Archive for December, 2019

Narrative Therapy: A Constellation of Unstoried Moments

Narrative Therapy: A Constellation of Unstoried Moments

An interview with Amy DiGennaro, MFA, MA, LMFT, ATR reported by Adam Grafa

Narrative Therapy is an exciting and empowering therapeutic modality that takes a unique approach to helping people work through hard times. I recently had the opportunity to talk to Narrative Therapist, Amy DiGennaro, MFA, MA, ATR, LMFT to learn more about what Narrative Therapy is, how it’s different and how it can help someone who wants to make a positive change in their life.

NOTE: Narrative Therapy is a rich, therapeutic approach so what follows is just a brief introduction. If you would like to learn more, check out the resources listed at the end of this article.

How would you describe Narrative Therapy for someone who has never heard of it before?

Narrative therapy is a worldview rather than a set of techniques. It holds the concept that we construct and give meaning to our lives through stories, some that we create around our own lived experiences and others that are given to us by our family and by the society in which we live. Because everyone’s stories are unique to them, Narrative Therapy elevates each of us as the experts on our lives, and that makes it a very collaborative and empowering approach to healing and change work.

A frequent metaphor used to teach about narrative therapy is to imagine a night sky, full of stars. The stars represent the millions of moments that make up our lives, and some of those moments we build individual stories around. Within those moments are influential problems and experiences that become connected and create ”constellations.“ And while there are many, many, many other potential stories to tell—plots and subplots that have as yet been “unstoried–” these constellations are what come to represent the major stories of our existence. For a variety of reasons these constellations are often heavily populated with difficult experiences. Narrative therapists recognize that even during the hard times there are other moments—plots, twists, and subplots—stories that speak to their strengths and resilience, that get left out of the constellations.

By externalizing problems and deconstructing problem stories, narrative therapy enables people to add in previously unstoried moments that they treasure. In time, people feel more connected to their preferred sense of self. So, knowing what people value and listening for “sparkling moments,” narrative therapists help people create a stronger connection to an alternative story, one of preferred ways of living and being, and a positive sense of identity instead of the negative identity that comes from their problem-stories.

What are the main differences between it and other forms therapy?

Narrative is non-pathologizing, meaning it doesn’t locate problems within people as individual faults or disease but rather looks deeply at the systems of their world that might cause distress and suffering. There is a narrative therapy saying, problems are problems, people are not problems.

Narrative does not use techniques but instead a narrative therapist will hold the ideas and the worldview but doesn’t follow what I call a “cookbook” approach where there is a set of pre-ordained steps to the work. It is not just about “thoughts” and changing thought patterns like in Cognitive Behavioral Therapy (CBT) or “positive thinking,” but rather engages with people about what they find meaningful and what they value in their lives. It emphasizes and raises up the wisdom and experience of the person coming to do the work over that of “expert knowledge” or truth claims of psychology of society. This means that narrative therapists don’t impose their own ideas during consultation, but instead strive to be de-centered yet influential. We believe that those we are working with possess the power and agency to stand up to problems and create the desired change in their lives.

Because it isn’t a problem-focused way of working, which many therapies are, it can be much more hopeful, empowering, and even fun, than other ways of working with hard times. It’s not that we don’t grapple with problems or do change work; but we are not talking repeatedly about what’s wrong, not listening for why those problems are showing up.

Narrative therapists believe that problems show up for a reason: that they are a kind of a protest for or against something in the person’s life. Problems can also show up as “unskillful friends” to try to gain access to something “absent-but-implicit” in the problem itself that the person is desiring or needing in life. An example of this might be the overuse of alcohol where alcohol shows up to “help” with confidence in social situations when a person doesn’t feel that confidence is otherwise available.  In this situation confidence is what is “absent-but-implied” in the problem use of alcohol.

What are the origins of Narrative Therapy?

Narrative therapy was initially developed by Michael White, an Australian social worker, and David Epston, a Canadian therapist living in New Zealand. It was conceived as an alternative to traditional psychotherapy, based on the idea that people’s lives are constituted through stories: family and cultural stories that are received, but also more personal stories that they tell and retell about their lives. Narrative Therapy has since become a worldwide practice with major works written by people who worked and studied with White and Epston and then carried the practices outward into the world, like Jill Freedman and Gene Combs who founded the Evanston Family Therapy Center.

Can you share more detail about how it works?

Narrative therapy works through conversation. When someone begins working with me, before we talk about the challenges they are facing, we talk about who they are, independent of those challenges. For example, I might ask them to tell me how their best friend, or someone who loves them, would describe them and about what the preferred stories of their lives have been. This helps me understand what they care about and who they want to be. We will also explore their constellations and talk about some of the main problem-saturated stories of their lives.

Then we might take some time to give problems “problem names,” staying away from people naming themselves the problems. For example, someone might think of themselves as the problem when they say something like, “I never try anything new that I want to try. I am such a loser.” A narrative therapist might inquire about what gets in the way of trying new things and find that Fear is the problem. By naming Fear the problem instead of a failure identity (“I’m a loser.”), we externalize Fear (put Fear outside the person) and talk about their relationship with Fear. Often, through this process of externalizing the problems, we see how problems influence their lives and how they influence problems back. Through all of this we get a good sense of what they want to work toward and what they want to achieve with me and with therapy.

Ultimately, it’s an organic process driven primarily by the person coming for consultation. I always tell the folks I work with that, “I am not the master, I am the midwife. I have some tips and tricks, I will make sure the baby stays alive and healthy, but it’s your baby.” I can tell them when to breathe and when to push but they’re the ones who are doing the work of creating this new life.

What can it help?

Everything and everyone. We all benefit from being supported to become empowered creators of our lives. Narrative therapy holds the idea that each of us is the author of our own lives, stories and meanings and we don’t have to be stuck in the stories that our families, or society may have handed us. It is a creative process that empowers people to move away from helplessness and hopelessness toward a more authentic way of relating to all of life, not just the problems.

If someone wants to learn more about Narrative Therapy, where would you suggest they look?

If you would like to learn more about Narrative Therapy these are good resources:

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Gratitude as Medicine

Gratitude as Medicine

By: Sharon Burris-Brown, LICSW, NBC-HWC

How many of us secretly roll our eyes when people advise us to see the brighter side?  Positive psychology is all around us. We hear that optimistic people live longer. We learn in Positive Psychology that individuals “should” have 3 positive thoughts to 1 negative one in order to have optimal mental health and wellbeing. This theory however, has recently come into question.

But what if you are a skeptic or a “glass half-empty” kind of person? Or what if you are simply going through a tremendous amount of stress and your regular coping skills are not working? How do you build resilience through tough times?

Simply being told to think about the good side of those things that are challenging you is like someone telling you to calm down. And being told to calm down or to look at the positive side of what is driving you crazy can sound (and feel) like nails being dragged along a chalkboard! And if you do that to yourself, how has that worked for you?

Acknowledge First

If you are like most of us, you want to feel better yesterday! Cut out the stress. Push aside the anxiety. But, many of us don’t think about the power of acknowledgment. Before we can see the gift in the struggle, we need to first notice and accept that the struggle is real and how it is affecting us. It is like giving our tough emotions a nod and a gentle pat before moving forward to figure out the solution.

Gratitude Benefits

Gratitude is different than Positivity. You can notice and accept that life feels rotten right now, but still be able to feel grateful for all that you have. Being able to accept that both can be true increases emotional and cognitive flexibility and tolerance for the complexities of life.

Research shows that practicing gratitude can lead to

Gratitude as a Practice

Gratitude does not come easy for many of us. It is natural to focus on the negative, because the tough stuff has the biggest emotional bang and captures our notice more easily. And as doers, we believe we need to fix whatever is wrong. But like any habit, repetition has the biggest rewards.  It takes a lot of repetition to rewire a brain.

Patricia Lucas, PhD, R-DMT, LPCC, a psychotherapist at Lyn Lake Psychotherapy and Wellness explains that gratitude is a “cornerstone” of her practice. She says that she often gives her clients small notebooks and an assignment to write 3 things they are grateful for, daily.

Strategies 

There are many strategies for practicing gratitude. Journaling is prevalent because it creates a structure for capturing those thoughts and a place to put them.

The benefits of a gratitude practice only continue if you make this process a lasting part of your life. It is easy to slide back into the old habit of focusing on what is wrong.

Creating a practice of gratitude “awakens a new perspective towards the self” explains Lucas. She further notes that those that surround the individual can come to new insights regarding them. Thus, gratitude can build and strengthen relationships.

In addition, it allows us to create a peaceful and joyful center even when the storms move through.

Articles

  1. https://www.health.harvard.edu/heart-health/optimism-and-your-health
  2. https://psycnet.apa.org/record/2013-32937-001
  3. https://journals.sagepub.com/doi/full/10.1177/0022167818762227
  4. https://ggsc.berkeley.edu/images/uploads/GGSC-JTF_White_Paper-Gratitude-FINAL.pdf?_ga=2.253577353.1688315782.1576007793-1237496988.1576007793
  5. https://fee.org/articles/how-gratitude-can-rewire-your-brain-for-happiness-and-success/
  6. https://ggia.berkeley.edu/practice/three-good-things?_ga=2.56436395.1688315782.1576007793-1237496988.1576007793#data-tab-why_you_should_try_it
  7. https://ggia.berkeley.edu/practice/mental_subtraction_positive_events?_ga=2.114649863.1688315782.1576007793-1237496988.1576007793
  8. https://ggia.berkeley.edu/practice/give_it_up?_ga=2.47661863.1688315782.1576007793-1237496988.1576007793#data-tab-why_you_should_try_it
  9. https://journals.sagepub.com/doi/abs/10.1177/1948550612473489
  10. https://ggia.berkeley.edu/practice/gratitude_letter?_ga=2.52765608.1688315782.1576007793-1237496988.1576007793
  11. https://greatergood.berkeley.edu/article/item/four_great_gratitude_strategies