Reflection: February: Post structuralism

[Aishwarya Chawla]

Narrative Therapy and Practice
Thinking behind practice

Aishwarya Chawla
5th March 2021

As I write my last reflection as a part of this course, I look back at this one year of learning, re-learning and unlearning I have experienced. Somehow, the last few years in the field directed my understanding in a more pathological way, as compared to how I consult clients on their problems today. I see myself stepping away from the dominant discourses of the field into looking at intersectionality’s of clients’ socio-political contexts.
For the longest time, I have been taught that the medical Bibles we use, such as the DSM/ICD will be able to help me with diagnosis, testing and treatment. It is only now that I realize the pathologizing constructs of this dominant western psychology, and create space to explore my relationship with these labels. In essence, I have learnt that these constructs formalize and give truth status to narratives of personal inadequacy, failure and dysfunction with diagnosis (Gergen, 1994).
This takes me back to a session with a young fourteen year old client, SS. During the process of externalization, she exclaimed, “This is me. I am ADHD and the ADHD is me”. This showcased the presence, heaviness and weight of the diagnosis in her life. Over the course of time, we were able to understand that the diagnosis isn’t her identity, yet her identity is an amalgamation of her relationship with others, it is socially constructed and deeply rooted in intersectionality.
The earlier structuralist schools of thought focused heavily on individualism and deficit discourses, stemming from psychoanalysis and cognitive-behavioral schools of thought. The breaking of narratives and exploring socio-political contexts within the therapeutic space was limited. The older deficit descriptions in the forms of diagnosis – created spaces where client’s sense of personal agency was lessened and reliance on the expert professional knowledge increased. I am now, in my journey of unlearning, slowly coming to realize the significance of systems, not symptoms in therapy.
Interestingly, the exploration of identity shifting from a lens that viewed it as fixed, to now understanding that identity states are fluid and can be created and assisted by the therapist. This takes me back to a conversation I had with a young seventeen year old client, ZB. She mentioned that at school, everyone sees her as her disorder, “Dyslexia” – which somehow seemed to take over and become her dominant narrative in the way she viewed herself. Through the narrative lens, we have tried to explore areas and aspects of her life that are not defined by the diagnosis. These conversations are underlying intersectionality – by focusing on socially constructed nature of identity, giving space to explore history, culture, sexuality, power, and various influences in our lives, thereby helping her to create a thicker and preferred alternative storyline.
In my therapeutic practice, I have been asked by potential clients on multiple occasions if I practice CBT – to which my response has always been, “no, because I don’t have the right to tell anyone that their thoughts are irrational”. Somewhere, I do believe that this confirms the belief that there is a shift in power and privilege between expert positions in my practice now.
Naturally, I believe that there is no objective reality – everything is socially and contextually driven. Initial schools of thought explored individuals who struggled with mental health to be passive and driven by dysfunction, however, now, the post-structuralist view creates space for individuals to be honored and witnessed, to take steps informed by intention as people who take significant acts of resistance to the problems in their lives.

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