Danger up ahead: Or, Questions about Narrative Therapy that you Might not Want to Ask
If you're looking for a well-researched, intellectually sound paper, this ain't it. This is me, in an admittedly cynical place, after having attended a narrative therapy salon. The list of points below is
derived from my reactions to what went on at the salon, as well as some of the thoughts I've been carrying about narrative for a long time. I don't know if any of these questions have been asked before, but thought they'd be worth raising.
Additional Disclaimer: I have recently begun to view myself as an unskilled empath, or a highly sensitive person, who sometimes has difficulty distinguishing between my feelings and those of others, which leads to all kinds of misuses and abuses and projections. I think this identity category is having a huge effect on how I look at the practice of therapy, most of which I haven't really processed yet, though I intend to, so bias abounds.
Disclaimer number Two: I've just written the first section of this, and I can't believe how bleak it is. So take all of this with a huge damn grain of salt because I'm sure there are plenty of amazing therapists out there who have the wisdom to avoid many of these pitfalls, and I am young and inexperienced and have not had the opportunity to be supervised by many of these people.
--Nicholas Rose said that modern psychology is about governing the soul. Tasha the pessimist wonders, "How is narrative therapy any different?" How does it avoid the prescriptivism that is the hallmark of modernist therapies? I worry that in its pure form, it doesn't avoid it at all, and here's why.
--First, look at the language of narrative therapy. People have two kinds of stories: problem-saturated or dominant stories, and preferred or subjugated stories. Narrative therapists say they aren't about dichotomizing; in other words, their intention isn't to align one kind of story with "good" and the other with "bad." In fact, one of the presenters at the salon described how a narrative therapist gently corrected someone when she called a preferred story a "right story." From what I've heard, these types of corrections are not uncommon. Why do you think practitioners of narrative therapy have developed this linguistic code that they adhere to as much as possible? Why do you think they can't be all postmodern and chill about it, and instead feel the need to correct others who use the wrong terminology? Could it be that they protest too much, that their insistence that they are not dichotomizing or pathologizing is a way to hide from the possibility that they may be doing both of these things?
--To me, something that always sends my bullshit detector into a frenzy is sterile or artificial language. Visually challenged person? Come on, who are we kidding. I'm totally blind, dammit, and it doesn't matter how uncomfortable that makes you. Unfortunately, narrative therapy is bursting with sterility. At first glance, "externalizing the problem" sounds like a lovely idea, and I don't want to completely dismiss it because I know it can be helpful. But it leads to the therapist asking all kinds of weirdly constructed questions, such as "Tell me what happened after drinking came into your life. How has being a person with blindness affected your hopes and dreams?" It might be that you are a person with incredible compassion and curiosity, and you don't actually have any agenda about wanting the person to stop drinking, or from engaging in a problem-saturated behavior (excuse me, I mean story). If that's the case, that's wonderful, and I applaud you. But you also might be like me, a graduate student doing a clinical internship in order to acquire hours towards licensure. You are being evaluated by your supervisor, your professors, and other agency personnel on your ability to decrease your clients' symptoms. That might not be how it is presented to you, but deep down in your gut, you know that this is the case. So you bet your ass you want that client to stop drinking, or smoking pot all day, or whatever it is he or she is doing. At the very least, you want the client to keep coming back so you can get your damn hours and get the fuck out of there. You might learn about narrative therapy in graduate school. "I love this," you might say. "It's not judging or pathologizing! I can externalize the problem, and everything will be all right." But yur truth (if there is such a thing) will probably rear its head. You can use as many stilted questions as you want to convince yourself and the client that you are not being prescriptive or pathologizing. The client may or may not catch on and realize that sometimes you really want to listen to what they have to say, but at other times, your "curiosity" is faker than Margarine. However, most of the time, the client receives the message that to out you as a power-hungry fake would be completely inappropriate; you might dress it up in narrative language, but you're totally going to accuse them of projecting onto you. Or you might not make that accusation, but your supervisor will make it for you. So what happens? The client plays along, and if you are decent, you might actually be able to convince them that you are collaborating, for realsies. They'll have no reason to think about how your power will inevitably leave a mark on the story the two of you co-create, and they definitely won't be thinking about how the people who have power over you are also leaving their marks on their text. Why should they? It's not why they came to therapy. The result? They leave therapy with a product that was essentially created under a false pretense of collaboration. This product may be extremely useful for them. It might help them to discover unknown capacities in themselves and stimulate their own creativity so that they can truly write their own story. Or, and this is what I worry about, in a few years, that so-called preferred story they've created might become as oppressive as the problem-saturated story. They might recognize this restriction, or they might say something like, "I am not liking this preferred story anymore. It doesn't really make sense to me now, and sometimes, I prefer my old problem-saturated story. SO I guess I'm failing, because my therapist and I created that shiny preferred story together, and he or she obviously knows more about this kind of stuff than I do."
Yet another disclaimer: I haven't yet read Michael White's article, "Addressing Personal Failure." I'm wondering if it speaks to some of the questions I asked above. But in my examples of narrative therapy gone wrong, I'm not really talking about Michael White. I'm talking about your average graduate student.
--So there's another consequence of the terms "problem-saturated" and "preferred story." Narrative therapy claims that it's all about being nonlinear, but the progression from one kind of story to another seems pretty linear to me. Hell, Michael White even gave us maps for how to get from one to the other. I haven't found anyone writing about how maybe, some people aren't ready to give up the problem-saturated story, for many understandable reasons. Also, I haven't found anyone who explores the possibility that the boundaries marking one kind of story from the other might change from moment to moment. We're humans. Most of us our masochistic, or we have masochistic days. Sometimes we really want to yell at ourselves for half an hour and give ourselves little lectures on how fucked up we are. During those moments, stories about our hopes and dreams and what our grandmother Marjorie said when we wiped our asses for the first time won't have any meaning. And that's okay. But if a client has gone through narrative therapy, I wonder if he or she feels such self-judgment is okay. And so here we've got a prescription: "Thou shalt not internalize thy problems." It might be a prettily worded, covert prescription, but it's a prescription all the same.
Here's an example of this prescription in action. The organizer of the salon talked about how David Epston can be "fierce" when doing narrative therapy with clients. He'll interrupt clients, correct their language, basically do anything he can do to push them towards externalizing and unique outcomes and all that stuff. When you interrupt someone, you're asserting your power. You're saying, "Yes, yes, yes. Bla bla bla. I've listened long enough. What I have to say is more important." How is this way of interacting collaborative? Aren't you sending the client the message that there are two kinds of talk, good talk and bad talk? How is this not pathologizing? And by placing all that you do under the sunny auspices of de-centered-ness and collaboration, aren't you making it harder for the client to challenge the rules of the system? By asking this last question, I wonder if I am being disempowering to the client. I'm sure some clients have raised issues about interrupting with their narrative therapists. I'd love to see more transcripts where the power imbalance between the two is openly acknowledged and discussed.
--Let's talk about social constructionism for a minute. Now, I love that shit as much as the next girl, but like any theory, it can be misused, misapplied, and taken to extremes. I'm tempted to use the idea that disability is socially constructed as an example, but that's probably going to make me want to throw things, so I'll choose something different. Julia, the organizer of the salon, is writing an article on the following situation: A man comes to therapy and tells his therapist that he is no longer attracted to his wife because she has put on weight. While the modernist therapist might take this statement as his truth and encourage him to leave his wife so he can be free to self-actualize, a narrative therapist might look at socially constructed ideas about the female body. She might ask the client a question like, "What can your wife's body do, despite the fact that she's gained weight?" Essentially, the client would be invited to acknowledge how he is being influenced by dominant discourses, which the therapist will then deconstruct to smithereens. The client will get the message that he has internalized evil evil ideas from big corporations and mass media. But (dun dun dun) there is hope for him. He can cast that flotsam aside, and he can go home and fuck his wife, no matter how fat she is, because his intention is to honor difference and inner beauty. Sounds nice, right? But who gave the therapist the right to play the morality police? I think it's great for the therapist to bring awareness of dominant discourses about the female body into the room. Maybe there is hope for the client to find a way to stay with his wife, and he can learn something new about himself and about her along the way. . But if the client isn't interested, the client isn't interested. You might think he's an asshole, or maybe you pity him, for succumbing to these dominant ideologies, but in the end, it's his life, not Women's Studies 101. More prescriptivism. Fun times.
--Back to this idea of externalizing the problem. Not only is the sterility of its linguistic practice a possible indicator of its inauthenticity, it is also a gross simplification. Disability is the best example I can think of here. If you take disability and externalize it, if you see it as purely a social construct that is separate from the person, you ignore the embodied nature of impairment. Worse, you run the risk of sending the message that people aren't allowed to see themselves as impaired at all. In essence what you are saying is, "Don't listen to that part of you that feels uncomfortable in a disabled body. That's just the part of you who has internalized all this crap from society about how people with disabilities are inferior. Society and your family trained you to want to be just like everyone else. But difference needs to be celebrated!" These ideas (with the sarcasm and snide exclamation point removed) might or might not resonate for a given individual with a disability, and if they do resonate, yea! Mazal tov. But by making the assumption that you know where their ideas about disability came from, you are totally putting a flat tire in your curiosity. Speaking for myself, I experience blindness as an impairment and loss, for a confusing mush of personal and societal and karmic and other completely mysterious reasons. If I came to therapy, someone who externalized the hell out of my disability has a decent chance of missing these things.
Julia pretty much flipped out when the work of Jeff Zimmerman was discussed. I don't know anything about Zimmerman's work, other than that he is interested in the neurobiology of narrative therapy. He criticizes narrative therapy for being too left-brain centric and talks about the importance of including right-brain-related activities, such as metaphors and bringing emotion into the room. He had a lot to say about how emotional or novel experiences increased the growth of neural pathways and would make preferred stories more meaningful. Julia's main beef with him is that he relied too heavily on scientific constructs and bogged down the theory of narrative therapy with modernist claims. She said that the idea that the body contains trapped unstoried material that needs to be located and storied is essentially modernist. I agree. However, I wonder how the body can be brought into narrative therapy. What happens if you conceptualize the body as text, as many scholars have done, and you express the same curiosity about learning more about that text as you do about "externalizing the problem?" What if problems are viewed as neither internal nor external, but something in between? What if we allowed our bodies to speak in the therapy room, even if some of the things they might have to say might terrify us, might go against all those sparkly intentions and values we think that we stand for?
--Okay, that's it for now. I wanted to talk about vulnerability in the therapeutic relationship, and more about how unspoken truths between therapist and client can be potentially toxic, but my brain is beginning to protest. SO, more next time.
Thoughts, lambasts, reasoned arguments, snowballs, puppies, and ice cream are all welcome.
derived from my reactions to what went on at the salon, as well as some of the thoughts I've been carrying about narrative for a long time. I don't know if any of these questions have been asked before, but thought they'd be worth raising.
Additional Disclaimer: I have recently begun to view myself as an unskilled empath, or a highly sensitive person, who sometimes has difficulty distinguishing between my feelings and those of others, which leads to all kinds of misuses and abuses and projections. I think this identity category is having a huge effect on how I look at the practice of therapy, most of which I haven't really processed yet, though I intend to, so bias abounds.
Disclaimer number Two: I've just written the first section of this, and I can't believe how bleak it is. So take all of this with a huge damn grain of salt because I'm sure there are plenty of amazing therapists out there who have the wisdom to avoid many of these pitfalls, and I am young and inexperienced and have not had the opportunity to be supervised by many of these people.
--Nicholas Rose said that modern psychology is about governing the soul. Tasha the pessimist wonders, "How is narrative therapy any different?" How does it avoid the prescriptivism that is the hallmark of modernist therapies? I worry that in its pure form, it doesn't avoid it at all, and here's why.
--First, look at the language of narrative therapy. People have two kinds of stories: problem-saturated or dominant stories, and preferred or subjugated stories. Narrative therapists say they aren't about dichotomizing; in other words, their intention isn't to align one kind of story with "good" and the other with "bad." In fact, one of the presenters at the salon described how a narrative therapist gently corrected someone when she called a preferred story a "right story." From what I've heard, these types of corrections are not uncommon. Why do you think practitioners of narrative therapy have developed this linguistic code that they adhere to as much as possible? Why do you think they can't be all postmodern and chill about it, and instead feel the need to correct others who use the wrong terminology? Could it be that they protest too much, that their insistence that they are not dichotomizing or pathologizing is a way to hide from the possibility that they may be doing both of these things?
--To me, something that always sends my bullshit detector into a frenzy is sterile or artificial language. Visually challenged person? Come on, who are we kidding. I'm totally blind, dammit, and it doesn't matter how uncomfortable that makes you. Unfortunately, narrative therapy is bursting with sterility. At first glance, "externalizing the problem" sounds like a lovely idea, and I don't want to completely dismiss it because I know it can be helpful. But it leads to the therapist asking all kinds of weirdly constructed questions, such as "Tell me what happened after drinking came into your life. How has being a person with blindness affected your hopes and dreams?" It might be that you are a person with incredible compassion and curiosity, and you don't actually have any agenda about wanting the person to stop drinking, or from engaging in a problem-saturated behavior (excuse me, I mean story). If that's the case, that's wonderful, and I applaud you. But you also might be like me, a graduate student doing a clinical internship in order to acquire hours towards licensure. You are being evaluated by your supervisor, your professors, and other agency personnel on your ability to decrease your clients' symptoms. That might not be how it is presented to you, but deep down in your gut, you know that this is the case. So you bet your ass you want that client to stop drinking, or smoking pot all day, or whatever it is he or she is doing. At the very least, you want the client to keep coming back so you can get your damn hours and get the fuck out of there. You might learn about narrative therapy in graduate school. "I love this," you might say. "It's not judging or pathologizing! I can externalize the problem, and everything will be all right." But yur truth (if there is such a thing) will probably rear its head. You can use as many stilted questions as you want to convince yourself and the client that you are not being prescriptive or pathologizing. The client may or may not catch on and realize that sometimes you really want to listen to what they have to say, but at other times, your "curiosity" is faker than Margarine. However, most of the time, the client receives the message that to out you as a power-hungry fake would be completely inappropriate; you might dress it up in narrative language, but you're totally going to accuse them of projecting onto you. Or you might not make that accusation, but your supervisor will make it for you. So what happens? The client plays along, and if you are decent, you might actually be able to convince them that you are collaborating, for realsies. They'll have no reason to think about how your power will inevitably leave a mark on the story the two of you co-create, and they definitely won't be thinking about how the people who have power over you are also leaving their marks on their text. Why should they? It's not why they came to therapy. The result? They leave therapy with a product that was essentially created under a false pretense of collaboration. This product may be extremely useful for them. It might help them to discover unknown capacities in themselves and stimulate their own creativity so that they can truly write their own story. Or, and this is what I worry about, in a few years, that so-called preferred story they've created might become as oppressive as the problem-saturated story. They might recognize this restriction, or they might say something like, "I am not liking this preferred story anymore. It doesn't really make sense to me now, and sometimes, I prefer my old problem-saturated story. SO I guess I'm failing, because my therapist and I created that shiny preferred story together, and he or she obviously knows more about this kind of stuff than I do."
Yet another disclaimer: I haven't yet read Michael White's article, "Addressing Personal Failure." I'm wondering if it speaks to some of the questions I asked above. But in my examples of narrative therapy gone wrong, I'm not really talking about Michael White. I'm talking about your average graduate student.
--So there's another consequence of the terms "problem-saturated" and "preferred story." Narrative therapy claims that it's all about being nonlinear, but the progression from one kind of story to another seems pretty linear to me. Hell, Michael White even gave us maps for how to get from one to the other. I haven't found anyone writing about how maybe, some people aren't ready to give up the problem-saturated story, for many understandable reasons. Also, I haven't found anyone who explores the possibility that the boundaries marking one kind of story from the other might change from moment to moment. We're humans. Most of us our masochistic, or we have masochistic days. Sometimes we really want to yell at ourselves for half an hour and give ourselves little lectures on how fucked up we are. During those moments, stories about our hopes and dreams and what our grandmother Marjorie said when we wiped our asses for the first time won't have any meaning. And that's okay. But if a client has gone through narrative therapy, I wonder if he or she feels such self-judgment is okay. And so here we've got a prescription: "Thou shalt not internalize thy problems." It might be a prettily worded, covert prescription, but it's a prescription all the same.
Here's an example of this prescription in action. The organizer of the salon talked about how David Epston can be "fierce" when doing narrative therapy with clients. He'll interrupt clients, correct their language, basically do anything he can do to push them towards externalizing and unique outcomes and all that stuff. When you interrupt someone, you're asserting your power. You're saying, "Yes, yes, yes. Bla bla bla. I've listened long enough. What I have to say is more important." How is this way of interacting collaborative? Aren't you sending the client the message that there are two kinds of talk, good talk and bad talk? How is this not pathologizing? And by placing all that you do under the sunny auspices of de-centered-ness and collaboration, aren't you making it harder for the client to challenge the rules of the system? By asking this last question, I wonder if I am being disempowering to the client. I'm sure some clients have raised issues about interrupting with their narrative therapists. I'd love to see more transcripts where the power imbalance between the two is openly acknowledged and discussed.
--Let's talk about social constructionism for a minute. Now, I love that shit as much as the next girl, but like any theory, it can be misused, misapplied, and taken to extremes. I'm tempted to use the idea that disability is socially constructed as an example, but that's probably going to make me want to throw things, so I'll choose something different. Julia, the organizer of the salon, is writing an article on the following situation: A man comes to therapy and tells his therapist that he is no longer attracted to his wife because she has put on weight. While the modernist therapist might take this statement as his truth and encourage him to leave his wife so he can be free to self-actualize, a narrative therapist might look at socially constructed ideas about the female body. She might ask the client a question like, "What can your wife's body do, despite the fact that she's gained weight?" Essentially, the client would be invited to acknowledge how he is being influenced by dominant discourses, which the therapist will then deconstruct to smithereens. The client will get the message that he has internalized evil evil ideas from big corporations and mass media. But (dun dun dun) there is hope for him. He can cast that flotsam aside, and he can go home and fuck his wife, no matter how fat she is, because his intention is to honor difference and inner beauty. Sounds nice, right? But who gave the therapist the right to play the morality police? I think it's great for the therapist to bring awareness of dominant discourses about the female body into the room. Maybe there is hope for the client to find a way to stay with his wife, and he can learn something new about himself and about her along the way. . But if the client isn't interested, the client isn't interested. You might think he's an asshole, or maybe you pity him, for succumbing to these dominant ideologies, but in the end, it's his life, not Women's Studies 101. More prescriptivism. Fun times.
--Back to this idea of externalizing the problem. Not only is the sterility of its linguistic practice a possible indicator of its inauthenticity, it is also a gross simplification. Disability is the best example I can think of here. If you take disability and externalize it, if you see it as purely a social construct that is separate from the person, you ignore the embodied nature of impairment. Worse, you run the risk of sending the message that people aren't allowed to see themselves as impaired at all. In essence what you are saying is, "Don't listen to that part of you that feels uncomfortable in a disabled body. That's just the part of you who has internalized all this crap from society about how people with disabilities are inferior. Society and your family trained you to want to be just like everyone else. But difference needs to be celebrated!" These ideas (with the sarcasm and snide exclamation point removed) might or might not resonate for a given individual with a disability, and if they do resonate, yea! Mazal tov. But by making the assumption that you know where their ideas about disability came from, you are totally putting a flat tire in your curiosity. Speaking for myself, I experience blindness as an impairment and loss, for a confusing mush of personal and societal and karmic and other completely mysterious reasons. If I came to therapy, someone who externalized the hell out of my disability has a decent chance of missing these things.
Julia pretty much flipped out when the work of Jeff Zimmerman was discussed. I don't know anything about Zimmerman's work, other than that he is interested in the neurobiology of narrative therapy. He criticizes narrative therapy for being too left-brain centric and talks about the importance of including right-brain-related activities, such as metaphors and bringing emotion into the room. He had a lot to say about how emotional or novel experiences increased the growth of neural pathways and would make preferred stories more meaningful. Julia's main beef with him is that he relied too heavily on scientific constructs and bogged down the theory of narrative therapy with modernist claims. She said that the idea that the body contains trapped unstoried material that needs to be located and storied is essentially modernist. I agree. However, I wonder how the body can be brought into narrative therapy. What happens if you conceptualize the body as text, as many scholars have done, and you express the same curiosity about learning more about that text as you do about "externalizing the problem?" What if problems are viewed as neither internal nor external, but something in between? What if we allowed our bodies to speak in the therapy room, even if some of the things they might have to say might terrify us, might go against all those sparkly intentions and values we think that we stand for?
--Okay, that's it for now. I wanted to talk about vulnerability in the therapeutic relationship, and more about how unspoken truths between therapist and client can be potentially toxic, but my brain is beginning to protest. SO, more next time.
Thoughts, lambasts, reasoned arguments, snowballs, puppies, and ice cream are all welcome.