Family Counsel Approach Essay
Family Counsel Approach
Within White’s therapy, the therapist adopts a position of consultant to those experiencing oppression at a personal level from their problems and at a political level from a mental-health discourse and set of practices which permeate western culture. Thus people with problems of living are viewed as requiring help in fighting back against these problems and practices which have invaded their lives. This positioning is described by White, drawing on ideas from the French philosopher Derrida (1981), as both deconstructionist and constitutionalist. A deconstructionist position entails empowering clients to subvert taken-for-granted mental-health definitions and
practices. A constitutionalist position entails working from the premise that lives and identities are constituted and shaped by three sets of factors:
• The meaning people give to their experiences or the stories they
tell themselves about themselves.
• The language practices that people are recruited into along
with the type of words these use to story their lives.
• The situation people occupy in social structures in which they
participate and the power relations entailed by these.
The positioning of the clinician within narrative therapy involves addressing these three sets of factors by deconstructing the sense people make of their lives, the language practices they use, and the power relationships in which they find themselves. In deconstructing practices of power, White draws on the work of the French philosopher Foucault (1965, 1975, 1979, 1980, 1984). People are unconsciously
recruited into the subjugation of their own lives by power practices that involve continual isolation, evaluation, and comparison.
Eventually our clients internalize ludicrous societal standards, yet believe that in doing so they are justifiably aspiring to valued ideals of fulfillment and excellence. This leads, for example, to self starvation and anorexia, extreme self-criticism in depression, or a sense of powerlessness in the face of threat and anxiety. In turn, mental health professions have compounded this problem by developing
global unitary accounts of these states that purport to be objective truths, such as the diagnostic categories contained in the Diagnostic and Statistical Manual IV (American Psychiatric Association, 1994) and the International Classification of Diseases, 10th Edition (World Health Organization, 1992). Furthermore, these professions support practices that prevent clients from questioning the socio-political contexts within which these so-called objective diagnostic truths emerged.
The collaborative co-authoring position central to narrative practice is neither a one-up expert position nor a one-down strategic position. At a 1997 workshop White showed a clip of videotape in which he used turn taking at questioning to help a young girl with a diagnosis of Attention Deficit Hyperactivity Disorder to participate in an interview.
Other professionals involved in the case had been unable to help the girl to do this and had labeled her as uncooperative. White made an agreement with her early in the meeting that for every question she answered, she could ask him a question. The girl stuck to this bargain because she was very curious about his perception of the
world, since he told her at the outset of the meeting that he was color blind. This collaborative approach was highly effective in helping the girl tell her story about her difficulties in managing friendships and school work.
Within White’s language in therapy there is an openness about the therapist’s working context, intentions, values, and biases. There is a privileging of the client’s language rather than the therapist’s language. There is a respect for working at the client’s pace that finds expression in regularly summarizing and checking that the client is comfortable with the pace. The therapist assumes that since social realities are constituted through language and organized through
narratives, all therapeutic conversations aim to explore multiple constructions of reality rather than tracking down the facts which constitute a single truth. There is no room for questions like:
• From an objective viewpoint, what happened?
All inquires are about individual viewpoints.
• How did you see the situation?
• How did your view differ from that of your mother/father/
There is a constant vigilance for marginalized stories that might offer an opening for the person to engage in what White (1989, 1995) refers to as an “insurrection of subjugated knowledges.” That is, an opening that will allow the person to select to construct the story of their lives in terms other than those dictated by the dominant narrative which feeds their problem. This requires the therapist to privilege listening over questioning, and to question in a way that helps
clients to see that the stories of their lives are actively constructed, rather than passively recounted and given.
EXTERNALIZING THE PROBLEM
Externalizing the problem is the central in counseling and supervision used by Michael White to help clients begin to define their problems as separate from their identities. A particular style of questioning is used to help clients begin to view their problems as separate from themselves. Central to this style of questioning is inquiring about how the problem has been affecting the person’s life and relationships.
Of a young boy with persistent soiling problems Michael White asked the boy and his parents a series of questions about Mr. Mischief, an externalized personification of the soiling problem:
• Are you happy what Mr. Mischief is doing to your relationship?
• How is Mr. Mischief interfering with your friendships?
Of a girl with a diagnosis of anorexia nervosa he asked:
• How far has anorexia nervosa encroached on your life?
• How did anorexia nervosa come to oppress you in this way?
With people diagnosed as psychotic and experiencing auditory
hallucinations he asked:
• What are the voices trying to talk you into?
• How will their wishes affect your life?
In a health education project which aimed to prevent the spread of aids, AIDS was personified and participants in the project were asked:
Where will AIDS be found?
• How will AIDS be recognized?
This procedure of asking questions in a way that assumes the problem and the person are quite separate helps clients to begin to externalize the problem and to internalize personal agency (Carr,1997). It may also interrupt the habitual enactment of the dominant problem-saturated story of the person’s identity.
In relative influence questioning the client is invited to first map out the influence of the problem on their lives and relationships, and second to map out the influence that they exert on the problem. Relative influence questioning allows clients to think of themselves not as problem-people but as individuals who have a relationship with a problem. Here are some examples of relative influence questions:
• In that situation were you stronger than the problem or was
the problem stronger than you?
• Who was in charge of your relationships then? Were you in
charge or was the problem in charge?
• To what extent were you controlling your life at that point and
to what extent was the problem controlling your life?
This type of questioning also opens up the possibility that clients may report that on some occasions the problem influences them to the point of oppression, whereas on others, they can resist the problem.
Thus relative influence questions allow clients to construct unique outcomes which are the seeds from which lives may be re-authored. When it is clear that in some situations problems have a greater influence than people, whereas in other instances people win out, questions may be asked about clients’ views of contextual influences on this. Here are some examples of such questions:
• What feeds the problem?
• What starves the problem?
• Who is for the problem?
• Who is against the problem?
University/College: University of Arkansas System
Type of paper: Thesis/Dissertation Chapter
Date: 28 September 2016
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