Inside Narrative Therapy
Content Warning: Please be advised that this article mentions trauma and other potentially triggering subjects. Read with discretion.
Studies have found that there are over 400 different types of therapy available to clients looking for support with their mental health. With such a wide variety, clients have a choice in the treatment they receive. One of these treatments is narrative therapy, which focuses on helping the client be a narrator to their own story, taking their concerns and forming them into roleplay, story-telling, and rewriting activities.
People use their life stories in many ways outside of therapy too, either as a way to entertain others or to cope. Journaling is one form of expressive narration. Whether we fully realize it or not, we all have our own life stories that we tell ourselves and others.
The History Of Narrative Therapy
Narrative therapy was developed during the 1970s and 1980s. Its founders were Michael White from Australia, and David Epston from New Zealand, who later created the Narrative Therapy Centre. Because narrative therapy is a more modern form of treatment, many people may not know much about it.
Michael White and David Epston believed that people are not their problems, which was a key component of their development of the treatment. Through sessions, they helped clients separate from their problems and realize the problems did not define them. Through narration exercises and other techniques, clients could use their skills to solve their problems and develop a healthier or more effective story. The therapy modality showed clients that they control many aspects of who they are and what they can achieve.
Narrative Therapy Techniques
Narrative therapy allows people to tell stories to gain and create the skills they seek to solve problems, change their futures, and set goals. At the beginning of therapy, they may be asked to separate themselves from their symptoms, unwanted beliefs, and external problems.
Afterward, the therapist and client can discuss the problem as part of a story, which can help clients deepen their understanding of themselves. By turning the problem into a story, people may feel less defensive about it, which often makes exploration of the problem and the possible solutions less challenging and intimidating. Below are a few of the techniques commonly used in narrative therapy.
The first goal of narrative therapy is to let people look at their problems and objectify them. Instead of the problem being intangible or inherently tied to a person, it is viewed as a concrete detail in a story and less abstract. Putting the problem into exact words instead of a nebulous idea can be critical.
In narrative therapy, stories are part of a bigger picture, and often, these stories can be looked at through a lens of a more extensive societal context. For example, if someone is experiencing conflict with their partner, they might take their own story and frame it as an external force and then consider their partner's story. Framing the bigger picture can help clients see how they play a role in their growth.
Creating Alternate Stories
Another lesson in narrative therapy is that alternative stories can be told. Besides discussing other people's stories, which helps humanize us and allows for empathy, the therapist may ask the client how they would like their story to end or what alternative storyline they prefer to fit their needs better.
For example, someone living with depression may initially narrate their story simply as "I have depression. I'm depressed," finding it difficult to see beyond this narrative. However, with narrative therapy, the client may be encouraged to explore how they would like their story to be told and could delve further to say, "I have depression, but I'm working through it. Doing so allows me to get to know myself deeper, which is beautiful." This process may allow the client to reframe their thinking and see their story from a different perspective.
"Stories" can also be taken in a more literal sense. For example, if a client experienced an adverse childhood event. They can rewrite what occurred to imagine it in an ideal sense. For example, if their parent struggled to provide them with food and shelter, they might tell their therapist what their ideal childhood would have looked like, imagining their parents having the funds to care for them as they needed. For those looking to do inner child work, this technique can be beneficial. Although they can't change the past, they can deeply imagine what a different past would look like and try to feel the emotions and sensations they would have felt if their needs were met.
The goal of narrative therapy may not be transformation. Instead, clients can learn to take a problem and modify it to understand it in a way that makes it easier to handle. By separating individuals from their problems, this practice may feel more achievable. Through identifying goals, clients can start shifting perspectives, creating alternative stories to their preferred realities, and reframing thoughts to guide their mental health onto a more positive path. Narrative therapy is often a solutions-based therapy for those looking to take control of their present and future realities.
Narrative Therapy For PTSD
Narrative therapy may be used to treat post-traumatic stress disorder (PTSD). Often, patterns of behavior may develop to safegaurd oneself from traumatic experiences. Long-term, however, these behaviors may cause challenges in an individual's daily routine.
With narrative therapy, clients can transform the traumatic experience in a way that gives them power over what occurred and allows them to feel self-compassion. This self-compassion can prompt self-serving changes.
Often, the process of meeting goals and reframing experiences is called post-traumatic growth. Post-traumatic growth allows positive changes to happen after experiencing a traumatic event.
Narrative therapy can also help the individual consider the situation's context. They can see themselves objectively, consider how they might support someone else going through that type of traumatic event, and then support themselves similarly.
When Is Narrative Therapy Used?
Many people can benefit from narrative therapy individually, but narrative therapy can also be applied to families and couples. Groups that tell a problem have different sides to the same story. Therefore, a narrative therapist can offer support by considering and combining the different stories of family into one. This process can allow families and couples to see other perspectives (narratives), think outside of themselves, agree on one story (or accept that there is more than one way to see the story), and move forward to resolution.
For example, when a couple argues, they may both experience their own understanding of the argument. In each alternative story, one may believe they are the hero, and the other is the antagonist. In truth, the labels may be somewhere in the middle, where both bring positive and negative influences to the situation and have valid points. Narrative therapy can help the couple realize if there is an objective answer. Thinking more objectively might help the couple find a solution rather than arguing about who is to blame or who is correct.
Controversies And Concerns With Narrative Therapy
Narrative therapy can be an effective tool for many, but it does have a few criticisms.
For example, narrators may be unreliable if they are the client. The client may pick the most comfortable narrative and put themselves in the best light possible, perhaps consciously or subconsciously. Often, narrative therapists work with clients to realize this. However, clients may not be honest with the therapist in every scenario.
In addition, as narrative therapy is a new form of treatment, there is less scientific evidence of its effectiveness than other types. Fewer American studies have been conducted to assess its validity. However, many clients report finding it effective.
If you think narrative therapy would help you and feel you're a creative individual, it may allow you to tell a story more conducive to a healthy life and put your concerns into perspective.
There are various ways to improve your mental health. One way is by seeking help from a therapist. By seeking help, you can take action against a challenge you want to address and resolve it. Asking for help can be challenging, but it can allow you to take the first step toward solutions.
If you're unsure if you can partake in therapy due to barriers, such as financial struggles, accessibility, or availability of providers, you can also try online therapy. Online therapists are trained, certified, and experienced in many treatment methods, including narrative therapy. Online therapy is also as effective as in-person therapy, with one study showing that 98% of users of an online platform experienced significant improvement in their mental health after treatment. 100% of users rated the treatment convenient, and nearly 100% formed a solid therapeutic alliance with their therapist, as opposed to 60% of in-person therapy users.
If you want to try an internet-based therapy like narrative therapy, consider signing up with a platform like BetterHelp. To begin, you can fill out a quick questionnaire that enables you to be paired with a therapist based on your preferences, including your preferences for the type of therapy you want to try. Sessions are customizable and can be held anytime, anywhere via phone call, video chat, or live chat messaging within the safe platform.
“Bruce invites a presence of understanding with humor. He does not take your feelings lightly, yet he challenges you in other ways to take the lighter side of things. He emphasizes and tells experiences that are presented as applicable to your story. Through narrative therapy, wondering, reframing, and as simple as reminding you to be present with your emotions, that it is ok - he gives the client space to their healing through his space.”
Frequently Asked Questions (FAQs)
Below are several frequently asked questions about narrative therapy.
What Are The Goals Of Narrative Therapy?
Narrative therapy aims to take negative narrative ideas that dominate a person's life, leading to unhealthy beliefs, anxiety, depression, or other mental health challenges, and turn them into positive or neutral stories. With narrative therapists, dominant problematic stories may undermine a person's autonomy when they become fixated on them. However, when clients can observe their dominant story in depth without becoming emotionally attached, it may reduce the story's effects on the person's life and decrease distress.
Is Narrative Therapy A Form Of CBT?
Narrative therapy is not CBT. While cognitive-behavioral therapy (CBT) and narrative therapy have some aspects in common, they are not the same form of therapy. To retrieve information on narrative therapy, Dulwich Centre Publications offers resources. The Dulwich Centre has been around since 1983 and is in Australia. It provides training opportunities, site work, and in-depth information for those interested in narrative therapy. The Australian & New Zealand Journal of Psychiatry also offers resources.
What Mental Health Conditions Can Narrative Therapy Treat?
By narrating the stories of their own lives, narrative therapy may support clients with the following:
Attention-deficit hyperactivity disorder (ADHD)
Trauma and post-traumatic stress disorder (PTSD)
Sexual identity challenges
Narrative therapy can also support those looking to discuss marital satisfaction; married couples can benefit from reframing their stories about their marriages with a non-blaming, non-pathological lens that brings new meaning and understanding.
Who Would Benefit From Narrative Therapy?
Anyone who feels they are struggling due to unhelpful stories or narratives that occurred throughout their lives may benefit from narrative therapy. Narrative therapy can also be used in a couples or family therapy format.
Is Narrative Therapy Effective For Anxiety?
Yes, narrative therapy is a systemic therapy that can target symptoms of anxiety disorders and other mental health conditions. During narrative counseling, the narrative therapist may help you see your "problem story" from a different perspective by respectfully and non-judgmentally listening to your primary and alternative stories while you are in the driver's seat as the expert of your own life. Even one session of narrative therapy may make a difference in helping clients feel in control of their anxiety symptoms.
How Many Sessions Does Narrative Therapy Take?
You and your narrative therapist can decide upon the number of sessions to partake in depending on your goals for therapy. Some clients may experience relief after a few sessions, while others might choose to tackle several concerns.
Do Narrative Therapists Diagnose?
If your narrative therapist is a licensed psychiatrist, psychologist, clinical social worker, counselor, or medical doctor, they can diagnose mental health conditions and provide professional medical advice.
Does Online Therapy Work?
A study from the Journal of Psychological Disorders found that online cognitive behavioral therapy from licensed therapists was effective, acceptable, and practical healthcare comparable to in-person therapy that can benefit individuals, couples, and families.
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