2016: Issue 4

Posted by on Jan 23, 2017 in | 0 comments

Welcome to this final journal issue for the year. It’s a bumper special edition on narrative practice and mental health!

It includes hopeful papers describing creative ways of responding to bulimia, hearing voices, and suicidal thoughts. It also contains an invitation to consider alternative suicide screening processes, a narrative research project from Mexico, and a review of ‘The book of human emotions’. Lastly, we have included a revised version of a paper about gender belonging as new understandings and activism in this realm are challenging and transforming taken-for-granted ideas in therapy and beyond.

This special issue features papers from Greece, Norway, Australia, Mexico, the UK and the USA. We hope you enjoy them!

Very soon we will be announcing a new way to subscribe to this journal and to gain access to all its back issues. Stay tuned.

Thank you for your support throughout this year and wishing you well for 2017.

Content

‘Uncovering Bulimia’s demanding voice: Challenges from a narrative therapist’s perspective’ Kassandra Pedersen. (Pages 1-13)

‘Hopeful conversations about voice hearing’ Chris Dolman and Michael Spurrier. (Pages 14-25)

‘We could be heroes: How film and comic book heroes helped a peer support group to reconnect with their gifts.’ Rachel Tolfree. (Pages 26-31)

‘Thickly describing together – utilising collaborative ethnography in narrative therapy work with young people’ Jonathan McClelland. (Pages 32-44)

‘Explorations with the written word in an inpatient mental health unit for young people’ David Newman. (Pages 45-58)

‘How we deal with ‘way out thoughts’: A living document … Ways of talking with young people about suicidal thoughts’ David Newman. (Pages 59-66)

‘First steps towards an alternative suicide risk screening tool: Navigating risk assessment and encouraging life-sustaining conversations’ Carly Forster and Rina Taub. (Pages 67-76)

‘A narrative approach to addressing pain in hospitalised paediatric patients: Handicraft and digital interventions’ Angélica Quiroga, Jessica V. Jiménez, Gabriela A. Beltrán,Valeria Casas, Bertha N. López. (Pages 77-85)

‘Deconstructing emotion: A review of “The book of human emotions” by Tiffany Watt Smith’ Zoy Kazan. (Pages 86-90)

‘Gender belonging: Children, adolescents, adults and the role of the therapist – Revised’ Esben Esther Pirelli Benestad. (Pages 91-106)


Showing all 10 results

  • Uncovering Bulimia’s demanding voice: Challenges from a narrative therapist’s perspective— Kassandra Pedersen

    $9.90

    This paper presents responses to a series of challenges faced during work with a 17-year-old girl who sought to reclaim her life from bulimia’s demanding voice. Kiki was at first unwilling to participate in therapeutic conversations, and initial contact occurred through her boyfriend, who became part of an anti-bulimia team. Encouraged by her boyfriend, Kiki, who was determined to ‘stop throwing up at last’, decided to attend sessions. Through externalising conversations, bulimia was personified as ‘The Guy’, who ruled her daily life with judgements. Kiki described The Guy’s effect on her life and developed a stance resisting his influence. The process of working with Kiki raised a number of challenges: assisting a person who initially declined to participate, overcoming pathologising discourses, resisting the tactics of the problem and its allies, supporting a preferred identity in an unsupportive environment, and keeping Kiki’s preferences and beliefs at the centre of our work. This paper explores the use of narrative practices, including externalising conversations, double listening, identifying unique outcomes, and the failure conversations map, to address these issues and support resistance to bulimia.

  • Hopeful conversations about voice hearing— Chris Dolman & Michael Spurrier

    $9.90

    Over a period of a couple of years, Michael and Chris met in the context of therapy in relation to the presence of critical and demanding voices in Michael’s life. These conversations covered much territory and this paper gives a partial account of these conversations – an interweaving of a description of narrative ideas and practices that shaped Chris’ approach, together with Michael’s experiences of participating in these conversations, which reinvigorated his interest in contributing to the lives of other people.

  • We could be heroes: How film and comic book heroes helped a peer support group to reconnect with their gifts— Rachel Tolfree

    $5.50

    This paper outlines how conversations about film and comic book protagonists enabled members of a peer support group to become the heroes of their own stories, finding meaning, strength, and purpose in their difficulties and the things that make them different from others.

  • Thickly describing together – utilising collaborative ethnography in narrative therapy work with young people— Jonathan McClelland

    $9.90

    An ethnographic stance involves attention to the ‘exotic’ within the familiar – often using the trick of being a ‘foreigner’ to a situation as a way of teasing out what is going on behind what appears ‘natural’ or ‘obvious’ to those who are stuck in the situation. This article explores the potential contributions to narrative therapy of tools and viewpoints from anthropology, specifically the concept of ‘collaborative ethnography’. The article engages with the difficulties of maintaining an ethical approach when working with adolescents in the mental health field, which often does not take the viewpoints and contributions of adolescents seriously, and points the way toward a way of working that does not privilege the expertise or use of power often exerted in this arena.

  • Explorations with the written word in an inpatient mental health unit for young people— David Newman

    $9.90

    In this paper David discusses the concept of the spoken word being ‘relatively unavailable’ to the people he works with at a Sydney based psychiatric unit for young people. He discusses some of his use of the written word in responding to this relative unavailability. This includes some fine tuning of the use of the written word by considering; language use that minimises the risk of people rejecting themselves, utilising the concept of people ‘getting their language through the language of others’, ways to use Michael White and David Epston’s concept of ‘failure proofing’ questions and crafting questions that come out of the dilemmas of therapeutic work. Finally, the ethics of documenting and living documentation more particularly is discussed.

  • How we deal with ‘way out thoughts’: A living document … Ways of talking with young people about suicidal thoughts— David Newman

    $9.90

    In this paper, I describe some of the ways that I use the written word, in the form of ‘living documents’, to enable the sharing of stories and know-how about the ways young people deal with suicidal thoughts, or what are also termed ‘way out thoughts’ or ‘die thoughts’. These explorations take place in my work with young people in a psychiatric unit. I share here an example of a one-to-one conversation and also describe how I collect and use stories in a group work or collective context. The young people I speak with have let me know that such conversations and shared documents are important to them.

  • First steps towards an alternative suicide risk screening tool: Navigating risk assessment and encouraging life-sustaining conversations— Carly Forster and Rina Taub

    $9.90

    This paper explores preferred ways of working in relation to suicide screening in situations where this is a requirement of professional practice. We describe our concerns about how approaches to ‘suicide risk assessment’ were affecting our work and the young people we were required to assess. We came to see the assessment process as an intervention of itself, with the potential for negative consequences for young people, workers and the therapeutic relationship. In response, we drew on a narrative and post-structuralist framework to develop an alternative set of assessment questions. Our questionnaire is intended to scaffold conversations that externalise the problem, elicit people’s life-sustaining practices, and enable assessment of distress and suicidal thoughts. The questionnaire has so far been trialled by a young person and psychologist in Sydney, and an adult and mental health worker in Singapore. We present our findings about these insiders’ experiences of the questionnaire. We hope this article will invite readers to connect to curiosity about ways of having conversations that open up space for people to speak of despair, and questions about living, in ways that are respectful and encouraging of life-sustaining steps.

  • A narrative approach to addressing pain in hospitalised paediatric patients: Handicraft and digital interventions—

    $9.90

    Children who have to stay in hospital for a period of time can experience anxiety, fear and insecurity. Narrative therapy has been used to help address the traumatic experiences of hospitalised paediatric patients by promoting changes in perspective, enabling distance from pain or trauma, and identifying skills and strategies for managing the hospitalisation process. To determine the effectiveness of narrative-based interventions on reducing the negative effects associated with hospitalisation, we conducted a trial with paediatric patients in four hospitals in Mexico. Using a narrative approach that involved externalising conversations, drawing and collage, we trialled both digital and handicraft interventions. Both interventions reduced perceived pain, generated positive associations with hospital and improved patient wellbeing. However, the digital intervention, using existing applications on a digital tablet, proved a richer medium. Considering that in Mexico hospitalised paediatric patients’ care is almost entirely medical, this digital health proposal represents an improvement to health services through a more comprehensive approach to the wellbeing of hospitalised paediatric patients.

  • Deconstructing Emotion: A review of “The book of human emotions” by Tiffany Watt Smith— Zoy Kazan

    $5.50

    Deconstructing Emotion: A review of “ The book of human emotions” by Tiffany Watt Smith

  • Gender belonging: Children, adolescents, adults and the role of the therapist – Revised— Esben Esther Pirelli Benestad

    $9.90

    This paper, originally published in 2001 and then revised 15 years later, describes key principles and practice of Esben Esther Pirelli Benestad, a Norweigian transgifted medical doctor and family therapist, when working with the families and networks of children and adolescents who display non-conformist or atypical gender expressions. This piece offers definitions for a wide variety of words and terms used to describe complex realms of gender, explores how responses to gender non-conformity have changed over time and continue to change, and conveys ways of ensuring that individuals displaying unusual expressions of gender have a chance to experience a sense of positive gender belonging.

1,972 Comments

  1. Listening to Tileah I was provoked to contemplate my own use of language when working with clients. I enjoy the narrative model of practice and I am aware that for some there is definitely stigma attached to the process of counselling or therapy. I have only had one experience of working with an Indigenous person as a client and I will be sure to look at my use of language. I like the idea of it just being a yarn, it takes the pressure and onus off of the client to do something.

  2. Hello:

    This is Andrea from Toronto.

    I found particularly helpful the discussion in the FAQ around the use of metaphors of conflict and combat. I expect to be working in healthcare settings with critically ill patients and their loved ones (mostly children and parents), and I anticipate hearing them use these kinds of combative metaphors during our conversations. I also anticipate meeting many people who are mentally, emotionally, and physically exhausted from “fighting” these problems. I appreciated the comments in the FAQ about combative metaphors, and the suggestions around exploring other kinds of metaphors which may be less conflict-laden and draining on their emotional resources. Thanks again for making this material available!

  3. I have started to use collaboration with clients when I am asked to write a report. I ask clients what they see as the areas of change and challenge of which they want others to be aware. I also at times share my report with the client first to be sure it accurately reflects their experience. In this way they are both acknowledging their ongoing journey and being acknowledged for the work they have done.

  4. Mike here, in London. I too was interested in “We were unwittingly adjusting people to poverty or other forms of injustice by addressing their symptoms, without affecting broader social and structural change.” It’s a really difficult question. I was involved for about 10 years in working with people suffering from homelessness. Sue Mann’s story really rang true for me. One thing I was involved in was a choir for marginalised people, literally helping them find their voices. That, I felt, was useful, and collaborative. But I have always been suspicious of things like distributing left-over sandwiches to people sleeping rough on the street, as if that made it OK for them to be there as long as we give them some stale sandwiches. Or giving them tents or sleeping bags. What message does it send? Even though it may be well-meaning.

  5. Hi, I’m Mike. I work as a couples counsellor in London, England. My main training was 50% psychodynamic and 50% systemic. Narrative work was touched on briefly, for one module, and I am looking forward to learning more. Couples certainly do bring stories, often rather thin stories. “My partner is selfish.” Or “My partner had an affair”. Full stop. That’s all there is to know. Even in happy couples, people seem to get shaped into rather thin roles: this partner is the one who’s good with people, that partner is the one who’s good with money, this one cooks, that one drives. If the relationship ends, they may discover, actually *I* also can drive, cook, manage my money, make friends, I am a complete person.

  6. I think it will be an important part of my practice to investigate with clients which elements of our systems (social, cultural, political, economic) that are contributing to or mitigating their problems and suffering. I was particularly struck by the following sentence from the Just Therapy article: “We were unwittingly adjusting people to poverty or other forms of injustice by addressing their symptoms, without affecting broader social and structural change.” I think it is incumbent upon those of us in helping professions to work with the people we are helping to begin addressing the systemic issues that are contributing to (or creating) their problems. Otherwise, we may fall into this trap of “adjusting people to injustice.”

  7. Hello! My name is Andrea and I am a Masters student in a spiritual care program located in Toronto.

    After reviewing this chapter, I’m reflecting upon the question that was raised: “how do we respond to grief when that grief has been caused by injustice?” and thinking about it in the context of working with seriously ill children and their families in a hospital/hospice setting. Patients and families in that setting also face grief that has been caused by injustice (in the form of incurable illness), and I see how the narrative metaphor can be used to help those families begin to reclaim their own lives in the face of tremendous loss caused by uncontrollable circumstances. I can see how the Articles of the Narrative Therapy Charter of Story-Telling Rights would be tremendously helpful when working with patients and families as a framework for telling and receiving their stories about their lives and their problems.

    For me, the material in this chapter also raises the question of how we can help to facilitate healing in a world where systems are seemingly becoming more unjust and creating deep suffering. My initial thought is that we continue to listen to each other’s stories with deep compassion, and the teachings of this course will help to provide us with new ideas and skills on how to do this.

  8. Chimamanda Adichie’s TED talk was incredible. The one line where she said “a single story creates a stereotype. And the problem with stereotypes is not that they are untrue but that they are incomplete”. This blew my mind. I am ashamed to have ever participated in the single story belief of anyone let alone whole cultures, communities and countries , continents and so on. I know that moving forward I will endeavour to hear more stories and to encourage others to tell their story. I am about to run a photovoice narrative project to do just this, give a whole community the opportunity to change their stereotype.

  9. “Narrative therapy doesn’t believe in a ‘whole self’ which needs to be integrated but rather that our identities are made up of many stories, and that these stories are constantly changing.”

    I like this, I find it very compatible with my beliefs as a Buddhist. In Buddhism, as I understand it, mistaken beliefs about a solid, fixed “self” are the source of our suffering.

    I work with couples using EFT for couples, and in that approach, there is a big emphasis on externalising the problem as “the cycle that you get trapped in”, and encouraging couples to come up with their own name for it.

  10. Thank you for this. I am a counsellor, and trying to make as much as possible of my notes “in quotes”, that is, writing down things that the clients said. And not my own opinions.

  11. hello

    I the ED of a Friendship Center in Terrace, BC where were mostly target the indigenous population in our city of 12,000. I found your video interesting and something that we may want to try. Havee you been able to to do any follow ups studies to gage the long term effect of your program?

    Regards

    Cal Albright
    ED
    Kermode Friendship Center
    http://www.keremodefriendship.ca
    Terrace, BC
    Canada

    • Hi Cal, thanks for the interest. At this point the only followup has been through conversations with with people who return to volunteer on additional walks or engage with our other programs.

      However, a group of fourth year medical students at a local university have offered to run a pre and post measured study / report in 2020 as part of their studies which should be interesting.

      Let me know if you would like more information.

      CD

  12. Thank you for this overview of Narrative Therapy. I am returning to practice after some time away, and these reminders are timely and appreciated.

  13. Hi Chris

    I really enjoyed watching your video about Narrative Walks. My project is based in Blaenau Gwent, in South Wales, Uk. I’m wondering whether I might use such an approach in my work with our Youth Service, who support young people between the ages of 11 and 25. Have you any thoughts on this? Are there any resources available, either free or to purchase?

    Best wishes

    Paul

    • Hi Paul, m

      Much of my early attempts of the program were with the 15-20 year old age bracket and I found it worked really well. When I recently had an opportunity to run the program again with this age bracket – I extended the finish time so that could spend more time at the stop points and have a fire at the last resting place to talk about our intentions after the walk. This meant that we used head torches for the 2km which added a bit of a sense of theatre to the day. It was pretty cool.

      If you email me on hello@embarkpsych.com I can send you the manual. Or ask any other questions via this page so others might share in the answers.

      CD

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