M. Guilfoyle-Concealing and revealing power in the therapeutic relationship CHAPTER EIGHT NARRATIVE THERAPY AND THE POSSIBILITY OF CRITICAL THERAPEUTIC PRACTICE8 8.1. Introduction This chapter follows on from chapter 7 by examining further the relationship between therapeutic practices and sociocultural and political systems of domination. The particular case of narrative therapy will be discussed, and attention will be given to the relationship between the micro level of therapeutic practice and the macro level of societal networks of power. The following question guides this chapter: Are local, within-therapy practices capable of stimulating effective resistances against culturally dominant discourses and practices? In the previous chapter, three main obstacles to a critical psychoanalytic practice were explored: the difficulties associated with paying attention to resistance and with respecting local knowledge; with taking a political stand; and with demonstrating reflexive responsivity. Because narrative therapy orients more or less explicitly around Foucaultian concepts of power/knowledge, resistance, and the insurrection of subjugated knowledges, one might expect some of these challenges to be more easily met than seems the case for psychoanalysis. But difficulties remain even in this instance. This chapter will consider some of the power-related challenges facing a form of therapy that overtly advocates sensitivity and responsivity to power-resistance dynamics, conceived in more political than psychological or psychoanalytic terms. As already noted, many practitioners of diverse theoretical orientations are critical of therapy’s participation in the cultural network, and seek to promote what will be referred to as “therapies of resistance”: approaches that not only privilege client rather than expert accounts, but that also render salient the situation of persons and their problems with respect to macro relations of domination, and promote political critique and even activism (e.g., Ali, 2002; Albee, 2000; Chaplin, 1999; Gilligan, Rogers & Tolman, 1991; Kaye, 1999; Newman & Holzman, 1997). Narrative therapy is one such therapy of resistance (e.g., Madigan & Goldner, 1998; Monk and Gehart, 2003; Nylund, 2002; Nylund & Ceske, 1997; Nylund & Corsiglia, 1996; Swann, 1999; White & Epston, 1990) that aims to use micro therapeutic procedures to effect or participate in macro changes. The importance of this approach is underscored by its emphasis on the central concepts of power and resistance that have pervaded the discussion in previous chapters. However, even in this case there are difficulties in attempting to launch political resistances from within the therapeutic domain. Despite numerous claims to therapy’s politicisation, we have much to be concerned about regarding therapy’s potentials - and the potentials of therapists and clients in the name of therapy - to perform protest to the extent that dominant discourses, practices and institutions are modified as a consequence. I shall begin by using the concept of power to formulate the micro-macro relation. The political significance of therapeutic exercises of power (and client 8 Chapter based on: Guilfoyle, M. (2005). From therapeutic power to resistance? Therapy and cultural hegemony. Theory & Psychology, 15 (1), 101-124. 163 M. Guilfoyle-Concealing and revealing power in the therapeutic relationship resistances against these) is frequently obscured from view in therapeutic work. In response, four ideas will be offered to make therapeutic power operations visible in a way that eventually reveals their engagement with the broader cultural and institutional domain: power as a productive force (and associated distinction between power and its effects); power’s integration with knowledge; the relationship between power and resistance; and power as a contextual phenomenon. While these issues were discussed in chapter 1, here I develop those arguments, drawing on material from the intervening chapters. Narrative therapy as critical practice will then be considered in terms of these ideas. Again, at numerous points this argument draws on the formulations of Foucault (e.g., 1980, 1982, 1990), whose views have been used to highlight problems of power in a variety of mental health fields: in nursing (e.g., Clinton & Hazelton, 2002), social work (e.g., Foote & Frank, 1999), psychiatry (e.g., Ali, 2002), and in the cross-disciplinary practices of psychotherapy (most notably in narrative therapy - e.g., Flaskas & Humphreys, 1993; Swann, 1999; White & Epston, 1990). However, there is no single Foucaultian approach to power, or indeed to therapy, and his ideas tend to be used, as he intended, more in the manner of a “tool kit” of ideas than as a coherent theoretical account. Further limiting theoretical consistency is the fact that his work was at times inconsistent and contradictory (Fish, 1999; Hindess, 1996), especially regarding the relationship between power on the one hand, and knowledge, resistance and the person on the other (the key issues to be considered below). However, given that my intention is to construct a coherent theoretical account of therapeutic practice’s participation in the broader context, Foucault’s particular conceptual inconsistencies will be subverted and I shall draw more from his later than earlier work. 8.2. Power and therapeutic practice In this section, I propose four primary conceptual tools to facilitate the visibility of typically unseen or unrecognised procedures and mechanisms of power in therapy, in a manner that highlights their contextual relevance. 8.2.1. A positive account of power This argument rests on Foucault’s “positive” account of power; as a generative or productive, rather than repressive force. In Foucault’s (1982) words, power “induces, it seduces, it makes easier and more difficult” (p. 220): power does things in the social world. This view enables an analytic separation of power from its effects. It means that we are able to consider therapeutic practice, if we take it as a bloc of knowledge/practice, as an effect of power, but also, to the extent that it involves exercises of power, as itself productive of effects. Therapy has been institutionalised as a legitimate and enduring cultural practice, integrated into networks of other institutionalised practices (e.g., medical, mental health, child protection and legal systems). As therapy is supported and maintained by its participation in these and other networks, it may be considered an effect of power. But it is also itself productive of effects; of discourses, practices, subjects and further power relations that become part of the broader cultural network. 164 M. Guilfoyle-Concealing and revealing power in the therapeutic relationship This point of departure diverges from accounts of power commonly (but not universally) espoused in the therapeutic domain: power as the local and immediate influence or control of one person over another (e.g., Anderson & Goolishian, 1990; Golann, 1988; Kuyken, 1999; Minuchin, 1994 – as discussed in chapter 1). The power-effects distinction permits the conceptual separation of these visible processes - of influence, control, hierarchy and persuasion - from the processes of power itself. As noted in chapter 1, these processes may be evidence of the workings of power, they may be its products or expression points, and they may operate as vehicles or conduits of power to reproduce particular relationship patterns and associated knowledge forms, but they do not constitute power, and should not be conflated with it. In other words, many therapeutic debates on power manage to circumnavigate the issue of power itself, and focus instead on only a localised and select portion of its most visible products. This limitation of what power can mean – as a between-persons phenomenon, and as overt and self-evident acts of influence – effectively limits the kinds of questions that can be asked of therapeutic work. It conceals a host of power-related therapeutic phenomena that do not appear, at first glance, to be practices of power, such as the constitution of the therapeutic relationship itself (see especially chapters 3 and 5), the therapeutic requirement of meaning-making (or the “incitement to discourse” – c.f., Foucault, 1990; see chapter 2), acts of knowing or interpretation, and even clients’ resistances (these issues will be elaborated below). But also, and significantly, as noted in chapter 6, it shields the therapeutic institution as a whole from critique, drawing attention away from the forms of power we have in common, in favour of attention to the differences between therapies in terms of their sensitivities to the ethics of one person influencing another. 8.2.2. Power, knowledge and the production of subject positions From the perspective of therapeutic practice, knowledge is one of the most important products and vehicles of power (c.f., Foucault, 1980). Power in itself is not a substance. It remains powerless and only a “virtual” reality if it is not given shape or empirical form (Deleuze, 1988). But in binding with knowledge or discourse, power can become actualised, given a direction, a method, and a rationale for its existence and functioning. Significantly, knowledge delineates objects on which power is able to operate, although knowledge continues to guide its operations, specifying what it can or cannot do, and constructing particular meaning out of its exercise. Power thus derives “targets”: those objects delineated by discourse to be