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Thickening Narrative Therapy Through Existential Psychotherapy
Once upon a time there was now, now. The past is written with many perspectives but the future is still empty and the present is an act of writing. Narrative therapy is a type of therapy that uses a story or narrative as our way of looking at our life situations. We look at that split through a lens that tells us another way to see our problems. Not to change the story but to tell it from a different perspective. Narrative therapy respects these stories and yet accepts that each perspective is imbued with meaning that the family, society, culture has predetermined as the “correct” meaning. Current treatments tend to be more individualized and focused on the “now” rather than the past or future. Next it examines limitations and extensions. The four main aspects of existentialism are meaning (vs. meaning), freedom (vs. confinement), death (vs. life), and alienation (vs. inclusion) (Yalom, 1980). Narrative therapy and existential psychotherapy can help bridge the gaps left by each other. Engaging the past, present, and future and giving meaning to both the individual and the collective.
The word meaning has survived philosophers for thousands of years. Giving it a precise definition proved almost impossible. How we use meaning is a thread that runs through most major schools of psychology. The idea in narrative therapy is that meaning is not given, nothing is imbued with meaning, but rather the interpretation of experience. That is explained by the social construction theory of reality. According to (:”The Social Construction of Reality”, 2009):
“The main idea of the Social Construction of Values is that people and groups interact together in a social way, over time, ideas or mental representations of each other’s actions, and these ideas are finally settled in the corresponding roles played by actors. When these roles are made available to other members of society to enter and play , reciprocal communication is said to be institutionalized. In the process of institutionalization, meaning is socially institutionalized. and belief) about what is true is socially institutionalized.”
A common way to describe this is that through language, symbols, and interactive dialogue we give meaning to experience. First come experiences and then these experiences are filtered through these cultural transactions that create interpretations. It is because we only see the color blue as “blue” because it has been given meaning in a cultural context. A quick formula for meaning in narrative therapy is experience and interpretation equals meaning.
One of the main tenets of existential psychotherapy is the oft-quoted phrase from Sartre “existence goes forward.” Meaning is personally constructed, as opposed to socially constructed. There are gifts like we will all die that we will have to face. Meaning is self-constructed within this framework. Since we are going to die at some point in the future what does this present mean? This meaning is believed to come from each person. We become an honest or true person when we acknowledge this obstacle but ask ourselves what we are going to do about it? First there is just being, as in the present moment, and then we create essence. Meaning in existing psychotherapy is often about deeply held beliefs such as the question “what is the meaning of life?”
A key theoretical movement in narrative therapy is to pay attention to what is called the shining moment. While the client conveys the story of what brought them to the therapist’s office the therapist listens to an episode within the story that contradicts the main story. A story that describes a different picture of the way we like, for example, if the client tells a story of depression then the therapist listens to an event or a time when depression was not present. The telling of this story is another form of narrative therapy called “re-writing”. The therapist can help with this by eliciting what is called a “reminiscing” conversation in which the emphasis is placed on the knowledge of a significant other who has greatly contributed to the client’s life. This could be a friend, lover, parent, musician, or writer.
To help the client in this way the therapist must remain de-centered, and unaffected. They can do this by helping the client to “enrich” the preferred story by encouraging details of what is being told, rather than just a small description of a particular event. For example, instead of just saying the weather is nice outside, ask questions about why the client thinks it’s nice outside. What a smell, a smell, a feeling, may remind them of something, The therapist would do well to keep in mind the rich history of psychotherapy that exists to help enrich the preferred way of being.
Contemporary psychotherapy has a rich history of recognizing how we use what Howard Gardner called multiple minds. They are, according to Wikipedia, body-kinesthetic, interpersonal, verbal-linguistic, logical-mathematical, naturalistic, intrapersonal, visual-spatial, and musical intelligences (” A Theory of Multiple Minds”, 2009). Howard Gardner proposed a ninth intelligence that could be the intelligence that exists. Existential intelligence will include the ability to question the larger issues in life such as death, life, and possible spiritual meaning (“Theory of Multiple Minds”, 2009). Narrative therapy also includes this concept of multiple intelligences even if this is not clear. The therapist is encouraged to explore with the client the best way to communicate. This could be music therapy, writing therapy, or art therapy. Contemporary psychotherapy and individual psychotherapy have historically promoted the concept of being a whole person including from an observational angle. The therapist does not appear in the role of expert but rather is interested in the real person or the phenomenological method. In order to be fully present in this way the intelligence that the client is working on must be a means of exploring further development.
We live forever in the present moment but are often focused on future plans, worries, hopes, or dreams. Likewise when we are not focused on the future we are past focus. The past focuses on our worries, shames, and doubts. This tends to be the realm of narrative therapy. That is to relate a sequence of events to a specific period of time and give that meaning. Narrative medicine is struggling at the moment. It posits the entity or self in opposition to the Buddhist concept of selflessness. This personal position refers to the situation of an observer researching or remembering a story. The concept of abstinence contradicts this position and no one is watching but this is temporary now. The concept of being is something that is now or emerging (like a flower opening into what it can be). Existential psychiatry pays homage to the past and possible futures but the real source of the moment is now. James Bugental calls this the living moment (Bugental, p.20). While in the stage of rewriting and enriching the story in narrative therapy this current situation can prove to be very informative. It can also be used on a full storytelling level. If the client seems to be holding on to issues of consequences or judgments of a particular event then ask what seems to be current feelings, thoughts, smells, etc. Living in the present moment there are many aspects that can be explored for example the kinesthetic experience of the moment. This is one way to help with the issue of being stuck.
Existing psychologists tend to focus on four different areas to make meaning. It is freedom, death, solitude, and meaninglessness (Yalom, 1980). Each of these areas can be constructed as a continuum. Freedom will have two extreme sides to it. On the other side of freedom would be the total prohibition of any freedom at all. Not having any kind of choice like being imprisoned. The other end would be total freedom as found in the libertine philosophy of everything moving without constraints. Current psychologists say that each of us falls somewhere along this continuum. In order to move, to find relief from our struggles with mental illness or depression, we need to come to an individual understanding of where we are on this continuum and where we would like to go or what we would like to be. For example, if we feel we have too much freedom from overindulging without restrictions we may need to move a little further along this continuum of restraint to help us balance. There are no right or wrong answers but what one feels is appropriate. To help enrich the preferred way of being within narrative therapy this theory may seem to limit what meaning is. This meaning is created by the therapist and the client, but I argue that if we use it as a map, it can help us stay focused.
This opinion piece is not intended to be a position based on a complete theoretical perspective. The author acknowledges that both narrative therapy and existential psychotherapy both come from rich philosophies but very different origins. There are a few philosophers who have tried to explore the similarities between post-modernism and existentialism. If one looks for connections they can always find, in the smallest details, those connections but each philosophy is a completely different project. The medical condition, or pou sto, is something completely different. Narrative therapy does not simply use postmodernism as a philosophical background and existential psychotherapy does not simply use a strict existentialist philosophy. Rather, these philosophical origins are a practical way of using these various therapies to try to help heal our mental illnesses. As Foucault explained in his last known interview (William V. Spanos, P.153) “For me Heidegger has always been an important philosopher… My entire philosophical development was determined by my study of Heidegger.”
What are some future directions for strengthening narrative therapy with existing psychotherapy? An initial narrative treatment would do well to further clarify what is meant by extending the preferred narrative. What does it mean to make this story more real or the main focus of the narratives? There needs to be more philosophical discussion about the concept of meaning as both therapies have a strong emphasis on meaning making but they just come at it from different angles and different projects. The question may be asked whether these two different treatments are as compatible as this author suggests they are. If not, why not? Is there a way forward?
As this story (theoretic standing) comes to an end it is important to remember that these are questions and not absolute truths. The story can be changed by adding subtle details and removing distractions. One thing to note is that narrative therapy and existing psychotherapy are unknown people walking the same path.
1. Bugental, James FT (1999). Psychotherapy is not what you think: Bringing Psychotherapeutic Interventions into the living moment. Phoenix, Az.: Zeig Tucker & Theisen Publishers.
2. The Social Construction of Value. (2009, July 8). From Wikipedia, The Free Encyclopedia. Retrieved 22:46, July 8, 2009, from http://en.wikipedia.org/w/index.php?title=The_Social_Construction_of_Reality&oldid=301080937.
3. Spanos, Williams V. (1993). Heidegger and critique: Reclaiming the cultural politics of destruction. Minneapolis, MN: University of Minnesota Press.
4. The theory of multiple minds. (2009, August 4). From Wikipedia, The Free Encyclopedia. Retrieved 16:07, August 4, 2009, from http://en.wikipedia.org/w/index.php?title=Theory_of_multiple_intelligences&oldid=306033977.
5. Yalom, Irvin D. (1980). Current Psychotherapy. New York: Basic Books.
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