Narrative therapy finds telling changes through stories
Graydon Royce
Star Tribune Saturday, June 9, 2001
Since time began, humans have told stories -- epics, myths, religious allegories -- that metaphorically struggled to explain the vast mysteries confronting each life. The stories stirred a chord deep inside the spirit that helped the evolution necessary to establish individual identity, personality, sense of purpose and place in the world. They created pictures for the visual mind, communicating images through words. "People are built to talk about stories," says Will Haas, a retired professor from the Minnesota School of Professional Psychology who also practiced clinically. "They seem to be that kind of symbolic creature." If so, wouldn't it follow that humans could better understand their lives if they learned to tell their own stories? What genre is your story? Who are the villains, the heroes? What subplots lurk beneath the main theme, and what inscrutable archetypes repeat themselves in the shadows? Finally, why do certain facts stand out and others -- just as real -- settle to the bottom of the memory banks? Certainly this concept is alive in the publishing industry -- witness the surfeit of confessionals and memoirs. But now an evolving movement in mental health therapy contends that by tapping into the primordial need for meaning, counseling can more effectively help people deal with their demons, their relationships and their understanding of life. Operating under several nomenclatures, the umbrella philosophy is generally referred to as "Narrative," a comprehensive perspective that trudges willingly into the human soul and eschews the diagnostic temptation to label and categorize pathologies. "This isn't only psychology we're talking about," said Jacquelyn Wiersma, a Minneapolis psychoanalyst, teacher and researcher. "It's a movement, an intellectual, world-understanding movement. Narrative is an approach to understanding life." Walter Bera, a family therapist and advocate, said Narrative "invites the premodern approaches of myth, story, ritual and faith." Some professionals demur, offering that Narrative has excellent applications but skims along the surface of the psyche. Creating the bogeyman The most popular manifestation of the movement is a form of family counseling called "Narrative Therapy." Michael White, an Australian, and David Epston, a New Zealand family therapist, are the principal proponents of this approach, which draws out the stories of clients, looks for omissions, and then helps the individual construct a "preferred reality." Bera, a Minneapolis psychologist, champions the Epston-White school for its ability to bring client and therapist together on more of an equal footing. "Many people come to a therapist in a supplicant mode, where they confess their problems to a priest. And the therapist turns to the diagnostic manual and pronounces a therapy course that sounds like a penance for your symptoms," he said. Instead of that model, Bera argues a therapist can be an ally in arms, a colleague or archaeologist in rummaging through the storehouse of individual experience. It is cathartic, Bera says, for a person struggling for their mental health, to have someone willing to listen to their history. "In the sea of experiences, they make sense of it by pulling out a subset of those experiences and saying this is more meaningful," he says. Within that storytelling, Epston-White's primary instrument is what has become known as "externalization," that is separating the condition from the person. To say a person "is depressed" definitively ignores myriad other aspects of their makeup, Bera says. More appropriately, it should be said that a person "struggles against depression." That pathology then takes on an identity of its own, becoming a villain in the story of the client's life. "What's a story without a villain?" asks Haas. "Or a hero who doesn't take responsibility for what he or she does? All those crucial issues are brought out by narrative." Once a client externalizes the pathology -- a concept not unlike "hating the sin, loving the sinner" -- he or she can begin to see where that villain pops up in different guises throughout the personal story. But equally important, the client can begin to realize there are many parts of the story where the villain isn't present and that those moments represent peace, happiness and homeostasis. "It's a story, of how did you come to be so unhappy," Bera says. "It's like a book, and a well-written book has many different themes and it's ambiguous. So I might ask a person, what percentage of the time are you depressed? And then I ask the counterplot question, what is going on in that time when depression is not obscuring your life? Who are you with? What are you thinking? And that's the beginning of the counterplot against the story of depression's influence. It's the story of resistance." Which can be a powerful story, one found in the barricades of the French Revolution, the heroes of the Alamo, even in the courageous fathers and mothers of the United States, resisting the tyranny of an external oppressor. Those images, the mythology of resistance, is what takes over and works in the spirit of the client. Deep enough? Narrative therapy has become a press darling, riding the trend of postmodern Zeitgeist. And it has produced results primarily in family therapy, where relationships are paramount and individuals wrestle within a group of distinct personalities. In that setting, the externalized problem simply becomes one more relationship to manage. Weirsma calls it a form of cognitive behavioral therapy -- which asks people to look at their thought patterns and change them in a behavioral way. Very fine as it goes, she and others say, but as developed by Epston-White it can rely too heavily on technique. "I like the approach, the idea that therapy is an exchange of stories," says Lyn Cowan, a Jungian analyst from Mendota Heights. "It might be practically effective, but it's intellectually not as satisfying. That's a long-term question." Carl Jung delved deeply into the world of archetypes and shared unconsciousness that would seem a perfect dovetail with a therapy based on the imagery of storytelling. Cowan, though, sees it as a prelude to psychological work that leads to deeper dimensions. "On an individual ego level, with everyday problems, narrative therapy offers excellent technique for giving real help," she says. "But it doesn't give me anything that explains the mystery of life. In Greek tragedy, the principle involved was how someone else's story affected me. Here, that theory is more about my story and how it affects me. The advantage is in dealing with personal problems, but it sacrifices mystery." Haas, too, wishes the Epston-White school had more of a footing in psychological academia, which might have the effect of making it more reflective about what it does. "Rather than just saying 'Oh, try externalization' -- which could be a wonderful thing, but there are places where I wouldn't do that -- give it a context of understanding, a rationale and an expectation for when it could be good and not good," he says. Wiersma calls externalization a "useful technique," particularly when dealing with such issues as shame. Where it fails, she says, is in addressing "profound meaning, something that is shaking you to the core." Bera agrees that it's legitimate to ask questions about Epston-White's grounding in research. It's new, after all, and needs time to develop its ideas, he says. But he cautions about making judgments based on a cursory reading or experience. "Critics often change their views once they have actually witnessed the work via videotapes or more in-depth reading," he says. In many ways, Narrative Therapy is a story that is still being written. Its complete meaning won't be known until the book is finished.
-- Graydon Royce is at groyce@startribune.com .