I’m going to use a hypothetical client, Sara, to help illustrate each of the main narrative therapy interventions. Sara is a 25-year-old woman seeking therapy to address symptoms of depression that she reports experiencing since she was a teenager. Sara no longer feels able to manage her symptoms on her own.
Narrative therapy has several broad main concepts and a variety of strategies for implementing those concepts in the therapy setting. The concepts below are the broadest explanation of how narrative therapy works – each of these concepts has more specific interventions.
Sara is given a journaling exercise to write out how depression impacts her life. As Sara shares this story, the therapist asks questions from a place of curiosity, such as “How might a friend have viewed you in these moments?” or "How might you have preferred things to have been?”. The therapist will also work on linking past experiences to current experiences to help find patterns arising from the dominant story.
Putting together the narrative. This is the basis of all narrative therapy! Narrative therapy encourages clients to tell their stories in their own words, and this can be done in a variety of ways. Verbal retelling, journaling, and even expressive arts are all ways of having clients begin to put their narratives together. As the story is shared, narrative therapists will work with the client on reframing, considering alternative perspectives, and gaining meaning from these stories.
Sara labels herself depressed. The therapist begins working with Sara on externalizing depression from herself using imagery during a session. Sara is asked to imagine and describe what depression looks like when separated from herself, and what she looks like without depression.
Externalization. People tend to internalize problems and view them as a part of one’s personality. For example, people experiencing depression often label themselves as “depressed”, or “helpless”. Externalizing the depression symptoms as separate from one’s identity can help create the momentum to begin combating the symptoms or learning to work with the symptoms rather than accepting them as a part of who we are. Often, when we separate our problems from ourselves it makes us easier to change our behavior or consider it from a different perspective.
Sara describes herself as depressed, helpless, and incapable of achieving her daily responsibilities. The therapist works with Sara on identifying specific daily responsibilities the client wants to meet and Sara lists hygiene care, regularly eating, and walking her dog.
Deconstruction. Narrative therapists help clients break down scenarios into smaller parts to see the overall picture more clearly. By breaking problems down into smaller pieces, solutions begin to arise to address components of the problem.
Sara is asked to share a time in her life when depression was not prevalent. Sara is able to identify a time when she felt fully present and connected to others. Using open questions and a curious approach, the therapist guides Sara to share more details about this unique outcome of her life.
Identifying Unique Outcomes. Also known as sparkling events. This technique helps clients identify times falling outside the main storyline. Sparkling events often highlight clients’ strengths and resilience. Having the client focus on a unique storyline can really help them begin to consider the main storyline differently.