Sunday, May 01, 2016

Narrative Approach to Family Counseling

Family Counseling Approach: Narrative Therapy
            Life is little less than a story, with characters and circumstances far more exquisite and complex than the most excellent writer could imagine. It is in these stories that meaning to a person’s life can be found. Narrative therapy is an approach that utilizes those stories, and new ways of looking at them in order to change the way the story ends. Narrative therapists have the beautiful gift of turning victim into heroin and tragedy into victory. Narrative therapy attempts to separate the person or family from the problem. It is based on the idea that a person’s identity is formed by our experiences. Problems are considered separate, something that a client has, not a definition of that client. While there are some similarities with traditional models of therapy, narrative therapy is profoundly different as it utilizes new ideas, assumptions, aims and methods. This approach takes a positive assumption that people are the experts in their lives, with “many skills, competencies, beliefs, values, commitments, and abilities that will assist them to reduce the influence of the problems in their lives” (Morgan,2000).
History and Philosophical Assumptions
Narrative therapy evolved out of the desire to work with individuals and families in a way that did not blame or pathologize clients (Freedman & Combs, 1996). As therapist explored new ways of working with clients, they found that families did not need to be described as “homeostatic systems, but as generative social systems with the ability to change their own lives” (Freeman & Couchonnal, 2006).  Narrative therapy was created by White and Epston based on Michael Foucault’s philosophy that “reality exists only in agreed-upon reality created between people” (Jones &Butman, 2011, p. 369).
Narrative therapy assumes that a person’s functioning is determined by the stories that families “emphasize and repeat” which create a language-based structure of “self understanding” (p.369). Thoughts become words, words become actions, and actions become character. Narrative therapy is considered a postmodern view of therapy as it posits that there are multiple realities based on each individual’s experiences, and that everything known is possible through the language (Yarhouse & Sells, 2008).
Language and how it shapes problem perceptions and definitions is vital in narrative therapy. The way in which a family tells their stories dictates how the problem affects them. Rather than see the family as problematic, the narrative therapist externalizes the problem and educates the family on how the problem has been oppressing them. By using metaphors and restructuring, the therapist helps the clients to notice their own expert knowledge and re-author their story with empowered stories (Rasheed, Rasheed, & Marley, 2010).
Narrative therapists assume that problems are located in contexts and relationships, not people (Papp, 2000). Culture and history help to shape the meanings people make about their lives; people are the meaning makers, not merely victims of circumstance without the power to change things. The people around a person attribute meaning to their life. Narratives become the frame in which a person views their world. For example, a person who feels hopeless will create a hopeless framework from which they view the world, thus making the world hopeless. When clients come into counseling, they tell stories which shape their reality and reveal the feelings and beliefs they hold about themselves and the world around them, narrative therapists pay particular attention to these stories. Narrative therapists listen not only to what the client says, but parts of the story that are not told. Most stories are originally told in a thin manner, devoid of the complexities of life. These stories ignore contradictions to the running themes of the person’s life, which are often created by others. Once a person has accepted these thin descriptions, it becomes easy for them to find supporting evidence for their story. It is the narrative therapists job to thicken the story by introducing those components left out in the original thin story. (Freedman & Combs, 1996; Papp, 2000).
Narrative Therapy in Action
Narrative therapist utilizes a respectful, non-blaming approach that centers the client as the expert in his or her own life. Narrative therapy involves structured interventions designed to help the client co-author new less problem-saturated stories (Gehart, 2010). Narrative therapy is the process of telling a story, deconstructing it, and reconstructing it in a way that provides new possibilities. The narrative therapist is seen as a collaborator in the therapeutic process instead of and expert as in other therapies. Their primary role is to assist in retelling the stories in a way that reduces the problem saturated nature of the original story. Narrative therapists are curious, always asking questions in an attempt to bring the family along a journey but do not stipulate that there is a right or wrong way to go. (Jones & Butman, 2011).
Narrative therapists have “well defined sets of questions and strategies for helping clients enact preferred narratives” (Gehart, 2010, p.403). A narrative therapist helps the client to evaluate and change their relationship to the problem. They pose questions, which help to externalize the problem thus making it less intimidating to overcome.
Narrative therapy posits that individuals interpret their lives though narratives. There is not a specific process or way in which a client’s story should be told. According to White (1995) there is:
a progression taking place in narrative therapy, and the principles that surface and play a role are not a linear, structured development of argument. In the counseling process, the therapist should be guided by and explore each client's unique story.
Practitioners of narrative therapy believe that through rearticulating family narratives and identifying the meaning attached to them, it is possible to change the story.
The techniques in narrative therapy are utilized to help separate the client from the problem. Separating the problem and person or family allows the counselor to objectify sensitive issues and dissipate defense mechanisms and resistance. By helping family members separate themselves from the problem, “externalization opens up possibilities for them to describe themselves, each other, and their relationships from a new non problem saturated perspective” (White and Epston, 1990, p.39). In essence, narrative family helps to create an alternative, more attractive family story.
            Externalizing the problem has multiple benefits. It decreases unproductive conflict, undermines the sense of failure that has developed, paves the way for family cooperation and opens up new possibilities for family members to rescue their relationship from the problem (White and Epston, 1990).
            Another vital component of narrative therapy is the utilization of exceptions. Exceptions are times in which the thinly described theme of the clients Many times when clients enter therapy they have reached a point of desperation where they are unable to see when and how things could ever be better. They have a very thin view of life and the possibilities it holds. The narrative therapists are tasked with helping the client to thicken the story, to see beyond the current circumstances to times in which they successfully navigated their circumstances. (Carr, 1998).
How Narrative Therapy is Similar/Dissimilar to Traditional Treatment
Narrative therapy differs greatly from other forms of therapy. Aside from the fact that the counselor is seen as a collaborator instead of an expert, narrative therapy also sees “the family through multiple storylines, all of which have legitimacy and must be reconciled with the other family story lines” (Yarhouse & Sells, 2008, p.271).
Narrative therapy takes an optimistic approach to clients, focusing on client strengths and abilities rather than the problems that brought them into counseling as is often the case with traditional forms of therapy (Gehart, 2010). The counselor is not interested in identifying problems but rather, focused on “conversations produced by numerous possible narratives that coincide with each family members perspective” (Miller & Forrest, 2009).
There are portions of narrative therapy that are similar and consistent with previous forms of therapy. Both person centered therapy and narrative therapy encourage knowledge and skills to be recognized and transformative. Cognitive approaches and narrative therapy recognize the effect of illogical thinking and it’s effect on the client. Narrative therapy and solution focused brief therapy both utilize the technique of identifying exceptions to the problem and using them as a basis for potential to change. (Payne, 2006).
What have I learned?
Narrative therapy is a process of story telling. The narrative therapist can empower the client to tell their story in a way changes their victim status to one capable of creating the kind of life they want. Change is possible. Narrative therapists have the unique ability to show hope in a black and white context. They do not focus on the past or the problem but on the opportunity to be different. This is something that has proven profoundly helpful in this writer’s life as the parent to a child with severe mental illness. She was adopted out of the foster care system and suffers from a multitude of severe issues. In fact, this particular paper will be submitted late as the day has been spent arguing with the behavioral health MCO and her providers trying to get her to continue to receive care in a residential treatment facility. Early in the afternoon, this writer was advised that the child needed to be picked up out of state several hours away and has spent the evening driving instead of finishing the paper. While it has been incredibly frustrating and has the potential for hopelessness to reign supreme, applying narrative therapy principles has enabled this writer to understand that this is just a part of the story, that the current circumstances can be told and rewritten in a way that allows for hope and potential. That is not something that this writer had before.
The bottom line is that successful narrative therapy is based on the concept that the individual is the expert, they are vital to the determining the direction of therapy and what is important to them (Wark, 2012). In this writer’s case, there are multiple individuals and agencies involved who have different priorities. The insurance company is trying to prevent spending money. The hospitals and counselors are trying to limit their liability for failing her. This writer is simply trying to be the heroin in a story full of monsters which seem most times to be within moments of stealing the life of her child. If this writer has learning nothing else, it is that regardless of the characters and circumstances, the story can be changed.
Christian Worldview Critique and Integration
Since there is no set standard for health, the dominant culture can influence how a family sees itself. Truth is relative which is a distinct contradiction of Christianity (Yarhouse & Sells, 2008). The primary problem with postmodern therapy and narrative therapy is that it posits that truth is relative. Human interpretation is fallible because it is based on fallible human beings. Culture and experience create a frame
As a Christian, it is vital that all ideas and concepts are filtered thoroughly through God’s word and that the principles within that word are applied. “I am the Alpha and the Omega,’ says the Lord God, ‘who is, and who was, and who is to come, the Almighty’” (Revelation 1:8). Any concept or thought, every story, no matter how firmly believed, or how well proven much be fileted through God’s Word. Our value is priceless, “For you know that it was not with perishable things such as silver or gold that you were redeemed…but with the precious blood of Christ, a lamb without blemish or defect” (1 Peter, 1990, 1:18, 19). With this in mind, the Christian counselor understands the beauty and value of God’s work. For this reason, it is altogether fitting that one’s ministry would be seek to understand the human personality and what is necessary to maintain mental and spiritual health.
“For you created my inmost being; you knit me together in my mother’s womb. I praise you because I am fearfully and wonderfully made” (Psalms, 139: 13, 14).  Our lives begin with our earliest experiences and are deeply effected by them later. Early choices made by those in control of us, and the choices we made the survive those choices define and outline our growth. (Wilson, 2001). We have chosen to believe the thin descriptions of who we are, rather than notice those times in which there were exceptions to the story.  As adults we can choose to rewrite our mindset, to repair the damage caused to our framework with both hard work and God’s grace. A person may respond positively or negatively to the changes around them as they go through development.
Our personality begins in childhood with our most early and formidable experiences. Many theorists point to the importance of parents in the formation of personality. In particular, Wilson (2001) refers to our parents as gods as they are the ones in ultimate control of everything we know, feel, and see as children. They provide a lens from which we will forever see the world. Proverbs 19:21 states, “The human mind may devise many plans, but it is the purpose of the LORD that will be established.” Personality is the compilation of who God is, who we are, and how we allow Him to direct our steps. “The body belongs to the physical side and the spirit and soul to the personal.” (Crabb, p.88). Personality is affected by outside factors, sin nature, and influence of the Holy Spirit, feelings, will, thoughts, temporal systems, and supernatural systems (Hawkins, 2008).
Problems arise when one has a skewed view of the world around them, caused oftentimes by the initial poor construction of our self-concept. Our interpretations can be misguided. This can cause one to lack motivation, feeling that our circumstances are beyond God’s reach. “Satan’s first and foremost strategy is deception” (Anderson, 2000, p. 23). However, as Christian counselors, we know that the arm of the Lord is never too short. By changing the way in which a client’s story is told, we may revive within them the motivation necessary to make changes that will bring about spiritual and psychological health. Health is defined as people who are able to accurately see their story and possess the ability to rewrite it, regardless of the circumstances around them. Healthy persons possess dedication and perseverance, but also the understanding that, “For God did not give us a spirit of timidity, but a spirit of power, of love and of self-discipline” (2 Timothy 1:7).
While God is the center and sufficient, it is this authors opinion that He has given others the wisdom to provide treatment both in and out of the Christian arena.
Any treatment method should reflect the ability to multi-task. Multitasking requires that the counselor view, “a person’s problems from several perspectives at the same time” (Hawkins, 2006).
God and/or Godly principles must be the basis for any action or thought of both the counselor and counselee. By starting with a firm foundation of God’s word, it is then possible to build upon it, to make repairs when necessary, and to train the client to tell their story in a positive regard, regardless of circumstance. When a client learns how to tell their story understanding that God is able and with Him all things are possible, they will live in a spiritually mature and healthy manner.
The best way to combat temptation is to name Satan’s lies and hold onto God’s truth. In order to most effectively bring about change, it is essential that we get our clients to see the truth about themselves and their lives, without it all other work is meaningless and built on sand. Wilson admonishes her readers to follow Paul's guidance in 1 Corinthians 11:13 which states, “When I was a child, I talked like a child, I thought like a child, I reasoned like a child. When I became a man, I put the ways of childhood behind me” (New International Version). According to Wilson, as we become adults, we must somehow change the ideas about ourselves and the world around us that we developed due to our childhood experiences. We must put away old thinking in order to become new creatures. We must learn to tell our own story instead of accepting the story told to us by others.
By locating and identifying the misbeliefs in their lives, a person can then argue against those misbeliefs, and finally replace them with the truth. (Wilson, 2001) By recognizing who they are in God, it is possible to “be the dynamic, loving, altogether whole people God meant us to be”. (Wilson, p.182) By changing those beliefs, we are able to change the cycle of hurt and fulfill the ultimate purpose God has for our lives. By lining up counseling methods and theories with God’s word, the counselor ensures the most probable success, as God’s Word is sufficient (Adams, 1986).
As Christians, we have hope because the bottom line is that regardless of original circumstances, Romans 8:28 says, “And we know that in all things God works for the good of those who love him.” He will take whatever mess of a story we have and repair it, or show us how to repair it, if we are only willing. We can use this hope to help those we have the blessing of coming into contact with so that they might not only be healthy, but also come to be one of God’s children.
 References
Adams, J. E. (1986). How To Help People Change. Grand Rapids: Zondervan.
Carr, A. (1998). Michael white’s narrative therapy. Contemporary Family Therapy: An International Journal, 20(4), 485-503.
Crabb, L. J. Jr., (1977).  Effective Biblical Counseling: A Model for Helping Caring            
Christians Become Capable Counselors.  Grand Rapids, Michigan: Zondervan Publishing House.
Freedman, J., & Combs, G. (1996). Narrative therapy: The social construction of preferred realities. New York: W. W. Norton
Freedman, J. & Combs, G. (1996). Shifting paradigms: From systems to stories. New York, NY: Norton.
Freeman, E. M., & Couchonnal, G. (2006). Narrative and culturally based approaches in practice with families. Families in Society, 87(2), 198-208,157-158. Retrieved from http://search.proquest.com/docview/230170174?accountid=12085
Gehart, D. (2010). Mastering competencies in family therapy: Theory based assessment. Belmont, CA: Cengage Learning.
Hawkins, R. E. (Speaker). (2006). Model for guiding the counseling process. Lynchburg, VA: Liberty University.
Jones, S.L. & Butman, R.E. (2011). Modern psychotherapies: A comprehensive christian appraisal. Downers Grove, IL: IVP Academic
Miller, C.P. & Forrest, A.W. (2009). Ethics of family narrative therapy. The Family Journal, 17, 156-159.
Morgan, A. (2000). What is narrative therapy?; An easy to read introduction. Adelaide, South Australia: Dulwich Centre Publications. Retrieved from http://www.dulwichcentre.com.au/what-is-narrative-therapy.html
Papp, P. (2000). Couples on the fault line. New York, NY: The Guildford Press.
Payne, M. (2006). Narrative therapy. London, GBR: Sage Publications Inc.
Rasheed, J.M., Rasheed, M.N., & Marley, J.A. (2010). Readings in family therapy: From theory to practice. London: SAGE Publications Ltd
Wark, S. (2012). Counseling support for people with intellectual disabilities: The use of narrative therapy. The Australian Journal of Rehabilitation Counseling, 18(1), 37-49. doi:http://dx.doi.org/10.1017/jrc.2012.6
White, M. & Epston, D. (1990). Narrative means to therapeutic ends. New York, NY: W.W. Norton & Company
White, M. (1995) Re-authoring lives: Interviews and Essays. Adelaide: Dulwich Centre Publications.
Wilson, S. D.  (2001).  Hurt people hurt people: Hope and healing for yourself and your
 relationships. Grand Rapids, MI: Discovery House Publishers.
Yarhouse, M.A. & Sells, J.N. (2008). Family therapies: A comprehensive christian appraisal. Downers Grove, IL: IVP Academic


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