CHCAOD511B

Session 5

31/03/11

Making sense of narrative therapy People use stories that frame their lives and

impact how they think and behave These stories are formed from previous

experiences and how the individual has interpreted these and the ongoing presumptions, beliefs and values they have formed due to it

They have the power to control how people makes sense of their past, present and future

Making sense... Re-focusing any negative themes in an

individual’s story can assist them to build their self esteem and improve their general wellbeing

Problem saturated stories can become identities and be difficult to overcome

Things such as feelings, problems between people, cultural and social practices, fears, addictions, and other ills can be externalized. All externalized stories are about the problems that are outside individuals and the effects they have on the individual.

What does “the fear,” “the addiction,” “the anger or guilt,” or” the depression” have to say about how you live your daily life?

Many people internalise problems, externalising them gives them a different perspective as seen in the comparison slides following

Internalising Externalising

Person is the problem

What is wrong with the person

Downplay social context

Thin conclusions of one’s self

Negative feelings of differences

Problem is the problem

Problem external to self-identity

Highlight social context

Looks at other influences in a person’s life

Celebrates differences

Internalising Externalising

Professionals seen as experts

Language is “I am...” Much focus on the

problem

Individuals experts over themselves

Language is “It is...” Looking for stories

outside of problem

Deconstructing stories Problems only survive when there are beliefs,

ideas and principles supporting them To alter problem behaviours you need to

deconstruct the supporting believes

A narrative therapist does this by.. Listening and asking themselves

What are the background assumptions that enable this story to make sense?

What unnamed background assumptions make this story work?

What are the ideas that might explain how people are speaking and acting?

What are some of the taken for granted ways of living and being that are assisting the life of the problem?

The use of questions Questions are essential to deconstruct the

story and to identify problems and explore them in depth How have you kept the problem from

becoming worse? Describe the times the problem is

manageable? How do you cope when things require the

problem not get in the way? What kind of things are more important to you

than your problem and when have you followed your impulses not to let the problem get in your way?

Some examples.. Addictive thinking (Self)

How does addictive thinking get you to use more than you intended to?

What are some things that give addictive thinking more space?

How does addictive thinking get you to use during times when you don’t want to?

Does addictive thinking get you to believe that you are not in danger when in fact you are?

Does addictive thinking cause you to be dishonest with yourself?

Even more examples Addictive thinking (relationships)

Does addictive thinking separate you from people who really care about you?

Does addictive thinking cause you to be dishonest with others?

Do you find that addictive thinking interferes with your abilities to be the parent that you prefer to be?

How has addictive thinking changed one of your relationships?

Do you find that addictive thinking causes you to associate with others who are also having problems with addictive thinking?

Do you find that addictive thinking causes you to avoid other people who do not have problems with addictive thinking?

Let’s have a go at some questioning to deconstruct stories

Alternative storylines By deconstructing an individual’s story, a

counsellor can listen to any alternative story lines which may be present

Clients should be encouraged to name this alternative storyline

Alternative storylines....

Problems never totally dominate lives and relationships. One mother’s experience of depression dominated stories of herself as mother, yet she told us, “the only reason I get up in the morning is that I have to make my kids breakfast and make sure they get off t o school in time”. In narrative practice, we are curious: “Is ‘getting up in the morning’ something you do every day or once in a while? Is this something new or did you always get up in the morning for your children? What steps do you take to insure you’ll get up, is there something you say or do to remind yourself of its importance? Who or what supports you in this commitment? How does this make a difference for your children or for you?” and so on.

A new story emerges about a simple event in life that has perhaps been taken for granted. Given a platform, it can provide clues to the hopes and dreams, purposes and intentions that have not been overtaken by troubles. Further questions, “Are there other sorts of things you do for your children that you’d never give up on, despite difficulties?”, can bring richness to an alternative storyline.

http://www.dulwichcentre.com.au/new-narratives-for-parents-with-mental-health-difficulties.pdf

ANOTHER EXAMPLE from http://www.narrativetherapycentre.com/index_files/Page2198.htm

A young boy steps in front of his mother in an attempt to protect her from abuse by her husband.  While one might legitimately be concerned about the effects on the boy of the violence against his mother, a subordinate storyline might also emerge from an exploration of why it is important to the boy to intervene, what it says about what he values for his life, what is the history of these values, etc.  Other examples might be elicited of times when the boy took actions in keeping with these values.  A different relationship to the violence is being storied

The absent but implicit approach

The absent but implicit perspective allows persons to articulate what it is about their use of substances that has been, and may still be, important to them. It is a way of honouring a person’s past without judgement, and finding out what the person values in life.

If a person’s use of substances is a key aspect of their life, then it is safe to assume that the use of substances, at least at some stage, has been linked to various purposes, hopes and values that the person holds.

Narrative therapy in addiction treatment Examples of questions may include:

• When you first began using, how was this substance use helpful to you in your life? • What does this say about what is important to you? • What purposes has it served and what has it enabled you to do that you value?• Is there anything that the substance gives you that you feel you just can’t live without? • If you were to decide to leave substances behind, is there anything you feel that you might miss?

Seeking out what is absent but implicit in a person’s substance use can provide the means for people to identify what is important in their lives, and this can be the first step in engaging with a sense of personal agency in relation to their substance use.

The benefits in addiction treatment

“ Separating my identity from the identity of the problem,

allows me to distance enough from my immediate

experience with ‘addiction’, to discern and unmask the drug

thinking that can be so capturing”

Re-authoring & re-membering

What is re-authoring? Re-authoring conversations invite people to do

what they routinely do - that is, to link events of their lives in sequences through time according to a theme/plot. However, in this activity, people are assisted to identify the more neglected events of their lives - the unique outcomes or exceptions - and are encouraged to take these into alternative story lines.

Unique outcomes or exceptions Listening for unique outcomes or exceptions is

essential to the re-authoring process These include times when the client has

behaved differently to their dominant story E.g. When they did not consume alcohol when

they went out with friends Counsellors use questions called scaffolding in

order to fill the gaps between the dominant storyline and the exceptions

Questions are introduced that encourage people to generate new proposals for action, accounts of the circumstances likely to be favourable to these proposals for action, and predictions about the outcome of these proposals.

In the first place, people are likely to respond to landscape of identity questions by generating identity conclusions that are informed by the well known structuralist categories of identity - needs, motives, attributes, traits, strengths, deficits, resources, properties, characteristics, drives and so on

As these conversations further evolve, there is opportunity for people to generate identity conclusions that informed by the well known non-structuralist categories of identity – intentions and purposes, values and beliefs, hopes, dreams and visions, commitments to ways of living, and so on

Re-membering conversations “I have revoked the membership of all mood-

altering substances to my life, and have downgraded relationships with persons to whom I feel my only connection was through substances” (Andrew C http://www.dulwichcentre.com.au/narrative-maps-of-practice-deconstructing-addiction.pdf)

Open possibilities for the revision of one’s membership of life: for the upgrading of some memberships and the downgrading of others; for the honouring of some memberships and for the revoking of others; for the granting of authority to some voices in regard to matters of one’s personal identity, and for the disqualification of other voices in regard to this matter

Re-membering conversations are often initiated through two sets of inquiry:

a) The first set of inquiry invites: i. a recounting of what the significant figure

contributed to the person’s life (figure’s contribution to person’s life),

ii. the person to enter the consciousness of this figure on matters of the person’s identity, initiating a rich description of the ways in which this connection shaped/had the potential to shape the person’s sense of who they are and what their life is about (person’s identity through the eyes of the figure).

b) The second set of inquiry invites: i. a recounting of what the person contributed to

the life of this figure (person’s contribution to the figure’s life), and

ii. the person to enter the consciousness of this figure on matters of this figure’s identity, initiating a rich description of the ways in which this connection shaped/had the potential to shape this figure’s sense of who they were and what their life was about (implications of this contribution for the figure’s sense of identity).

Using re-remembering conversations to enrich the presentation of the alternative new story. Who would validate the new story by personal experience with the person? Such is a way to link to the past, near present and future vital social supports These recollections may also be related or unrelated, real or imaginary, and may include animals, toys, pets, places symbols or objects. http://www.able-differently.org/PDF_forms/

usingStories/Narrative%20Therapy.pdf

Documentation

Therapeutic documents are written when people make important commitments or when they are celebrating important achievements. They may include; letters to and from significant people that follow

on from a re-membering conversation documents which records the commitments and

directions that people have chosen to redirect their lives with

Types of documents Family peace document – reminding all family

members of commitments they have made Declarations- written with the intention of

sharing them with others e.g. a new and preferred story

Certificates- can be drawn up and signed to commemorate special events or turning points

Handbooks- a way to formally record people’s knowledges and expertise

Notes from session Lists- keep track of experiences Pictures

An example of a list   What helps me lead a drug free life   What interferes with this   Seeing Benny The cravings Something bad happening Not going to counselling Not being able to cope    

Example of a list

Helpers to a drug free life Interference

Samantha Getting a job Going to counselling Being part of my

family again Having stuff to do Playing footy again

Seeing Benny The cravings Something bad

happening Not going to

counselling Not being able to

cope

Letters Letter writing is also a strategy to document

change and can include letters as a summary of the session letters of invitation or to build relationships letters of redundancy letters of reference