Narrative psychosocial work in Bangladesh

by Maksuda Begum

Doing narrative practice in Bangladesh is still very innovative work. A group of us received training in 2005, but we would like to have more training, as well as supervision, to develop our effective use of these ideas.

I work in a clinical setup in a child hospital named Dhaka Shishu Hospital. This hospital has also a research centre for child development, and a child neurology unit. Treating all types of special needs children from all over the country, we provide a ‘psychosocial support service centre’, and I work here to provide psychotherapy to parents who are struggling to find ways to negotiate the dominant stories of children with special needs. In the hospital setup, after doing medical assessments, our multi-professional team offers family therapy, physiotherapy, and special education plans for autistic children.

I’d like to briefly share one example of this work, and how I found narrative ideas helpful. Dev, a young boy, was referred to us by his school teacher, and visited us with his father. He had been given labels of ‘delayed learning’ and ‘behaviour problems’, and often stayed away from home – often until dark, when someone would eventually find him and take him home. I was able to learn that his father punished him every day, which contributed to this (corporal punishment of children is still widely accepted and common in Bangladesh). Subsequently, when Dev went to school, his homework was not done, which got him into more trouble – both at school and at home. He had begun to withdraw from many activities.

In speaking with Dev, I realised I would need to create some space, separate from these problems, for him first. In an externalising conversation, I helped my young client to separate the problem as an influencing ‘thing’ that was affecting his life. Then, when exploring his abilities, strengths, and interests, we go onto some alternative stories. We were then able to counter-pose the problem-saturated story and this alternative story during a conversation about why he stayed away from home, and what he did.

Maksuda : Please say, Dev, what happens when you don’t go back home?

Dev: I keep waiting to go home but I am scared.

M: About what?

D: Punishment; my father will punish me, as he saw me flying kites instead of doing my homework.

M: Tell me something about your kite.

D: I like flying kites very much. It blows my mind.

M :Blows it where?

D: To infinity … I like flying a kite every day, all the time. But then my parents hit me.

M: I am so sorry to hear that. Do you know any antonyms of the word ‘punishment’?

D: Yes, ‘reward’.

M: Have you ever got any rewards from any of your family members or teacher or friends?

D: Yes!

M : How did you get that? What was that reward?

D: It was a bamboo flute.

I managed to get a flute and let Dev play. He enjoyed it very much, and this helped create a space where Dev felt respected, and had an opportunity to talk and be heard. The next day, we explored an alternative story about Dev’s understanding maths, and his ability to summarise any complicated subject matter. Through a series of tellings and re-tellings about this, we were able to increase his meaning-making about these alternative stories.

After listening to this, Dev’s father had a sense of Dev’s different dreams and hopes. He expressed his enthusiasm to be in an outsider–witness position to explore more about Dev’s world. This contributed greatly to an improvement in communication between them.

I also asked Dev’s father to place himself in Dev’s position, and he remembered his past experiences as a child. He told me that his childhood was full of happiness and pleasure. He then said he felt guilty that he could not make the same times of playfulness and happiness available to his son. Through making meaning about these small events, Dev’s father began to think quite differently from how he had before, realising that Dev was finding his own ways of creating happiness, even if this was on his own, while his father was at work. He even acknowledged that Dev’s unwillingness to come home because he knew he would get a beating was also part of this wish for happiness in his life, which Dev’s father had shared when he was a child. Dev’s father expressed that he wanted to take responsibility for his son, to get him ready for his future. He said he wanted to show more parental love and the care Dev needs. This was quite a change from his previous position, and led to a much better relationship between Dev, his father, and the rest of his family.

Maksuda Begum Maksuda Begum worked for many years at the Bangladesh Protibondhi Foundation. She is now working at Dhaka Shishi (child) Hospital as a special education consultant and narrative therapist. Maksuda provides training to professionals within different educational setups and health centres. Areas of strong interest include research, publication and training for professional development in the area of disability and psychosocial development in private and organisational contexts. She can be contacted at [email protected]

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