What Is Narrative Therapy?

Narrative therapy (NT) is a therapeutic technique that guides the client through a process of identifying and deconstructing the narratives they hold true, and reconstructing or re-authoring (Epston & White, 1990) new and empowering narratives. It is based on the idea that people understand their lives through their narration of lived experience (DiLollo, Neimeyer & Manning, 2002). “As narrators, the significance of our lives is dictated by the stories that we live and that we tell — that is, by the ways that we link events in meaningful sequences and thereby constitute a sense of self as the protagonist of our own autobiography” (Neimeyer, 1995). Narrative therapists tend to look for metaphors that have powerful connotations in a person’s

Cognitive Processing Theory and Emotional Processing Theory support the notion that following a traumatic event, distortions can occur to survivors’ basic assumptions about the world and themselves, which lead to changes in thinking and behaviour (Sharma-Patel, Brown & Chaplin, 2012). To treat the symptoms of post-traumatic stress, one must treat the underlying narrative surrounding the trauma (Sharma-Patel et al. 2012). Both theories posit that distorted assumptions must be challenged and corrected to enable the survivor to experience themselves as ‘competent and courageous’ (Sharma-Patel, et al. 2012). Emotion-Focused Therapy for Trauma (EFTT) is an evidence-based, short-term individual therapy that has proven highly effective in treating clients with trauma through its emphasis on both narrative and emotion processes (Paivio & Angus, 2017). Pennebaker (1997) argues that writing about a traumatic event allows the individual to organize the traumatic memory and most importantly, allows for cognitive change (i.e., accommodation) over the course of writing. Ramanathan (2015) suggests that in PTSD, it is possible that a part of one’s working memory has gone into ‘automatic mode’, so that mindful writing in

Erbes et al. (2014) trialled NT with veterans who had previously been diagnosed with PTSD. Using the CAPS as a measure of PTSD symptom severity, they found that the mean CAPS score after NT was 24.2% lower that pre-treatment scores, indicating an 18.45 drop, in comparison to 10-12 point reduction size deemed significant in prior studies (Erbes et al., 2014). Erbes et al. (2014) commend NT on being able to engage with negative effects of trauma without requiring a recounting of the traumatic event (i.e., exposure to trauma memories). Although narrative therapy does offer guidelines for how to discuss traumatic events if the client is willing, it does not prescribe exposure to the trauma, which can lead to emotional stress, especially in cases of recent or severe trauma (Erbes et al. 2014). Van der Velden and Koops (2005) combined storytelling and art therapy in a group therapy for veterans. The World War II survivors attended a group therapy program over 8 months. Participants revealed their life story and the therapists and other participants asked them questions. The therapeutic aim of the story group was to enable the participants to tell their trauma story safely. The interesting component of this study is that the therapy was taking place 60 years post the trauma, which could be argued had naturally reduced the presentation