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How To Start a Narrative Therapy Conversation

August 4, 2017

 

I am frequently asked how to start a narrative conversation.  Here is one way to do so:
 
When I start meeting with someone, I think of a metaphor of climbing a mountain (Stillman, 2010). 
 
There are three ways to think of climbing the mountain.  You can go straight up, you can take a route with some height, or you can take an easy course circling at a slight incline. 
 
I propose these options to the person by saying that there are several ways to start a conversation.  I know that they are coming in to talk about something that is a problem for them.  (I sometimes use this opportunity to try my humor out and say that this is an occupational hazard.)
 
I let them know that we can start off talking about the specific experience of the problem (straight up the mountain), we can talk about the effects of the problem (the middle route), or we can take some time for me to get to know them outside of the problem (the easier path).
 
I let them know that over the course of our conversation we can take any of these paths, but that it is helpful to choose an initial path. 
 
I tell them that people sometimes come in and have been carrying the problem so long that they feel that they need to talk about it right away.  This can be in the form of the steep trek as they need to tell me the specific experience of what happened and when it occurred.  If this is the case, I let them know that while we ascend this path and I listen to them retell the events, I will also be listening for times and ways that they acted in ways or took positions that seemed to stand against the problem or didn’t accept it.  In narrative language, this is called “double listening”. 
 
The person might not want to talk about the specific experience, particularly if it comes to a trauma experience or even if it's a less defined experience like depression, but they might want to share the effects of the trauma or the depression. 
 
In this conversation, they would talk about anger, sadness, shame, trouble sleeping, etc.  This would be taking the middle route up the mountain.  We are still talking directly about the problem, but it’s less intense since we are talking about the effects of the problem and not the experience itself. 
 
If they choose this path, I let them know that I will be interested in how they name the problem in their own terms.  I would tell them that it will be important for us to situate the effects of the problem outside of them so we can talk about “the anger” for instance and how it affects their life.

This way of addressing problems outside of a person, rather than seeing the problem as internal is called Externalization.  Relocating the problem outside offers new opportunities for people, one of which is taking a position on it or in narrative language, asserting Personal Agency.
 
If we take this middle route, along with naming problems, I may let them know I will be asking questions about how these problems get in the way of what they prefer.  This narrative principle is called the Absent but Implicit.  This will let them know that I will be respecting their discussion of the effects but similarly to the steep path, I will let them know I am listening for something different as well.
 
Finally, I let them know of the third option, the easier path where I respect that there is a problem, but start by asking questions about when the problem has less influence. 
 
I let them know that I prefer this path as it gives me an opportunity to get to know ‘outside of the problem’ them before we start talking about the problem.  Using the metaphor of climbing a mountain, it allows me to know how they prefer to hike, what pace they set, who will be helpful on their journey, what resources they are carrying and their preferred destination. 
 
I have the opportunity to learn the contexts where the problem has less influence, the people in their life who support them, their hopes and dreams and what they value, and times they have felt good about their life and their direction.
 
This conversation using the narrative principle of Repositioning can have effects of its own on the problem.  David Epston, a co-founder of narrative, has mentioned this type of conversation alone can alter the effects of problems. 
 
Each of these three paths is an option, and how explicit I am about the details I share about each varies. 
 
Sharing these options also serves the purpose of putting the person in control of the course of the conversation from the start, establishing their centered position in the work we will do (Narrative principle of Positioning- De-Centered yet Influential). 
 
Sharing multiple ways to start also deconstructs the therapeutic process more generally (Narrative principle of Deconstruction).  People come to a conversation with various expectations from previous experience or what they have been exposed to on the media or have heard from others.  These expectations bring with them certain power relations between the therapist and the person. 
 
Narrative conversations address power and are often experienced as different from other approaches.  
 
These choices allow the person to see there are multiple ways to go about therapy, and they can experience several, choosing the best for them. 
 
I do add my preference so often we start with the easier path.  I am aware I am asserting power to do so.  I justify this by offering alternative options and basing it on experience where I have found the easier path to be a good fit for starting conversations.  The exception to this is when there is an acute crisis where time and safety don’t allow for a slower route. 

Stillman, J. (2010). Narrative therapy trauma manual: A principle-based approach. Minneapolis, MN: Caspersen, LLC

I sincerely hope you found this conversation starter helpful and that it allows you to begin using the principles of Narrative Therapy in your practice. If you'd like to know more about how to embrace and utilize the principles of Narrative Therapy CLICK HERE.

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