Narrative Means to Therapeutic Ends / W47 Michael White, David Epston

Narrative means iu uicia^ci RC489.W75 W47 21195 White, Michael. NEW COLLEGE OF CALIFORNIA (SF) • RC #8910 489 White, Michael. W75 Narrative means to therapeutic ends / W47 Michael White, David Epston. — 1st ed. — New York : Norton, cl990. xvii, 229 p. : ill. ; 22 eta. "A Norton professional book." Includes bibliographical references and index. #8910 Gift:Henry $ . ISBN 0-393-70098-4 1. Letter—wr i ting—Therapeutic use. 2. Psychotherapy. I. Epston, David. II. Title 15 NOV 90 20828023 NEWCxc 89-48776 DATE DUE Narrative Means to Therapeutic Ends David Epston is a Co-director of The Family Therapy Centre in Auckland, New Zealand. Michael White is a Co-director of the Dulwich Centre, Adelaide, Australia. The authors made different, but equal, contributions to this book. A NORTON PROFESSIONAL BOOK Narrative Means to Therapeutic Ends Michael White David Epston tt W.W. NORTON & COMPANY NEW YORK • LONDON Copyright © 1990 by Dulwich Centre, Adelaide, South Australia All rights reserved. Printed in the United States of America. Available in Australia and New Zealand from Dulwich Centre, 345 Carrington Street, Adelaide, Sth Australia 5000, Australia First Edition Library of Congress Cataloging-in-Publication Data White, Michael. Narrative means to therapeutic ends / Michael White, David Epston. p. cm. "A Norton professional book." Includes bibliographical references. 1. Letter-writing — Therapeutic use. 2. Psychotherapy. I. Epston, David. II. Title. RC489.W75W47 1990 616.89'166-dc20 89-48776 ISBN: 0-393-70098-4 I W W Norton & Company, Inc., 500 Fifth Avenue, New York, N.Y. 10110 W. W Norton & Company Ltd., 37 Great Russell Street, London WC1B 3NU 12 3 4 5 6 7 8 9 . 3 Contents Foreword vii by Karl Tomm, M.D. Acknowledgments xiii Introduction xv 1 Story, Knowledge, and Power 1 Analogy 4 The Text Analogy 9 The Text Analogy and Therapy 1 Dominant Narrative as Dominant Knowledge and Unit of Power 18 Alternative Stories and Culturally Available Discourses 27 Oral and Written Traditions: A Distinction 33 Conclusion 37 2. Externalizing of the Problem 38 Relative Influence Questioning 42 Defining the Problem to Be Externalized 48 Unique Outcomes 55 The Revision of Persons' Relationships with Problems 63 Responsibility 65 The Cultural Context 65 The Panopticon 67 Some Final Thoughts 75 3. A Storied Therapy 77 Distinctions Between Logico — Scientific and Narrative Modes 80 Letters of Invitation 84 vi Narrative Means to Therapeutic Ends Redundancy Letters 90 Letters of Prediction 94 Counter-Referral Letters 96 Letters of Reference 98 Letters for Special Occasions 1 03 Brief Letters 107 Letters as Narrative 125 Self Stories 1 63 4. Counter Documents 188 Certificates 1 92 Declarations 1 92 Self-certification 212 Conclusion 216 References 218 Index 223 Foreword Breaking new ground in any field is a major accomplishment. To do so in different directions at the same time and, in so doing, to open up whole new territories reflect a tour de force. In my opinion, Michael White and David Epston are engaged in just this kind of trailblazing for the field of family therapy. This compact book represents a distillate of some of their major achievements. It charts a series of bold strides in their reconnaissance into the domain of human problems and stakes out some original therapeutic contributions. White and Epston are both extremely gifted clinicians, each with his own unique style, but with much in common. Their synergistic collaboration over the last few years has been unusually productive in generating a wide range of new ideas and methods. They have already had a major impact on the clinical practice of many professionals in their home countries of Australia and New Zealand, and now their influence is being felt in the international family therapy scene as well. Since encountering their work three years ago, my own therapeutic methods have changed enormously. Because of the "new trail" they have broken, I have been able to enter into some entirely new domains of practice. Needless to say, this has been extremely gratifying both professionally and person- ally. Many of my friends and colleagues are having similar experiences. In other words, Epston and White are not only extending their own clinical understanding and skill into new areas but ena- bling other therapists to do so as well. But just what are these new territories that Epston and White have been exploring and are inviting us into? In my opinion, the single most important domain that White has opened is that of "externalizing the problem." When the distinction of the problem vii viii Narrative Means to Therapeutic Ends can be clearly separated from the distinction of the person, it becomes possible to carefully examine the dynamics and direction of the interaction between persons and problems. One can then address a crucial question: Is the problem gaining more influence over the person or is the person gaining more influence over the problem? An in-depth theoretical exploration of this question has led White to reveal not only the oppressive effects of the manner in which problems are typically described, but also the constitutive and subjugating effects of descriptive knowledge itself. In so doing, he has entered the awesome territory of ontology and episte- mology. While this aspect of our lives may seem extremely remote and perhaps a bit intimidating to some of us, we are implicitly grounded in it at all times. For instance, our personal identities are constituted by what we "know" about ourselves and how we de- scribe ourselves as persons. But what we know about ourselves is defined, for the most part, by the cultural practices (of describing, labeling, classifying, evaluating, segregating, excluding, etc.) in which we are embedded. As human beings in language, we are, in fact, all subjugated by invisible social "controls" of presupposi- tional linguistic practices and implicit sociocultural patterns of coordination. In other words, if family members, friends, neigh- bors, coworkers, and professionals think of a person as "having" a certain characteristic or problem, they exercise "power" over him or her by "performing" this knowledge with respect to that person. Thus, in the social domain, knowledge and power are inextricably interrelated. In exploring and explicating these complex issues, White draws heavily from the philosophical analysis of modern history by Foucault. Indeed, one of the most important original contributions of this book is White's analysis of Foucault's perspective and its relevance to therapy. This is offered in the first chapter which is, in fact, a major theoretical statement covering a number of important areas. The most significant of these, however, is the discussion of "knowledge as power"— a vast territory that is only beginning to be explored by family therapists. In this statement White is essentially extending his pioneering work on externalizing problems. He does this by disclosing how "knowledge techniques" inadvertently disempower persons and may empower problems in Foreword ix the process. When these covert techniques (such as collapsing problematic descriptions onto persons) can be identified, it becomes much easier to externalize problems and to coordinate a person's escape from them. The second major territory that Epston and White open for us in this book is the multiplicity of ways in which the written word may be employed therapeutically. This is the land of Narrative Means to Therapeutic Ends, and comprises the remaining content of the book. White and Epston offer an incredibly diverse and rich sampling of therapeutic initiatives "in black and white." Using brief case vignettes, they provide numerous inspiring examples of therapeutic letters, invitations, references, certificates, predictions, declarations, etc. As readers, we are free to pick and choose among a variety of new interventions (as we reap the fruits of a new area that has already been carefully ploughed, watered, and weeded for us). The manifold examples bear rereading and careful study to glean the full harvest. Indeed, I suspect that many readers will find themselves drawn back into this territory again and again as they begin to discover how fertile it can be for their own clinical work. David Epston, in particular, places a great deal of emphasis on the therapeutic potential of routine letters that summarize each session. He has disciplined himself to write a letter to the client or family after almost every interview. The carbon copy of the letter usually constitutes his only written record of the session. In this way the clinical "file" is virtually shared by both the family and the therapist. This pattern of practice constitutes a significant foray into a more egalitarian relationship between professional and client. What is most intriguing about the Epston and White letters is their fascinating content and style. They are far from being simple "objective" descriptions. The content is carefully selected to bring forth distinctions that are liable to be heuristic, to link specific experiences and events that promise to be resourceful, and to promote those kinds of "stories" that have healing potential. The style tends to employ the subjunctive mood and to rely heavily on the use of vernacular language. Common words and phrases are used in uncommon ways. This generates an enticing novelty that stimulates the reader's imagination and participation in the text. x Narrative Means to Therapeutic Ends For instance, a sentence like "A guilt-driven life is a life sentence" can be arresting, while the juxtaposition of contrasting statements like "getting into trouble and become more troubled . or . getting out of trouble and becoming untroubled" can tantalize the experience of choice. This style of writing is unusually gripping, even for an "outside" reader whose life is not directly involved. In an attempt to provide a conceptual framework for their exploration of narrative means, Epston and White have drawn on the notion of "narrative texts." They propose the analogy of therapy as a process of "storying" and/or "re-storying" the lives and experiences of persons who present with problems.

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