–         No… not just

  • The main benefit of this technique is that it allows a person to see himself or herself as separate from the problem which then makes it easier for that person to look at the problem from a different perspective.
  • The technique also encourages people to stop using unhelpful generalization so that they can see when the problem has less or no impact on their life.
    • Example: if you are a depressed person then you have made the generalization that you are always depressed. If you are a person with depression than it is easier to perceive the times when depression was not ‘with’ you.

 

Externalization is also perhaps a more helpful and compassionate way to communicate with a person concerning a problem that they hold.

            * For example – would your rather be told that you are a messy person or that you are a person with some messy habits? Would you want someone to say that you are a mean person or would you rather he or she said that you are a person that uses less sensitive language?

Over-identification causes suffering – certain Buddhist beliefs suggest that our over attachment to labels, material items, identities etc are the root of our suffering.

 

Hope – hope is a statistically significant variable in relation to therapeutic and medical outcomes – hope has a positive correlation with recovery. The more you believe that you will heal = the more likely you are to heal.

  • It is easier to foster hope in a person when that person believes that they are separate from their problem… If a person believes that they are the problem then they believe they have to change themselves – that process is far more difficult than changing an externalized problem.

 

Externalization trick – Something that you can practice in your life.

 

 * Try adding a verb and/or a preposition before your descriptors.

 

I am depressed – I am living with depression

I am learning disabled – I am a person who has a learning disability

I am unhappy – I am a person who notices unhappiness in my life

My cousin in developmentally disabled – my cousin has a developmental disability

“Word choice effects your perception and your perception affects your emotions.”

“I am with the snow balls … the snow balls are separate from me.” – Lucy the dog

William Hambleton Bishop is a practicing therapist in Steamboat Springs Colorado.