Harlene Anderson, Ph.D.
Postmodern-Social
Construction Collaborative Practices:
Creating Successful Relationships, Conversations & Possibilities
Harlene Anderson: Selected Writings
POSTMODERN SOCIAL CONSTRUCTION THERAPIES (Draft)
Harlene
Anderson, Ph.D.
Family therapy as we know it
today can be traced back to two main roots. One perspective—the etiology,
insight, and family patterns view of Nathan Ackerman—focused on the
individual in the family and viewed families as a collection of individuals.
Coming from within the child guidance movement and drawing from psychodynamic
and social theories, Ackerman was interested in family role relationships
and their influence on the intrapsychic
development and make-up of the individual (Ackerman, 1958, 1966).
The other perspective, the rhetorical communication and interactional
view, grew from the early works of Donald Jackson and Gregory Bateson
and their later collaborative efforts with interdisciplinary colleagues
at the Mental Research Institute in
During these years the world
around us was fast changing, shrinking, becoming enormously more complex
and uncertain and was impacting human beings and our everyday lives.
Familiar concepts such as universal truths, knowledge and knower as
independent, language as representative, and the meaning is in the
word no longer seemed helpful in accounting for and dealing with the
changes and complexities and their associated impact. The familiar
systems concepts, whether first- or second-order, did not help either.
Such concepts risked placing human behavior into frameworks of understanding
that seduced therapists into hierarchical expert-nonexpert
structures, into discourses of pathology and dysfunction, and into
a world of the known and certain. Among developments in philosophy
and the natural and social sciences, postmodernism and social constructionism
have emerged as more fitting, offering alternative ways to think of
people and their problems and therapists’ relationship to both.
Broadly speaking,
postmodern refers to a family of concepts that critically challenge
the certainty of objective truths, the relevance of universal or meta-narratives,
and language as representative of the truth (Lyotard, 1984; Kvale, 1992[ETS2]). Postmodernism
is not a meta-narrative, but rather one among numerous others. Inherent
in postmodernism is a self-critique of postmodernism itself; that
is, it invites and demands continued analysis of its premises and
their applications. Social construction, a particular postmodern theory,
places emphasis on truth, reality, and knowledge as socially embedded
and the role that language plays in the creation of these products.
According to the foremost proponent of social constructionism,
social psychologist Kenneth Gergen (1982,
1985, 1994[ETS3], 1999), it
is “...principally concerned with explicating the processes by which
people come to describe, explain, or otherwise account for the world
(including themselves) in which they live ” (1985, p. 266).
Language emerged
as the meaningful and useful metaphor, especially its role in the
creation of knowledge, the power of discourse and transformation,
and its role in human systems and interaction. This ideological and
epistemological shift holds significant implications and challenges
for therapists’ thoughts, actions, and interpretations of others.
It offers a broad challenge to the culture, traditions, and practices
of the helping professions. It invites reexamination and reimagination
of psychotherapy traditions and the practices that flow from them,
including: how problems are conceptualized, client-therapist relationships,
the process of therapy, and therapists’ expertise. For varying reasons,
a focus away from the family as the limited target of treatment is
inherent in this shift. Instead, the postmodern/social construction
ideology-informed approaches are not limited to families but are applicable
to individuals, couples, families and groups. In the words of family
therapist historian Lynn
Hoffman (2002), [ETS4]the shift
changed the definition of what needs to be changed: The target has
moved from the unit to the situation. Problems are not believed to
reside within the person, the family, or the larger system. Instead,
problems are considered as linguistic constructions, with various
punctuations such as the local dialogical context and process of people’s
everyday lives and the subjugating and oppressing influence of dominant
universal narratives. Thus, the aim of the therapist has changed:
to set a context and facilitate a process for change, rather than
to change a person or group of people.
Common Premises
Postmodern
social construction premises influence a dialogical and relational
perspective on understanding human behavior, including the dilemmas
of everyday life and a therapist’s stance regarding these. Although
there are significant variations among the postmodern social construction
therapies, generally speaking, some common basic premises (although
with slight variations and differences in emphasis) include:
- The notion of objective discoverable knowledge and
universal absolute truths is viewed skeptically.
- The world, our truths, is not out there waiting
to be discovered.
- Knowledge and social realities are linguistically
and communally constructed; reality, therefore is a multiverse.
- Language is the vehicle through which people know
and attribute meaning to their world, including realities about
the people, events, and experiences of their lives. Neither problems
nor solutions exist within a person or a family; they take shape
and have meaning within a relational and dialogical context.
- The goal of therapy is to create a relational and
dialogical context for transformation.
- Transformation--outcomes and solutions--is inherent
and emerges in dialogue.
- Transformation is unique to the client and the participants
in the therapy conversation and therefore cannot be predetermined
ahead of time.
- The person and self, including development and human agency, are viewed as interdependent,
communal, and dialogic entities and processes rather than as isolated
autonomous interior ones.
- People have multiple identities and their Identities
are shaped and reshaped in social interaction.
Common Values
Therapies based on these premises
share common values (with slight variations and emphasis):
- Taking a non-pathological, non-judgmental view.
- Appreciating, respecting and utilizing the client’s
reality and uniqueness.
- Using story and narrative metaphors.
- Being collaborative in structure and process.
- Avoiding labeling and blaming classifications of
individuals and families, or their behaviors.
- Being more “public” or “transparent” with information
and biases.
More so than
others, the postmodern/social construction therapies have captured
practitioners’ interest in learning about the effectiveness of their
therapy in their everyday settings (Andersen, 1997a; Anderson, 1997b). [ETS5]This interest
has created a number of studies that provide in-depth first-person
descriptions of the lived experience of therapy processes and the
nuances of its effectiveness, or lack of, from both therapists and
clients’ perspectives. What is learned from the “insiders” can have
relevancy to both current and future practices and yields a more thorough
story of the nuances of therapy than can be captured in “outsider”
qualitative research. Together these efforts join other family therapy
approaches at the forefront of promoting multiple alternative research
methodologies, particularly those categorized as qualitative such
as single case studies, ethnographic interviews and narrative accounts
(see
A growing
number of therapists place their practice under a postmodern/social
construction umbrella or are heavily influenced by it. The author
chose to discuss three therapies in this chapter: the collaborative
approach of Harlene Anderson and Harry Goolishian
(Anderson & Goolishian, 1988, 1992; Anderson, 1997a)[ETS7], the narrative
approach of David Epston and Michael White
(White & Epston, 1990; White, 1995), [ETS8]and the solution-focused
approach of Insoo Berg and Steve DeShazer (de Shazer, 1985,
1988, 1991; Berg & de Shazer, 1993). [ETS9]This choice
was made because these three therapies are often the core therapies
that are typically found in graduate and postgraduate family therapy
courses with titles such as postmodern/social construction, advanced
systems, and narrative therapies. Other significant contributors to
the emergence of postmodern social construction practices included
in these courses who must be acknowledged are Tom Andersen in Norway,
and Lynn Hoffman and Peggy Penn in the United States (Andersen, 1987, 1991; Hoffman 1981, 1998, 2002;
Penn, 1985, 2001; Penn & Frankfurt, 1994[ETS10], and Jaakko Seikkula in Finland 1993,
2002). Although each of the above approaches is historically or currently
influenced by the postmodern social construction perspectives to various
extents, they are not necessarily limited to these influences and
their originators might make different theoretical and practice applications
punctuations than this author.[i]
Some Distinctions
Comparing and contrasting can be helpful in learning. A reader,
therefore, might want to do this as they read along. In doing so they
might note these distinctions among the three approaches regarding
power, client-therapist relationships, the therapist’s role, and the
process of therapy.
- Collaborative and Narrative therapies place importance
on power. Similarly, they value client-therapist relationships and
systems that are more egalitarian and less hierarchical; they are
careful to be respectively, public and transparent about their views
and biases. Dissimilarly, Narrative Therapy holds an agenda to liberate
people from constraining or oppressive dominant narratives; Collaborative
therapists pay attention to these narratives when the client thinks
it is important; and Solution-Focused therapists do not find the
issue relevant.
- Collaborative and Narrative therapies place emphasis
on the client-therapist relationship, although perhaps a different
emphasis; Solution-Focused therapies do not accent the relationship.
- Therapists’ expertise can be thought of as along
a continuum in terms of importance and intent. Collaborative therapists
espouse that the clients are the experts on their lives and the
therapist is in a not-knowing position regarding it. Narrative therapists
are experts in helping clients achieve preferred stories and living
them, and Solution-Focused therapists use their expertise in strategies
toward goals.
- Collaborative therapists favor a process of mutual
inquiry and are not invested in a content outcome; they view themselves
as walking along side their client toward an unknown destination
of new meaning and action. Narrative therapists favor a process
that leads to preferred stories and people being able to live these;
their role is like a narrative editor. Solution-Focused therapists
overtly steer clients toward solution-talk and a specified behavioral
goal.
- Observers might notice a Narrative or Solution-Focused
therapist systematically, for instance, ask questions and make comments
as if moving the conversation in a particular direction; whereas,
a Collaborative therapist might be described as wandering here and
there.
Collaborative Therapy
History and Background: A Search
The Collaborative Approach evolved from the twenty-year mutual
work of Harlene Anderson and Harry Goolishian
and their colleagues and students, beginning in the early 1970s within
the context of a medical school and later in what is now the Houston
Galveston Institute. Its roots can be traced back to Goolishian’s
participation in the early Multiple Impact Therapy (MIT) family therapy
research project at the medical school (McGregor, Ritchie, Serrano,
Schuster, McDanald & Goolishian,
1964). Quite innovative at the time, the theory used to describe and
understand the MIT practice was limited by the psychodynamic, psychoanalytic,
and developmental theories available at that time. Soon deciding that
these theories could not provide adequate descriptions of their clients
and their experiences of therapy, Goolishian and his colleagues began what became a continuous
search for new theoretical tools. Now, the stage was set for the important
reflexive process of the interaction of practice and theory. That
is, new practices led to new theories that influenced the practices,
which in turn began to require new theories, and so forth. This early
interest was influenced by the voices of clients and therapists–their
experiences, descriptions, and understandings of successful and unsuccessful
therapy— and has remained an important thread throughout the development
of the Collaborative Approach.
Major Theoretical Constructs: Human
Systems as Linguistic Systems
As
Anderson and Goolishian and their colleagues
searched for new descriptions and understandings, they went down a
meandering path to revolutions in the social, natural, and physical
sciences, philosophy, and eventually to the postmodern philosophical
movement and the works of thinkers such as (Bakhtin, 1981; Bruner,
1986, 1990; Geertz,
1983; Gergen, 1985; Lyotard,
1984; Rorty, 1979; Schon,
1984; Shotter, 1993; Vygotsky, L.S.,
1986; and Wittgenstein, 1953
who focused on the relational and generative nature of knowledge and
language.. Anderson and Goolishian found contemporary hermeneutics and social constructionism primarily relevant: the concepts of a socially
constructed world of truths and knowledge, language as the vehicle
and product of human interchange, understanding as an interpretive
process, and language as generative. These concepts took their interests
in language, which had been inspired by the work of Bateson
and his colleagues at the Mental Research Institute in Palo Alto,
California, away from learning clients’ language toward using it in
a strategic sense and away from systems theories and in a different
direction.
Specifically,
knowledge--what we think we know or might know--is linguistically
constructed. Furthermore, its development and transformation is a
communal process, and the knower and knowledge are interdependent.
Knowledge, therefore, is neither static nor discoverable; rather,
it is fluid and created. Authoritative discourses from this perspective
give way to knowledge constructed on the local level that has practical
relevance for the participants involved. Language in this perspective—spoken
and unspoken communication or expression—is the primary vehicle through
which we construct and make sense of our world and ourselves. As philosopher
Richard Rorty (1979) suggests, language
does not mirror what is; for instance, it is not an outward description
of an internal process and does not describe accurately what actually
happened. Rather, language allows a description of what happened and
an attribution of meaning to it. Language gains its meaning and its
value through its use. Thus, it limits and shapes thoughts and experiences
and expressions of them. What is created in and through language (realities
such as knowledge, truth, and meaning) is multi-authored among a community
of persons. That is, the reality that we attribute to the events,
experiences, and people in our lives does not exist in the thing itself;
rather, it is a socially constructed attribution that is created within
a particular culture and is shaped and reshaped in language. What
is created, therefore, is only one of multiple perspectives (realities
such as narratives or possibilities).[ii] Language, therefore, is fluid and creative.
Combined,
these perspectives influenced Anderson and Goolishian
to move away from the familiar, general, and second-order cybernetic
systems notions on which family therapy had been based to the notion
of human beings as systems in language or language systems (Anderson
& Goolishian, 1988). Human systems are
meaning-making systems. Therapy becomes one kind of language or meaning-making
system. Originally, Anderson and Goolishian
referred to their work as a Collaborative Language Systems Approach
and more recently .
Etiology of Clinical Problems
A Collaborative
therapist takes the position that there is no such thing as an objective
problem. Problems are a form of co-evolved meaning that exists in
ongoing communication among others and self. Through our interpretations
we attribute meaning to others, events, actions, and ourselves. Problems
cannot be separated from an observer’s conceptualizations.
Problems are
considered part of everyday living; they are not considered the product
of pathological individuals or dysfunctional families. What is problematic
to one person or family may not be problematic to another: “Each problem
is conceived as a unique set of events or experiences that has meaning
only in the context of the social exchange in which it happened” (
Assessment
Traditional notions of diagnosis and assessment are based on
the idea of objective reality, commonality across problems, and linear
cause and effect. Inherent in the notion of assessment is a determination
of what is: A problem can be defined, its cause can be located,
and it can be solved. From a collaborative perspective each observation,
problem description, and understanding is unique to the people involved
and their context. Problems are collaboratively explored and defined
through conversation. Because conversation or dialogue is generative,
a problem is never fixed; it shifts as its definitions, meanings,
and shapes change over time through conversation.
Although collaborative therapists seldom find traditional notions
of diagnosis and assessment useful, they acknowledge that they and
their clients live and work in systems in which these are important.
This is simply a challenge for therapists to respect, be in conversation
with, and navigate multiple realities. In other words, it is a challenge
to be true to one’s beliefs and act accordingly whatever the situation
or context.
Clinical Change Mechanisms and Curative Factors: Collaborative
Relationships and Dialogical Conversations
Therapy is a process or activity that involves
collaborative relationships and dialogical conversations. It is a
process of coexploring, clarifying, and
expanding the familiar; therapy invites and forms the “unsaid:” the
newness. Although newness in some form or another—stories, self-identities,
etc—can be the result, the emphasis of therapy is on this process,
not on content or product. Collaborative therapists strive to be aware
of this essentialist trap.
Dialogical conversation is distinguished by shared inquiry.
Shared inquiry is the mutual process in which participants are in
a fluid mode and is characterized by people talking with
each other as they seek understanding and generate meanings; it is
an in-there-together, two-way, give-and-take, back-and-forth exchange
(Anderson Anderson
& Goolishian, 1988; Anderson, 1997[ETS12],
1997a). Dialogical conversation begins
with the therapist as a learner whose interest and curiosity about
the client naturally invites the client into shared inquiry. This
shift and the interpretive process of shared inquiry are transformational
processes.
Language is
the primary vehicle for therapy. Transformation (e.g. new knowledge,
meanings, expertise, identities, agency, actions, and futures) is
inherent in the inventive and creative aspects of language, and therefore,
dialogue: “In dialogue, new meaning is under constant evolution and
no ‘problem’ will exist forever. In time all problems will dissolve”
(Anderson & Goolishian, 1988 p. 379). This transformative nature of language
invites a view of human beings as resilient, and it invites an appreciation
of each person’s contributions and potentials.
Specific Interventions: A Philosophical Stance
Like most
other postmodern/social construction oriented therapies, Collaborative
Therapy does not consider the therapist’s position or actions as techniques.
Anderson and Goolishian (1988) distinguished
their work as a philosophy of therapy rather than a theory or model.
For them, philosophy involves questions and ongoing analysis about
ordinary human life such as self-identity, relationships, mind, and
knowledge. Their conceptualizations of knowledge and language inform
a worldview or philosophical
stance-a way of being in the world that does not separate professional
and personal. The stance characterizes a way of thinking about, experiencing,
being in relationship with, talking with, acting with, and responding
with the people therapists meet in therapy. Several interrelated characteristics
partly define the stance.
Conversational Partners. The collaborative
therapist and client become conversational partners as they engage
in dialogical conversations
and collaborative relationships. Dialogical
conversation and collaborative relationship refer to the shared inquiry
process in which people talk with
each other rather than to
each other. Inviting this kind of partnership requires that the client’s
story take center stage. It requires that the therapist constantly
learn—listening and trying to understand the client from the client’s
perspective.
This
therapist learning position acts to spontaneously engage the client
as a co-learner or what collaborative therapists refer to as a mutual
or shared inquiry as they co-explore the familiar and co-develop the
new. In this inquiry, the client’s story is told in a way that it
clarifies, expands, and shifts. Whatever newness created is co-constructed
from within the conversation in contrast to being imported from outside
of it. In this kind of conversation and relationship all members have
a sense of belonging. Collaborative
therapists report that this sense of belonging invites participation
and shared responsibility (Anderson
Client as Expert. The collaborative therapist
believes that the client is the expert on his or her life and as such
is the therapist’s teacher (Anderson, 1997b;
Anderson
&Goolishian, 1992)teacher.
The therapist respects and honors the client’s story, listens to hear
what is important for the client, and takes seriously what the client
says and how they say it. This includes any and all knowledge; for
instance, whether dominant cultural discourse or popular folklore
informs the client’s descriptions and interpretations, and it includes
the many ways that the client may express his or her knowledge. For
instance, the therapist does not hold expectations that a story should
unfold in a chronological order or at a certain pace. The therapist
does not expect certain answers and does not judge whether an answer
is direct or indirect, right or wrong. Tom Andersen (1991)
[ETS13]suggests just
how challenging it is to respect the client’s expertise, “...what
I myself found important, but extremely difficult, to do was to try
to listen to what clients say instead of making up meaning about what
they say. Just listen to what they say” (p. 321). Inherent in this
approach is an appreciative belief that most human beings value, want,
and strive towards healthy successful relationships and qualities
of life.
Collaborative
therapists often work with members of clients’ personal or professional
systems. The therapist appreciates, respects, and values each voice and their reality and strives to understand
the multiple and unique understandings from each member’s perspectives:
the richness of these differences are found to hold infinite possibilities.
Not-Knowing. The collaborative
therapist is a not-knowing therapist. Not-knowing refers to the way
the therapist thinks about and positions themselves with their knowledge
and expertise. They do not believe they have superior knowledge or
hold a monopoly on the truth. They offer what they know or think they
might know but always hold it and present it in a tentative manner.
That is, therapists offer their voice, including previous knowledge,
questions, comments, opinions, and suggestions as food for thought
and dialogue. Therapists remain willing and able to have their knowledge
(including professional and personal values and biases) questioned,
ignored, and changed.
Not-knowing
can be misunderstood as a therapist knowing nothing, pretending ignorance,
or forgetting what they have learned. Instead, it simply refers to
how therapists position themselves with their knowledge, including
the timing and the intent with which knowledge is introduced.
Being Public. Therapists
often learn to operate from invisible private thoughts—whether professionally,
personally, theoretically, or experientially informed. Such therapist
thoughts include diagnoses, judgments, or hypotheses about the client
that influence how they listen and hear and that form and guide their
questions. From a collaborative stance, therapists are open and make
their invisible thoughts visible. They do not operate or try to guide
the therapy from private thoughts. For instance, if a therapist has
an idea or opinion it is shared with the client, again offered as
food for thought and dialogue. Important are the manner, attitude,
and timing in which therapists offer opinions, not whether they can
or cannot share them. Keeping therapists’ thoughts public minimizes
the risk of therapist and therapist-client monologue—being occupied
by one idea about a person or situation. Monologue can subsequently
lead to a therapist’s participating in, creating, or maintaining external
descriptions of clients such as ‘resistance’ and ‘denial.’
Mutual Transformation.
The therapist is not an expert agent of change;
that is, a therapist does not change another person. Rather the therapist’s
expertise is in creating a space and facilitating a process for dialogical
conversations and collaborative relationships. When involved in this
kind of process, both client and therapist are shaped and reshaped—transformed--as
they work together.
Uncertainty. Being a collaborative therapist invites and entails uncertainty. When a therapist accompanies a client on a journey and walks alongside them, the newness (e.g. solutions, resolutions, and outcomes) develops from within the local conversation, is mutually created, and is uniquely tailored to the person or persons involved. How transformation occurs and what it looks like will vary from client to client, from therapist to therapist, and from situation to situation. Put simply, there is no way to know for sure the direction in which the story will unfold or the outcome of therapy when involved in a generative process of dialogical conversation and collaborative relationship.
Everyday Ordinary Life. Therapy from
a collaborative perspective becomes less hierarchical and dualistic.
It resembles the everyday ordinary conversations and relationships
that most people prefer. This does not mean chitchat, without agenda,
or a friendship. Therapy conversations and relationships occur within
a particular context and have an agenda: simply, a client wants help
and a therapist wants to help. Clients and problems are not categorized
as challenging or difficult. Collaborative therapists believe that
each client presents a dilemma of everyday ordinary life.
If
a therapist assumes the described philosophical stance, they will
naturally and spontaneously act and talk in ways that create a space
for and invite conversations and relationships where clients and therapists
connect, collaborate, and construct with each other. Because the philosophical stance becomes
a natural and spontaneous way of being as a therapist, there are no
therapist techniques and skills as we know them. The stance is unique
for each therapist and for each client and situation they encounter.
Effectiveness of
Approach: Who Decides?
Collaborative
Therapy contrasts with therapy approaches in which professional knowledge
externally defines problems, solutions, outcomes, and success--creating
expert-nonexpert dichotomies. Collaborative therapists believe that
one must ask the client to determine whether therapy was useful, and
if so how. Although therapists' experiences and opinions are valued,
every effort is made to privilege clients' perceptions and evaluations
of therapy and to pay attention to what therapists can learn from
them. Research, so to speak, becomes part of everyday practice, with
therapists and clients as co-researchers during the process of therapy,
as well as at its conclusion (Andersen,
1997; Anderson, 1997a). Findings are used during the therapy
process to make therapy more useful to the client and, of course,
influence the further evolution of ideas and practices (see Andersen, 1997[ETS14]).
The
strengths of the approach are in the relationships and conversations
that are created between the client and the therapist and in their
inherent possibilities. Consequently, therapy becomes less hierarchical
and dualistic, less technical and instrumental, and more of an insider
rather than an outsider endeavor. Clients report a sense of ownership,
belonging, and shared responsibility. Therapists report an increased
sense of appreciation for their clients, sense of enthusiasm, and
sense of competency, creativity, flexibility, and hopefulness for
their work. They also report a reduction in burnout.
Most evidence
of the effectiveness of Collaborative Therapy is anecdotal: client
and therapist stories about their experiences of therapy and the usefulness
of the approach for them are included, for instance, in articles on
child abuse and other types of domestic violence, eating disorders,
and substance
abuse, war trauma (Anderson, 1997a; Anderson
& Levin, 1998; Anderson, Burney & Levin, 1999; Anderson
& Creson, 2002); Chang,
1999; London, Ruiz, Gargollo
& MC, 1998; St. George & Wulff,
1999 ; Swim, Helms, Plotkin & Bettye,
1998)[ETS15]. As in Narrative
Therapy it is not unusual for therapists to invite clients to participate
in writing and professional presentations
(London, Ruiz, Gargollo & MC[ETS16], 1998; Swim, Helms, Plotkin & Bettye, 1998[ETS17]). Qualitative
research includes studies of the effectiveness of Collaborative Therapy
and analysis of whether therapists’ behaviors and attitudes were consistent
with their therapy philosophy (Gehart-Brooks
& Lyle, 1999; Swint, 1995), and the
application of the ideas in supervision and education (St. George,
1994).
The
history of its development also supports its effectiveness. The collaborative
approach evolved in practice settings with a variety of challenging
clients. These include chronic treatment failures and patients in
outpatient and inpatient psychiatric settings and later with public
agency clients such as children’s protective services, women’s shelters,
and adult and juvenile probation who were often mandated for therapy
and from various cultures (Anderson, 1991; Anderson & Goolishian, 1986, 1991; Anderson
& Levin, 1998 ; Levin, Reese, Raser,
Niles, 1986). [ETS18]Finnish
psychologist Jaakko Sekkula
and his colleagues have aptly demonstrated effectiveness of a dialogue
approach through a research project with a five-year follow-up with
psychotic patients and their families (Seikkula,
1993; Seikkula, Aaltonen, Alakare, Haarakangas, Keranen & Sutela, 1995). [ETS19]
Often asked questions
about the effectiveness of the collaborative approach include: (1)
“What are its limits?;” and (2) “It sounds so cognitive, how does
it work with people who are not so verbal or bright or who are psychotic?”
When limits are experienced, the therapist creates the limits, not
the client or the kind or severity of their problem. Therapist-created
limits are usually associated with slipping out of a collaborative
mode. When clients are approached from a collaborative perspective,
they talk, they are forth coming, and they are active in addressing
their problem.
Narrative Therapy
Social workers
Michael White at the Dulwich Centre in
Major
Theoretical Constructs: Narrative, Knowledge, and Power
Narrative
therapy is based in a narrative/story metaphor: people make sense
of and give meaning to their lives including the people and events
in it through their narratives, the stories they tell others and themselves
and the stories they are told. That is, narratives or stories about
others and self shape experiences, and thus lives. People’s narratives
are their realities. We are born into the dominant narratives or discourses
of our unique cultures that are created by the culture’s power brokers.
These dominant discourses, or truths, influence local and personal
narratives, affect the words we use and the knowledge we have, and
become internalized truths. The lived experience of the person becomes
lost or subjugated to the dominant narratives. Narrative therapy views
problems--their formation and their resolution--from this dominant
narrative perspective.
Based on this
cultural discourse problem formation perspective, narrative therapy
carries a political and social agenda: to help people deconstruct
and liberate themselves from their culture dominated problem stories
and to construct stories about themselves that give more possibilities
to their lives. This applies to therapists as well as clients. Therapists
are also subject to being captives of cultural privileged truths and
imposing them on their clients. To avoid this risk, narrative therapists
examine the influence of larger cultural discourses on their own narratives,
preferred truths, and actions, and they openly disclose, or are transparent
about, their beliefs and biases about problems, therapy, and so forth.
In the development
of narrative therapy, this perspective and agenda were strongly influenced
by the post-structuralism view of the French social philosopher Michel Foucault (1965, 19725,
1984)[ETS22], more so
than by a postmodern perspective. Foucault’s life work was committed
to calling attention to and challenging the taken-for-granted and
often invisible but pervasively influential social, political and
cultural institutional structures and practices in which people live.
Foucault, persuaded by his studies of institutions such as justice-penal
systems and medical-psychiatric systems, believed that the dominant
discourses of these institutions gave power and influence to some
people, usually to those deemed to have expert knowledge, and objectified,
marginalized, or victimized others. This consciousness-raising became
a guiding principle for narrative therapy in relation to the goal
of therapy, the process of therapy, and the position of the therapist.
Narrative therapy’s commitment to social justice and questioning of
power influences outside and inside the therapy room drew many therapists
who shared this commitment to it.
The works
of French literary deconstructionist Jacques Derrida (197892), [ETS23]North American
anthropologist Clifford Geertz
Geertz (19873) and psychologist
Jerome
Bruner (1986) [ETS24]have also
influenced the narrative approach. Derrida’s work focuses on meaning
and its relation to the texts. For Derrida, a text has no one true
meaning. The reader, through reading and interpreting a text, creates
a text and its meaning. It is a linguistic trap to assume that a certain
text exists or that one can search for and find it. Narrative therapists
have also adopted Derrida’s concept of deconstruction: “the critical
analysis of texts . . . how a text is given meaning by its author
or producers” (Smith, Harre, Langenhove, 1995, p. 52[ETS25]). For Epston and White the text analogy “advances the idea that
the stories or narratives that persons live through determine their
interaction and organization, and that the evolution of lives and
relationships occurs through the performance of such stories or narratives”
(White & Epston, 1990, p. 12). [ETS26]Geertz introduced the concept of “context analysis:” an interpretive
process of looking into the meaning of talk and action in their social
and cultural contexts. The analysis gives a local “native” (1983)
[ETS27]understanding,
or a fuller understanding that Geertz referred
to as ‘thick description” (1973). Through these local understandings
access is gained to the human lived experience rather than to normative
objective descriptions, labels and classifications. A common thread
through the works of Foucault, Derrida, and Geertz
is a strong plea to the human sciences to be aware of and not participate
in the entrapping danger of normalization to subjugate and control.
Narrative therapists borrowed from Burner’s narrative theory, including
his ideas about the structure of stories, how people understand and
give meaning to their experiences through them, and how they create
realities for the writer (teller) and the reader (listener).
Combined,
these conceptual works influenced the designation narrative therapy: the way that our narratives, our stories about
others and ourselves shape our experiences, and thus our lives. They
are our realities. And, they influence the mission of a narrative
therapist: to help people deconstruct the stories that guide their
lives, emancipate themselves from limiting or oppressive stories,
and live their preferred stories. The influence of these conceptual
works on the premises and promises of narrative therapy are apparent
in the following sections.
Etiology of Problems
From the narrative
perspective, dominant cultural discourses and institutions influence
the problem stories that people bring to therapy. Discourses of pathology
and causality that exist within our broader social and psychotherapy
cultures are large influences and are easily internalized, inviting
problem-saturated stories. Problem stories effect people’s identities
and generate blame and hopeless feelings. Problems persist because
problem-saturated stories persist. Thoughts and experiences of others
and self become the interpreting and validating lens that fix and
perpetuate the problem story. In the words of Epston and White (1990) [ETS28]“. . . persons
experience problems, for which they frequently seek therapy, when
the narratives in which they are ’storying’
their experience, and/or in which they are having their experiences
’storied’ by others, do not sufficiently represent their lived experience,
and that, in these circumstances, there will be significant aspects
of their lived experience that contradict these dominant narratives”
(p. 14).
A problem
is not inside a person, couple or family; it is not found within family
structures or interaction patterns. Instead, problems are viewed as
external to each person, limiting or oppressing them and other members
of their system. People, therefore, are not blamed for problems.
Assessment
Assessment
assumes that there is something—e.g., a structure, a pattern, a personality,
or a relationship--to evaluate. And, usually embedded in that assumption
is that the something is static. Traditionally, in psychotherapy,
assessment tends to focus on determining the correct diagnosis, which
in turn informs the treatment. Narrative therapists do not use standardized
assessment instruments or focus on quantifiable diagnoses. Narrative
therapists value the local or the native description of the problem.
The person consulting the therapist is the best source of description
of the problem and the best judge of what they want from therapy and
the therapist, and whether the therapy is helpful. Assessment is not
seen as a beginning phase of treatment that determines the goal and
the strategies for reaching that goal. Rather, assessment, or learning
about the problem, is part of the continuous process of telling and
re-telling the story. Narrative therapists are interested in mapping
the impact and effect of the problem on the individual and the family
rather than in finding its cause.
Because narrative
therapists hold assumptions about limiting and oppressing dominant
discourses, they would have ideas about which discourses these might
be as they listen to the client’s narrative. So, part of the assessment
would include determining the discourse in which the client’s problem
is located and the restraints that it poses on the client’s life.
Although, introducing the taken-for-granted or invisible discourse
can be viewed as an intervention, it is also viewed as an opportunity
to assess the client’s response and negotiate understanding.
Clinical Change Mechanisms and Curative Factors
Narrative
therapy is based on the assumption that resolution requires a change
in story or narrative. Narrative therapists want to help people “re-author”
( 19866) [ETS29]their lives
and relationships and to form new identities that liberate them from
limiting and oppressing narratives. Re-authoring involves re-envisioning
both the past and the future. It also requires making the invisible
constraining problem-supporting discourses visible and helping people
“confront the discourses that oppress or limit people as they pursue
their preferred directions in life” (Freedman & Combs, 2000).
The new or alternative story is sometimes called a preferred outcome.
The new story becomes the vehicle for a new self-identity.
The focus
is not on the more usual techniques and goals of therapy such as improving
communication among family members or encouraging people to express
their feelings. Instead, the primary therapist activity is deconstructing
the problem story and its supporting assumptions and on externalizing
the problem. Critical to change is the therapist’s attitude of respectful
confidence in the client and tenacious hope.
Specific Interventions
The preferred
position for a narrative therapist is one that exemplifies a worldview
of a “way of living that supports collaboration, social justice and
local, situated, context-specific knowledge rather than normative
thinking, diagnostic labeling, and generalized (non-contextualized)
’expert’ knowledge” (Freedman and Combs, 2000, p. 345)[ETS30]. This de-centered
therapist position is critical to achieving the mission of narrative
therapy, more so that seeming interventions and techniques.
Whether narrative
therapists describe their work in the language of technique and intervention
varies. For example, some speak of “practices” (Freedman & Combs, 2002, p. 350). [ETS31]Narrative
therapists take several identifiable actions, regardless of what they
call them, to help them achieve their mission to deconstruct the problem
story, liberate people from it, and construct a preferred story. Questions
lead this agenda; that is, narrative therapists ask questions to influence
the emergence of preferred outcomes.
Deconstructing. A therapist asks questions to deconstruct
the problem story—detail it, explore its context—and to reveal the
dominant social, cultural and political practices that have helped
create and maintain the problem. Some therapists refer to the deconstructing
process as unpacking.
Externalizing. A therapist asks questions and makes comments that emphasize the problem as an outside influence on the person rather than as a characteristic or defect inside them or their actions. Externalizing separates the person from the problem and disrupts the idea that problems originate within people. To aid in this separation and to help people renegotiate their relationship with the problem and exercise control over it, the problem is often given a name or personified. Externalizing the problem challenges not only the location of the problem, but also the idea of it as fixed and as a totalizing entity.
Thickening stories. A therapist asks questions that help create fuller descriptions and understandings of the lived experience of the client and that invite new preferred life narratives. Deconstructing, unpacking, and externalizing are part of the thickening process.
Realizing unique outcomes and creating preferred outcomes. Critical aspects of creating external definitions of problems
are what narrative therapists call realizing unique outcomes and creating
preferred outcomes. A therapist asks questions that help elicit unique
outcomes--instances or “sparkling events” that contradict or open
the way for an alternate or preferred story. They identify, highlight,
and reinforce these unique outcomes, inviting and supporting the client
to have power over the problem and his or her life. In addition to
focusing on past and present unique outcomes, a narrative therapist
focuses on future unique and unexpected outcomes. Therapists ask questions,
using their knowledge of the problem story and their imagination to
help the clients construct a preferred or more useful story.
Being transparent. One way of minimizing the power differential between clients and therapists,
narrative therapists offer information about themselves and invite
clients to ask them questions about the their experiences and beliefs.
In the words of Freedman and Combs, “We try to be transparent about our own values, explaining enough about
our situation and our life experience that people can understand us
as people rather than experts or conduits for professional knowledge”
(1996, p. 36).[ETS32]
Reflecting. Using Tom Andersen’s notion of reflecting
process (Andersen,
1995) [ETS33]a therapist
gives a therapy client, a therapy team, or any observers of the therapy
the opportunity to reflect on the conversation while the client and
therapist listen. The reflectors are thought of as one kind of community
of concern (discussed below).
Writing letters. A therapist or team writes letters
as another way of participating in a client’s story, externalizing
the problem, and creating unique outcomes. Letters are most often
written and mailed to a client after a therapy session or at the end
of a course of therapy. Letters are used to show therapists’ recognition
of the client’s situation and to help support and sustain change during
the course of therapy or at its end. A client will then have the letter
to read and re-read long after therapy has concluded. Letters may
take any creative form and their content may vary, all depending on
the clients and their circumstances and what the therapist hopes to
accomplish. Numerous examples of a variety of letters can be found
in White
and Epston’s book[ETS34], Narrative Means to Therapeutic Ends (1990,
pp. 84-187).
Two other
techniques, creating communities of concern and designing definitional
ceremonies, serve as important aids to acknowledging, solidifying,
and sustaining the new story. They create another way of telling and
retelling the story or what Wolfgang
Iser (1978)[ETS35] calls a “performance
of meaning.” They also invite a sense of ownership for the client
and a sense of joint responsibility for all participants.
Creating communities of concern. A therapist invites the client to bring into the conversation, literally or figuratively,