Narrative Therapy - Case Study Example

Based on social construction, the narrative model developed by adopting the post-structuralist perspective of Derrida and Foucault. From a philosophical point of view, the narrative model is categorized as a post-modernist approach in therapy, as it demonstrates socially constructed definitions of developing and resolving issues through therapy. The narrative therapy approach is developed by Michael White and David Epston aiming to create relationships with the clients and to resolve their personal issues through deconstruction and externalization. The nature of the narrative therapy focuses on the collaboration with clients to discover the impacts of their problems and issues in their life and to find solutions for the issues rather than focusing on the past experiences. It makes the client look forward to a better life without having to bother with the said issues. It empowers the clients to allow them to take control of their problems and issues rather than allow them to accept that the problems are the center and the cause of all the misfortunes in their life. Using the case study of Eddie, an individual having problems with his family and himself because of his life experiences and his behavior towards these problems and family issues, we would present how the narrative therapy is most applicable to resolve his case. The narrative therapy approach in family therapy does not only focus on the individual but also looks into the influences of the family’s behavior and their reactions towards the problematic behavior. Eddie’s case shows us that he is currently in trouble with his family with his wife filing a legal separation and his children being affected by the troubles of their families, causing anger, violence and depression in his children. Because of this, his parents took him in again to take care of him, like they have always done in the past. The case study shows how Eddie, despite his behaviors and actions towards his siblings and other people, has been cuddled, protected and taken cared of by his parents. This became the enabling factor in the consistent and continuous behavior of Eddie that is detrimental for his development and improvement. Enabling factors that are present in Eddie’s parent’s behavior were: covering up and making excuses for him, shielding him from the consequences of his actions and even not reprimanding him for his wrong behaviors and doing his share of the responsibility. These parental enabling behavior became a norm for Eddie and because of the consistency of his parents’ reaction towards his behavior, it was imbibed in him that his parents will always be there for him no matter what he has done. And so, even as he grew up, his parents closed their eyes on the fact that Eddie has a problem and that their actions were factors in facilitating these kinds of behavior. Eventually, when Eddie turned to alcohol, his parents continued this enabling behavior by taking Eddie in and acting as fallbacks when he encountered problems with losing his job and his own family. The symptoms of alcohol abuse and dependency signify its effect on the family of the client. With their withdrawal from their family and increased activities outside their homes, the relationship of the adolescent and their family is placed in danger or worse, broken down. It affects the family negatively, as such, because it creates a gap between the parents and their children. Since alcohol dependency increases problematic behaviors, the parents impose more rules on the adolescent on which he sees as a threat to his alcohol dependency. This increases conflict and tension within their homes. There is also a defined change with their relationship with other family members depending on how that family member sees alcohol. If the member is also at risk of alcoholism, then the client is more inclined to having increased personal interrelation with him. Alcoholism has many negative effects on the individual and his family and friends. Since alcoholism is dependency on the substance, the individual becomes more centered on the substance and the activities associated with it rather than recognizing their family and friends, especially when intervention and treatment is presented to them. Eddie’s case shows that his parents had never accepted that there was a problem in Eddie’s behavior and their own reactions towards his behavior. By using the narrative therapy, the therapist will be able to determine the effects of the problem, and further issues that may make it more complicated or difficult to resolve. In addition to that, using narrative therapy can help therapists guide the client to determine his problem and the necessary steps in dealing, and eventually, solving it. Eddie’s family should undergo family therapy, in order for them to realize that Eddie shows problematic behaviors that affects his relationship with other people and, also, affects the entire family’s relationship with each other. The entire family needs to undergo therapy because of the issues that has been evident ever since Eddie was young. The family’s relationship with each broke down because of the parents’ treatment of Eddie and because of Eddie’s behavior. Because of this, his three other siblings show different signs of being affected by this situation. Larry learned to accept parental responsibilities at an early age, and this made him reject his father. Though eventually, he had understood and accepted his father’s abusive behavior, he has no intentions of fixing their relationship, especially when Larry feels that his father is enabling his younger brother with the same behavior that his father has. Jose, being a slow learner was repeatedly bullied by the youngest in the family, Eddie, which made him more of a loner, with no intentions of fixing his relationship with the family. Maria, on the other hand, has always wanted to fix the family. She sought to stop the cycle of abuse in the family but oftentimes fail and harbors feelings of regret when she helps Eddie out due to her kindness and the desire to fix the family, especially Eddie. Eddie has always been the favorite of his parents and he unmistakably took advantage of it. Even when he has done wrong, he still received all the love, care and attention from his parents, something that his siblings never received despite of their good grades and good behavior. His father verbally abused his mother and his older brother, and his mother turned to religion to be able to accept the situation where she is and to turn a blind eye on the destruction that is happening in the family. Eddie turned out to be like his father when he married and started his own family. He verbally abused his wife and this became the reason why she is filing for legal separation. When their parents took Eddie in during this crisis in his life, Larry, knowing that they are still in denial and continuously enabling dependency and unacceptable behavior in Eddie, refuses to communicate with his brother and parents any longer. Narrative therapy will help the entire family because it will make each one accept and understand the feelings of each other, but first and foremost, accept that they are having problems and they are in a way, enabling Eddie’s wrong behavior. With this, the family will be able to separate the problem from Eddie, making the problem the problem and not Eddie as the problem, as how Larry sees it. By externalizing the problem, the clients will be able to understand and deal with the problem since the problem has been separated from the person and the family. The role of the therapist, then, becomes the investigator that poses questions that will allow the clients to narrate, in their own words and beliefs, how the problem started, how the problem influenced them and how the problem will be solved. It is important to understand that the self understands itself through his own personal narratives and the version of self that he believes in (Boston, 2000; Alasuutari, 1992). Because of this, the primary description that the client believes in has been internalized deeply within himself that he believes that it is what he is. Externalization is important in narrative therapy because it is in this way that the client will be able to address the problem by not thinking that he is changing himself. Language is a very important aspect in using the narrative therapy. This allows the client to tell his story in his own manner. With these information, the therapist will help the client begin to examine, explore, externalize and deconstruct the problem. By narrating their life story, the therapist will be able to pose questions to the client to make him realize how he views the problem, and how the issue dominates his life. With language, the narrative therapist will be able to assist the client in externalizing and separating the problem from the client and this will structure the therapy (McCollum & Trepper, 2001). Clients come into therapy with their own stories about what their problem is. Through externalization, the client will be able to see problem on its own and how it affects him and the people around him. By externalizing and deconstructing the problem, the therapy focuses on the problem and not the person himself (Boston, 2000). And since the narratives are societal and involves stories about one’s life, which obviously includes other people, then there is also a responsibility placed on family members to recognize the problem and find solutions for it to be solved by cooperating with the solutions proposed by the client himself. Using the client’s words and beliefs, the therapist will structure the therapy around the client’s skills, principles and knowledge so that the client will regain control over the situation. In empowering the client of his own behavior and actions, the viewpoint of the therapy will shift from past experiences to the positive future possibilities that the client will create through creating solutions for the said problem (Target, et.al., 2005). The narrative therapy also focuses on restoring values and principles that have been jeopardized by the problem and provide an alternative to the way of life that the client has been living up to the present. It will then allow the client to see another perspective other than what he’s been used to seeing. There is always the notion that the client can be helped by allowing him to remember the forgotten memories of values and important events that have given a positive influence in his life. With the parents, this might be the religion that they have turned to when driven by guilt and regret of their actions and past behavior. By remembering and, once again, instilling in them these values, an alternative to the situation is opened. The method of communication that the narrative therapy uses offers a way to interrupt thinking and communication patterns that takes the blame and causes of the problem. It also one method that the therapy uses in order to externalize and deconstruct the problem The linguistic structure of the therapy focuses on describing the problem and letting the client identify, and name, the problem so that it will lead to the externalization of the problem. This is important in a narrative therapy as it detaches the problem from the person, and so it can be seen as something that can be solved by the person, himself, with the help of the family, as with Eddie’s case. Narrative therapy works to bring in the open positive images of the self and the fact that they are responsible for their behaviors and problems, and being the one responsible for it, that they can do something about it. With this, narrative therapy ensures that the client will have confidence in his own abilities and skills, and not rely on anyone to bring within himself the will to conquer the problem. With Eddie’s case, when his parents realize that Eddie is and should be responsible for his own actions, then they will stop enabling his behavior by covering up for him and by watching his back. But Eddie is not only responsible in externalizing the problem, his family should do the same thing as well. It is important to allow the entire family to discuss and narrate their feelings and perceptions towards the problem, and not Eddie. By making the family members realize that it is Eddie’s behavior that is the problem, they will soon be able to realize the solutions in helping Eddie out in stopping his behavior. By keeping in mind that there is a problem that needs to be solved, the family will not cover and protect Eddie, but help him go through this stage by allowing him to take responsibility of his actions. With the narrative approach used in family therapy, the issue of Eddie’s substance abuse and dependency will be covered, discussed and eventually solved. The narrative approach can be effective in this case because it will allow the entire family to cooperate together and find solutions for the problem that they themselves have a hand in creating. With this, the family will be able to, at least, recover from the problem and reestablish their connections and ties, if not, bring closeness to each other. The goal of the therapy is to create possibilities and opportunities for an alternate life. The narrative approach to resolving a problems allows the client to get in touch and explore the problem through his personal narratives, to accept that they have a problem, to find solutions and let go of their dependency, insecurities and issues, and to engage in positive and meaningful relationships and experiences as an alternative way of living (Diamond, 2000). It sees problems and issues as influenced and impacted by culture and the environment, thus, deconstructing the meanings within one’s narration is a way to understanding and determining what is the deeper problem or root cause in one’s behaviour, as with Eddie’s case, the inaction of his parents towards his younger self’s mischiefs. By understanding the meanings and symbols hidden within one’s language and storytelling, the therapist will be able to guide the client in realizing his own problem, determining if it can be solved and if it can be solved, finding the solutions for it (Cook & Graham, 2002; Alasuutari, 1992). It may be that the problem shows biological and physical symptoms of an illness or disease, but the narrative therapy aims to work deeper into the apparent problem and find out how this have impacted the life of the client. This is significantly important in dealing with the entire family as well, since they have one way or other influenced or have been influenced by the problem (Alasuutari, 1992). Using the narrative approach in family therapy allows the family to work together and determine the meanings and their own narratives regarding the issue. In Eddie’s case, this can be effective since there are viewpoints that have to be considered on how the problem grew and how it influenced and impacted each family member’s lives. This indicates that narratives show that people create their own realities and so they themselves can also change, or rewrite their lives. The interaction of the family members are treated as different narratives and as a whole, to determine the meanings and realities that each created for himself and the other members of the family. With this, it clearly indicates that Eddie’s family have constructed their own meanings towards each member’s behaviors, and by undergoing family therapy, they will all understand that each one has been a trigger of the problem and has been influenced by the problem. With this understanding, the family will be able to recreate the meanings, and in turn, their relationships with each other. Works Cited Alasuutari, P. (1992). Desire and Craving: A Cultural Theory of Alcoholism. NY: State University of New York Press. Boston, P. (2000). Systemic family therapy and the influence of post-modernism . Advances in Psychiatric Treatmen , pp.450-457. Cook, J., & Graham, A. (2002). Understanding the Whole Person: Developmental Issues in the Patient-Centered Approach to Substance Abuse. In M. eds. Floyd, & J. Seale, Substance Abuse: A Patient-Centered Approach (pp. pp.53-72). Oxon, UK: Radcliffe Medical Press, Ltd. Diamond, J. (2000). Narrative Means to Sober Ends: Treating Addiction and Its Aftermath. NY: The Guilford Press. McCollum, E., & Trepper, T. (2001). Family Solutions for Substance Abuse: Clinical and Counseling Approaches. NY: The Haworth Press, Inc. Target, M., Slade, A., Cottrell, D., Fuggle, P., & Fonagy, P. (2005). Psychosocial Therapies with Children. In G. eds. Gabbard, J. Beck, & J. Holmes, Oxford Textbook of Psychotherapy (pp. pp.341-352). NY: Oxford University Press, Inc. Read More