What is Narrative Therapy founded by Davide Epstein and Michael White? In narrative approaches, we use the word ‘assumptions’ because these are just ideas and metaphors. They are the assumptions those who study narrative ideas carry with us into conversations. We all carry with us a multitude of assumptions everyday. We use the word ‘assumption’ to mean a way of thinking, as opposed to saying that this is the TRUTH about the way the world is.
These assumption-descriptions evolved from my handwritten notes from training with Michael White in 2007. They were expanded by me, to present at a workshop entitled
What is Narrative Therapy: A route to developing cultural awareness and sensitivity.
1. Problems are located in contexts and in relationships, not in people.
Most people in health care can agree that stress exacerbates health problems. That stress occurs in the context and relationships of people’s lives. Living through a hard circumstance is context. And, having a conflict in a relationship is usually a tender context. Problems come out of these experiences. Being a member of a marginalized race, gender, socioeconomic position, age or sexual orientation is also a significant context. Consequently, a difficult circumstance in addition to the experiences of marginalization multiplies the effects.
This assumption helps us remember not to depend solely the medical model of mental health care- that the problem is inside of us. It is up to us to bring this into the conversation by asking about these contexts. (For example: The anxiety of a middle age white recently divorced man and the anxiety of a young Bosnian woman whose house was just broken into are located in two different contexts.)
Narrative therapists often quip:
“The problem is the problem, the person is not the problem.” We live in a culture that often places the problem right in us. And each of us takes this up and blames our self even more.
Most people who come to therapy, have an account of a problem to talk about. And more often than not, they have made some significant identity conclusions about themselves that fits with that problem. Such as, ‘I am depressed’.
This is a statement about who they are as a person, and while it is a very thin statement, people create lots of meaning behind it. I am sure we can all think about what it might mean to someone who says, “I am depressed.”
I am depressed
Another example: A girl went to the hospital with a panic attack, and the nurse there told her that this is who you are and it will be like this your whole life.” This sent her into a tail spin. When you have anxiety there often is a fear that you’ll always feel this distraught. The anxiety feels like your identity – no separation – and that notion is terrifying. What would bring her out of it the fastest is if she believed she was separate from it and that her relationship to anxiety is always changing. The anxiety loses its power. Relationship with anxiety can and does change all the time in every minute.
Externalizing conversations set a stage for taking the problem outside the person and helping a person think about the problem as outside of themselves. The fact that this is an assumption, helps us to know this is not just a technique to call a problem a personified name – like Ed the eating disorder, is it a way of thinking about problems. Instead of blaming ourselves for being flawed, we can take responsibility for our actions and how they might contribute to or resist the problem.
We can say that a person is depressed and think of it as a mental illness but the author, researcher and family therapist, Peggy Papp * found that. “Depression takes place in interpersonal contexts and is profoundly influenced by close intimate relationships.” She says, “The most stressful event that precipitates depression is marital conflict and marital conflict is the single most predictable indicator of relapse.”? So, if depression comes out of different contexts, how can we treat everyone one the same way? If we ignore the contexts that affect people, like oppression, or feeling culturally different: we greatly risk, reproducing the same discourses in our therapy room, therefore, potentially causing them harm.
Locating problems in their context can significantly start to deconstruct a person’s negative identity conclusion on account of that problem.
How many of you have heard someone say that they are really depressed for no reason? This contributes to self blame, because perhaps only a weak person is depressed for no reason. This self blame can and usually does more than double the dark cloud hanging over their head. Often when a therapist starts asking questions about the context of a person’s life, we often find there is a significant context for this depression: for example: a difficult relationship, one or many losses, a sense of not belonging or feeling different, institutionalized and or personal discrimination, history of trauma, the possibilities go on. Recognizing the context decreases the self-blame, cutting the problem down to size.
*Papp, Peggy. (2000) Couples on the Fault Line. NewYork: The Guildford Press.
2. People are meaning makers and are actively engaged in making meaning about their lives.
These meanings are specific to culture and history.
Once people’s problems lead to negative identity conclusions, there is much meaning people could create around this. So “I am depressed” can mean among other things: “I can never get better” “I am weak” “I am worthless” “No one will love me this way”.
When we have a dominant story like depression, we create meaning around this. And then when events happen in our life, we create meaning around these events. For example, if we text someone and they do not text us back, this can mean many, many things.
Including but not limited to; They were busy, the battery on their phone is dead, they are in a meeting, or the shower, they don’t know what to say, they don’t actually like you, they have the ringer off, they lost their phone, they do not know texting etiquette, their thumbs are broken, no minutes left on their phone, or they dropped it in the toilet, they cannot be bothered with answering you, etc, etc. Now if you think you are worthless, which of these meanings will you attribute? Right, they do not like you. And then there is some meanings around why they don’t like you, and there is a voice in your head listing all of your problems.
The second part of this assumption is that meanings are specific to culture and history. We know what we know. And what we know has been taught to us by our family, experiences and communities. These are local knowledges. The dominant stories and cultural knowledges are how we make meaning.
3. People who consult us have meaning making skills, everybody makes meaning about the world around them.
4. Personal narratives or stories are the frames through which people make meaning.
We can think back to the texting example. Someone who feels worthless, will see the event with a frame of worthlessness. If a war refugee’s experience has been danger, they will see the world as a dangerous place. Dangerous events are emphasized and will be noticed more often. Even beautiful spring weather could trigger a very scary memory when in similar weather as they were captured. This is one way the effects of trauma are sustained.
This is the crux of being culturally sensitive. Coming at conversations with this assumption, helps us asks into these local skills and knowledges and or cultural stories so we see the world from their frame. People who consult us will feel more richly understood.
Let’s take the example of grief: people from different cultures and religions have many different meanings of death and how to grieve. How can we expect them to grieve remotely in the same way?
5. When people consult us, they tell very specific stories about their lives.
Time is important and people are often precise about dates. They link events in some sequence and a plot is always present from the outset. (Events, Sequence, Time and Plot make up the narrative.) In other words, people have skills in story telling.
6. Stories are constitutive of life.
They shape life and have real consequences as people live their stories. We create our reality with the stories we hold about ourselves. We perform our stories. Equally, we step into that reality as actors do when they are performing. Examples: Thinking that we are worthless often has us participating in activities that justify this description, like staying in hurtful relationships.
Or, continuing to lie if we see our self as a liar. Conversely, seeing yourself as have good skills in knowing what you could trust about others has these skills more accessible to you. Or seeing oneself as kind has that person living kindness.
7. We are selective about the events of life we give meaning to.
We often place meanings around the events that match our dominant story or stories. So if it is a problem story like an eating disorder, events and initiatives that run counter to that story, like reaching past isolation to reach out to a friend, are often quite invisible and or are rendered insignificant.
So everyday there are thousands of minute, large and everything in between, events and initiatives and decisions that we make. If we have a thin account of our life where a problem is the dominant story, the events, initiatives and decisions we notice are one’s that go along with the problem.
If the ‘story’ is “PTSD”, the following effects stand out: panic attacks, poor concentration, fear of leaving the house, etc. Those events are prominent, even though there are other stories going on, like: I played with the dog, I called someone, I took a shower, etc. They don’t carry the significance.
So we are selective: The meaning depends on so many things. Let’s take the example of putting toothpaste on our toothbrush, one of the thousands of occurrences in our day. Mostly this goes without much notice and is pretty insignificant. Yet, if money is absent in a household, and a family cannot afford the luxury of toothpaste, once they have some, this is quite a significant event.
8. Life is multi storied.
We have many stories that make us up. For example, being a yoga student is only one small part of who I am. I am also a gardener, mother, sister, writer, therapist, friend, movie lover, pet owner.
During a session, a teenage boy told me that he gave up caring about anything. He was at rock bottom and he just did not care about doing anything. I said, “You mean nothing? Nothing at all, like you don’t even brush your teeth.” He said, “No, I still do things like that” “I asked why bother?” I know there’s other stories, I wanted to find some and make them visible. It is through the therapeutic conversations that these other stories made visible and meaning can be created around them.
9. People often come to therapy with an account of their life that is quite ‘thin’ (singled storied) and problem saturated.
One story or more stories become dominant. These have potential to give them ‘thin’ conclusions of their identity, (i.e., depressed, anorexic, abused).
10. There is a stock of lived experiences that exist outside the dominant stories people have of their lives that can be the source of new meanings.
For the teenager I just mentioned, brushing his teeth was off his radar, but it still means there is other stories going on.
I always assume these other initiatives are there, no matter what. There is such an ocean! Michael White used the term “stock of lived experiences,” which gives me such a great image of rooms and rooms full of lives experience to find new meanings. This fills me with so much hope. People have skills, knowledges, beliefs, values, people and history, etc, to find. Sometimes the problem makes them inaccessible. Our conversations are interested in making them more accessible.
11. There are ever present story lines subordinate to these dominate stories that therapists can find entries to.
These subordinate story lines are specific to their culture and history. People already have skills and what skills they do not have they have access to them in their family and cultural communities. If we employ a position of curiosity– rather than as an expert who teaches skills to those who consult us– we can always be culturally sensitive. Assuming that people already have the skills as well as bringing out these cultural stories so they are acknowledged, (where they might have otherwise been de-valued) can quickly bring preferable results.
It is through the therapeutic conversations that these subordinate story lines can get visiblized and meaning can be created around them. Once entry is found into these stories, developing them becomes the focus of conversations. Therapists can then provide structure and therapeutic conversations can provide foundation for people to step into these alternate, more preferred stories.
What is narrative therapy?