[Music] foreign [Music] to narrative therapy and so today I am going to talk about um narrative therapy and really about how to uh apply using it um so we'll go over less of the history and just more about the key Concepts and how to use it in contemporary practice so let's get going so the least you need to know about narrative so narrative therapy um I guess I should start by at least saying that it really evolved out of the work from um Michael White and David Epstein down in Australia New Zealand and it has been I would say one of the most popular post-modern approaches out there in the United States it's definitely very very popular but it is very closely related to collaborative therapy and the work of Tom Anderson who did reflecting teams and Harlan Anderson and Harry galusian they're all very much grounded in social constructionism and narrative therapy puts a little more emphasis we'll talk a lot about these dominant discourses and local discourses where I would say collaborative therapy focuses more on the local discourses and you know brings in the dominant discourses as needed so but I think the concepts of social construction is foundations of both are very very similar and I I think when you look at like collaborative versus narrative collaborative has a lot fewer clearly structured interventions and it's grounded more in philosophy where the narrative therapy you're going to see has tons of interventions in fact um you know Michael White has passed and right before he passed he did write a whole new book with describing his work with a whole new set of interventions so in my textbooks I swear to God the intervention section and narrative goes on and on and on in fact I cut some of them out for this presentation because I'm like this is just overwhelming um so the narrative has a lot more structure and so you will see actually in cultures where very Hands-On practical cultures like the United States they tend to gravitate to narrative because it's like I can grab onto this I see what I'm supposed to do in other cultures like in Europe where there's a lot more training in philosophy and World Views the collaborative kind of fit so you will notice that there's some real personal differences as well as I think cultural differences in terms of which form of post-modern approach resonates and makes more sense to you that said I I think there's so much wisdom in both of these approaches that they're it's you know if you're gonna you know they're they're both worth learning and actually all of us have a lot to learn from these approaches because post-modern Concepts have been integrated across all the major therapy approaches because they are really um some of the best ways to address diversity Equity social justice issues and so these are very important approaches whether or not they're your primary way of working wow that was a lot to say to get started but let's keep going because now I'm going to get to the slide here so the least you need to know so grounded in social constructionism narrative therapists really um conceptualize lived realities as being our realities or stories our identity is stored and you know the truth is when you look at neurobiological research our brains work in stories we are our memory is all storied and so there is both some neurological foundations and this is also how narrative therapists they use the metaphor of of story a narrative um to conceptualize what is going on and so you know life happens and then all the you know it's you know in a given day we actually have an infinite number of data points to put into our story of the day of our identity and we all have to pick and choose what we put into those stories and narrative therapy is really a process for helping people do that a lot more consciously to get the life results and the outcomes um that you're hoping for and so these stories are really affected by dominant discourses about and these dominant discourses every society has to have a dominant discourse and I think the best explanation for this really comes from the work of John schotter who is a social constructionist not necessarily a therapist but more of a a theoretician and he talks about every culture is organized and has to be organized around a set of shoulds and goods these are the good behaviors that we all use these are the behaviors that mean we are safe we're working as a community these are our shared meanings these ideas about how to organize and humans cannot coordinate action we could not create you know towns we you know we could not rely on each other for food and everything else we need in a society unless we have shared meaning and so these dominant discourses really start out as a way for any group of people to coordinate behaviors um so that we can create societies create safe relationships and to create and pursue a good life together that's actually where they come from they're not these evil they don't come from an evil purpose right but every culture has to do this around the planet and they always have and as long as humans live in groups we need to do this or we don't know what is safe or not safe and we spend the whole day trying to figure out like if you know when a person does it x what does that mean is is that good or is that bad or you know are we going forward are we making the sale are we gonna you know is we have to have a set we have to have some form of dominant discourse you cannot get away from them and so what happens from a narrative perspective how problems get formed okay is when your lived experience isn't matching up with that dominant discourse and there's a distance there you know this is what you know happy life should look like so in the United States we have the you know white picket fence you know 2.1 children you know home you know coupled with children you know that's kind of the white picket fence you know story of What happiness is supposed to look like and what you're supposed to be going for right and so when your life doesn't look like that for example you may feel sad depressed angry whatever you you don't you know so you can create a problem because your life doesn't look like this and of course we all live in we all have multiple different dominant discourses actually affecting us which is both good and bad I think in today's world especially with the internet and social media you know it's very possible you know Society has now more dominant discourses out there um than ever before and it as I think we're experiencing it can make Society very chaotic because we have so many competing different dominant discourses out there and so if there's not just one affecting us and the various you know an individual can have many different dominant discourses affecting them and they all can have very different definitions of what the good life is what a good person does what you know constitutes happiness you know where I think you see this the most sharply or one of the many places we see this very sharply is in immigrant families right so you have you know a family that's immigrating to the United States and their children get exposed to some very different dominant discourses especially around middle and high school and and that can often clash with their parents and so there's no simple answer there there are just you know two very different cultures with two different sets of goods and shoulds two different you know actually more than two but you know two main different sets of dominant discourses that that there's no simple resolution sometimes and it can be a very difficult to navigate you know successfully so um but that's how problems form from a narrative perspective so and a lot of the process of narrative therapy you're going to see involves separating the person from the problem in a process that they call externalizing there are many different ways to externalize in narrative therapy and I think when you read the original literature like from around 1990 it was a very literal externalization and over time as you know white white in particular's work has evolved it's it ends up being much more linguistic and um a little more subtle and there are lots of different ways to do this sometimes you'll meet clients who really resonate with literally externalizing the problem you know it's the you know it can be let's say an eating disorder like anorexia or um you know depression or anxiety whatever it is some people almost talk like this naturally or they they really pick up on it if you talk like that uh in session and for other people there it doesn't resonate and it feels really weird forest and foreign and you know in general my guideline my personal recommendation there is you know do what works it's my motto um so there are many ways to externalize and we will be talking about that and that is some of why there are so many different interventions in narrative therapy um so but that's the um but by separating the person from the problem you start having different types of conversations and dialogues with the problem seeing it from New angles and that's what creates the new possibilities and perspectives so let's talk about uh the juice the significant contributions to the field so I think narrative therapy more than any other major approach um besides you know I would say feminist types of therapies really puts societal concerns societal discourses social justice you know at the center and the Heart of this approach in terms of how they conceptualize and so they talk about these dominant discourses which are these culturally generated stories about how life should go and you know sometimes people get into this like utopian well you know we just need to get Beyond these dominant discourses they're bad they're the problem and you're never going to get Beyond now we need a a healthy culture As We Know when I talk about um in the postmodern philosophy sections of my books is that you need to there are these dominances courses but the most important thing is those marginalized voices are able to be heard and influenced and reshape dominant discourses so we're constantly in every society hopefully and every known oppressive Society um that these marginalized voices are being able to be heard and reshaped the dominant discourses we create a new dominant discourse that lasts for a while and then it re gets reshaped again as marginalized and so that is ideally what a Humane Society what democracies are hopefully designed to do is to keep evolving that dominant discourse but you cannot get away from dominant discourses if you want to coordinate human behavior so don't think of them as something totally negative that needs to be dismissed and gotten rid of and totally rebelled against that's not the right attitude toward a dominant discourse and so and so we're using this though to coordinate this is how we coordinate our relationships you know happiness job success all of this and and typically there is always some kernel of good I mean these these dominant discourses began with people seeking good in the world um but there's no because every dominant discourse has to oppress something you know so you know everything from shaking hands you know hugging people versus kissing them you know on their cheek to greet people all of these are just socially coordinated ways of um organizing behavior and and so just remembering that there's not um there's no kind of getting rid of these uh discourses they are part of the fabric of our society and being Humane means creating space to always have them be questioned and in therapy what we are doing is we're working with our clients to look at how they even interpret those discourses where they came from do they as an individual agree with them are they working in their life or not what would be another way to to look at this you know Human Experience from a different lens are there other discourses that really resonate more with them and so we're really it's not like one discourse replaces another I think of it as we're often just braiding we're pulling together lots of different discourses is combining them together in a way that resonates more with the person helps them see new possibilities and you know reshapes their identity in a way that really helps them enact what they would say is their preferred Identity or narrative so local discourses and this is kind of a a strange dichotomy there's not like there are lots of ways to Define what's dominant and what's local and you know one discourse can actually qualify for both in different contexts and circumstances so please don't get obsessed over whether it's dominant or local necessarily but the local discourses typically refer to those marginalized voices that aren't lining up with the dominant ones so these are might be what's going on in our heads and our relationships and marginalized communities that really have identified an alternative set of goods and shoulds right now and so there is this tension that every society has and on an individual level we all have both of these playing out in our lives and a lot of what narrative therapy does is just have us identify what these discourses are name them put them into words because most of us don't name them and put them into words to begin with and to allow a person to step back and reflect on all of these different um definitions of what's good and what should be happening and to to identify what's what really works for them individually and how to move forward in a way where you combine all these discourses uh in a way that really resonates and feels true and right and good for your own life so let's look um just how treatment big overview of treatment and the phases here so the first phase of narrative is what they call meeting the person apart from the problem and what they mean by that is just getting to know the person what are they interested in you know where do they grow up you know what do they do for fun who are they as a human when they're not having the problem and so oftentimes that means when you first sit down instead of saying you know tell me why you're here you would ask you know um you know um so tell me you know before you would say something like before we get into why you're here I just want to get to know you a little bit as a person so can you share with me you know some of your hobbies or interests if it's a family what do you all do for fun you can ask where someone grew up what they do for work what they like about their work what they don't like uh you know so you're getting to just know the person apart from the problem and a lot of what you're listening for when you're doing this is for strengths abilities resilience meaning what's important to them like who are they as a human being and so getting to know the person apart from the problem and this is especially good for anyone who might be hesitant to come to therapy because it's like an easy conversation it is about strengths um and it's just an easier conversation to have and it often feels um just sets the the tone for I'm going to see you as a full human being who has all these other abilities and um to be curious about who they are what their life is like and sometimes they're you know that that often for a lot of people just takes down some of the stress of first coming in um to to therapy to talk about their problems so and it's really a fun way to start it's great and you may only spend like usually five five ten minutes um and so so this is typically how it starts and it's interesting as I'm saying this you know the other person who did this was Jay Haley who had the social stage he called it where he would just begin just talking and as a normal human being with clients so the next thing so even as you're listening for this okay you're listening for um dominant discourses and the effects of the problem in the client's life so whether you're working with an individual couple or family you're listening for you know so then you get into why what brings you in here today right and they start talking about it and you're listening for how either you know sometimes they're family dominant just families can have their own discourses and narratives I guess it's more of a so Life's a good example family narratives right uh like intergenerational family narratives they're kind of local but boy they can have the effect of a dominant discourse it feels very oppressive so but you're listening for those family narratives Society narratives um what their friends are saying what they believe about the problem you know and how you have to solve whatever their problem might be where their problem came from you know so you're listening for all of this as they're sharing um about whatever the problem is whether they're talking about depression or anxiety or conflict with couples or families and then as you're listening you start separating the people from their problems so you start looking at how the problems are influencing the people whether it's an individual or a family problem and then also how the people are affecting the life of the problem which is we're going to get into those interventions but you you literally they literally see them as separate there's people who you know and there's the problem that's influencing the people and the people who are influencing the problem they see it as a two-way relationship and they're listening for those Dynamics and we'll get into the techniques and specifically how they do that and then once you know we've spent some time getting to know the person and getting to know the problem we start looking for what is their preferred reality what is their preferred narrative their preferred identity how are they prefer to be relating to this problem in their life and so that is where the change starts happening and so you know so that's kind of how they conceptualize um therapy and the process of therapy in narrative oh one more bullet I'm so sorry uh so at the end of course you're solidifying these preferred narratives and um so that this really becomes your dominant way of being and relating to the problem and the world so there's you know just kind of solidifying those preferred identities um through therapy at the end of therapy so and a lot of what's Happening Here and I really want to emphasize this this is not a storyectomy meaning we're not trying to get rid of the problem story and replace it with a preferred one it's not like we're switching out stories because sometimes when people first hear about narrative they get that kind of impression so I want to be really clear that what's not what's happening is we're pulling in in most cases what you are doing sometimes there are some case cases where you're really just deconstructing a you know a particular narrative that might be going on um but in most cases the way you're deconstructing is you're you're looking at alternative narratives or alternative perspectives on that dominant discourse so there's we're deconstructing it in a way and then we're pulling in lots of other usually local narratives and it's more like we're weaving together a more complex holistic comprehensive thicker description is what they call it in narrative and if you ever do qualitative research they talk a lot about thickening descriptions these rich descriptions so it's more like you're you're not getting rid of you know the story that let's say you were abused right we're not we're not getting rid of that story because that would be total denial and unhealthy okay that would be crazy so what we're doing though is you know oftentimes we're looking at that you know small acts of resistance and how a person did resist the abuse the things that they did do we're pulling in a much more realistic way of looking you know at what a small town what a small child can do in these types of situations we're pulling in let's say the neurobiology of trauma and how that played out across what happened to them as a child so we're thickening it we're pulling in all of these other goods and truths and shoulds and ways of looking at what happened so we end up with a much richer um ruler comprehensive narrative that allows people to move on and enact their preferred narrative so to move on in such a way that let's say their childhood trauma no longer affects their day-to-day behavior and so so that is the thickening of descriptions and so it's not getting rid of all bad difficult painful stories it is pulling in revisioning reinterpreting looking at other narratives Alternatives sometimes dominant discourses it could be alternative local discourses but we're pulling things in to just have a much thicker richer description of what is going on so let's look at how narrative therapists connect and form a therapeutic relationship and I will say this it is very similar to what collaborative therapists are doing in fact I have an article I published with Gerald monk who is a well-recognized narrative therapist and we wrote it about the therapeutic relationship and collaborative versus narrative and it was a very funny article to co-write with narrative with Cheryl because I'm like Gerald get out of my section stay in the narrative section you keep crossing the border over to over to collaborative any honest to God truth is and yes Gerald and I did publish an article on distinguishing the two but I think when you watch collaborative narrative people in action there's a very similar field because it is a social construction you know the therapist is entering the client's meaning making system using a lot of not knowing curiosity um really wanting to understand the world from within the client's perspective so a lot of what happens in collaborative and narrative this social constructionist way of connecting has a lot of similarities and um I just think that's helpful to to Just note as we get into this section so um thankfully they use different vocabulary so here we go meeting the person about apart from the problem that's a real important um mindset that narrative therapists have and this is similar also to solution focused therapists where they there really is this strength focus when meeting the person and you see the person as capable as having strengths and resilience and the capacity to deal with whatever they are coming in for help with and so there really is this Aura of Hope and positivity that is palpable in um narrative therapy and I would say you see it in the other post-modern approaches so they they begin by wanting to meet this person and I can't describe it other than the fundamental assumption is the person is not the problem the problem's not part of the person it is a you know something separate and distinct that is influencing the person person is influencing the problem but they are separate and distinct that's just really how they see them and there was just a mind shift set that comes here so seeing people as dysfunctional or families as dysfunctional you know that's just not how they see people it's just not the template that you use I don't know how else to describe it and so when I say the problem is the problem the person is the person the person's not the problem like that it is just this fundamental mindset shift that really characters people who've learned how to use narrative well um you will also see narrative therapists um and I would say you see this very clearly also a lot of solution focused work and in collaborative but there is this optimism and hope that is I I like to jokingly call it neurotically optimistic it's my loving way to refer to it um because they are just so hopeful um it is unwavering there is this you know deep sense of you know we are going to work together to you know resolve whatever is going on and and so it is sincere it is not patronizing it is not Pollyanna there is this and I think you see this in a lot of the postmodern practitioners it's it's like we have this approach that really can help people um unravel what's going on and find better and you know more effective ways to move forward and there is a belief in the process and there is this unwavering Hope For Humanity and I actually would say as a practice someone who practices in this way a lot of my personal life you know actually involves ensuring that I maintain high levels of Hope For Humanity and so that affects how I you know how I read the news and access that if you know I need a steady diet of positive influence I'm always reading something do you know uplifting about Humanity you know I have my good news you know newscast you know I cry when I read it because it's so many good humans out there doing great things and I I think actually when you do this work is it reshapes your personal life and what you allow in and out and that doesn't mean I'm like like um you know trying to be Pollyanna and how I live my life but the truth is drama cells right the negative news is what people read and so all of our capitalist media systems are totally built around the fact that people are more likely to spend money listening to drama gossip and negativity and humans are a lot less likely to spend money on just the positive stuff and so you you need to you want to make sure you're getting realistic news about the world but you know knowing that much of the media is biased towards negative and you often need to counterbalance that with positivity um and for me that involves reading a lot of spiritual stuff always on my bedside table and the day with some hopeful you know version of humanity and I think it's a real important part of doing this work well and I think how you leave your private life affects your ability to connect in these ways there um so sometimes in narrative literature especially I would say the earlier in literature you'll see they sometimes refer to the therapist's role as a co-author or co-editor it doesn't mean that you are rewriting their story okay and what it means is though that you're helping them be thoughtful about how they shape their narrative about who they are what their life is about with the people in their life are about so that is a um one metaphor you'll see in the literature another metaphorical in later literature this was in Michael White's later work he and this is why the chapter gets so long I apologize it's really not my fault um that he called himself an investigative reporter where there is this intense curiosity wanting to know the details of the story and I resonate with this for me um I think more of as an anthropologist or archaeologist in fact that is Gerald Monk and um and Wednesday they used the archeology metaphor but and that kind of brings us when I said it's very similar to collaborative it's all about this curiosity about how it all works and this intense curiosity about how all that comes together where those influences are and the dominant the local and wow how did that happen there is this uh it feels like you're on an adventure I don't know how else to describe it so in my therapy that works unifying framework I talk about entering you know the clients 3D virtual reality like a Holodeck where you're just like in this totally new world that has all these different you know rules for relating and how things happen and so there is this just like intense curiosity um and it could be investigative reporter archaeologists Holodeck but curiosity is the key there and it's because you're really seeing the world through someone else's eyes trying to use their meaning making system under standing it and how they make sense of their world so this is really hope it gives you a sense of how narrative therapists relate so let's look about their conceptualization case conceptualization and kind of how they would assess the problem so the first thing that they're listening for is the problem saturated story so this is the story where the problem plays a leading role in the client's life and often the client doesn't have as much power and oftenly often feels like a victim in some way and so this could be depression or anxiety it can be um it can be the conflict in a couple or a family so we're listening for the problem-saturated story you know who what's the problem that has you know so much agency in the client's life and that make where the client feels like they don't have agency where they feel like they're a victim and um and then they listed for you're always listening for unexpected outcomes unique outcomes or what they call sparkling events actually on um unique outcomes is the term that's typically used but these are like stories subplots when the problem doesn't play out in the normal way it's like the problem could have happened but it didn't and this is where you're looking for how people may have influenced this or even external factors but you want to understand those kind of um sparkling moments right um and so you're listening both for this problem-saturated knowledge and and then the times where things didn't quite play out the way the dominant problem narrative would have said it it should so you're listening for these sparkling moments and oftentimes you're gonna you can ask directly about these you know is there ever a time where you know XYZ or whatever normally your fights happen you know but you two didn't end up fighting and sometimes they can come up with it and then sometimes they just tell you you know we don't fight when X Y and Z they're very aware of it sometimes it kind of comes out in a story now sometimes what you're here listening for is just the problem is less severe or versus more severe so sometimes like with depression it's normally like all gone you know totally gone versus you know you know totally bombarded by depression and but there's often times where it Ebbs and it flows like for a lot of people they are just they experience their depression less at school or at work okay so even though it may not be depressed they're Curative depression when they're at work or at school it certainly has lessened and it doesn't follow them as heavily in these it doesn't influence them as much at work or in school and so you would be curious as to why that might be so and then you're also listening specifically for any um dominant culture gender sexual orientation any type of marginalization that they might be experiencing due to their social location and listening specifically for that asking about that bringing it up and talking about that because most clients aren't going to bring it up unless you talk about it so and you're not gonna and you're going to bring it up in a very open-ended way you know you can say do you think in any way being um a man woman non-binary whatever it might be is related to this problem and see what they have to say and there will be times where the client might say no I don't think so but you as a therapist may think so and in those cases you know hold it tentatively you're not going to force it on a client you might find another have another conversation where it makes sense to bring it up in a different layer a different angle but you're always going to honor the client's reality rather than you know forcing any of this um on them and and so being very respectful about how they see which of these um discourses around social location may or may not be affecting them and then again you're also listening for local or alternative discourses so um you know for example if you have someone who's your client is from you know a specific ethnic group and you know you can ask directly about that sometimes they do have local communities they might be religious communities they may just be around ethnicity they can be around you know particular type of ethnic dancing or other you know hobby or music or whatever it might be and so asking about those smaller local discourses and how that might be affecting them and their experience of the problem so just being curious and kind of understanding how all of these different discourses you know unique outcomes all kind of play and come together and you're not necessarily trying to identify the one discourse that is the problem you're more Curious and open and just tracking the influence and you kind of let them percolate in the client's mind okay you're not you're just pulling on all these threads together and what happens is with all that once you lay all of these out in a conversation the client starts putting those pieces together in a way that has meaning and significance for them and typically what's going to happen is they're going to see new oh yeah I can see that angle I never thought of that oh yes I see that angle and as they see these new angles there's new possibilities for how to deal with things and often it's not so much that they're going to sit there and literally rewrite their identity narrative or really you know surprise you know move one story and prefer one and or edit a story literally but you're like pulling all of these things together and letting them you know percolate and float in the conversation and allowing the client to kind of reorganize how they see all of these influences in their lives and and I think the key really is you start consciously choosing which of these discourses you are going to value and align your behaviors and your actions and your emotions to and there's this conscious Choice which reduces that sense of being a victim because now you have agency and that is so important in all of these post-modern approaches so let's look at how they approach change in narrative therapy okay so the overarching goal in narrative therapy so you can put this at the end of all your treatment plans is enacting a preferred reality or an identity okay and ultimately it's increasing one sense of agency and this is the exact same um long-term goal that you'll see in collaborative therapy is increasing a sense of agency because these problem-saturated stories make us feel like victims and and there are a lot of dominant discourses and at least I I think American society where you know it brings out this victim identity and so what a lot of these post-modern approaches collaborative narrative it's increasing a sense of agency reducing that sense of being a victim so obviously in the early phases you're going to be stabilizing um the client and you're also beginning to do some externalizing in the middle phase is where you're targeting the immediate you know symptoms the presenting problem and in the later phase you're really looking at helping people really solidify a personal identity relational identities and even an expanded Community identity where um where they feel like they have a sense of agency it is a preferred identity in reality um and so you're that's kind of what you're doing in the later phases okay so now let's look at some of the narrative therapy interventions there are a lot of narrative therapy interventions and so um but I'm gonna we're gonna try to highlight some of the major ones and I I think there is a real theme that runs through a lot of these um but narrative therapists had a lot of fun constructing lots of different ways to describe what they do okay so externalizing um so this is where both conceptually and linguistically you are separating the person from the problem and the therapist always sees the client and the problem separate and a lot of what we're doing is helping the client to see the problem as something separate outside of them um at least conceptually and sometimes it becomes very literal and to be able to then to use that space and distance to relate to it in different ways so um and so so you're you know working with helping clients shift from seeing themselves as having a problem to seeing that there is this problem that is influencing them it could be Panic it could be a couple conflict it could be ADHD it could be anorexia it can be um you know looking at how we're going to name this problem is separate and see how it influences us so and there are lots of different ways that narrative clinicians have done this over the years so the classic beginning I would say approach from Michael and white was called mapping the influence of problems and then you go back and you map the influence of persons so it's this two-part process don't ever just map the influence of the problem without mapping the influence of the person please so make sure you always do both um and so when you're mapping the influence of the problem you are actually looking at how the problem has influenced the person and you typically start by you know what's going on in the person it might be physical emotional um just how it affects the person and their behaviors and then you start looking at the next ring of all their relationships school work you know their community and you you actually even expand it bigger than the client probably thought about the problem when they walked in the door okay so and I you can look at my textbooks it has all the you know the specific questions for this but you're you know expanding it so don't ever like expand it really big because that's actually what you do in the beginning here you know so like for example if you have a kid who's got like ADHD you'll be looking at how it even affects the parents and their identities and their work life and their social lives like you actually really map it out big okay never stop there always go back and then map the influence of the person or the people involved typically it's usually more than one and so here now you're looking at how the client and their significant others and family have shaped the life of the problem so why isn't this so one of the best questions in all of psychotherapy why isn't the problem worse than it currently is okay so things could always be worse knock on wood here but um so why why aren't they worse why why hasn't it gotten more out of control where has the person how where have people influenced the problem how big it gets when it happens um where have they successfully Managed IT and you know what other parts of their lives have they kept going despite the problem right so you're looking for and this is how it's affecting everyone and how everyone has influenced it so much there's a lot of Hope and positivity and strengths and this is also where you often hear what works where they have the most influence and you get a lot of good ideas for what to do more of and for sometimes with clients that's all they need because they weren't conscious so many clients are not conscious well most of us not just clients let's not just pick on them most of us are not conscious of what we do that makes our lives work well and that's all because we have a limbic system here if you know the handy model of the brain from Dad and single right mini version of this prefrontal cortex smart part all the conscious Choice language executive functioning self-regulation we have the lizard brain down here which is our fight and flight freeze response so in our rep it's I know it's not literally reptilian I use it as a metaphor we know medically it is not a lizard brain but yeah I teach mindfulness to kids and let me tell you this metaphor works I teach it to adults this metaphor works so but in this fight flight freeze we have the amygdala and the amygdala is always noticing what causes problems we do not have a similar part of our brain that is tracking what works and so all of us humans clinicians clients the average human we have to use our prefrontal cortex to consciously go and look for what solve problems when does the problem not happen what works that takes effort and conscious choice and so that's why mapping the influence a problem of the person is so important because that is not something that takes effort and that's what the clinician is there to help clients do so always make sure you do both parts and so again when you're mapping you know we have separated the person from the problem you really also want to avoid very totalizing descriptions so even describing the problem is all bad is it can be problematic believe it or not and so you want to even avoid dualistic thinking um because in some ways you can get into areas where it's kind of invalidating um and it may even kind of obscure a broader context and so for example couple or family conflict right sometimes it is because someone's voice they need to advocate for their needs because they're not being addressed right now in the couple system or the family system so even you know conflict within a relational system isn't always all bad because sometimes you know someone's voice is not being heard and it needs there needs to be more room made for it so you also you know everything every symptom in life has strengths and and weaknesses you know for example you know obsessive compulsive thinking you know it can be part of a you know very difficult disorder but on the other side you know it can also create you know an ability to plan and organize and so it cuts both ways so there's always every problem has is a strength and a different context so I like to joke when I hire saw an administrative assistant I'm like yeah a little OCD goes a long way I'll take a little of that don't want them to suffer too much but boy I want someone who can keep details and date straight right so so whatever the even you know whether it's depression or anxiety um whatever it is everything in a different context can be a strength or resilience there's always what I call Shadow strength through any symptom that a person might have so oftentimes people who tend to be depressed right they're they're actually often assessing things realistically quite frankly there's research behind that um they often are deep profound thinkers they often feel deeply right so someone who has a capacity for depression also has the capacity for a lot of depth and reflection you know on life and the meaning of life existential issues so you know in a different context it can be a real strength and so just being careful when you talk about problems and not demonize the problem we're building a different relationship with the problem is a better way to think of it and often those symptoms began because you know a part of us was try trying to deal with another it was something that was going on in our life that was difficult so for example childhood trauma or abuse or neglect right you can end up with adult symptoms you know that you developed as a child dealing with something difficult but at the time that's the only coping skill the child had available right so that was a child trying to deal with really difficult situation and this symptom was the best way they could figure out how to do it so just making sure that you you even have a compassionate Humane relationship with the problem so a very common way to externalize is with questions and typically what you're going to do is take the adjective and turn it into a noun right so instead of saying when did you first become depressed right depressed is describing you and it's an adjective for you you would say when did you you know narrative therapist would say when did you first notice Depression started influencing your life or when did you start first noticing that anxiety started influencing your life when did you start noticing conflict you know influencing your relationship so you you turn it into a noun and whenever you're talking about the problem you talk about it as a noun and then there's also this kind of presumption in your externalizing question that the problem is separate and you see this two-way relationship that's how you see it that's how you talk about it and that's how you ask questions about it so you know when have you been able to influence depression and keep it from you know taking over you or sometimes you're going to say it if they talk about depression is the cloud so when have you been able to get out from underneath that cloud and separate yourself from that cloud you know um and and sometimes you'll play with that metaphor you know when were you able to shine enough sunlight to have the cloud disappear so you can play with a metaphor too but you're seeing it as separate um from yourself and typically you're going to see whatever metaphor the client likes and works with um and what resonates with them for how to talk about and and how to externalize the problem so um this is definitely one of my favorite narrative interventions it's a different way of it's a different form of mapping I guess yet we are mapping again but you're mapping in the landscape of action versus the landscape of identity and consciousness and so what this mean is you start so typically what you're going to do with this one is you're going to find a unique outcome so when the problem could have happened and it didn't or the problem was a lot less severe than we expected it to be and then you are going to make sure that this is an outcome they'd like to have more of these things happen in their life and then you're going to map in the landscape of action so this is getting critical events circumstances sequencing timing and the overall plot like exactly what happened you're getting a lot of detail of what exactly happened here um and I call this kind of getting the movie and then what you look for next is how did the client what happened in the person's Identity or Consciousness you know as this preferred outcome unfolded so looking for you know what was going on how do they feel about themselves their relationship where do you know if they got courage or got a new idea how did that happen where did they get it so you're looking then what's happening in um Consciousness and as you map these two things out typically clients become a lot clearer on what works what doesn't and and looking at how they can use their resources and skills to have more of the to have more of these preferred outcomes in their life okay yet another set of questions um so intentional State questions so these are questions where when someone's talking whether it is about a preferred outcome or a problem saturated narrative you can ask about what were your intentions so whether or not things ended up the way they wanted to you have them identify and state out loud what their intentions are and that helps build a sense of personal agency and to hopefully see um sometimes especially if things didn't play out the way they hoped that they had the good they had good intentions they were trying to do XYZ and some unforeseen things happen but increases a sense of hope and agency and also more positive sense of identity overall and then they also look at um when they're looking at agency what are you thinking feeling when all of this is happening and so um so so this internal State question um is helping them identify um you know uh where they had a diminished self of agency versus you know and hopefully then see also where they um where they could have more agencies so oftentimes we feel very powerless because of a circumstance and so these you know intentional internal State questions are helping people realize oh yeah I just totally bought into I couldn't Rock the Boat you know and I wasn't willing to you know upset people and I just went along with it you know and I can see you know that and my intention was to you know keep you know this piece so I you know rather than have this immediate conflict and sometimes that is the right decision sometimes they're like yeah I probably you know should have said something so this is where you're trying to gonna get just get a sense of what was going on internally for them foreign narrative interventions that you'll hear talked I think a lot about in contemporary narrative circles is this concept of scaffolding questions and so that is taking clients from what is familiar to what is novel okay and so you don't start by immediately rushing to their preferred outcome but you scaffold it you slowly ask questions is this you know there's a whole series of questions you can find them in my textbook but you're going to ask you know a series of questions to help move them from these low-level distancing tasks so what was going on for you at the time how did you feel you know was there any part of you that was you know surprised or had you know second thoughts or whatever that might be and then you you know starts asking medium level you know so as you look back now when you think about that you know do you have a different perspective or other ideas and then you slowly start moving them to a place where what would you have preferred to done what could it you know how would you like to see this go better you know and so you're slowly moving them from the problem saturated narrative to their preferred narrative and then tracking their beliefs their hopes and weaving their identity together from you know this is what totally made sense in that circumstance and you know going forward you know I think this would make more sense for me is kind of weird but you're scaffolding it so that the their preferred identity is really grounded in thoughts feelings identities and behaviors really in a clear solid way so permission questions are brilliant and I think every clinician on the planet should use these regularly and often because this is I think narrative therapists remind us to walk [Music] um to walk carefully and respectfully and Tom Anderson who did reflecting teams also did a lot of permission questions but it's asking can I ask about X Y and Z first is it okay if we talk about this is it okay if I ask some more questions about this and to really emphasize that this is a democratic relationship to recognize that we're often talking about very sensitive things and and so this is getting the clients permission to continue with a particular line of questioning and if from a post-modern perspective a social constructionist perspective certainly with narrative therapy Tom Anderson was a huge advocate of this if the client says no that means you don't push okay they are allowed to say no on a different day you might go back and see if they're willing to talk about it again but um so this is just a way of truly respecting their autonomy as a human being and not assuming because we wear the you know professionals hat that we can just bulldoze in and ask about any sensitive area so obviously when talking about sexuality um or abuse those are obvious times to do this but anytime you're going to embark on a particular you know line of questioning that may kind of like be surprising to a client um to ask permission and so I do this often when I'm just trying to even get a description a detailed description you know of the problem because oftentimes people just want to do they want to go through and talk you know about how they felt and you know what they thought about everyone else and why they think everyone behaved the way they did and and so I will often and this is often in the first you know session where people are coming in and they're just wondering dump right and I will often say do you mind if I just take a moment because I really want to understand what's going on here and slow you down and ask some more detailed questions because I ask very detailed questions about what will you know what happened first and who is doing what and where was that and right so I I do a very detailed assessment and I ask permission because it's a little little Annoying they prefer not to talk like that um you know and so you know certainly you know there are times where um you know like for a good example is abuse you know if you're doing a trauma work right and they may come in you say you know can we talk about this and they may say no I don't want to talk about it this week and I have them sometimes I'll just start the session I'm not talking about you know the abuse today we're going to talk about what's going on in my life today fine and in another week I can go back and ask is this a good week to talk about that and sometimes they say yes and sometimes they say no so a lot with my when I'm working with really heavy duty child abuse I almost asked this question every single week you know and with a couple for example around sex sex I've had couples say you know one of them I don't want to talk about that today okay and it's certainly if the other partner is saying sex is an issue I will bring it up in a different session and so and hopefully on a different week we'll be able to sometimes they'll say you know what would be you know what would be helpful for you to want to talk about this your partner wants to talk about it you're not wanting to talk about it today and you know in the future what do you think would be helpful and just have a conversation then you know if it's something that you feel like needs to be talked about right typically I would ask you know you know do you think and again asking their permission do you think talking about you know this topic with me you know would at some point be helpful usually they say yes and if they say no you know I'm going to honor that and at the same time I'm going to also keep you noticing what what I think what is my clinic you still have your own clinical opinions and observations right and you're going to keep that in the back of your head and you will bring it in when you feel it is appropriate but you're you're going to only follow lines of questioning and conversation when the client wants to go there too and I just think this is basic human decency I don't care what theory you're working from that you know you're not going to ignore what your clinical um perspective is an assessment is but you are going to respect what they want to do and you know it is possible that client may never talk about that subject with you and you can say Hey you know if you still really believe as a clinician and you talk about all the other stuff you feel like it's not making progress because we ignore we didn't want to talk about this you can have that conversation with them do you want to be referred do you think it needs to be addressed do you want to be referred out to someone else it's extremely rare that I have thought that something needed to be talked about and a client wouldn't say yeah I probably do need to talk about it but it's not now and it's not today you know maybe in the future that's normally the response I get it's extremely I I can't even come up with a great the only time I have had one couple where one partner did not want to talk about sex with a third party I have had that happen um but normally with most clients it's it's they just don't want to talk about it today having a conversation and knowing that they have control especially when it's something like abuse it's essential that you don't force them to talk about it because they've already been forced to do things they don't want to do in their life and you don't want to replicate that same um you know interaction where you know some person with powers forcing you to do something you don't want to do that is abuse and I think clinicians with very good intentions following their evidence-based treatment models can replicate an abuse pattern you know with the best of intentions of trying to be helpful and you know health and resolve abuse but you need to talk about it in order to get over it so um and so it's just important to really honor clients I think and their wishes so situation situating comments is very similar I would say and this is um another great intervention no matter what approach you use is to situate your comments and to say where they're coming from and so this is like I said no matter your approach this is you kind of contextualizing where your thoughts are coming from and it makes the conversation um more democratic and so and it's not like you're the professional and you're kind of bringing it you know down to their level so you know I'm trying to think of um so sometimes you know I situate a comment let's say by you know saying as you're talking it's reminding me of you know sometimes I'll say you know what this other therapist or theoretician has said and so do you want to hear about that um and so I ask again permission do you you know do you want to know this um sometimes I will say you know because I'm a professor so you know as a teacher an instructor and so sometimes I will say you know as someone who has been a Prof you know professional educator you know as I'm listening to you talk the I have some thoughts coming to my head would you like to hear hear from me about that so I situated sometimes it's actually um you know with like Professional Knowledge or what would be called psycho-education you know whatever that might be and I will even when I'm introducing Professional Knowledge I would say there are some researchers who think or say or blah blah blah this you know so it's not like this is what we know to be true about human behavior because we don't know anything to be true about human behavior let's get over ourselves right but we do have some really interesting research that could be useful to clients and so I I situated this is some research and some researchers have found this or there's some you know therapists or you know or you know who think this or and so I I introduce it but not as this you know ultimate higher more valid truth but this might be something that's useful to you um or the you know I come from this perspective and so let me you know share what I'm seeing can I share what I'm seeing from this perspective okay or not and if they say no again you don't share it so um something uh fun and really unique in narrative therapy they have a tradition of creating leagues these are clubs or associations but teams of clients kind of struggling around the same issues so you have an anti-anorexia League anti-bulimia leagues have been big um but this is you know where you um you bring clients who are perceiving the problem you know in the way that narrative therapists who want to talk about counter-cultural things for like anorexia and a bulimia we talk a lot about body image and uh how it's portrayed in the media and how we buy into these narratives um they also have like temper Tamer clubs for kids and so you get membership certificates and all this stuff so using this larger sense of community is a beautiful tradition that comes out of narrative similarly they can do something called the definitional ceremony and so this is where you're going to bring in significant others to witness the new story so um so typically there's a telling of the new narrative new identity there can be then you have the uh significant others help retell or share what they have seen and then you have the retelling of the retelling where the clients incorporating these broader narratives but it really helps solidify this new identity to bring other people into seeing you in the way you want to be seen and so these are a very unique um and I think beautiful tradition that comes at a narrative and then there's also a tradition around writing letters and giving certificates that are just trying to help solidify so in the early days of narrative therapy instead of writing the traditional progress note uh Epstein white would actually send a letter to their client that kind of talked about you know the um the narrative the preferred narrative and what they heard and writing it down they'd send it to clients extremely powerful if you work in a context where you can do this this is great you can I've also given narrative letters at the end of treatment for clients where I I just talk about how I have seen them grow and evolve you know and help really solidify that new narrative um but these are really powerful putting anything in writing is powerful you could have clients write their own narrative down type thing um but yeah so uh really of some fun unusual interventions in narrative so just wanted to wrap up a little bit talking about working with diverse clients and we'll talk a little bit about research as well so in terms of working with diverse clients uh narrative therapy is certainly one of the top approaches talk considering racial ethnic social economic class gender sexual orientation all of those layers is built into the heart of narrative and so it has been used widely cross-culturally it does have international Roots um and a lot of very specific um applications there's been a lot of work uh with around Native American First Nations Aboriginal um folks in fact I think definitional ceremony uh came out of some uh you know native Traditions right there so you'll see it used with a lot of different um diverse uh groups especially those have been marginalized also definitely working around gender and sexual identity deconstructing a lot of the heterosexist and gendered discourses all the work with anti-anorexia and bulimia leagues there's a lot of just uh even gender narratives around Beauty so really working on um helping and having very practical interventions for helping people work with and I well let's just be you got to identify it first because most people aren't even aware of how all these discourses are affecting them having they narrative just has a very useful practical tons of different ways of talking about dominant discourses having clients kind of kind of get separate and you start to see their influence and then consciously choose how to pull all of those strings together certainly I I find narratives so useful working with anyone with immigrant you know backgrounds and this is even not just first second third generation all of those intergenerational discourses around immigration and different you know different cultural values and beliefs and goods and shoulds right there's so much there and to a certain extent even in an individual family each member is putting those together in different ways and so narrative just gives us some really beautiful tools for working around diversity and social location that is respectful and just gives a us tools to do that and I think ways that you know many other approaches haven't which is why you will see post-modern evolutions of psychodynamic and humanistic CBT you know so we're you know all of the different approaches have you know I think leaned into a lot of the postmodern ways of talking around diversity so narrative is certainly an excellent approach you also want to be very careful because I have seen people in the name of narrative therapy actually be oppressive even with some counter-cultural discourses and so you want to also be careful there that um that as you are working with clients that um you don't inadvertently impose your own values and beliefs um around you know right ways of being or not being and then lastly here just talking about the research and evidence base there's certainly been a ton of qualitative research around narrative but there definitely is um merging research increasing research that shows outcome research is quantitative that you know narrative therapy is has comparable outcomes to most other approaches very reliable Improvement um and also looking at you look at the work coming out of Psychiatry and like Dan Siegel's work around trauma memories and identity narratives that a lot of what we are doing um how narrative is even talking about um how the human mind works is lining up with interpersonal neurobiology and Psychiatry and understanding those narratives and with trauma what happens is you don't end up with a coherent narrative and so much a trauma work is pulling together all of the implicit Memories the sight sounds smells thoughts um Sensations that happen during a traumatic moment and working it into a trauma narrative to really um put all of those flashbacks and implicit memories into a coherent narrative that we can story in the past to deal with flashbacks and those intrusive memory those intrusive memories and thoughts that are very characteristic of trauma and the other thing um that is talked about an interpersonal neurobiology and Psychiatry is top down versus bottom-up processing so this refers to the cortex six layers of the cortex so you know top-down processing is labeling things and putting them into categories and bottom up is taking your lived experience and re-categorizing creating categories from that lived experience and so typically when anyone's experiencing a problem we have too much top down we can't think of another solution we can't see things in you know other ways and the brain has to use top down just so you know in order to get through the day we have to organize what's safe and what's not safe so you can't get away from top down and we need top down but you know but therapy is typically bottom up and so we need to get back into what were you experiencing were you thinking were you feeling what happened and let's take a look at that and you know ex you know and then use that to re-label our experience chance so that is the bottom up processing that I I think you know most you know if you look at even like the humanistic way of talking there are lots of therapies bottom up and that's certainly what a narrative creates that process as well so in conclusion I I think narrative really is um a it's a very popular approach it is a very respectful way especially to work cross-culturally we're always working cross-culturally we're always working across differences you're never not even if someone looks same age you know social class ethnic background gender and sexual orientation identity is the same even if you look really really similar to your clients they have a different they're coming in with a different way of making meaning different relationships to those discourses and I think narrative just really gives us a beautiful way um to work especially in our extremely diverse world that we live in today um given the just how many discordant narratives I think we're all exposed to on a daily basis and there's just so many different ways of being in the world that I think creates a lot of stress for folks and I think narrative just offers a lot of beautiful ways to talk about these very difficult subjects these very difficult subjects and themes in a way that is very humanizing so hopefully you can use narrative Concepts and hopefully this lecture kind of gave you a better sense of what narrative therapy is like and what narrative practitioners are doing [Music]