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Narrative Papers |
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11/8/2003 |
Written by Kate Ingram Edited by Susan Corby |
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Kate Ingram is a Melbourne family therapist who undertook a research project looking at the effects on therapists and families of gathering stories from families who had managed to overcome or move away from problems, and sharing these stories with other families facing similar troubles. Kate made some interesting and surprising findings.
I was very interested when invited by The Bouverie Centre in Melbourne to take part in a research project examining the effects on people currently in therapy of reading the narratives of change of people who had previously been in therapy. I already knew from my own experience that such a process can be most inspiring. I was greatly aided by the stories of others in the anorexia league when I was co-facilitating a therapeutic group for adolescents diagnosed with anorexia nervosa. Also, as a member of a buddhist organisation, I have been inspired by the testimonies of others who have overcome problems through Buddhist practice.
The Telling We called the writings that described the discoveries and changes that people made in relation to problems they experienced, their Wisdom narratives. Accordingly, the research came to be known as the Wisdoms project. I realised that the therapists at The Bouverie Centre, like many others, rarely had the time and opportunity to share their experiences of the successes of the people with whom they worked. More often than not, peer supervision in these settings is about solving current therapeutic difficulties. It seemed to me that this project could provide us with a unique opportunity to celebrate these successes and learn from each other. Seven therapists agreed to take part in the research known as the Wisdoms project. It seemed logical to use participatory action research methodology for the project, which could potentially develop and expand the knowledge and practice of the therapists. This interested me because I wanted to obtain 'useful' knowledge that a therapist might find helpful in clinical work with people. There were a number of preconceptions that had to be ironed out before the group could start to plan the collection of Wisdom narratives. One therapist asked, 'I am a systemic therapist. To what extent is this a Narrative approach to my practice?' I wondered if having invited David Epston to the Centre to introduce ideas about co-research, and my own leanings towards Narrative therapy, might have implied that the research would require the therapists who were gathering the Wisdoms to use a Narrative therapy model. It appeared this way as each group member voiced concern. Most of the group members saw themselves as systemic family therapists. One said, 'Narrative therapy is not my style. I am not going to be able to talk to them in that way,' and 'It raises for me the tension I am having with narratives, whether they be pure or whether we are doing a White/Epston co-research.' For myself, I was simply thinking that the most important aspect of all of the therapeutic models was their ability to free people of painful and distressing problems. My interest in Narrative therapy, and in the project, was about improving my practice and understanding to better help the people who come to me, more than entering into a debate about the relative merits of differing models. Finally we decided to remain open minded about ways of approaching the gathering and circulating of the Wisdoms. There were also a number of ethical issues to consider including ensuring confidentiality at all stages of the process, and ensuring each person was fully cognisant of all relevant information about the research. Each participant signed a consent form giving permission for their Wisdom narratives to be shared with other people. At any time, a person could change details in their story, or withdraw permission for it to be shown to others. To minimise the possibility of identifying individuals by their voices, all of the recordings were transcribed onto paper. The group of seven therapists met for one hour every three weeks for six months. They followed the steps of action research, for example, writing or listening to a person's narrative, acting on and observing the process and its consequences, reflecting individually, then as a group on the process and consequences, then replanning, acting, observing, and reflecting again (Kemmis and McTaggart, 2000).
THE GETTING OF WISDOMS Although each therapist gathered each story from each individual or family in a different way, there was commonality of intention, for the stories were written to support or inspire another person or family who was experiencing something similar to themselves. Here are some of the findings of the therapists who were involved in documenting people's Wisdom narratives:
Writing about an experience with a view mailto: to helping others has therapeutic implications One therapist found that a person who wrote ten pages in a 'stream of consciousness' was able to disclose past abuse that had not been spoken of in two years of therapy. Writing about an experience seems to help people think more clearly about what has happened. The group speculated on the possibility that reframing an experience that has previously been fragmented, into a coherent whole, enables a person to reflect on life as it has been lived. This somehow frames the experience in a more positive way for them. This idea was supported by participants who reported that even though remembering where they had been and documenting the changes was painful, they were nonetheless pleased with the steps they had taken and this generated a sense of achievement, strength and pride in themselves.
The writing of a story can generate a cycle of re-solution We wondered how we as a group might generate stories in a way that was not just about producing documents for an archive, but was also about providing therapeutic benefit for the writers of the stories. I was involved in a situation that illustrates the therapeutic benefits of using the process of writing as part of the therapy. I asked a woman if she would write her story in order to help someone else. Later the woman told me, 'This was a helpful process because it brings you back and you have to think about how you were thinking and feeling at that time and not just now. As you are writing, it makes you think of what happened and see it as a past experience - I actually feel better writing about all of that, because I probably didn't get it half as much off my chest as what I thought'. The group observed that this process, for this woman, was a virtuous cycle that facilitated what it was designed to achieve.
A story that is 'ghost written' by a therapist then read back to the person, can engender feelings of self-compassion It seemed to the group that in the process of hearing their stories told with pseudonyms, people had been able to separate themselves from the hurt, fear and shame of their past experiences. They looked at their lives as if they were looking at other people's lives, and felt the compassion for themselves that they might feel for others in similar circumstances. People can be incredibly compassionate towards others who have themselves experienced hardship and abuse.
THE GIVING OF WISDOMS The group speculated that sharing people's Wisdoms in therapy might provide benefits similar to those received from a self-help group. They found that when an individual or family heard the experience of another individual or family, they seemed to connect it with something in their own lives. Listening to another individual or family's ideas and perspectives enabled them to take on a new perspective themselves. This is of course one of the benefits often gained from self-help groups, where people with similar problems join together to share, support and learn from each other. One woman who found it hard to accept that her family's problem was big enough for her to go to therapy and felt guilty for taking up therapy time, changed her perspective after hearing someone else's narrative. On another occasion, after having heard someone else's experience of anorexia, the same woman starting talking about her own experience of anorexia, something she had not disclosed previously. Sharing this experience gave her a chance to reconsider her position in relation to her daughter who was beginning to engage in an anorexic lifestyle. There were other times too, when hearing a Wisdom narrative stimulated conversations that lead to more helpful perspectives on more than one occasion.
A therapist cannot predict what a person will draw from any given story Time and time again, the group was surprised at what a person valued or found important in a story. The group also found that any particular Wisdom narrative chosen for recounting did not have to correlate closely with a person's own situation. One therapist who worked in the area of acquired brain injury, felt that having an archive to share with her clients from which to draw stories of hope and discovery, might help her not to be so consumed by their tragic stories.
Therapists found that using Wisdom narratives in therapy is not as simple or self-evident as it seems For some therapists, the process of reading the Wisdoms clashed with their preferred style of working. For example one felt awkward bringing in someone else's story to the session because this might deflect from where the client is at. There was also anxiety about the different ways in which a person might interpret the introduction of another's experience into their therapy session. Therapists wondered if clients might be second guessing their intention in doing so. In addition, fears were raised about the possibility of a story having a negative - even unhelpful - impact on a person. The group further wondered how to proceed in conversation with a person after a story had been read to them. As one therapist put it, ' I ask a couple of questions, but then I feel like I am prying into something that is quite deep as though it is more for my needs than theirs.' We decided that the introduction of a Wisdom narrative into another individual or family's therapy session needed to be a consultative process. Suggestions for ways of doing this included:
- introducing a Wisdom narrative in a similar way to a reflection given by a member of a reflecting team, in which people are encouraged to choose from a multiplicity of interpretations or responses;
- drawing from David Epston's ideas on 'cross-referencing' interviews, in which the therapist and person explore the Wisdom together, wondering about its relevancy, emotional and thought-provoking resonances, and have conversations around this. The aim is to use other people's stories as interesting references with which to draw comparisons, inspire or stimulate conversation, or as a 'reference map' for the person's journey.
Conclusion What then, were the findings of this group of therapists about the writing and hearing of Wisdom narratives with their clients? It appears that writing narratives like these creates a distance that helps people see themselves in a different context. The reflexivity that comes with the act of writing seems to allow people to be able to acknowledge their strengths and act differently. When a therapist 'ghost wrote' a story and read it back, people found themselves able to reflect on their lives without needing to respond, in contrast with other styles of therapy. It seems that a reflexive position like this enables a person to have thoughts and feelings about their thoughts and feelings, and to be an audience to themselves. This can have an empowering effect. It is interesting to reflect on the consequences for the writers of the stories, of setting themselves this task to help someone in a similar position. Not only does this give the writer the therapeutic benefit of putting words to past trauma, problems or difficult circumstances, but it also gives them a potential change in self-perception arising from the realisation that they have a success story to offer. The group found that while all the writers shared the common intention of supporting someone else, there was a great deal; of variation in each person's experience of writing. From this arose questions about which steps to include in order to ensure that the process of writing is beneficial to the writer. Is it enough to establish a reflexive position, or is something else needed? In relation to the giving of wisdoms to others in therapy, the group was unsure whether it was the hearing of stories alone that gave rise to positive effects. It was suggested that the introduction of Wisdoms is simply another way for a therapist to stimulate an individual or family into new and different ways of thinking and feeling. It may be that this giving of wisdoms parallels the experiences of members of self-help groups. Having someone articulate what you are feeling but have not found the words to describe, can enable people to reflect on and to change their feelings, thoughts and actions. Nonetheless, the giving of wisdoms is certainly one way of generating dialogue with people - and for me, dialogue is most instrumental in effective therapy. With it comes the possibility of emergence of new ways of relating to self and to problems. The reflective process invites the type of dialogue that can counteract a prevailing dominant monologue about life and relationship to a problem or problems. Like listening in a reflective team, listening to a Wisdom allows for a 'to and fro' action to occur between listening and talking, and supports self-reflection. Of course it is very important to be aware of potential 'risks' of introducing Wisdom narratives in therapy. Therapists need to work with people in a collaborative and consultative manner, continually exploring more effective ways of doing this. As a result of this research project, a number of Wisdom narratives have been generated at The Bouverie Centre. A community of ''wisdom tellers' or 'wise sayers' is being created in a folder that is available for perusal in the Reception area of the Centre. Time and again, I have found it very rewarding to see someone at Reception intently pouring over this folder. We are using the stories in training workshops to teach and inspire student therapists. Also we are generating student Wisdom narratives about the experience of presenting families of origin in a learning context. Some therapists who took part in the research are continuing to meet as a group to learn more about the 'getting and giving' of Wisdoms. Some have acknowledged that hearing families' stories adds new dimensions to their appreciation of people's courage and strength. Sadly, this can be lost in routine sessions. As for myself, I am sure that a sense of pride is generated in a person who experiences me believing that she has important learnings to share with me. This will benefit my life and work. The Wisdom narrative that is produced also becomes a testimony to work that has been done and progress that has been made during our joint endeavour. I celebrate this mutual creativity together with the people with whom I work. I believe that a person who has something to give feels important and is less isolated from the community of human beings.
REFERENCE Epston D, White M, Murray K (1992) A Proposal for re-authoring therapy in S McNamee and K Gergen (Eds) Therapy as Social Construction. Sage, London.
A comprehensive report on this research project is currently being prepared for publication. For further information, contact Kate Ingram by email at kany@alphalink.com.au
1 The Bouverie Family Centre is a clinic and teaching organisation with specialist teams addressing effects on families of MI, ABI, sexual abuse, same sex parents, and also dealing with a range of other presentations 2 Funding provided by the Faculty of Occupational Health Sciences, Latrobe University, Melbourne 3 www.narrativeapproaches/anti-anorexia
Our clients are the authors of the knowledges from whom we learn, not the object of our observations. We are comrades standing side by side caring about the same thing. Epston, 1997
Kate Ingram entered the family therapy field in the 1990's. She chose the Narrative model for her work partly because she was so inspired by the revolutionary idea of locating the problem, not in the person or in family relationships, but in the problem. She realised that the process of 'externalising' freed people from the need to apportion blame, and invited them to learn something different about themselves and change patterns of behaviour.
The idea of positioning herself not as an expert knower of a family's life, but as an explorer with the family of their lived experience, is important to Kate. Focusing on the ways in which people make sense of their lives and how this influences their interpersonal interactions and direction of their lives, rather than focusing on interactions between family members per se, is why she does not see herself as systemic therapist. Kate recognises the potential for dominant discourses to limit and control people's lives and influence their perceptions of reality, and believes re-authoring conversations are powerful intervening tools for a therapist. What clinches it for her though is that Narrative therapy is unique in the field in adopting the idea of 'audience to change'. Epston, White and Murray (1992) say, 'If one looks at agency as a resource that is distributed by others - being granted the right to speak - then what others think of oneself must be taken into account; it is not sufficient simply to change one's picture of oneself privately; one must in addition have a convincing picture to show others.' For Kate, this idea of inviting audiences to change through creating an archive, has been one of the most important aspects of the Wisdoms project. Kate Ingram can be contacted by email kany@alphalink.com.au
The article first appeared in Narrative Network News December 2002 - email nnn@swift.net.au.
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