The principles of narrative therapy are anchored in certain ways of viewing the therapeutic interaction as well as the ethics or politics of treatment. The main goal of this approach is to use a narrative filter to revisit particular life experiences (Morgan, 2000). The therapy utilizes several techniques that are aimed at overcoming the problems. Externalising the problem to understand the triggers of the issue is one of the most crucial among them. This allows clients to see themselves outside of the frame and creates a buffer between them and their difficulties (Bradbury, 2020). Narrative therapists use it to analyze and evaluate the situation by putting it into different contexts and elaborating on how it affects personal goals (Bradbury, 2020). Deconstruction is a technique for bringing clarity to a narrative since breaking the story down clarifies the situation and makes it more approachable (Burnham, 2005). The reframing of the story and elicitation of the unique outcomes and possible exceptions bring the narrative into new directions, thus emphasizing the important role of the approach in dealing with various issues (Hedges, 2010). This essay intends to explain the narrative therapy model in the historical context, its critique from a theoretical and personal perspective, and its applicability through a case study.
I am a 47-year-old white female who works part-time at the Adult Eating Disorders Unit as a medical practitioner. In addition, I operate as a professional hypnotherapist in private practice, specializing in Rapid Transformational Therapy (RTT). A component of my job at the Eating Disorders Unit is to work with carers and families once a month during our caregiver’s nights, in addition to providing individual and patient group support. In these settings, we employ the New Maudsley Method, a collaborative approach that asserts that carers and families are experts on their loved ones but may require assistance in developing new skills to be more supportive of them. This became of the reasons for choosing the narrative therapy for the research since it relies on the collaborative approach.
Narrative Therapy in Historical Context
Despite the fact that narrative therapy is a relatively new discovery in the area of family therapy, the concepts and ideas that it is built on have a long history. Narrative therapists rely on their clients’ abilities to construct their own stories. Alfred Korzybski proposed the concept of a linguistic map of the experience of world terrain, which explains the importance of language in narrative theory (Weingarten, 1998). In his thesis, the speaker’s role in giving events significance is stressed. People behave on the basis of language constructions that assist them in navigating the world, according to constructivists. In its present form, narrative therapy is primarily based on the concepts of a wide range of postmodern theorists. Gregory Bateson is one of them, and his ideas about the subjective character of reality and “news of difference” impacted White’s work (Bradbury, 2020). Bateson discovered that many clients needed to be reminded of the changes that occurred as a result of their problem-solving efforts. They may take a fresh look at their own resourcefulness and have a better notion of how to go forward in a more productive way by sharing this “news” (O’Toole and Brewster, 2021). People may choose the preferred experience by distinguishing between different experiences. This became a cornerstone of narrative therapy.
The narrative metaphor was coined by ethnographer Edward Bruner, who demonstrated that individuals tell tales to make sense of their experiences and that these stories have a significant impact on which experiences are chosen to be further articulated and enacted (Morgan, 2000). People’s stories, in other words, enable them to understand themselves and direct their actions. Some of Foucault’s concepts have led White to develop several therapeutic approaches (Hedges, 2010). They were aimed at allowing people to live lives of their own design rather than being constrained by discourses or standards that may or may not be appropriate for them (White et al., 1990). These influences are, of course, more numerous, but the ones described are the most notable instances that have had a significant impact on the historical development of narrative therapy.
Narrative therapy, along with other distinctive branches such as structural family therapy, systemic family therapy, constructivist family therapy, and other schools of family therapy, is recognized as one of the numerous subdivisions of family therapy. While all of these schools of thought have some common aspects, they have a lot of distinctions. Not only is there diversity in the area of family therapy, but there is a significant difference in how people employ narrative metaphors in treatment. Some writers have looked into the impact of postmodern concepts on therapeutic dialogues, while others have looked into the impact of poststructuralist theories (Bradbury, 2020). Other therapists now refer to themselves as discursive therapists, and they share a lot of ideas with critical psychology. People interact differently with certain narrative techniques in the same way that they interact differently with narrative metaphors in therapy (White, 2002). This is the fundamental reason why there is such a wide range of perspectives and methods in the general field of family therapy.
Criticism of Narrative Therapy
One of the key theoretical criticisms of the narrative therapy and adherents of this approach is the assumption that narrative therapy deviated from the systemic interaction and got back to the individual psychology. Privileging individual narrative over some systemic practices has indeed taken place, however, some of the practices are simply invaluable to narrative therapy (Ghavibazou et al., 2022). While, for instance, circular causality can be dismissed in certain cases, the social constructions and team reflections occupy a significant place in the course of the sessions.
In general, not many systemic principles or practices are shared by all family therapy paradigms. Many models and methods, including narrative therapy, consider the nature, meaning, and implications of relational concepts and activities (O’Toole and Brewster, 2021). Strategic interventions, functional hypotheses, and structural intensification are all systemic conceptions that are incongruent with storytelling techniques (White et al., 1990). For instance, there may be possibilities for outside observation, practice, or resumption of talks when interviewing someone. These systemic concepts were developed by narrative therapy and its practitioners.
Many systemic attributes, such as circular questioning, I believe, contribute to effective narrative therapy courses. As a result, the debate over whether narrative therapy is more, less, or ‘not quite’ systemic appears to be a bit nitpicky. It is understandable to account for larger social processes and describe other techniques as more ‘really systemic,’ but that does not make narrative therapy unsystematic. On a personal level, I have abandoned certain systematic practices, retained others, and gained new ones. In addition, through my past experiences, I discovered some new and exciting methods to engage with those who want a more social and involved experience.
Moving on to the more personal perspective, the main critique of narrative therapy goes with linking it to activism. The examination of people’s values, according to White’s ideas about scaffolding discussions, is a vital step toward non-structuralist definitions of identity (White, 2002). Although narrative therapy might be theoretical, it is impossible to envisage any new narrative practice that does not represent ideals like transparency and cooperation (Morgan, 2000). While each model might reflect a unique viewpoint on a problem, the narrative therapy approach encompasses much more. Domestic societies, histories of social conditioning and community, political climates, therapeutic traditions, the power of language, identity creation —few variables are irrelevant in narrative therapy. As a result, narrative therapists tend to place themselves in more aspects of life than therapists of other schools of thought (Ghavibazou et al., 2022). Other approaches simply do not employ political or cultural positioning in the same way as narrative therapists do (Burnham, 2005). It can be said that other models are simply more theory-driven than value-driven.
The role of language in moulding people’s realities is emphasized by narrative theory. The emphasis between doctor and patient in narrative therapy is on making room for the development and coexistence of different points of view (Hedges, 2010). The therapist can form a satisfying relationship with the patient not just with his sickness but also with his life (White, 2002). The case study demonstrates that this is a helpful methodology that can be used for a wide range of patients since the preceding parts dealt with the theoretical underpinnings of this approach.
As a case study, we will consider Isabelle, a client in my private practice who has previously sought treatment for her nutrition and relationship concerns. I pondered whether this technique would provide her the space to comprehend her perspective of herself, examine the issue without judgment or pressure, and redefine her perceptions of herself in order to construct a more desirable tale as I worked with her and learned more about the concepts of narrative therapy. Isabelle’s GRACE includes factors such as her being a white lady who has faced death at an early age. However, it became evident that her age, culture, and immigrant status were all different at the same time. Previously I had experience working with patients with completely different GRACE factors, and that was beneficial in the initial connection with Isabelle. My own background and inherent curiosity probably help to get the attention of the clients and their responsiveness.
The purpose of adopting the genogram was to be honest, and clear about how personal and societal identity influenced it. Furthermore, Isabelle stated that she had never created a genogram before and that she found it to be a great method for better understanding of herself. I was aware that creating a genogram can be beneficial, moreover, it is a fascinating process, which is usually enjoyed by the client as well. The genogram that was generated depicts the link between Isabelle’s family members across the generations. It brought to light generational traumas that damaged family ties. For example, the client’s adversarial relationship with her uncle, as well as her tight relationship with her grandmother, had a significant impact on the family’s overall perspective. We can observe from this genogram that Isabelle’s current situation is influenced by both inherited and psychological variables. Discussing family history and listening to Isabelle’s narrative helped to bring her closer together and reveal the maternal side of the family’s connection.
As she began to talk, it became evident that she and her family had picked certain incidents to construct the story of her “inability to make judgments.” The main goal is to thicken the tale by looking for any evidence that may lead to a new preferred scenario (Ghavibazou et al., 2022). The question “Do you believe your decision to relocate, despite your parents’ and therapist’s opposition, was meant to take care of yourself, determine what you want, and an indication that you are in charge of your own life?” became the most optimal intervention in this scenario. Isabelle was able to investigate how her intention to leave England occurred at a moment when she felt compelled to do something she was not prepared to undertake. She could see that, as an adult, she had taken the decision to relocate to a place where she felt confident and content. This choice was beneficial since it allowed her to build a safer environment for herself, get assistance with relationship and abuse issues, start a business from the ground up, and enjoy spending time with her nan before she died.
The discussion continued, alternating between focusing on a problem-filled scenario, dissecting the story, and attempting to pinpoint the problem. Finally, by taking a step back and assuming the role of a non-specialist, the issue of boredom and loneliness was brought to light. Here, I was able to make another intervention of naming and mapping the problem. This allows researchers to investigate the problem’s influence on a client as well as the client’s impact on the problem (Hardy and Laszloffy, 1995). Isabelle claimed that “I get lost in my thoughts and simply sit around when I am bored… comparing myself to other people who do a lot of activities… I will not strive to alter anything… I would just lie on the bed and think before falling asleep.”
During the sessions, I believed I had built a solid relationship with a client and that narrative therapy would be beneficial to her. When considering what may be altered, one possibility is that the alliance could be strengthened. I recognized Isabelle’s stories, but I did not always listen to her completely. Instead, the emphasis was on identifying and externalizing the problem so that it could be fixed. Although Isabelle responded well to narrative therapy, the Miracle Question was used as a solution-oriented therapy method. It aided Isabelle in considering how she would act if she were not bothered by boredom or loneliness, and it aided her in determining what she needed to do in order to live a more balanced life.
Despite her traumatic experiences, Isabelle was assisted by narrative method’ interventions, including identifying (and then renaming) the situation, thickening the problem, mapping the issue, and assessing. This allowed her to concentrate on her capacity to make decisions that had already benefited her life, as well as her ability to make future ones. Isabelle described feeling a sense of clarity and the capacity to stand up for herself in order to achieve the life she desired throughout the subsequent conversation. She eventually discovered a side job she enjoys and is now able to enjoy her leisure time. Isabelle’s new narrative began to take shape, weaving together positive ideas and deeds from the past and future into a unified narrative. I became more of an editor than a co-author when constructing a new narrative for Isabelle. Following the fundamental tenets of narrative therapy, my purpose was to assist her in making sense of problem behavior, record contradicting facts, and reflect on their significance rather than to sell her conclusions. The patient fits the puzzle pieces together.
The aim of the essay was to introduce narrative theory and therapy as a method that has the potential to give therapists new tools to assist them faced with complex doctor-patient interactions. It looked into the history of narrative therapy as well as its theoretical underpinnings in connection to social notions. We examined the unique role of story therapy in the setting of family therapy, as well as criticisms of this method from a variety of perspectives. In an unexpected and fascinating approach, the narrative physician may create a relationship with the patient’s condition as well as with his life. The case study proved that narrative therapy techniques can and should be used in various contexts and situations and can potentially lead to patients’ benefit. Although I would not say that Isabelle’s therapy was a complete success, the usage of narrative therapy helped her make huge progress. Emphasizing the role of narrative, we could see how the story told by her helped to map the problem.
Narrative therapy empowers people to not only make their own decisions but also to make excellent use of their words. This approach is less concerned with etiology and more concerned with the client’s view of what caused their condition. As a result, narrative therapy aims to give the client a sense of optimism, which can help counteract the despair, low self-image, and lack of energy.
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