Narrative Therapy is a type of psychotherapy that was originally coined and created by Michael White and David Epstein from Australia and New Zealand respectively, and has been developed and shaped by many others (e.g., Steven Matigan, David Nylund, Jeff Zimmerman, and others) over the past several decades.
My favorite and most influential professor in graduate school was very enthusiastic about Narrative Therapy at the time our paths crossed, which made Narrative Therapy a significant influence on my development as a therapist. In the decade since then, my interests have meandered among many other theories, but I believe that Narrative Therapy remains an important color in my professional palette. The “narrative” style of thinking and relating weaves together with others and forms an important part of my work with clients and inner work with myself.
Story metaphor
Narrative therapy is based on the metaphor of a story. In narrative therapy, “story” simply refers to the experiences we’ve attended to and the different meanings we’ve attached to those experiences.
As incredible and complex as our brains are, they do not remember everything that happens to us. We perceive and record a relatively small fraction of events in which we are involved. And we make even fewer of them part of our life story that constitutes our identity and place in the world.
Narrative therapy operates on the assumption that there is a large degree of liberty in the interpretation of events. Because of “brain bugs” such as memory biases, selective attention, and filtering, the vast majority of events that take place in our lives are not noticed, dismissed, or forgotten when they do not support our already established view. Meanwhile, other events (e.g. traumatic ones) stick like glue to our psyches, take on too much significance, and become overweighted in our perceptions and identities. Narrative Therapy attempts to correct these distortions (as with CBT), except without assuming that there is some objective reality to be discovered. Instead, the reality is to be created, or written, like a story.
Postmodern assumptions
Narrative therapists sometimes distinguish themselves from other schools of therapy as postmodernists. Postmodernism in psychotherapy is an axiomatic supposition that reality is subjective and socially constructed. Prior to postmodern thought, “modern” psychotherapy, while being founded on respect and care of clients, tended to position therapists into an expert role. Pure postmodern thinking makes the client, or no one at all, the expert. For me, between these two absolutes lies a continuum. A helpful and simple metaphor is that therapist and client are putting together a jigsaw puzzle, with the client as the expert on the puzzle pieces, and the therapist having some general puzzle-completing experience they bring to the situation.
I believe in both socially constructed reality and objective reality, depending on the context. Gold has 79 protons” is an objective fact. But the narratives that we create about ourselves lend themselves to a lot of subjectivity. Just about everyone coming to therapy is wrestling with some story that needs modifying, whether they are stories about the self, others, the past, the future, etc. I find Ken Wilber’s integral theory useful in making space for both objective/modern and subjective/postmodern reality. Wilber’s view is that that subjective reality “includes and transcends” objective reality. I believe that narrative therapy can be practiced in an integrative manner alongside other “modern” psychotherapies, such as CBT, ACT, psychodynamic therapy, and humanistic therapy.
Narrative Therapy attempts to diversify the range of socially acceptable stories, by crafting a story that is unique and customized to the person, rather than attempting to fit the person into a pre-existing set of socially ordained roles or niches. Some examples of social scripts/stories that are presented to us as we grow up are “supermom”, “wealthy successful man/father”, “wise and always generous grandparent”, “athletic star”, “brilliant academic”, “kind-hearted helper”, “the creative genius artist”, “powerful politician”, “daring adventurer”, and many others. While it’s great if we happen to naturally fit into such a celebrated category, it can be life-deteriorating to dedicate our lives to fitting a script that we don’t fit into, because we are afraid to live our own, unpredictable and unwritten story as it unfolds.
There are also roles and scripts that are deemed unacceptable by cultural norms, such as “divorced”, “fired”, “stubborn”, or “too sensitive”. These stories can be viewed differently, such as “compassionately decoupled” or “moved on to better opportunities”, “determined”, or “empathic and perceptive.” Of course, simply swapping out stigmatizing labels with euphemisms is not in itself curative and can even be a defense against pain, but most people tend to lean too far towards self-indicting stories that do not, in fact, capture an accurate balance of their strengths, limitations, successes, and setbacks.
We suffer when we believe that our story should match some culturally dominant and accepted story, and it doesn’t. Most people try to give the impression that it does. We do our best to emulate celebrities and beauty and success icons. We sometimes succeed at this to varying degrees, but we don’t tend to feel that our story measures up to the ones we’re exposed to in the zeitgeist. No person is fully categorizable. The array of stories with which our culture presents us is limited and doesn’t capture the richness of society or the individuals in it. Narrative Therapy aims to create a story that fits the individual person, along with their unique set of experiences and ascribed meanings, and to let go of attempting to live a socially pre-written story that does not fit.
Externalizing
“The person is the person and the problem is the problem. The person is not the problem.”
Narrative Therapy refrain
Externalizing is the process of helping a person conceptually separate their identity from the problem that brings them into therapy.
The statement “I am depressed” uses the verb “to be” to fuse the person who is speaking with depression. This type of thinking is built in to English and other languages. There are ways of speaking about the problem that have varying degrees of internalization vs externalization of the problem within the person:
“I feel depressed.”
“I am feeling depressed now.”
“There’s a depression.”
“Depression is visiting.”
In the past it was more common to say, “I am a manic depressive.” It appears to me that such statements are more cringeworthy today because more people understand that they oversimplify, pathologize, and dehumanize a person by fusing a problem with a person’s identity, rather than keeping a respectful separation between the person and the problem.
Instead many people today are more likely to say something like, “I struggle with depression.”
The traditional medical model of mental health tends to internalize problems by diagnosing people. It is also said to “individualize” problems within a person by labeling them as having a “disorder” or mental illness that is not dependent on the person’s context, and tends to be conceptualized as a biological issue. Narrative Therapists tend to not endorse the medical model, which they see as disempowering and sometimes oppressive to the client.
Externalizing is helpful because it gives us more options. If the goal is to reduce or eliminate a problem, and if we identify with the problem, then the only way to meet the goal is to reduce or eliminate ourselves. This is, of course, a double bind: keep the problem or lose ourselves. But if we are able to separate the problem from our identity, the double bind is resolved. We can eliminate the problem while retaining our own identity.
It may seem at first that externalizing could lead to a denial or abdication of responsibility. If we separate ourselves from the problem, then perhaps we won’t take it seriously. But externalizing also involves discussion about the ways that we assist and help the problem. Perhaps we help the depression by indulging in unhelpful, negative thoughts instead of doing something productive. Maybe we help the arguing by not taking our time to cool down and respond rather than react. By seeing the problem as separate from ourselves, we have choice to either help or hinder it, and so our responsibility becomes more apparent. We also have the responsibility because the problem has a negative impact on our life, and because it is our life, it is incumbent upon us to protect and safeguard it.
In narrative therapy you might be asked questions about the influence of the problem in your life, or the strategies and behaviors of the problem, for example, “tell me about how the depression began in your life” or even, “what does the depression want?” or “how does depression trick you into staying in bed” and “what is its life-support system?”
Externalizing has an analogy in mindfulness-based approaches to therapy. In mindfulness, we attempt to “get distance” from our experience, such as distressing thoughts and feelings. We become the observer by placing our attention on the “objects of awareness”, which includes our narratives of ourselves and the presenting problem of therapy. Externalizing is Narrative Therapy’s way of creating space between the person and the problem, placing the person in a position of witnessing the problem, rather than being “fused” (a term from ACT) with the problem and thus unable to see it clearly or change it.
The influence and functioning of the problem
At the outset of therapy, problematic moments are at the forefront of people’s minds: the times when conflicts erupted in yelling and hurt feelings, when addiction caused us to drink too much, or when fear caused us to forgo a special opportunity, etc. Initially it is important to hear some of these stories in order for the therapist to better understand the problem, and to help the client map out the influence of the problem, the problem’s functioning, and the problem’s “life support system” (including other problems).
The life support system of a problem can be any contextual factor that increases the strength of, and likelihood of, the main problem manifesting and being successful. For example, anger might be supported by hunger or anxiety. Depression might be supported by shame or powerlessness. Which problem is primary and which are support problems is socially constructed, and depends on the metaphors, language, and perspectives that are cocreated by the client, including in therapy.
The problem effects are ways that the problem creates pain and undesirable situations for the client and others in the client’s life. Depression’s effects might be described by one client as “robbing them of their life” or “putting a wedge between” them and others. The effect of fear might be creating isolation by either avoiding or overwhelming others. The possibilities for describing problem effects are virtually endless and will be mapped out according to the client’s experience.
Exploring the effects of the problem is also a way to create motivation for change. When people see the problem as a part of themselves, they often feel shame and guilt around creating the effects of the problem themselves. But once some distance is created between themselves and the problem, they can visualize the problem as a separate entity that does not have their best interests in mind, or the interests of their families and friends. From there they can align with their own support system against the problem, with the goal of eliminating the effects of the problem. This is essentially the therapy goal for that person.
Problem effects can also be projected into the future, for example by speculating what will happen if depression is allowed to continue indefinitely without being stopped. This way imagination is invoked to look at a future direction to not aim for. My sense is that it is important to balance out these inquiries by also visualizing the direction to aim for, by exploring what life could look like in the future (near and distant) after the problem is eliminated or reduced to a satisfying extent. I think we do tend to create what we focus on, so emphasizing what we want, rather than what we don’t want, is important. So, I think it can be helpful in smaller doses to imagine what we don’t want as a motivation orient elsewhere.
Re-authoring
“Be careful which stories you tell about yourself, because we tend to live those stories.”
Narrative Therapy saying
Re-authoring is the central process of Narrative Therapy. Essentially, we are examining a story of ourselves and our life and modifying it based on a more thorough examination of actual events and forgotten events, as well as the subjective and largely arbitrary nature of social meaning-making.
In Narrative Therapy it is assumed from the outset that the person seeking help is oriented primarily by what might be called the dominant narrative. The term dominant narrative is basically synonymous with the story of the problem or the problem-saturated story.
The aim of Narrative Therapy is to build up the subordinate narrative, which initially is the story of the person.
The objective here is not to spin falsehoods or prop up the ego based on flimsy evidence or denial. It is actually to deconstruct problem-saturated narratives that are based on flimsy evidence, or evidence that has been amplified disproportionately relative to more life-enhancing evidence.
Narrative Therapy texts I’ve read don’t tend to cite research from cognitive science, but I believe that the problem-saturated story is common and possible due to cognitive biases such as selective attention, loss-aversion bias, memory bias, and many others. Our memory of our lives is actually a very incomplete approximation of what we’ve been through. When we access memory, we don’t reach into the past, but instead construct a model of past events based on bits of stored information that are modified with each memory recall. We also don’t initially store those bits of information in an unbiased or neutral way. A lot could be said here, but in short, Narrative Therapy is, I think, similar to Cognitive Behavioral Therapy, in that it is an attempt to correct distorted meaning-making. The difference, however, is that CBT tends to take the stance that the more positive truth is more objective whereas in Narrative Therapy it is assumed that the truth is subjective and meaning is what we want it to be. In my own work I fall in the middle of these two lenses (modern and postmodern), seeing truth as a combination of the objective and the subjective.
Unique Outcomes
Multiple narratives are possible because of the fact that the human mind does not faithfully store and make perfect sense of reality, which is infinitely complex. We selectively remember and focus on certain events and meanings while forgetting other events and possible meanings. We do this at a biological level to save energy, as the the reality perception and sensemaking that we do is already a process that is heavy in cognition and thus metabolically and neurologically expensive.
A unique outcome is one of the forgotten events that runs counter to the dominant, problem-saturated narrative in a person’s life. For example, if the problem being addressed was depression, a unique outcome could be a time when we felt joyful, alive, and lived with purpose. If the problem was anxiety, a unique outcome would be a time when we felt deeply peaceful and at ease.
Exploring unique outcomes intertwines with externalizing, since a unique outcome is an instance of the person being, for a moment, present, when the problem was absent. Remembering and amplifying unique outcomes is an exercise in getting distance from the problem so that we can change our behavior and thinking to decrease or eliminate the problem.
Unique outcomes can also show up in the present moment in therapy. For example, someone who has difficulty with trust may share deeply and vulnerably. Or a person who has trouble with confrontation may exercise assertiveness. This is also called immediacy in other theoretical orientations such as humanistic or experiential therapy. Group therapy is an especially rich setting for unique outcomes to play out in real time, and may be in fact the most powerful mechanism through which change occurs in individual or group therapy.
Unique outcomes can even be imagined and projected into the future. For example, the therapist might ask “how do you think next weekend will go now that you’re feeling more confident?” This question essentially elicits a visualization of a preferred scenario, which can increase its likelihood of occurring.
Landscapes of action and identity
Unique outcomes are first told in the landscape of action, which is a timeline of a person’s life along which events occur. Graduating from college, handling a tough situation well, or setting a personal best in a sport would all be examples of events in the landscape of action. The landscape of identity is the sensemaking that we do with those events, from which we derive our self-image and our narratives of the world and others, and our relationships to them. For example, the above events could be interpreted as signifying that we are someone who works hard, doesn’t run from adversity, or cares about our future. There are virtually infinite conclusions we could make from the same set of events. So, Narrative Therapy assists in both remembering events that have been filtered out through memory biases, and also ascribing healthier and more life-enhancing meaning to those events.
Stories have both events and meanings. In the story of the Three Little Pigs, the events are that a wolf could blow down 2 houses but not the 3rd house. Those are the landscape of action. If that was all there was to the story, we probably wouldn’t be telling it anymore. But the meaning is that the 3rd little pig had a work ethic and forward-thinking approach and that turned out well for him and for his friends. That meaning teaches kids the value of effort, planning, and delayed gratification. That is the landscape of identity, which I think could also be called the landscape of meaning. We might note that multiple interpretations of the same story are possible. For example, one could derive either “work hard and plan” or “make hard-working friends” from the story of the Three Little Pigs.
The stories of our lives similarly have these two parallel landscapes: what we do and happens to us, and what we conclude from that. Often people are in therapy because they’ve forgotten a lot of the good things that they’ve done and that have happened to them, and they’ve also ascribed unhelpful meanings to the events and actions that they do tend to recall.
Re-membering
Re-membering has the double meaning from the two words “remember” as well as “membership”. Re-membering is essentially re-authoring with the help of other people, whether those people are directly giving input, or their input is being speculated by those who are available. People in our lives can be thought of as members of a particular club, and that membership sometimes needs to be adjusted, with some people taking on larger or smaller roles or being brought in or removed, depending on the goals and needs of the person and the path taken to reduce the problem. Re-membering could be asking the client what they think a certain supportive person would think about an event and what it says about the client’s identity and character. It could also be inviting another person or people to attend a session to give their input firsthand.
Emotion in Narrative Therapy
What makes a story a story, rather than a dry data set of factual events and conclusions, is the emotion that it brings up. Narrative therapy can, and should, incorporate affective/emotional experiences in order to create enduring changes. When remembering problematic moments or unique outcomes, it is helpful to explore the emotions that arise in the session, as well as where the emotion is felt in the body.
Narrative Therapy has been criticized as being an overly cognitive process, which can lead to an intellectual-only understanding and lack the emotional and whole-body activation needed for lasting change. But I believe that Narrative Therapy can be applied in a deep and impactful way, especially when it is integrated with other theoretical orientations, such as relational therapy and emotion-focused therapy. Like dancing, which can be executed mechanically (often while one is learning) and with soul, Narrative Therapy can involve varying proportions of intellect and heart.
References
- Matigan, S. (2012). Narrative Therapy (Theories of Psychotherapy)
- Morgan, A.(2000). What is Narrative Therapy
- White, M.(2007). Maps of Narrative Practice
- White, M. (1990). Narrative Means to Therapeutic Ends
- Zimmerman, J (2018). Neuro-Narrative Therapy: New Possibilities for Emotion-Filled Conversations