Post-Modern Models of Family Therapy

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Post-Modern Models of Family Therapy

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Title: Post-Modern Models of Family Therapy

1
Post-Modern Modelsof Family Therapy

University of Guelph
Centre for Open Learning
and Educational Support
William Corrigan, MTS, RMFT Carlton
Brown, MSc., MDiv, RMFT
AAMFT Approved Supervisor AAMFT Approved
Supervisor
(519) 265-3599 (905) 388-8728
williamcorrigan_at_rogers.com
carl_at_mftsolutions.ca

2
Day Three

Narrative Therapy

3
By the end of today

Reflections on day 2
Narrative Therapy
Use of letters in Narrative Therapy
Work on Debate for Day 5

4
Day 2 Reflections (900 930)

Reflecting and dialogue can create new meanings
What was Day 2 like for you?
What did you like/enjoy that you want to see/do
more of?
What are you most curious about?
On a scale from 0 10, where 0 is not at all
and 10
is 100, how would you rate your integration
of
information from Day 2 into your practice?
What would make that an X 1?

5
Narrative Therapy

Assumptions and the Process of Therapy

6
Post-modern View of Reality

Realities are socially constructed
Realities are constituted through language
Realities are organized and maintained through
narratives (stories)
There are no essential truths
(Freedman Combs, 1996, p.22)

7
Small Pieces of Narrative
The person is never the problem the problem
is the problem (Michael White, 1991)
8
The Narrative Therapist

Curious, respectful, solicitous, and persistent
Solidarity with the people who seek help
Having hope for people psychotically
optimistic (Bill OHanlon, The Third Wave,
Networker, Nov/Dec 94)
Choose what to attend to multiple threads
More active at first, then less so as people
become more engaged
Co-creator of new realities with
individuals/families
A humble collaborator
Transparency

9
Use of externalization(White Epston, 1990,
39-40)

Decreases conflict between persons (eg. blame,
shame, guilt, etc.)
Undermines the sense of failure around the
problem
Increases cooperation, uniting against the
problem
Opens up new possibilities to retrieve their
lives and relationships from the problem and its
influence
Frees people to take a lighter, more effective,
and less stressed approach to deadly serious
problems
Presents options for dialogue, rather than
monologue, about the problem

10
Externalising Conversations

In groups of three
Investigative Reporter, Problem, and Problems
Subject
Choose roles and what the Problem is
Reporter talks to the Problem about its successes
Reporter talks to the Problem about its failures
Problems Subject listens carefully
wo/interrupting
Share the experience of these two interviews

11
Externalising Conversations 1. Problems
Successes

Problems tend to be boastful and arrogant,
disclosing their secrets
Dont try to change the Problem
Ask about the Problems influence in different
parts of life (relationships, impact on feelings,
interference in thoughts, effect on how subject
sees him/herself)
Strategies, techniques, deceits, and tricks
Problem resorts to
Special qualities possessed by Problem used to
undermine and disqualify subjects knowledge and
skills
Purposes that guide Problems attempts to
dominate dreams and hopes for subjects life
Who stands with the Problem allies
How Problem might react to its dominance being
threatened

12
Externalising Conversations 2. Problems Failures

Problems grudgingly begin to admit their failures
Areas of life that the Subject still has some
influence despite the Problems efforts
The counter-techniques/strategies and tricks
developed by the Subject to mess up the Problems
plans
Special qualities, knowledge, and skills Subject
has that the Problem has had difficulty
undermining or disqualifying
The purpose and commitment that guides the
Subjects efforts to challenge the attempts by
the Problem to dominate
Who stands with the Subject and how have they
helped deny the Problems wishes
The options available to the Subject for taking
advantage of the Problems vulnerabilities and
for the reclamation of their life

13
BREAK1030 1045
14
Process of Narrative Therapy
(J. Myers-Avis, 2008)

Deconstruction
Engage in externalizing conversation
Externalize the problem
Review the effects of the problem on clients
life relationships, with particular emphasis on
its effect on their view of themselves/relationshi
ps
Taking a position
Elicit history of the dominant story using
recruitment/training questions
Discover meaning client attributes to past
experiences
Inquire about anticipated future impact of the
problem
Evaluation of problem in terms of preferred way
of being/relating/seeing self

15
Process of Narrative Therapy
(J. Myers-Avis, 2008)

Reconstruction
Identify a unique outcome
Engagement in a re-authoring process through
Unique account questions
Unique re-description questions
Unique possibility questions
Unique circulation questions
Experience of experience (indirect) questions
Questions that historicize unique outcomes

16
Deconstruction1. Externalize the problem

Review the effect of the problem on the persons
life and relationships, with emphasis on its
effect on their view of themselves and their
relationships
The problem is separated from the identity of the
person and the underlying dominant narrative is
unmasked
How is the problem affecting you, your life,
your relationships, and/or your view of
yourself? responses reveal the dominant or
problem-saturated story

17
Deconstruction1. Externalize the problem

Dont rush this step - a broad mapping at this
stage gives a broad area to explore for unique
outcomes in the next stage
e.g. How has depression affected the way you see
yourself and possibilities for your life?
What does anorexia get you to believe about
yourself?
When frustration is having its way with
you, how
does it affect your relationship with your
children?

18
Finding a name for the problem

Listen for metaphors
Use familys language
Modify it so problem is objectified or
personified
Check it out with the family to see if it fits
May take some time to find something that
accurately describes the problem
May be more than one problem

19
Small Pieces of Narrative

Our lives are multi-storied. No single story of
life can be free of ambiguity or contradiction.
No self narrative can handle all the
contingencies of life.
(White, 1994)

20
Metaphors used in externalization

Escaping or freeing their life of the problem
Undermining the problem
Declining or refusing invitations to cooperate
with the problem
Reducing the problems grip on their lives
Resigning from the problems service

Walking out on the problem
Dispelling the problem
Going on strike against the problem
Setting themselves apart from the problem
Defying the problems requirements
Taming the problem

usually more than one metaphor used
beware of totalizing defining problems in
terms that are totally
negative
may invalidate what people give value to and
what might be
sustaining
do not introduce battle metaphors or initiate
totalizing of the
problem

21
Deconstruction2. Taking a position

Separation from the dominant story leads to the
possibility of choice
Recruitment/training questions
History of dominant story is elicited through
questions that explore how client came to hold
these beliefs
Training/recruitment questions are powerful in
opening space for the person to contextualize
their experience the problem is examined in a
larger context such as issues of gender, class,
culture, etc.
e.g. Do you have any ideas about how you were
recruited into this view of yourself as a
failure?
Do you think that women are more vulnerable to
the view that they have failed their
children?

22
Deconstruction2. Taking a position

The meaning the client attributes to these past
experiences is elicited
Listen for particular words or phrases
Check your assumptions (e.g. not-knowing)
Ideas about success or failure
Ideas about what a good relationship is
Ideas about confidence, insecurity, etc.
Explore the future impact of the problem
What do you imagine will happen if
Evaluation of whether this is a preferred effect
in the clients life
Client is asked to judge whether the influence of
the problem is preferred or not preferred
What assumptions might be keeping the problem in
place?

23
Unique Outcomes

There is always a history of protest, resistance
or struggle - MW
Unique outcomes must be considered significant by
the person
It is never the size of the step that a person
takes that counts, but its direction (White
Epston, 61)

24
Reconstruction3. Identify a unique outcome

An entry point for the beginning of authoring a
new story
Seeks to identify occasions when the
person/family/relationship has not been oppressed
by the problem (similar to exceptions in SFBT)
Invite people to notice those intentions and
actions that contradict, the problem-saturated
story i.e. unique outcomes that could not have
been predicted/accounted for from a reading of
the dominant story

25
Reconstruction3. Identify a unique outcome

These can be historical, or can be located in the
events which occur in the session
Given your fathers encouragement of secrecy,
were there any times when you were able to rebel
against it and tell someone about what was
happening to you?
Can you recall any occasion when you could have
been pushed around by frustration but werent?
Have there been some areas of your life that have
been untouched by this view of yourself as a
failure?

26
Reconstruction4. Engagement in re-authoring

There is always an alternative story attached to
any unique outcome - the process of uncovering it
is like unraveling a loose thread
a) Unique Account Questions
Invite people to make sense of unique outcomes
(i.e. events that dont fit the dominant story)
How questions - utilize a grammar of agency,
turning points and change
There is an assumption that unique outcomes
always have a history
e.g. Despite the hold that fear and secrecy
had on you, how do
you think you were able to stand up to them
and get help to
escape?
How did you manage to take this step to
turn your back on
frustration?
How did you resist or refuse the tyranny
of the problem (habit,
story)?

27
Reconstruction4. Engagement in re-authoring

b) Unique Re-description Questions
Invite people to give significance to the unique
outcomes and unique accounts through
re-description of themselves, others, and their
relationships.
How do they think and feel about these? How do
they fit with their preferred way of being?
preferred way of relating? preferred way of
viewing self?
e.g. What does this tell you about yourself?
What does this tell your partner (friend,
daughter) about you?
What does this tell you about your
commitment to yourself?
about the kind of person you are?
If your best friend was here, what would
she/he say that it
tells them about you?

28
Reconstruction4. Engagement in re-authoring

c) Unique Possibility Questions
next step questions
Invite people to speculate about the personal and
relationship futures that are attached to the
unique accounts and unique re-descriptions
e.g. What does it tell you about your future,
knowing that you have been
faced with a situation of great fear and
intimidation, and that you
took strong action to escape it?
What do you see for you and Susie in the
future if you continue in this
direction?
What difference will it make to your
future if you keep this knowledge
of how you dealt with this situation close to
your heart?
These can lead back to unique re-description
questions
e.g. If you find yourself taking this next
step, how will this affect how you
feel about yourself?

29
Reconstruction4. Engagement in re-authoring

d) Unique Circulation Questions (related to
definitional ceremony/outsider witnesses MW)
Circulation is critical to the continuation of
the alternative story
If there is an audience to a performance of a new
story, the story is authenticated
e.g. Who is someone youd like to let know
about this
new direction that youre taking?
Who has already noticed that you have
begun
moving in this new direction?
Who might be the first to notice? What
would they
say about you?

30
Reconstruction5. Experience of experience
questions

Can be asked in each category and are often most
helpful in the development of a new story
These questions invite people to be an audience
to their own story
e.g. What do you think that I am learning about
your
relationship as I hear how you were able to
avoid being
totally overwhelmed by the effects of
secrecy?
(or conflict or anger?)
What do you think this tells me about the
nature of your
new direction?

31
Reconstruction5. Experience of experience
questions

Questions Which Historicize Unique Outcomes
These are important questions, which assist
people to get in touch with an alternative story
e.g. Of all the people whove known you over
the years, who would be least surprised that
youve been able to take this
step?
Of all the people who knew you as you
were growing up, who
would have been most likely to predict
that....?
Following this, a whole series of questions can
be asked about the context
e.g. What would ........ have seen you doing
which would have
encouraged him/her to predict that you would be
able to take
this step?
What qualities would ....... have noticed
about you that would
have led him/her to not be surprised that you
have been able
to.......?

32
Small Pieces of Narrative

The role of therapy
is to bring these alternate stories out of the
shadows and to elevate them so that they play a
far more central role in the shaping of peoples
lives.
(White, 1994)

33
(No Transcript)
34
Definitional CeremoniesMaps of Narrative
Practice (2007) M. White

first referred to as reflecting teams (T.
Andersen, 1987)
rituals that deeply acknowledge peoples lived
experience
provide an opportunity to tell the stories of
their lives before an audience of carefully
chosen outsider witnesses
through these retellings people experience their
lives as joined around shared themes that thicken
the counterplot
witnesses discuss what they were drawn to, the
images that were evoked (metaphors), their own
personal experiences that resonated with these
expressions, and how their lives have been
touched by these expressions
outsider witness is a witness to the
conversation
outsider witness registry former clients who
volunteer to participate as outsider witnesses

35
Definitional CeremoniesMaps of Narrative
Practice (2007) M. White

process
interview with client(s), interview with outsider
witnesses (expression, image, resonance, and
transport), interview client(s) again
eliciting reflections from witness
When people are an audience to important
stories, and when they have had the opportunity
to respond in the way you have, they often go on
a journey in their own lives. Id be interested
in any reflections that you might have about
where this has taken you. Maybe to new thoughts
about your own life. Maybe to some realizations.
Anything. (p. 174)
in the retelling of the retelling, the same
categories of inquiry are used (expression,
image, resonance, and transport) except the image
is focused on the persons life and identity
rather than on those of the outsider witness

36
Definitional CeremoniesMaps of Narrative
Practice (2007) M. White

invite outsider witness to
play a part in a tradition of acknowledgement
that is particularly relevant to rich story
development
engage in retellings that are the outcome of
close listening and that are composed of
particular aspects of the stories that they were
drawn to
express these retellings in ways that will not be
imposing
respond personally in speaking of their
understanding of why they are drawn to what they
are drawn to and about how this affected them
step back from many of the common ways that
people respond to the stories of other peoples
lives, including from giving opinions or advice,
making judgments, and theorizing

LUNCH
1220 105

38
Narrative Therapy

The Use of
Letter Writing
in Therapy

39
Narrative Letters

Letters from therapists to clients can be
powerful tools for re-authoring lives
Help client remember what happened in session
bare witness to the work of therapy and
immortalize it (DE)
As a jumping off point for next session
Helps both therapist and client with recall
Including and privileging the clients point of
view

40
Narrative Letters

Used by many narrative therapists as case notes
Use clients own words and quotes
Explain use of letters in therapy with clients
re. taking notes
Read notes back to client during the session to
check for accuracy
Slows therapy down

41
Narrative Letters

Pay attention to the metaphors people use often
have powerful meaning for them
DE follows the flow of the session in writing
letters for more coherence - follows the
client's inner logic of their own story
Able to ask questions in letter you didnt think
of before
Able to salvage a bad session by admitting
mistakes and asking questions about it to client
Reflect confusion back to client transparency

42
Narrative Letters

Look for and highlight small changes
Using letter as a reflecting team what are you
curious about, what do you wonder, what else
would you like to know, what might you predict,
etc.
Different types of letters
letters of invitation written to invite other
members into therapy
letters of redundancy to help someone give up
an old role in a family
documents of identity - written charters
celebrating the persons strengths, capacities
and current progress
discharge letters or letters of retirement

43
Tips on WritingNarrative Letters (DE)

Start with an introductory paragraph reconnecting
the client(s) to the previous therapy session
Highlight some novel aspect of the clients
personhood
Describe the influence of the problem on the
client(s)
Make comments that reinforce the externalization
of the problem
Ask the client questions that you thought of
after the meeting
Use of tentative language, I wonder if....
Document and highlight unique outcomes or
exceptions to the problem
Honour the clients own solutions rather than
imposing your own

44
The Economics of Narrative

In a survey by David Nylund on the value of
letters to clients
40 respondents
37 said they were very helpful
3 considered them helpful
The average worth of a letter was 3.2
face-to-face interviews (range from 10-0.25)
52.8 of gains made in therapy were attributed to
the letters alone
the average length of therapy was 4.5 sessions

45
Narrative Letters

Examples
For supervision in Narrative Therapy Judith
Myers Avis, AAMFT Supervisor, Guelph, (519)
821-2493
For more on Narrative Therapy, articles, news
events
www.dulwichcentre.com.au

46
Narrative Therapywith CouplesTips Techniques
47
Narrative Therapy with Couples (2014) J. Freedman

Try to locate the problem in a larger discourse
Things you try to live up to
Notice what stands outside the problem discourse
Problem may not go away but it doesnt have as
much power
May be quick or it may take time
Did they say anything that doesnt fit with the
problem?
Tell me something about you that has nothing to
do with the reason you are here

48
Narrative Therapy with Couples (2014) J. Freedman

Keeping notes
Problem story Alternate Story
Dont talk most of Sometimes talk
time
Listen to problem stories and what is meaningful
to them enough to get there
What do these ideas have you doing?

49
Narrative Therapy with Couples (2014) J. Freedman

Start the next session by reading the notes from
the last session
Continuity, focus
Helps to avoid getting bogged down in the
problem of the week
Catch me up on how this has continued?
Give them a copy of your notes if they want them
between sessions transparency
Would it be ok if we limit what we talk about
today to ____?
Get permission, collaboration

50
Narrative Therapy with Couples (2014) J. Freedman

Four questions to end the session
Was this useful?
How was this useful?
Would you like to come back?
When would you like to come back?

51
Narrative Therapy with Couples (2014) J. Freedman

Think of it all as story or construction
Looking through your partners eyes, how would
you describe yourself?
And what is it like thinking of yourself
described this way?
A story is a sequence of events organized over
time
Describe it to me like I was watching it happen
gets them back into the experience

52
Narrative Therapy with Couples (2014) J. Freedman

Having it witnessed and supported is important
Witnessing
A position from which someone can listen to
anothers story
A position from which to offer reflections
If youre in the room, are you focused on
correcting another or proving your point to the
therapist? youre not really listening
Interview one person and ask the other to just
listen, talk to one person at a time
Im aware that there are two different stories
Choosing questions for the listener that keep the
conversation moving in the right direction how
is the information being received?
MW spent more time with one before turning to the
other
Turn to the other when something significant
comes up

53
Narrative Therapy with Couples (2014) J. Freedman

Positioning (MW)
Team by your side - Who might be here with you,
to help/remind you
Different context like youre at work
Self in touch with whats important rather than
being right, what do you really value, try to
hold onto it
Vantage point of the relationship think about
your children, what you want for them if you
were listening as the relationship vs. as your
self
An anti-anger position give examples imagine
your childs face, a value you connect to,
exceptions to anger
One way mirror pretend theres a mirror or a
pane of glass in between
Using video tape session and give them a copy
to watch

54
Narrative Therapy with Couples (2014) J. Freedman

Absent but implicit
In order to make a distinction, you have to
compare it to something else
Double-listening (MW)
Not always a contrast like mistrust to trust
Questions to elicit ABI
What does this say about what you treasure?
If this problem is a protest against something,
what would you say that something is?

55
Narrative Therapy with Couples (2014) J. Freedman

Questions to elicit ABI
Has something important been violated? Can you
put what has been violated into words?
Could we say that your naming this as problematic
means that you dont go along with it? In not
going along with it, are you standing for
something else?

56
Narrative Therapy with Couples (2014) J. Freedman

Questions to elicit ABI
Im getting the impression as you speak of this
that there is something you miss. Is that right?
Can you put that into words?
In saying no to this, what are you saying yes
to?
Why is it important that you speak of this in
front of your partner?

57
BREAK205 220
58
Narrative Therapy with Couples (2014) J. Freedman

Relational identity
In Western society, much more individualistic
In other cultures/societies much more of a
relational concept
The checklist doesnt necessarily have anything
to do with who you are in a relationship
(multiple selves?)
Socio-cultural discourses that we measure
ourselves against

59
Narrative Therapy with Couples (2014) J. Freedman