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THE NARRATIVE IDEA IN THE CONSTRUCTION OF CHANGE


Date: 27/01/22

Author Name: Bhavya P

Qualifications: BSc (Hons), MA- Applied Psychology (specialisation in clinical psychology).

Designation: Consultant Psychologist, ACRO Mental Health & Wellness.

Word count: 1,197.

Reading time: 8 minutes

Reviewed by: Sareem Athar, Mariyam Mohd, Ayesha Begum & Aishwarya Krishna Priya.


As an emerging field practice, narrative perspectives have been used in psychotherapy to understand the depth of social context and stories in people's lives (1).

Narratives usually refer to personal stories, with multiple stories stemming from different interactions (2).



Lighted words


Here, the person's identity is an interplay of their efforts to make meaning out of various episodes of action, dilemmas, and distressing situations they encounter (3). For instance, clients experiencing distressing emotions that overwhelm them have so much resilience to find meaning in them (4). Human beings have the intrinsic ability to perceive things and make moral choices (5).


The Narrative ideas have been the surface of the development of its form of psychotherapy and dialogical approach (6). Narrative therapies seek respectful, non-blaming, and non-stigmatising approaches to therapy (7). It views problems as separate from people; clients are more than their problems; they are also their competencies, skills, and capacity to construct change (8).


Narrative therapy focuses on the possibilities for building conversations, which comprise the dialogical processes of negotiation, disagreement, and alliance (9). We have a concept of the metaphor of self; here, there's a distinction between "I" and "me" (10). This metaphor is used in the framework to seek the client's sense of agency to take power and authorship of their narratives (11).


As in narrative therapy, there is a connection between dialogical processes and the role of understanding multiple perspectives in viewing the self (12). Each perspective or voice has its own story, enabling clients to see themselves as potential and competent (13).

For example, if a child is concerned about not adjusting to school, here we highlight their narrative with their family, their relationship with teachers, friends, and so on (14). The idea is not to shift blame but to reframe narratives into more satisfying stories (15).


In this scenario of having a dominant narrative, the other narrative of self is silenced (16). Referring to the above-mentioned example, the other narratives, like "trying hard to be a good student and making parents happy," are not heard (17). Therefore, our reality is constructed as "having some fault for not adjusting in school" (18).


To talk about the mental health condition itself, labelling someone as being depressed results from being unable to see the possibilities(19), e.g., the situations in which we behave differently and are not depressed (20).


Coming to the article's core, how dialogical narratives are being built is a result of elaborating specific narratives, looking for possibilities, and facilitating the construction of unique life outcomes (21). Research has shown that therapy facilitates the construction of a problem-saturated narrative that builds on "unique outcomes" (22).


There are certain attempts to explore further developing a model for diversification in the construction of change (23). The approach is comprehensive, such that all other stories that constitute the higher picture are "mapped" together that hold space (24).


Unique Outcomes and Change

Considering narrative therapy's exploratory style, the client can dwell on previously unexplored perspectives (25).


EXTERNALISING THE PROBLEM.

This concept is defined as an approach that enables the client to see a more significant part of self, culture and history and not just be limited to it (26). By the term "not limiting to", other social constructs beyond culture and history like race, ethnicity, gender and sexuality are observed (27). These together shape our identity and have contributed to the construction of the problem (28).


It extends to providing storylines. For example, a therapist might respond by breaking down the term "depression" into its aspects (29). Questioning is a skill adopted to facilitate and enable the client to gain insight into the presenting concern. (30)

The externalising conversation provides opportunities for the client to objectify the problem and clarify the relationship of the situation in the life of the person (31)

Here, the client can pay attention to the meanings of specific unsaid episodes in the story that aren't "absent but are implicit" (32).


UNDERSTANDING THE PERSON THROUGH THE NARRATIVE.

Narratives offer us a means of communicating time-ordered events with the characters who play a specific role and the role of social constructs (33). These together shape and communicate personal and wider social meanings (34).


There are different levels concerning narratives, the series of events on which the story is based, and how the narration is carried out in retelling these events (35). Depending on this, we also adopt the idea that narratives are co-created by both the author and the listener (36). The author, that is, the client, reveals their subjective experiences that can be personal and thereby mentions the role of social collectives and the identification of social constructs. (37)



TRAUMA NARRATIVES



Clearly and more consistently, narrative therapy is widely advocated in conjunction with providing trauma-informed care (TIC) (38). TIC has basically to do with having trauma awareness and understanding the role of historical shards of evidence of interaction patterns in any social construct that have been passed on to future generations (39).

Surviving trauma and stories of recovery are narrative forms directed with evidence of coping and resilience (40).


NARRATIVE TECHNIQUES

Some techniques in this approach might guide clients to understand their story better and re-narrate their experience by looking for possibilities for action (41).


  • Understanding your story

In this phase, the therapist actively listens to the language and tone used by the client to understand their story from their point of view. (42)


  • Externalising your story from your identity

Once the client can get clarity, the therapist can facilitate conversations about the client's narrative (43).

Questioning the possibilities in the narrative would help reframe it and enable to have an empowering language in the client (44)


  • Reauthoring your story

This is where re-narration comes in, the application of using an alternative perspective in viewing the concern and the use of different language enhances the ability to see empowering notes of self (45).




A NARRATIVE THERAPY IS ABOUT:

  • Options for telling or retelling preferred stories of people’s lives (52).

  • It attempts to help families remodel their lives through externalisation and enhances the potential to open the doors that lead to a new life (53).

  • It allows people to introspect their problems and strengths and helps them reevaluate their judgements about themselves (54).


PROS AND CONS OF NARRATIVE APPROACHES.

PROS

  • It allows the client to search for social meanings and find the stories silenced by the dominant narrative (46).

  • It focuses on the client's strengths and competencies, enabling them to restructure their reality (47).

  • It is respectful, non-blaming and mainly specific to the individual’s needs (55)

CONS

  • Narrative therapy is a relatively new emerging approach. However, there is a lack of research articles supporting it as a stand-alone therapy approach (48).

  • There are some discrepancies regarding using this approach among families (49).

  • It might also be challenging to use narrative therapy when working with relationship aspects (50).

  • There is little scientific research to back the effectiveness of narrative therapy. Some professionals also critique the assumption that life has no absolute truths (56).

Though narrative approaches have certain limitations, it focuses on empowering the client, putting the client as an expert (51).




AUDIO-VISUAL CREDITS.


1) Lighted words, Unsplash, Social cut.

2) Photo by Annie Spratt on Unsplash

3) People remember stories, Unsplash, Brett jordan



REFERENCES


(1) Bruner, (1986) Ethnography as narrative: The anthropology of experience (pp. 139-155), Chicago


(2) Dulwich centre, What is narrative therapy, Available from https://dulwich centre.com.au


(3) Van der Gaag MAE, De Ruiter NMP, Kunnen SE, Bosma H. The landscape of identity model: An integration of qualitative and quantitative aspects of identity development. Identity (Mahwah, NJ) [Internet]. 2020;20(4):272–89. Available from: http://dx.doi.org/10.1080/15283488.2020.1821154


(4) McGrath RL, Parnell T, Verdon S, Pope R. “We take on people’s emotions”: a qualitative study of physiotherapists’ experiences with patients experiencing psychological distress. Physiother Theory Pract [Internet]. 2022;1–23. Available from: http://dx.doi.org/10.1080/09593985.2022.2116964


(5) Sarbin (1986) Narrative psychology: The storied nature of human conduct, Available from https://psy.net.apa.org


(6) Lengelle R. Portrait of a scientist: in conversation with Hubert Hermans, founder of Dialogical Self Theory1. Br J Guid Counc [Internet]. 2021;1–15. Available from: http://dx.doi.org/10.1080/03069885.2021.1900779


(7) Morrison P. Current narratives current narratives volume 1 issue 2 embracing multiple dimensions article 6 [Internet]. Edu.au. 2010 [cited 2023 Mar 27]. Available from:https://ro.uow.edu.au/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1012&context=currentnarratives


(8) Narrative therapy [Internet]. Goodtherapy.org. 2009 [cited 2023 Feb 22]. Available from: https://www.goodtherapy.org/learn-about-therapy/types/narrative-therapy


(9) Hall, J. M., & Powell, J. (2011). Understanding the person through narrative. Nursing Research and Practice, 2011, 293837. https://doi.org/10.1155/2011/293837

Herman's & Kempen (1993), The dialogical self: Meaning as Movement, Available from www.researchgate.net


(10)Cunha C, Mendes I, Ribeiro AP, Angus L, Greenberg LS, Gonçalves MM. Self-narrative reconstruction in emotion-focused therapy: A preliminary task analysis. Psychother Res [Internet]. 2017;27(6):692–709. Available from: http://dx.doi.org/10.1080/10503307.2016.1158429


(11) James (1980) Structure of narrative retelling Available from