Contents
Executive summary……………………………………………………………………………. 3
Research question or hypothesis………………………………………………………….. 3
Literature review……………………………………………………………………………….. 5
Findings……………………………………………………………………………………………. 6
Discussion………………………………………………………………………………………… 8
Conclusion………………………………………………………………………………………… 9
Reference list………………………………………………………………………………….. 10
Narrative Therapy: A Place for Healing Trauma
The Benefit of Externalising the Problem.
Executive summary
Narrative therapy; externalization of the problem in clients who have experienced trauma. Narrative Therapy seeks to address trauma through a redevelopment and reinvigoration of a sense of oneself. This is achieved by placing the problem in context of culture and history, providing a platform upon which people can find strength. More importantly, externalising the problem and creating different narratives allows clients to find their own truth. Resulting in individuals, and communities re authoring their stories, and families, individuals, and communities aligning in healthier goals.
Research question or hypothesis
This report seeks to examine the use of Narrative Therapy in clients who have experienced trauma.
Why Trauma?
Narrative therapy typically deals with some of the most difficult cases in Psychotherapy such as conduct, child abuse, eating disorders, marital conflict, grief and mental illness (Carr, 1998). There appears to be a natural relationship in narrative therapy to the particularly difficult subject matter of trauma,
History of Narrative Therapy
Narrative therapy had its Seminal beginnings in the 1980’s through the works of Micheal White and David Epston. Their work ‘Literate means to therapeutic ends ‘ (1989), is now what amounts to the bible of narrative therapy with this work being the central work cited in many narrative therapy articles.
Narrative therapy draws on a variety of influences for example Foucault (Foucault, 1979) (White M. , 1987), post modernist constructivism (Biggs & Hinton-Bayre, 2008), Feminism, (Walker, Gilmore, & Scott, 1995), and anthropology (Denborough, 2012), With Modern Therapists also finding new links to concepts like Buddhism (Benjamin & Zook-Stanley, 2012).
Objectifying the problem not the person
Narrative therapy uses a variety of techniques to facilitate a client to a favourable outcome one of which is externalisation; a method by which the client and therapist extract the problem to sit outside of the person rather then seeing the problem as the person (Carr, 1998). This technique is particularly relevant to trauma work where problems do become internalized and the person or group becomes objectified as indigenous, addict, rape victim queer etc (Maps of Narrative Practice). Externalising seeks to objectify the problem rather then the person, for example “the addiction, political oppression, the crime, sexual preference”.
Research (including methodology)
A detailed and thorough review of the foundational work “maps of Narrative Practice” was performed to gain a deeper understanding of Narrative Therapy and the components within it. The four articles within the Topic folder were then reviewed, and once a thorough understanding was gained about the subject A broad search was conducted from the university library website, google scholar, and the online journal database Wiley. While reviewing the broad topic particular themes began to emerge, of significance to me was, the subject of Trauma, In light of this theme I began to focus on particular key words and a technique at the core of NT which is externalisation.
As themes emerged I narrowed down my search to those articles that would strengthen my understanding of the field of trauma and branched from psychology journals into sociology and medical journals to gain a greater context around the concept of trauma.
Of the 16 pieces researched, 8 were articles from recognized peer reviewed journals, and 4 were Research Reports, with two being Individual Case Studies and the other two being Quantittative studies of subjects. The remaining 4 pieces were musings and anecdotal pieces.
I reviewed these articles for content and validity, summarizing the keypoints and highlighting sections that I wished to quote or that supported my argument. I then reviewed the references cited in these articles for additional works of interest.
Literature review
The major theme that appears in the literature is trauma. Within each subset there appears to be a common thread of isolation and oppression. In this report trauma is used to describe an external force that imposes such a dominant voice on an individual or community that they find it difficult to have power in their own narrative. In this light trauma in this article relates to the effects of addiction, being from a marginalised community, such as gay, bi, transgendered; being politically marginalized, and having experienced Sexual Abuse,
Clients with trauma often experience feelings of Fear shame and self blame. Traditional models of therapy can incite or reignite trauma, Internalised feelings can often be ignored and contextual elements dismissed.
Within group therapy such as couple or family counseling victims can experience implicit blame when those affected by trauma are seen as ‘the problem’.
Within NT the practice of externalization provides a safe harbor for clients to talk about and witness the problem. It becomes a platform and framework from which they can relate. Clients become empowered through making rather then taking history. Clients begin to see themselves through a different lens one that is not dominated by trauma and abuse.
Findings
Narrative Therapy seeks to address trauma through a redevelopment and reinvigoration of a sense of oneself (White M. , 2004).
Trauma as defined in this paper means situations where people find it difficult to have power in their own narrative. In a detailed case study Benjamin and Zook-Stanley (2012) detail and describe how trauma individualizes and isolates us, they believe externalising seeks to arrest this phenomeneon and results in a buddhist like position of deep compassion where both joy and suffering are held in equal status. Externalisisng involves naming the problem and this in turn allows a person to connecvt the dots and make sense of their experiences.
Narrative therapy seeks to place the problem in context of culture and history
Problems are cultural not personal, when we label people they become marginalized which exacerbates the problem as ppl are uneccesarily normalized. (White M. , Maps of Narrative Practice, 2007)
In his work in indigenous communities Denborough (2012) writes about Aboriginal deaths in custody, a setup of creating listening teams which allowed aboriginal ppl to tell their stories name the words and free themselves from oppression. This helps because problems become bad guys which clients can wage war on. Simil;arly Lapsley (2002) in his work with victims of Apartheid found that Allowing people in unison to tell and witness each others stories was the beginning of healing.
Narrative therapy seeks to provide a platform upon which people can find strength.
Danilopoulos (2011) in a complex case study of addiction over 3 generations illustrated how externalising the problem can lead to islands of hope, strength courage and survival. Conversly, individual identification can subject people to pathology, others opinions, and detrimental social comparisons. (The Deconstructing Addiction League, 2006).
Butt (2011) In his 2011 article cites a case study in Pakistan where by assisting the client to externalize his addiction (which the client described as sin) he then became able to reintegrate parts of his moral and ethical story.
Narrative Therapy seeks to allow clients to find their own truth
Almaas & Esther Pirelli Benestad (2011) assert that clients can reclaim their sexuality and pleasure, and have found that while most therapies focus on pain removal as opposed to pleasure induction, narrative therapy can go beyond this. Clients can choose what acts they do want to engage in, this is done through creating co narratives, eg one with abuse one without, clients can then reclaim arousal, and reauthor their sexuality, ie learn new ways to be sexual.
Interestingly there are physiological differences in the brains of woman with sexual abuse. A study of 42 woman have shown that woman who had sexual abuse in their history had a smaller hippocampus, and they potentially have an interrupted ability to integrate their own recollections into a cohesive narrative in the context of self. (Stein, Koverola, Hanna, Torchia, & McClarty, 1997). Whilst this study was unable to determine whether a smaller hippocampus was the result of sexual abuse or sexual abuse was the result of a smaller hippocampus, it illustrates a potential physiological barrier to the effectiveness of Narrative Therapy.
Sexual Trauma can lead to Negative beliefs about self, where externalising and naming the trauma helps self review of the problem. When we externalize but do not pathologise, clients can gain linguistic freedom to describe and treat their problem. (Mann & Russell, 2003)
Another study of 22 men and woman who had experienced sexual abuse as a child conducted by Hunter (2011) found that 17 out of 22 people did not disclose the abuse as a child out of fear, shame and self blame. As these people grew older all of them disclosed at some level with 10 participants disclosing to an authority figure and the remaining 12 selectively disclosing to only trusted persons. These results indicate that internalizing trauma can have life long consequences.
Discussion
Trauma as a field of study already exists in mainstream therapy with a focus on symptoms and solutions. Narrative Therapy however focuses on experiencing and contextualizing trauma as a force outside of the person. In this way Narrative therapy does not seek to define the person by what they experience. Narrative Therapy empowers the individual to create a narrative that exemplifies the courageous and objectifies the troublesome.
In a collective sense Narrative Therapy allows communities to create healthier contexts and relieves a burden of isolation and loneliness through the sharing of a narrative which can act as a powerful force of healing and change.
On an individual level externalization creates a new landscape where hope courage and strength is valued and where the burden of being socially normative is discarded, infact where people find they are oppressed by labels, Narrative Therapy seeks redress by labeling problems, not people.
In areas such as sexual trauma and gender identity externalization allows a person to make considered decisions about their future behaviours, and more importantly take away the notion that they are intrinsically defective or damaged. Externalising opens up a platform to communicate with the problem as a character in a play, and in doing so shape its path.
Conclusion
Narrative therapy offers an opportunity for the marginilised and labeled to achieve personal redemption through externalization, however in giving up the labels they may also be giving up the wisdom of many scholars. For the person subjected to sexual abuse this may lead to a temporary sense of freedom where they can now define themselves as a person with reactive sexual behaviours instead of a victim, however there is also freedom in saying this collection of thoughts feelings and actions is called alcoholic.
Part of the beauty of labels is that sense that we are not alone. Externalising in some senses just changes the name of the labels. Perhaps the true freedom that appears so beneficial is the power to name the collective thought feeling action and then throw that label away. The implication being that we can never truly externalize a problem that we are part of.
Reference list
Almaas, E., & Esther Pirelli Benestad, E. (2011). Talking about sexuality with survivors of sexual trauma. International Journal of Narrative Therapy and Community Work(2), 16-22.
Benjamin, D., & Zook-Stanley, L. (2012). An invitation to people struggling with trauma and to the practitioners working with them. The International Journal of Narrative Therapy and Community Work(3), 62-68.
Biggs, H. C., & Hinton-Bayre, A. D. (2008). Telling Tails to End wails: Narrative Therapy Techniques and Rehabilitation Counselling. Australian Journal of Rehabilitation Counselling, 14(1), 16-25.
Butt, M. M. (2011). Using narrative therapy to respond to addiction: An experience of practice in Pakistan. The International Journal of Narrative Therapy and Community Work(2), 51-61.
Carr, A. (1998). Michael White’s Narrative Therapy. Contemporary Family Therapy, 20(4), 485-503.
Danilopoulos, D. (2011). Rooftop dreams: Steps during a rite of passage from a life dominated by the effects of drugs and abuse to a ‘safe and full of care’ life. The International Journal of Narrative Therapy and Community Work(2), 40-50.
Denborough, D. (2012). A storyline of collective narrative practice: A HISTORY OF IDEAS, SOCIAL PROJECTS AND PARTNERSHIPS. The International Journal of Narrative Therapy and Community Work(1), 40-65.
Findlay, R. (2012). Talking about sex: Narrative approaches to discussing sex life in therapy. The International Journal of Narrative Therapy and Community Work(2), 11-33.
Foucault, M. (1979). Discipline and Punish: The birth of the prison. New York: Random House.
Hunter, S. V. (2011). Disclosure of Child Sexual Abuse as a LifeLong Process: Implications for Health Professionals. Australian and New Zealand Journal of Family Therapy, 32(2), 159-172.
Lapsley, F. M. (2002). The healing of memories. The International Journal of Narrative Therapy and Community Work(2), 72-75.
Mann, S., & Russell, S. (2003). Narrative ways of working with women whose lives have been affected by child sexual abuse. Australia: Dulwich Centre Publications.
Miller, C. P., & Forest, A. W. (2009). Ethics of Family Narrative Therapy. The Family Journal: Counseling and Therapy for Couples and Families, 17(2), 156-159.
Stein, M. B., Koverola, C., Hanna, C., Torchia, M. G., & McClarty, B. (1997). Hippocampal volume in women victimized by childhood sexual abuse. Psychological Medicine(27), 951-959.
The Deconstructing Addiction League. (2006). Deconstructing addiction & reclaiming joy. The International Journal of Narrative Therapy and Community Work(4), 53-79.
Walker, L., Gilmore, K., & Scott, D. (1995). Breaking the Silence: A guide to supporting adult survivors of sexual abuse. Carlton, Victoria: CASA House.
White, M. (1987). Family therapy and schizophrenia: Addressing the ‘in-the-corner’ lifestyle. Adelaide: Dulwich Centre Publications.
White, M. (2004). Working with people who are suffering the consequences of multiple trauma: A narrative perspective. International Journal of Narrative Therapy and Community Work(1), 45-76.
White, M. (2007). Maps of Narrative Practice. New York: W.W. Norton and Company.
White, M., & Epston, D. (1989). Literate Means to Therapeutic Ends. Adelaide, South Australia: Dulwich Centre Publications.
Zala, S. (2012). Complex Couples: MultiTheoretical Couples Counselling with Traumatised Adults Who have a History of Child Sexual Abuse. Australian and New Zealand Journal of Family Therapy(33), 219-231.
Bachelor of Psychology 