Post-Modern Models of Family Therapy University of Guelph Centre for Open Learning and Educational Support William Corrigan, MTS, RMFT Carlton Brown, MSc.,

Post-Modern Modelsof Family Therapy

University of Guelph

Centre for Open Learningand Educational Support

William Corrigan, MTS, RMFT Carlton Brown, MSc., MDiv, RMFTAAMFT Approved Supervisor AAMFT Approved Supervisor(519) 265-3599 (905) [email protected] [email protected]

Day Three

Narrative Therapy

By the end of today

Reflections on day 2Narrative TherapyUse of letters in Narrative TherapyWork on Debate for Day 5

Day 2 Reflections (9:00 – 9:30)

Reflecting and dialogue can create new meanings: What was Day 2 like for you? What did you like/enjoy that you want to see/do

more of? What are you most curious about? On a scale from 0 – 10, where 0 is “not at all” and

10 is “100%”, how would you rate your integration of information from Day 2 into your practice? What would make that an X + 1?

Narrative Therapy

Assumptions and the Process of Therapy

Post-modern View of Reality

1. Realities are socially constructed2. Realities are constituted through

language3. Realities are organized and

maintained through narratives (stories)

4. There are no essential truths (Freedman & Combs, 1996, p.22)

Small Pieces of Narrative

“The person is never the problem… the problem isthe problem”

(Michael White, 1991)

The Narrative Therapist

Curious, respectful, solicitous, and persistent Solidarity with the people who seek help Having hope for people; “psychotically optimistic”

(Bill O’Hanlon, The Third Wave, Networker, Nov/Dec ‘94)

Choose what to attend to – multiple threads More active at first, then less so as people become

more engaged Co-creator of new realities with individuals/families A humble collaborator Transparency

Use of externalization(White & Epston, 1990, 39-40)

1. Decreases conflict between persons (eg. blame, shame, guilt, etc.)

2. Undermines the sense of failure around the problem3. Increases cooperation, uniting against the problem4. Opens up new possibilities to retrieve their lives and

relationships from the problem and its influence5. Frees people to take a lighter, more effective, and less

stressed approach to “deadly serious” problems6. Presents options for dialogue, rather than monologue,

about the problem

Externalising Conversations

In groups of three:1. Investigative Reporter, Problem, and

Problem’s Subject

2. Choose roles and what the Problem is1. Reporter talks to the Problem about its successes2. Reporter talks to the Problem about its failures3. Problem’s Subject listens carefully wo/interrupting

3. Share the experience of these two interviews

Externalising Conversations: 1. Problem’s Successes

Problems tend to be boastful and arrogant, disclosing their secrets

Don’t try to change the Problem Ask about the Problem’s influence in different parts of life

(relationships, impact on feelings, interference in thoughts, effect on how subject sees him/herself)

Strategies, techniques, deceits, and tricks Problem resorts to

Special qualities possessed by Problem used to undermine and disqualify subject’s knowledge and skills

Purposes that guide Problem’s attempts to dominate; dreams and hopes for subject’s life

Who stands with the Problem – allies How Problem might react to its dominance being

threatened

Externalising Conversations: 2. Problem’s Failures

Problems grudgingly begin to admit their failures Areas of life that the Subject still has some influence

despite the Problem’s efforts The counter-techniques/strategies and tricks developed by

the Subject to mess up the Problem’s plans Special qualities, knowledge, and skills Subject has that the

Problem has had difficulty undermining or disqualifying The purpose and commitment that guides the Subject’s

efforts to challenge the attempts by the Problem to dominate

Who stands with the Subject and how have they helped deny the Problem’s wishes

The options available to the Subject for taking advantage of the Problem’s vulnerabilities and for the reclamation of their life

BREAK10:30 – 10:45

Process of Narrative Therapy (J. Myers-Avis, 2008)

Deconstruction1.Engage in externalizing conversation

1. Externalize the problem2. Review the effects of the problem on client’s life &

relationships, with particular emphasis on its effect on their view of themselves/relationships

2.Taking a position1. Elicit history of the dominant story using

recruitment/training questions2. Discover meaning client attributes to past

experiences3. Inquire about anticipated future impact of the

problem4. Evaluation of problem in terms of preferred way of

being/relating/seeing self

Process of Narrative Therapy (J. Myers-Avis, 2008)

Reconstruction3.Identify a unique outcome4.Engagement in a re-authoring process through:

1. Unique account questions2. Unique re-description questions3. Unique possibility questions4. Unique circulation questions

5.“Experience of experience” (indirect) questions1. Questions that historicize unique outcomes

Deconstruction:1. Externalize the problem

Review the effect of the problem on the person’s life and relationships, with emphasis on its effect on their view of themselves and their relationships

The problem is separated from the identity of the person and the underlying dominant narrative is unmasked

“How is the problem affecting you, your life, your relationships, and/or your view of yourself?” – responses reveal the dominant or problem-saturated story

Deconstruction:1. Externalize the problem

Don’t rush this step - a broad “mapping” at this stage gives a broad area to explore for unique outcomes in the next stagee.g. How has depression affected the way you see

yourself and possibilities for your life?What does anorexia get you to believe about yourself?

When frustration is having its way with you, howdoes it affect your relationship with your

children?

Finding a name for the problem

Listen for metaphorsUse family’s languageModify it so problem is objectified or

personifiedCheck it out with the family to see if it fitsMay take some time to find something

that accurately describes the problemMay be more than one problem


“Our lives are multi-storied. No single story of life can be free of ambiguity or contradiction. No self narrative can handle all the contingencies of life.”

(White, 1994)

Metaphors used in externalization

Walking out on the problem Dispelling the problem Going on strike against the

problem Setting themselves apart from

the problem Defying the problem’s

requirements Taming the problem

Escaping or freeing their life of the problem

Undermining the problem Declining or refusing invitations

to cooperate with the problem Reducing the problem’s grip on

their lives Resigning from the problem’s

service

• usually more than one metaphor used• beware of ‘totalizing’ – defining problems in terms that are totally negative• may invalidate what people give value to and what might be sustaining• do not introduce battle metaphors or initiate totalizing of the problem

Deconstruction:2. Taking a position

Separation from the dominant story leads to the possibility of choice

Recruitment/training questions: History of dominant story is elicited through

questions that explore how client came to hold these beliefs

Training/recruitment questions are powerful in opening space for the person to contextualize their experience; the problem is examined in a larger context such as issues of gender, class, culture, etc.

e.g. Do you have any ideas about how you were recruited into this view of yourself as a failure? Do you think that women are more vulnerable to

the view that they have failed their children?

Deconstruction:2. Taking a position

The meaning the client attributes to these past experiences is elicited Listen for particular words or phrases Check your assumptions (e.g. “not-knowing”)

Ideas about success or failureIdeas about what a good relationship isIdeas about confidence, insecurity, etc.

Explore the future impact of the problem What do you imagine will happen if…

Evaluation of whether this is a preferred effect in the client’s life Client is asked to judge whether the influence of the

problem is preferred or not preferred What assumptions might be keeping the problem in place?

Unique Outcomes

“There is always a history of protest, resistance or struggle” - MW

Unique outcomes must be considered significant by the person

“It is never the size of the step that a person takes that counts, but its direction” (White & Epston, 61)

Reconstruction:3. Identify a unique outcome

An entry point for the beginning of authoring a new story

Seeks to identify occasions when the person/family/relationship has not been oppressed by the problem (similar to exceptions in SFBT)

Invite people to notice those intentions and actions that contradict, the problem-saturated story i.e. unique outcomes that could not have been predicted/accounted for from a reading of the dominant story

Reconstruction:3. Identify a unique outcome

These can be historical, or can be located in the events which occur in the session: Given your father’s encouragement of

secrecy, were there any times when you were able to rebel against it and tell someone about what was happening to you?

Can you recall any occasion when you could have been pushed around by frustration but weren’t?

Have there been some areas of your life that have been untouched by this view of yourself as a failure?

Reconstruction:4. Engagement in re-authoring

There is always an alternative story attached to any unique outcome - the process of uncovering it is like unraveling a loose thread

a) Unique Account Questions Invite people to make sense of unique outcomes (i.e. events that

don’t fit the dominant story) “How” questions - utilize a grammar of agency, turning points

and change There is an assumption that unique outcomes always have a

history e.g. Despite the hold that fear and secrecy had on you, how do

you think you were able to stand up to them and get help to

escape? How did you manage to take this step to turn your back on frustration? How did you resist or refuse the tyranny of the problem (habit,

story)?


b) Unique Re-description Questions: Invite people to give significance to the unique outcomes

and unique accounts through re-description of themselves, others, and their relationships.

How do they think and feel about these? How do they fit with their preferred way of being? preferred way of relating? preferred way of viewing self?e.g. What does this tell you about yourself? What does this tell your partner (friend, daughter) about you? What does this tell you about your commitment to yourself?

about the kind of person you are? If your best friend was here, what would she/he say that it

tells them about you?


c) Unique Possibility Questions “next step” questions Invite people to speculate about the personal and relationship futures

that are attached to the unique accounts and unique re-descriptionse.g. What does it tell you about your future, knowing that you have been

faced with a situation of great fear and intimidation, and that youtook strong action to escape it?

What do you see for you and Susie in the future if you continue in this

direction? What difference will it make to your future if you keep this knowledge

of how you dealt with this situation close to your heart? These can lead back to unique re-description questions:

e.g. If you find yourself taking this next step, how will this affect how youfeel about yourself?


d) Unique Circulation Questions (related to definitional ceremony/outsider witnesses – MW)

Circulation is critical to the continuation of the alternative story

If there is an audience to a performance of a new story, the story is authenticatede.g. Who is someone you’d like to let know about this

new direction that you’re taking? Who has already noticed that you have begun

moving in this new direction? Who might be the first to notice? What would they

say about you?

Reconstruction:5. “Experience of experience” questions

Can be asked in each category and are often most helpful in the development of a new story

These questions invite people to be an audience to their own storye.g. What do you think that I am learning about your

relationship as I hear how you were able to avoid being

totally overwhelmed by the effects of secrecy? (or conflict or anger?)

What do you think this tells me about the nature of your

new direction?

Reconstruction:5. “Experience of experience” questions

Questions Which Historicize Unique Outcomes These are important questions, which assist people to get in

touch with an alternative storye.g. Of all the people who’ve known you over the years, who

would be least surprised that you’ve been able to take this step?

Of all the people who knew you as you were growing up, whowould have been most likely to predict that....?

Following this, a whole series of questions can be asked about the context:e.g. What would ........ have seen you doing which would have

encouraged him/her to predict that you would be able to take

this step? What qualities would ....... have noticed about you that would

have led him/her to not be surprised that you have been able

to.......?


The role of therapy …

“is to bring these alternate stories out of the shadows and to elevate them so that they play a far more central role in the shaping of people’s lives.”

(White, 1994)

Definitional CeremoniesMaps of Narrative Practice (2007) M. White

first referred to as ‘reflecting teams’ (T. Andersen, 1987) rituals that deeply acknowledge people’s lived experience provide an opportunity to tell the stories of their lives

before an audience of carefully chosen outsider witnesses through these retellings people experience their lives as

joined around shared themes that thicken the counterplot witnesses discuss what they were drawn to, the images

that were evoked (metaphors), their own personal experiences that resonated with these expressions, and how their lives have been touched by these expressions

outsider witness is a ‘witness’ to the conversation “outsider witness registry” – former clients who volunteer

to participate as outsider witnesses


process: interview with client(s), interview with outsider witnesses

(expression, image, resonance, and transport), interview client(s) again

eliciting reflections from witness: “When people are an audience to important stories, and when

they have had the opportunity to respond in the way you have, they often go on a journey in their own lives. I’d be interested in any reflections that you might have about where this has taken you. Maybe to new thoughts about your own life. Maybe to some realizations. Anything.” (p. 174)

in the retelling of the retelling, the same categories of inquiry are used (expression, image, resonance, and transport) except the image is focused on the person’s life and identity rather than on those of the outsider witness


invite outsider witness to: play a part in a tradition of acknowledgement that is

particularly relevant to rich story development engage in retellings that are the outcome of close

listening and that are composed of particular aspects of the stories that they were drawn to

express these retellings in ways that will not be imposing respond personally in speaking of their understanding of

why they are drawn to what they are drawn to and about how this affected them

step back from many of the common ways that people respond to the stories of other people’s lives, including from giving opinions or advice, making judgments, and theorizing

LUNCH12:20 – 1:05

Narrative Therapy

The Use ofLetter Writing in Therapy

Narrative Letters

Letters from therapists to clients can be powerful tools for re-authoring lives

Help client remember what happened in session

“bare witness to the work of therapy and immortalize it” (DE)

As a jumping off point for next sessionHelps both therapist and client with recall Including and privileging the client’s point

of view

Narrative Letters

Used by many narrative therapists as case notes

Use client’s own words and quotesExplain use of letters in therapy with

clients re. taking notesRead notes back to client during the

session to check for accuracySlows therapy down

Narrative Letters

Pay attention to the metaphors people use – often have powerful meaning for them

DE follows the flow of the session in writing letters for more coherence - “follow’s the client's inner logic of their own story”

Able to ask questions in letter you didn’t think of before

Able to salvage a bad session by admitting mistakes and asking questions about it to client

Reflect confusion back to client – transparency

Narrative Letters

Look for and highlight small changes Using letter as a reflecting team: what are you

curious about, what do you wonder, what else would you like to know, what might you predict, etc.

Different types of letters: letters of invitation – written to invite other members into

therapy letters of redundancy – to help someone give up an old

role in a family documents of identity - written “charters” celebrating the

person’s strengths, capacities and current progress discharge letters or letters of retirement

Tips on WritingNarrative Letters (DE)

Start with an introductory paragraph reconnecting the client(s) to the previous therapy session

Highlight some novel aspect of the client’s personhood Describe the influence of the problem on the client(s) Make comments that reinforce the externalization of the

problem Ask the client questions that you thought of after the

meeting Use of tentative language, “I wonder if....” Document and highlight unique outcomes or exceptions to

the problem Honour the client’s own solutions rather than imposing

your own

The “Economics” of Narrative

In a survey by David Nylund on the value of letters to clients: 40 respondents 37 said they were “very helpful” 3 considered them “helpful” The average worth of a letter was 3.2 face-to-

face interviews (range from 10-0.25) 52.8% of gains made in therapy were

attributed to the letters alone the average length of therapy was 4.5 sessions

Narrative Letters

ExamplesFor supervision in Narrative Therapy:

Judith Myers Avis, AAMFT Supervisor, Guelph, (519) 821-2493

For more on Narrative Therapy, articles, news & events:

www.dulwichcentre.com.au

http://www.dulwichcentre.com.au/

Narrative Therapywith Couples:Tips & Techniques

Narrative Therapy with Couples (2014) J. Freedman

Try to locate the problem in a larger discourse Things you try to live up to Notice what stands outside the problem

discourse Problem may not go away but it doesn’t have

as much power May be quick or it may take time Did they say anything that doesn’t fit with the

problem? “Tell me something about you that has

nothing to do with the reason you are here”


Keeping notes:

Problem story Alternate Story

Don’t talk most of Sometimes talk

timeListen to problem stories and what is

meaningful to them enough to get there“What do these ideas have you doing?”


Start the next session by reading the notes from the last session: Continuity, focus Helps to avoid getting bogged down in the

‘problem of the week’ “Catch me up on how this has continued?” Give them a copy of your notes if they want

them between sessions – transparency “Would it be ok if we limit what we talk

about today to ____?” Get permission, collaboration


Four questions to end the session: Was this useful? How was this useful? Would you like to come back? When would you like to come back?


Think of it all as story or construction “Looking through your partner’s eyes, how

would you describe yourself?” “And what is it like thinking of yourself

described this way?”A story is a sequence of events

organized over timeDescribe it to me like I was watching it

happen – gets them back into the experience


Having it witnessed and supported is important Witnessing

A position from which someone can listen to another’s story A position from which to offer reflections If you’re in the room, are you focused on correcting another or

proving your point to the therapist? – you’re not really listening

Interview one person and ask the other to just listen, talk to one person at a time

“I’m aware that there are two different stories” Choosing questions for the listener that keep the

conversation moving in the right direction – how is the information being received?

MW spent more time with one before turning to the other Turn to the other when something significant comes up


Positioning (MW): Team by your side - Who might be here with you, to

help/remind you Different context – like you’re at work Self in touch with what’s important – rather than being

right, what do you really value, try to hold onto it Vantage point of the relationship – think about your

children, what you want for them; if you were listening as the relationship vs. as your self

An anti-anger position – give examples: imagine your child’s face, a value you connect to, exceptions to anger

One way mirror – pretend there’s a mirror or a pane of glass in between

Using video – tape session and give them a copy to watch


Absent but implicit In order to make a distinction, you have to

compare it to something else Double-listening (MW) Not always a contrast like mistrust to trust

Questions to elicit ABI: What does this say about what you treasure? If this problem is a protest against something,

what would you say that something is?


Questions to elicit ABI: Has something important been

violated? Can you put what has been violated into words?

Could we say that your naming this as problematic means that you don’t go along with it? In not going along with it, are you standing for something else?


Questions to elicit ABI: I’m getting the impression as you speak

of this that there is something you miss. Is that right? Can you put that into words?

In saying “no” to this, what are you saying “yes” to?

Why is it important that you speak of this in front of your partner?

BREAK2:05 – 2:20


Relational identity In Western society, much more individualistic In other cultures/societies much more of a

relational concept The “checklist” doesn’t necessarily have

anything to do with who you are in a relationship (multiple selves?)

Socio-cultural discourses that we measure ourselves against


Relational identity questions A description of the partner’s contribution

to identity A description of the partner’s appreciation

of identity A description of the effects of the partner’s

contribution and appreciation (and the effect of these effects)

Who are you vs. who are you becoming (other than who you’ve already been)


Relational Identity Exercise In pairs, follow instructions and

questions on handout as guide

References

White & Epston (1990) Narrative Means to Therapeutic EndsJenkins (1990) Invitations to Responsibility Epston & White (1992) Experience, Contradiction, Narrative & ImaginationWhite (1995) Re-Authoring Lives: Interviews & EssaysFreedman & Coombs (1996) Narrative Therapy: The Social Construction of Preferred RealitiesFreeman, Epston & Lobovits (1997) Playful Approaches to Serious ProblemsSmith & Nylund (1997) Narrative Therapies with Children and AdolescentsDiamond (2000) Narrative Means to Sober EndsWhite (2007) Maps of Narrative Practice

Work on Debate for Day 5

Three groups: Collaborative, Narrative, Solution-focussed

Need to describe: Strengths, advantages, benefits of your

approach Weaknesses, disadvantages, drawbacks of the

other two approaches Be able to defend your approach against

criticisms from othersPresent opening/closing arguments

Wrap Up

Evaluation of the dayQuestionsSee you tomorrow!

Documents

Post-Modern Models of Family Therapy University of Guelph Centre for Open Learning and Educational Support William Corrigan, MTS, RMFT Carlton Brown, MSc.,