MMN 042: Narrative Therapy – with Zemeira Singer

On this episode of the Make a Mental Note podcast, Zemeira Singer, a licensed marriage and family therapist, discusses how clients’ stories influence how they function and relate to others and how therapists can help them change elements of those stories to overcome problems and make life more meaningful. Give it a listen and find out why this episode is worthy of a mental note!

Zemeira Singer interview (click on Zemeira’s name to listen to interview)

Mental Notes:

* Narrative therapy – developed by two family therapists. They applied elements of post-structural and post-modernist approaches to family therapy.

* In the past, the medical model was the dominant force in the field of psychotherapy in which therapists/analysts thought they knew more about the unconscious and internal drives of clients. Clients would come into therapy thinking that something was deeply wrong with them and were reliant on therapists to provide them with help.

* The new approach took into consideration the power differential between the therapist and client and tried to balance the power between them. This approach is rooted in social justice and respect for the client. Thus, narrative therapy involves decentering power in the therapist and allowing the client to take the lead in counseling sessions. The therapist does not function in an expert/diagnostic role.

* Changes that were taking place politically in the 1960s and 1970s influenced the narrative therapy approach.

* Collaboration & transparency are important elements of narrative therapy. Externalization also helps – if someone is coming in with a problem (e.g., depression) the therapist can externalize by asking questions like, “How has depression gotten in the way of your relationships?” Talking about the problem as if it doesn’t belong to the client helps to reduce shame and gives clients power. Making depression an entity that is not part of the client helps reduce its power if clients do not choose to believe that it defines who they are. It also helps clients who have been marginalized.

* Narrative therapists take into consideration culture/cultural context (e.g., people of color, LGBT, immigrants) with regard to how these elements affect their life stories.

* Story development – when people are experiencing problems they usually have a problem story (“Ever since I was a kid this thing is happening to me and since then I’ve had all of these experiences that justified this and that, etc.”). David Epston – founder of narrative terapy – looked at literature and story development and wondered if a client who had a deeply entrenched problem story could be helped to craft an alternate story (e.g., bravery or success in the face of great difficulty).

* Humans are faced with challenges and overcome them and the way they overcome them might not be socially appropriate but might make sense on some level. “Re-storying” – looking for unique outcomes is something that’s looked for (e.g., “Even though you got really upset and yelled – which is something that isn’t always helpful – what were you resisting against? What was happening for you when that occurred? Were you protesting against someone when they called you ‘crazy?’”).

* By creating an alternate story and using more playful language – and creating characters – it helps clients have a different and more positive understanding of events and experiences.

* Narrative therapists do not believe in resistance. What looks like resistance is an entrenched problem. It means that the problem is getting nervous. The problem wants to hang on for dear life and stay with the client. A narrative therapist would express curiosity about the client’s response if they (therapist) is trying to re-story something and the client expresses resistance (“e.g., No, no. That’s not it. You don’t get it.”). Backing off and expressing curiosity is important to find out more about the problem. Once again, in the conversation the therapist tries to separate the problem/“entity” from the client.

* How do clients respond to narrative therapists when they talk to the client as if the problem is separate from them? Some clients become excited to think that it is not part of them or define them. Other clients are surprised because they are not used to thinking about their problems in those terms. Yet other clients are not so responsive or think the use of this approach is weird so it might not be as helpful. In these cases, the therapist needs to back off and perhaps build the relationship and do additional work before externalization is used.

* If a client does not buy into the externalization approach the therapist can still think of the problem as external to them and speak to the part of them that is not as “colonized” by the problem even if nothing different is done with language.

* One way of thinking about this approach is that there are three entities participating in the therapy process: therapist, client, and client’s problem. Sometimes therapists address/talk to the client’s problem “in front of the client.” There are different ways that this can be done. Teenagers like it when they give a name to the problem and then are asked to become the problem (to visualize themselves in a form that’s different from themselves) permission to interview “the problem.”  As part of the interview process, the therapist might ask “the problem” how they affect the client’s life – “How long have you and [client’s name] known one another?” etc. Following the interview, the problem is thanked for talking to the therapist and the therapist asks it if s/he can talk the client again and then the teenagers is asked what the experience was like for them. Clients oftentimes become aware of how problem operates that they might not have known previously.

* Helping a client move from point A (start of therapy) to point B (end of therapy/problem has been resolved) is based in large part on how things are set up from the beginning. Trust and understanding is essential. If a client doesn’t feel like the therapist gets what they’re struggling with they are less likely to collaborate. Being transparent and communicating to clients that they can ask questions and disagree with the therapist is also important. Making a map of where they want to go figures into the process too. Getting clear on what “point B” looks like is important (“What would it look like if you were at the point where you didn’t need to come and see me anymore?”)…getting their picture of success. Sometimes goals change and therapists need to adjust.

* Challenges – when clients have experienced a lot of difficulties in their lives they can be wary of the therapist and thus work that occurs in therapy can take a long time. The lives of some clients involve living in unsafe neighborhoods as well as institutionalized racism and systemic poverty. Although therapy can help these clients, it cannot eradicate systemic problems that are the roots of their problems. Viewing problems in their context is essential.

* Clients with more severe problems (e.g., schizophrenia, Bipolar Disorder) require more support & resources than other clients. A therapist cannot address their problems by him/herself (i.e., wraparound services are essential).

* People should learn how to be their own best friend. Although there might be part of them that might not be for their well-being (e.g., inner critical voice) people can learn to recognize it and not allow it to be in charge. People can externalize the problem/separate themselves from the problem. In the case of the inner critic, a person could give it a name to help in the separation process. People can learn how to be kind to themselves. Mindfulness mediation is also very useful for general well-being.

Mental Notes Takeaway:

* Our life stories can take on many different meanings and how we choose to interpret those stories will define who we are and influence our stories moving on.

Check It Out:

* Zemeira Singer’s website: new-narratives.com

* Zemeira’s phone number: 510-463-4809



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Murfreesboro, TN 37130

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