• The psychoanalytic approach emphasizes the importance of early childhood development and events.  Do you find that current problems are mostly rooted in early childhood events or influences?  To what extent do you believe people can resolve their adult problems that stem from childhood without exploring past events?  When you apply this basic psychoanalytic concept specifically to yourself, what connections between your own past and present are you aware?

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Application: Therapeutic Techniques and Procedures

The effective application of narrative therapy is more dependent on thera- LO10 pists’ attitudes or perspectives than on techniques. In the practice of narrative therapy, there is no recipe, no set agenda, and no formula that the therapist can follow to assure positive results (Drewery & Winslade, 1997). When externalizing questions are approached mainly as a technique, the intervention will be shallow, forced, and unlikely to produce significant therapeutic effects (Freedman & Combs, 1996; O’Hanlon, 1994).

Narrative therapists are in agreement with Carl Rogers on the importance of the therapist’s way of being rather than being technique driven. A narrative approach to counseling is more than the application of skills; it is based on the therapist’s personal characteristics that create a climate that encourages clients to see their stories from different perspectives. Narrative therapists emphasize their willingness to see beyond dominant cultural norms and to appreciate clients’ differences. However, a series of “maps” of narrative conversational trajectories can help give structure and direction to a therapeutic conversation (White, 2007).

Questions . . . and More Questions The questions narrative therapists ask may seem embedded in a unique conversation, part of a dialogue about earlier dialogues, a discovery of unique events, or an exploration of dominant culture processes and imperatives. Whatever the purpose, the questions are often circular, or relational, and they seek to empower clients in new ways. To use Gregory Bateson’s (1972) famous phrase, they are questions in search of a difference that will make a difference.

Narrative therapists use questions as a way to generate experience rather than to gather information. The aim of questioning is to progressively discover or construct the client’s experience so that the client has a sense of a preferred direction. Questions are always asked from a position of respect, curiosity, and openness. Therapists ask questions from a not-knowing position, meaning that they do not pose questions that they think they already know the answers to.

Through the process of asking questions, therapists provide clients with an opportunity to explore various dimensions of their life situations. This questioning process helps bring out the unstated cultural assumptions that contribute to the original construction of the problem. The therapist is interested in finding out how the problems first became evident, and how they have affected clients’ views of themselves (Monk, 1997). Narrative therapists attempt to engage people in deconstructing problem-saturated stories, identifying preferred directions, and creating alternative stories that support these preferred directions. For a more complete discussion of the use of questions in narrative therapy, see Madigan (2011).

Externalization and Deconstruction Narrative therapists believe it is not the person that is the problem, but the problem that is the problem (White, 1989). These problems often are products of the cultural world or of the power relations in which this world is located. Living life means relating to problems, not being fused with them. Narrative therapists help clients deconstruct these problematic stories by disassembling the taken-for-granted assumptions that are made about an event, which then opens alternative possibilities for living.

Externalization is one process for deconstructing the power of a narrative. This process separates the person from identification with the problem. When clients view themselves as “being” the problem, they are limited in the ways they can effectively deal with the problem. When clients experience the problem as being located outside of themselves, they create a relationship with the problem. For example, there is quite a difference between labeling someone an alcoholic and indicating that alcohol has invaded his or her life. Separating the problem from the individual facilitates hope and enables clients to take a stand against specific story lines, such as self-blame. By understanding the cultural invitations to blame oneself, clients can deconstruct this story line and generate a more positive, healing story.

The method used to separate the person from the problem is referred to as externalizing conversation, which opens up space for new stories to emerge. This method is particularly useful when people have internalized diagnoses and labels that have not been validating or empowering of the change process (Bertolino & O’Hanlon, 2002). externalizing conversations counteract oppressive, problem-saturated stories and empower clients to feel competent to handle the problems they face. Two stages of structuring externalizing conversations are (1) to map the influence of the problem in the person’s life, and (2) to map the influence of the person’s life back on the problem (McKenzie & Monk, 1997).

Mapping the influence of the problem on the person generates a great deal of useful information and often results in people feeling less shamed and blamed. People feel listened to and understood when the problem’s influences are explored in a systematic fashion. A common question is, “When did this problem first appear in your life?” When this mapping is done carefully, it lays the foundation for coauthoring a new story line for the client. Often clients feel outraged when they see for the first time how much the problem is affecting them. The job of the therapist is to assist clients in tracing the problem from when it originated to the present. Therapists may put a future twist on the problem by asking, “If the problem were to continue for a month (or any time period), what would this mean for you?” This question can motivate the client to join with the therapist in combating the impact of the problem’s effects. Other useful questions are “To what extent has this problem influenced your life?” and “How deeply has this problem affected you?”

It is important to identify instances when the problem did not completely dominate a client’s life. This kind of mapping can help the client who is disillusioned by the problem see some hope for a different kind of life. Therapists look for these “sparkling moments” as they engage in externalizing conversations with clients (White & Epston, 1990).

The case of Brandon illustrates an externalizing conversation. Brandon says that he gets angry far too much, especially when he feels that his wife is criticizing him unjustly: “I just flare! I pop off, get upset, fight back. Later, I wish I hadn’t, but it’s too late. I’ve messed up again.” Questions about how his anger occurs, complete with specific examples and events, can help chart the influence of the problem. However, it is questions like the ones that follow that externalize the problem: “What is the mission of the anger, and how does it recruit you into this mission?” “How does the anger get you, and how does it trick you into letting it become so powerful?” “What does the anger require of you, and what happens to you when you meet its requirements?” “What cultural supports (in your family/community/world) have shaped the role that anger plays for you?”

Search for Unique Outcomes In the narrative approach, externalizing questions are followed by questions searching for unique outcomes. The therapist talks to the client about moments of choice or success regarding the problem. This is done by selecting for attention any experience that stands apart from the problem story, regardless of how insignificant it might seem to the client. The therapist may ask: “Was there ever a time in which anger wanted to take you over, and you resisted? What was that like for you? How did you do it?” These questions are aimed at highlighting moments when the problem has not occurred or when the problem has been dealt with successfully. Unique outcomes can often be found in the past or the present, but they can also be hypothesized for the future: “What form would standing up against your anger take?” Exploring questions such as these enables clients to see that change is possible. Linking a series of such unique outcomes together starts to form a counter story. It is within the account of unique outcomes that a gateway is provided for alternative versions of a person’s life (White, 1992).

Following the description of a unique outcome, White (1992) suggests posing questions, both direct and indirect, that lead to the elaboration of preferred identity stories:

What do you think this tells me about what you have wanted for your life and about what you have been trying for in your life?

How do you think knowing this has affected my view of you as a person?

Of all those people who have known you, who would be least surprised that you have been able to take this step in addressing your problem’s influence in your life?

What actions might you commit yourself to if you were to more fully embrace this knowledge of who you are? (p. 133)

The development of unique outcome stories into solution stories is facilitated by what Epston and White (1992) call “circulation questions”:

Now that you have reached this point in life, who else should know about it?

I guess there are a number of people who have an outdated view of who you are as a person. What ideas do you have about updating these views?

If other people seek therapy for the same reasons you did, can I share with them any of the important discoveries you have made? (p. 23)

These questions are not asked in a barrage-like manner. Questioning is an integral part of the context of the narrative conversation, and each question is sensitively attuned to the responses brought out by the previous question (White, 1992).

McKenzie and Monk (1997) suggest that therapists seek permission from the client before asking a series of questions. By letting a client know that they do not have answers to the

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