Narrative therapy

Narrative therapy was developed in the 1980s by therapists Michael White and David Epston. They sought to create a treatment that addressed problems through creating empowering life stories. These stories would replace negative and ineffective narratives that contributed to difficulties in an individual’s life. In short, narrative therapy helps clients answer the question: What are your strengths and values that make success possible?

What is Narrative Therapy?

Narrative therapy looks at a person’s life as intertwining stories that focus on different themes. There may be a separate story for work, relationships, self-image, etc. The narratives that people have created often lead to problems or prevent meaningful solutions. 

The therapist helps the client recognize their experience, identify their values, and weave a new story that will help them develop a more adaptive outcome. For example, maybe a person comes to therapy with the narrative that they are stupid and will never be successful at their job. 

The goal of narrative therapy would be to help the individuals focus on their strengths, believe in their worth, and gain the confidence to approach work with a more positive perspective. Narrative therapy helps a person create a new story for themselves that will facilitate more adaptive emotions and behavior.

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Concepts of Narrative Therapy

The following are the core principles of narrative therapy:

Collaboration: In narrative therapy, the client is seen as an expert on their own life. The therapist will work with the individual to identify their various stories and help them be open to other perspectives. The therapist then cooperates with the client to create a more positive narrative based on their strengths and values, rather than telling them what to do.

Positivity: Individuals frequently create stories that are critical and judgmental of themselves and others. These are viewed as unhelpful in narrative therapy. Narrative therapists help their clients take a fresh perspective on their situation and create stories that emphasize their talents while—at the same time—incorporating their principles. It is an empowering approach.

Dominant vs. alternate stories: Dominant stories are those that the client has developed on their own. They are based upon their life experiences and they are what the therapist helps uncover at the beginning of therapy. Alternate stories, in contrast, are what the client and the therapist create together to help address various problems. 

In simple terms, alternate stories are a reframing of a dominant story that leads to a more favorable outcome. For example, a client may come to therapy with the narrative that they are unlovable and will never get married. They believe this narrative because their parents didn’t exhibit love towards them and they never had a long-term romantic relationship. 

After some narrative therapy, the client is shown that they possess many qualities that make them desirable but they developed self-doubt due to their parent’s lack of love. With a change in confidence and approach, they will likely find that many people will be romantically interested in them.

Perception is reality: One of the main tenets of narrative therapy is that we construct our realities based on our personal experiences. There is no universal truth. Therefore, if we shift our perspectives, our stories will change as well. As such, a therapist must keep in mind religious, cultural, and racial differences when constructing a new narrative.

Techniques of Narrative Therapy

These three techniques are often used by the narrative therapist:

Externalization: One of the main goals of the narrative therapist is to help the client externalize their weaknesses. Problems are seen as separate from the person. For example, “You did a bad thing” rather than “You are a bad person”. This technique helps the client be less critical of themselves and allows them to examine their narrative more objectively. 

Deconstruction: Deconstruction is another technique that changes the view of problematic stories. The therapist helps the client break down difficulties into smaller, more specific pieces. This allows the client to focus on particular problems, rather than accepting general beliefs that may not be true. For example, the client may realize that their partner is simply disappointed by their lack of intimacy rather than believe “my wife hates me.”

Unique outcomes: Unique outcomes are exceptions, or alternate perspectives, that poke holes in the dominant story. The therapist will point out these unique outcomes to help the client see that the dominant story is not the only option and that a new narrative might be more realistic. For example, the therapist might note that the client received multiple “likes” on a dating app, indicating that other people found them attractive and worthy of love.

Does Narrative Therapy work?

The following studies are a sample of the effectiveness of narrative therapy:

• Narrative therapy was associated with a significant reduction in anxiety and depressive symptoms in a population suffering from drug addiction.

• Narrative therapy increased marital satisfaction in women by improving communication patterns.

• Narrative therapy’s positive approach was associated with a reduction of depressive symptoms  in a group therapy setting.

Note: One of the concerns about the efficacy of narrative therapy is that it is difficult to operationalize and its practice can vary from one clinician to another. As such, research on its effectiveness might suffer from weaknesses in psychometric properties. Additionally, despite it being around for almost 40 years, the research is limited.

Resources in Narrative Therapy

• The Dulwich Centre is one of the preeminent resources for narrative therapy in the world. They offer training opportunities at every level, including week-long intensive training (in-person and online) and numerous online courses, some of which are free. The website also has other learning opportunities, including links to videos and relevant research on narrative therapy.

• The Narrative Therapy Initiative is another valuable resource for all things narrative therapy. They provide a year-long certificate course as well as numerous smaller online trainings.

• If you like to learn through reading, Alice Morgan’s, What is narrative therapy?: an easy-to-read introduction includes the basics to start you on your way.

• If video is more your medium, Todd Grande, Ph.D., gives a nice overview of the fundamentals of narrative therapy.

Narrative therapy is a collaborative and empowering treatment that helps people deal with their problems through the creation of adaptive personal stories. The therapist works with the client to recognize their values and strengths and use them as a source of healing.