Thinking behind practice – post-structuralism, culture, and individualism

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

I chose this set of readings for reflection because post-structuralism has been a significant influence towards my approach to counselling and other aspects of life.  In the counselling arena it has been liberating for me and my clients.  I have a client, X, who was referred to me by school personnel for anger and defiance issues.  Problems happened over the past year and the school counsellor described him as being “resistant” and unwilling to speak.

In my first meeting with the 15 year old boy at his home, he stood by the door and softly apologised for getting home late before going to his room to change out of his school uniform.  I imagined if I had taken up the image of a “resistant” angry boy as a fixed identity then I might not have noticed such subtle expressions of an alternative identity (Thomas, 2002).

Post-structuralism for me invites a sense of inquisitiveness that leaves no stone unturned, where I become an investigative journalist writing an expose (this was how Michael White described a therapist’s role during a 2007 workshop). The brief referral report on X seemed totalizing of his identity and I chose to open an inquiry into the report, allowing X to read the report and respond to all the statements.  There have been other occasions where I invited clients to expose the labels that structuralist ideas may impose on them and this endeavour has often proven fruitful in uncovering their skills, knowledge, and values in response to problems faced.

In later dialogues with X, many other stories unfolded around his school life that contradicted the problem saturated story.  This included his experience of the injustice inflicted on him by certain teachers who did not listen to his explanations, the experience of humiliation when unusual punishments were enforced on him, and the skill of walking away as a means to prevent anger from blowing up.

In his telling over two sessions, the label of an angry defiant youth was not a problem isolated to his “self” or an identity that pervaded in all contexts. I was delighted when X told me he felt more relaxed after the second session.

In working with youths, I have become more aware of their culture and how the culture encompasses their preferred response to life’s problems.  In reading about psychological colonisation (Arulampalam, Perera, Mel, White, & Denborough, 2006)  it reminds me that as adults we often impose our adult ways of problem solving as the sole acceptable or “normal” way.  I have learned to be sensitive to and to be appreciative of youth culture because privileging their ways invites personal agency and relieves the effort of introducing an alien culture to them.  For each client that I meet, I envision a meeting of cultures and therefore an exciting opportunity to learn more about my client’s life.

References

Arulampalam, S., Perera, L., Mel, S. d., White, C., & Denborough, D. (2006). Chap 3: Avoiding psychological colonisation: Stories from Sri Lanka. In Trauma: Narrative responses to traumatic experience. Adelaide: Dulwich Centre Publications.

Thomas, L. (2002). Poststructuralism and therapy - what's it all about. The International Journal of Narrative Therapy and Community Work(2), pp 91-99.

Working with children

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

What I found valuable in readings about working with trauma and children is the care taken to facilitate the building of “territories of identity” (Ncube & Denborough, 2008; White, 2006) which has helped children speak about trauma in a way that does not re-traumatize them.

I used this approach in a recent first time interview with a 17 year old gay teen whose mum described him as having been traumatized by an encounter with an adult male.  No other details were provided. Our conversations explored various parts of his life such as his love for children, his uncertainty over loving a best friend, and his own knowledge about his sexual orientation since age eleven.  I was wondering how to ask about the details of the trauma but after twenty minutes the details gushed out as he described how a man had tried to have unsafe sex with him without his knowledge.  The tellings about other aspects of his life had somehow equipped him to speak freely on this trauma event.  I am thinking my respectful and curious response as an audience to his tellings also contributed to his feeling safe enough to say more.

Michael White further wrote about avenues for therapeutic enquiry into children’s responses to trauma.  In the same interview, which I transcribed for a clinical consultation with Chris Dolman, I attempted to identify such a response and discovered that I had missed something subtle.  The boy spoke about an “uneasy feeling” and “didn’t want to do it”. After discussing with Chris, it dawned on me that somehow I held notions about the word “response” that were limited to action based responses.  I have now expanded my meanings of “response” to include expressions of feeling and intent that could indicate an entry into conversations about the absent but implicit.

Reading about the experiences of using the Tree of Life metaphor has also sparked off my interest in using it to invite conversations about difficult times in the coming out process of gay men (Ncube & Denborough, 2008).  My main consideration is how to invite meaningful conversations in a short span of time and being careful about re-traumatization. I am excited about the next two months when I facilitate a brief support group programme for gay men.

References

Ncube, N., & Denborough, D. (2008). Chap 4: The Tree of Life: responding to  vulnerable children In Collective Narrative Practice: Responding to individuals, groups and communities who have experienced trauma. Adelaide: Dulwich Centre Publications.

White, M. (2006). Chap 7: Children, trauma and subordinate storyline development. In Trauma: Narrative responses to traumatic experience. Adelaide: Dulwich Centre Publications.

Working with couples

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

I have always wondered since coming into contact with narrative ideas how might couples counselling be practiced.  Jill Freedman and Gene Combs’ writing (Freedman & Combs, 2002) provided me a comprehensive picture of how it could be done.  This helped validate that I was on the right track but somehow it did not address my doubts on the idea of “repositioning” in the definitional ceremony for couple work. It seemed daunting to begin on such a task especially with couples in “high and long standing conflict”.

After reading Michael’s paper on conflict dissolution (White, 2004), it became clearer to me that there was much to be considered and managed by the therapist.  It was a relief to read that it can be “extraordinarily difficult” to reproduce the tradition of outsider-witness responses between a couple.  So far my attempts have been getting into a re-authoring conversation with one partner while the other remains an audience, followed by a re-telling with the other.  This works when emotions are not so intense between them.  I also found the linguagram to be helpful in inspiring me to work with couples through externalizing their values, skills, and knowledges by placing them onto diagrams that can then invite further reflections to thicken the alternative stories (Løge, 2007).  I believe having words in print increases the effect of externalizing the words from the speaker, and thus enables couples to speak and notice the unheard stories about each other without escalating emotions.

I have always valued the strong emotions that are present between couples and amongst family members, and often wonder about how emotions can be part of the re-authoring process.  I noticed my practice had gradually shifted away from a “here and now” stance towards one that emphasized “journalistic enquiry”.  Perhaps this was influenced by what Michael White had mentioned during one workshop about his preference of not dwelling on emotions even though he may be touched by a client’s story.  Perhaps I had misunderstood what he said.  It was only recently that I found a fit for using the “here and now” practices after seeing how another narrative practitioner demonstrated her work.  I feel reconnected with what I value and this brings about greater possibilities for how I wish to work with couples and families.

References

Freedman, J., & Combs, G. (2002). Narrative couple therapy. In Narrative therapy with couples ... and a whole lot more! a collection of papers, essays, and exercises. Adelaide: Dulwich Centre Publications.

Løge, A. K. (2007). Conversations with divorced parents: Disarming the conflict and developing skills of collaboration. The International Journal of Narrative Therapy and Community Work, 1, pp 3-14.

White, M. (2004). Chap 1: Narrative practice, couple therapy and conflict dissolution. In Narrative Practice and Exotic Lives: Resurrecting diversity in everyday life (pp. 1-41). Adelaide: Dulwich Centre Publications.

Responding to trauma and abuse

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

It was rather timely that I had read Angel Yuen’s article (Yuen, 2007) and the interview with Michael White (McLean, 1995) about working with clients who experienced trauma and abuse.  It reaffirmed my own principle of how I wished to work with clients, and helped clarify for myself how I wished to practice. This was most relevant in a recent meeting with a gay teenage boy who had a traumatic sexual experience with an older man.

Before being introduced to narrative ideas, I value and still do value creating the space for clients to speak about their difficult experiences.  I am influenced by other schools of thought, especially around emotions.  In my earlier work in counselling clients for HIV testing, the effect of telling another person provides catharsis which clears the way for clients to think differently or act differently for their future.  When I first heard Michael White in 2007 speaking in objection to the Western ways of revisiting traumatic experiences, it struck me as something important in knowing there was more than one way to work with difficult experiences.  These were ways that were culturally relevant and powerfully acknowledging of client’s own resources.

I found this phrase to be significant for me: “Distress yes, re-traumatisation no” (McLean, 1995), because it is an encouragement that I can be influential in asking  questions about the trauma, and more specifically the response to it.  In the process of enquiry with the teenager, we uncovered the skills and knowledge that he already had in terms of negotiating with men on what he preferred, and an acknowledgement that this incident came about because of the unfair power difference exerted by the older man in withholding to send him home. His feedback that the session was “like having a wind to clear the haze” signified to me that he was gradually redefining his view about the traumatic experience.

The levels of enquiry described by Angel Yuen made my work easier as it pulled together questions that centred on client’s expertise, connection and contribution from significant persons, and identification of personal agency.  I recognized the scaffolding nature of this enquiry and in my limited practice have come to appreciate how it helps clients to reach a rich meaningful conclusion about the trauma that is not totalizing of their identity.

References

McLean, C. (1995). 'Naming abuse and breaking from its effects' an interview with Michael White. In Re-Authoring Lives: Interviews & Essays. Adelaide: Dulwich Centre Publications.

Yuen, A. (2007). Discovering children's responses to trauma: a response based narrative practice. The International Journal of Narrative Therapy and Community Work(4), pp 3-18.

Definitional ceremonies and enabling contribution

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

What I appreciate from the readings is the emphasis on enabling contributions and the discussion on hazards to watch for in outsider-witness practice.  In my training as a counsellor, I am more attuned to the first metaphor of “curiosity and mystery” used in outsider-witness practice (Carey & Russell, 2003).  When I introduced the outsider-witness practice in my organization and volunteer work place, the second metaphor of “acknowledging resonance and transport” drew a blank from colleagues and even invited some critique and words of caution on such a practice from clinical supervisors.  This was definitely something unfamiliar for them.

The current dominant discourse about reflecting teams, at least in Singapore, is centred on the traditional practice of “neutral observation”.  Other terms found in this discourse include “containment” and “boundaries” for therapists.   The practice of reflecting is also frequently positioned as a means to help “unstuck” a therapist.  In a way this is true because the effect of reflecting does introduce a breath of fresh air.  My first attempt at outsider-witness practice was in 2008, partly based on wanting to get “unstuck” by trying to move clients into new territories after seven sessions, and partly being enthusiastic in wanting to try out the outsider-witness practice. 

The clients were a mother-son dyad with a strained relationship due to concerns over his transgender identity.  I assembled an outsider-witness team consisting of a gay male counsellor, a straight female social worker, and a transgender female adult.  It did help clients through acknowledging their struggles and helped strengthen their resolve to journey onwards.  New imagery was also described by the clients in relation to coping with the problems.

What I found valuable was the learning experience about some of the unique hazards and challenges that I encountered:

·        Witnessing and the culture of “家丑不可外扬” (jia1 chou3 bu4 ke3 wai4 yang2)[1]

In most Asian cultures, such as the Chinese, family problems are often kept internal to family members.  The phrase “家丑不可外扬” is a cautionary saying similar to admonishing the airing of dirty laundry in public. I got curious and traced the history of this to ancient teachings and discovered its original intention was to protect the family from external threats by not exposing its vulnerabilities.  Although I had informed the mother about the possible benefits of the outsider-witness session, I did not address this cultural aspect more adequately and believe it might have limited her participation in the telling process.

·        Recognizing the influence of other good intentions

Although that session went well, the sessions after that did not seem to connect with the themes brought out.  Reviewing the readings helped me realize that the outsider-witness practice is premised on helping clients build on their preferred stories and thus construct their preferred identities.

Besides “unstucking” the therapist, other notions had crept in, such as “providing a resource” and possible “role model” or “mentor” through introducing a transgender figure.  I believe these good intentions did not warrant the use of an outsider-witness group especially when alternative stories had barely emerged.

·        Supporting outsider-witnesses in responding to enquiries on transport

The outsider-witnesses felt the process was meaningful for them as they were privileged to make a contribution towards the clients.  I felt there was resonance when the witnesses could situate and link their personal stories to clients’ stories, however getting a response to my enquiry on transport was difficult (Denborough, 2008).  Thus clients did not get a sense that they were contributing towards others.  Together with other outsider-witness experiences, I have found that asking about transport often draws a vague or generalized answer.  I do believe spending more time in scaffolding questions is necessary to support outsider-witnesses in this aspect.

·        Determining when to use an outsider-witness group

Inviting a transgender person as outsider-witness was an idea that I proposed.  The mother expressed her reservation that the son could be negatively influenced, whereas the son welcomed it fully.  I believe this will be a constant dilemma when there is more than one client to work with. I have a sense that that the mother’s discomfort may be linked to the lack of development of a rich alternative story about the relationship with her son.  This is something which I need to be responsible and skilful about in terms of considering when to use an outsider-witness practice.  I am reminded of what Michael had written that “as these (re-authoring) conversations proceed, these alternative storylines thicken, become more significantly rooted in history, and provide people with a foundation for new initiatives in addressing the problems, predicaments, and dilemmas of their lives” (White, 2007).

References

Carey, M., & Russell, S. (2003). Outsider-witness practices: some answers to commonly asked questions. The International Journal of Narrative Therapy and Community Work(1), 63-90.

Denborough, D. (2008). Enabling contribution: Exchanging messages and convening definitional ceremonies. In Collective Narrative Practice: Responding to individuals, groups, and communities who have experienced trauma. Adelaide: Dulwich Centre Publications.

White, M. (2007). Chapter 2: Re-Authoring Conversations. In Maps of Narrative Practice (1st ed., pp. 61-128). NY: W. W. Norton & Company.

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[1] Hanyu Pinyin romanization system for Standard Mandarin language

 

Considering the absent but implicit and addressing personal failure

I am doing a series of reflections as part of a post graduate course on Narrative Therapy. Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

I found the set of readings to be heavy going because the sheer volume of writing by Michael seems to point to something very important in narrative therapy and its practice (White, 2000, 2004).  For me it urges the opening of our sight on seeing people, including ourselves, as living outside the definition of norms, the dominant discourses that surround us, or universal truths -- that there is not a specific “substance” but a “form” of how we are.

In practice, it creates for me a deep sense of hope that there will always be something that escapes the dominant problem stories that clients and those concerned with them present to me.  This something could come from various acts, thoughts, or expressions in response to problems, including the response to personal failure.  Such responses to problems point to a violation of what is valued by clients.  Problems become an opportunity for a “cross-over” to preferred stories.

In reading about the ethics of living and professional ethics, I feel encouraged to continue to actively question the various traditional practices and systems that may limit helpful developments for clients and my own practice.  Reading Jane Hutton’s article in which she explored her personal failure in relation to being a mother also reminded me of how such questions can be used in my own personal life as an ethical way of living (Hutton, 2008)

Whenever I encounter problem narratives I try to tune in to what is left unsaid or abandoned by others.  A school counsellor recently told me that a student was continually defiant to his teacher and had been complaining about him to her.  She had referred the student to me because she could not access his emotions and thus advised me that getting through to his emotions would be difficult because of this “complaining”.  I got very curious about what he is complaining about as in what exactly is he responding to so strongly.  Culturally “complaints” were meant to be kept private or otherwise they were perceived as “distractions” or “defensiveness”.

The discovery was not surprising as he described how this teacher was behaving oddly in class, spending time sharing his personal stories, especially mentioning his mum being ill in hospital.  There were signs that the teacher needed help. In the school system, questioning the performance of a teacher seemed taboo when I consulted the school counsellor about this.  I sensed my discovery and intervention in this situation posed a dilemma for the school counsellor.

In wanting to negotiate the relationship between the teacher and student I am in the midst of setting the context for some form of dialogue between them.  It is somewhat daunting but I am beginning to appreciate what was described as “another version of ethics … not passively received … is an activity in which we find ourselves exercised and stretched” (White, 2004).

References

Hutton, J. (2008). Turning the spotlight on the normalising gaze. The International Journal of Narrative Therapy and Community Work, 1, 3-16.

White, M. (2000). Chapter 3: Re-engaging with history: the absent but implicit. In M. White (Ed.), Reflections on Narrative Practices: Interviews and Essays. Adelaide: Dulwich Centre Publications.

White, M. (2004). Chap 5: Addressing personal failure. In Narrative Practice and Exotic Lives: Resurrecting Diversity in Everyday Life. Adelaide: Dulwich Centre Publications.

Documentation of alternative stories/knowledges

I am doing a series of reflections as part of a post graduate course on Narrative Therapy.  Overall there will be about ten reflection papers on various concepts and practices that currently form and shape Narrative Therapy.

On reading Michael’s response to tackling the challenges of crafting therapeutic documents, it struck me as precisely addressing the kind of lethargy I feel about including this practice into my work (White, 1998).  I had attempted using documents on a few occasions and reviewing the work done helped me to consolidate a sense of achievement knowing what went well in some instances.

In 2008 I attempted my first therapeutic document. It was a document of declaration crafted from an interview with a 16 year old girl who sometimes felt frustrated with her studies. It documented why she wanted to go to school, how she hangs on to studies, how she relaxes when stressed, and who she would like to celebrate her exam results with. An audience for the document was also identified and this included her teachers, mother, and social workers.

When the document was ready, she was asked where she might place her own copy and it surprised me that she wanted to keep it under her pillow.  I realized the success of this project was something cumulative because it spanned two sessions for setting the “receiving context”, interview, and discussion of the final document (White, 1998). 

Another document was based on a Transformer cartoon character named Jazz who was a hero in the eyes of an 8 year old boy brought in for anger issues.  The humorous and heroic traits of Jazz stood out for him as he identified himself closely with Jazz.  He was very pleased with the document that included a picture of Jazz.  Having brought Jazz into the discussion also enabled his mum to speak of his kindness via the voice of Jazz.  In this case the document not only helped document skills and knowledge in managing anger but also allowed externalizing conversations to take place.

There were also times when documents did not work well.  There was an attempt to send email summaries of sessions to an 18 year old client who came in for relationship issues with his mother.  He had been keeping typed records of his feelings and so I thought reading and writing emails would be meaningful for him.  After a few tries I stopped the emails because he later admitted he was not good at using email.  Looking back I had not set the “receiving context” and had let my enthusiasm run ahead of us.  Much later, I realized by accident that he was interested in reading my printed case notes rather than emails.

Email summary of sessions were also sent to a couple to invite reflections.  Though the emails were read, it never became an active part of the work.  In this case it was due to my less than deliberate attempt to weave documents into the work with them.

For me the dilemma has not been whether to use documents or not because they have been shown to work well, the challenge is for me to take an active influencing role in setting the “receiving context” and researching with the client on what type of “document” fits for them.  By this I mean the transmission mode, medium, frequency, presentation (words or pictures), and other acts that support the production and delivery of a “document”.

I am motivated by documents being a “gift of consultancy” from clients and how such gifts can be gathered into a collective “living document” that could make skills and knowledge available to future clients (Epston & White, 1990; Newman, 2008).  These ideas and the concept of “legacy” which I wrote about in the reflection on re-membering have given me more grounds to consider what project I might be able to embark on with the LGBT (lesbian, gay, bisexual, transgendered) community.

References

Denborough, D. (2008). Collective documents as a response to collective trauma. In Collective Narrative Practice: Responding to individuals, groups and communities who have experienced trauma (pp. 26-49): Dulwich Centre Publications.

Epston, D., & White, M. (1990). Consulting your consultants: The documentation of alternative knowledges. In Experience, Contradiction, Narrative & Imagination: Selected papers of David Epston & Michael White (2nd ed., pp. 11-26): Dulwich Centre Publications.

Newman, D. (2008). Rescuing the said from the saying of it: Living documentation in narrative therapy. The International Journal of Narrative Therapy and Community Work(3), 24-34.

White, M. (1998). Therapeutic Documents Revisited. In Re-Authoring Lives: Interviews & Essays (pp. 199-213): Dulwich Centre.