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Experimental and narrative therapy
Weakness of narrative therapy
PTSD abstract
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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 …show more content…
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 …show more content…
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
Weisel-Barth, J 2014 ‘Review of “The Stories We Tell”’, International Journal of Psychoanalytic Self Psychology, Vol.9(2), p.162-166, DOI: 10.1080/15551024.2014.884526
Boone, Katherine. "The Paradox of PTSD." Wilson Quarterly. 35.4 (2011): 18-22. Web. 14 Apr. 2014.
Overall this genre of conversational narrative is useful to those who need to “reconstruct and make sense of actual and possible life experiences” (7). There are pieces to a story that may not come as clear to a person who has been through traumatic situations, and storytelling is used to help not only with getting the story straight, but for healing as well.
The present session depicted in the video is Kelly’s third CPT session, where the goal is to identify thoughts and feelings through the use of an A-B-C worksheet while discussing “stuck points” and addressing self-blame issues (Resick, Monson, & Chard, 2014). The clinician notices Kelly expressing slight anxiety and engages her in a deep breathing exercise to help her relax. In the first session, the clinician educated Kelly on PTSD and her presenting symptoms; this was then revisited again in the present session (08:16). An “impact statement” was also assigned in the previous session, and Kelly was asked to present this aloud (10:49). The verbalization of the statement in a safe environment helps the client process their thoughts differently
Writing is generally referred to as being a hard to endure, long-lasting task, but my practice has changed and improved over the duration of this course. The choice to write these types of stories stemmed from my interactions with young women who had given up on life because they felt no cared about them or those who had become completely emotionless so that they wouldn’t be taken advantage of again. In a paper for Creative Research Journal, Charlotte Doyle writes, “Like other creative endeavours, the creative process in fiction writing is a voyage of discovery but differs from most other arts in one of its major modes of thoughts- narrative improvisation, a non-reflective mode that typically involves stances in a fiction world from viewpoints different from one’s own” (1998). The general advice given to writers is to write what they know; emotional abuse is something I know a little about from experience. Transferring that knowledge into a narrative that would appeal to readers in a way that would allow them empathize with those women was my
Payne et al. (2007) contend that although CCT has not been widely used or studied in literature pertaining to therapy for individuals suffering from post-traumatic stress disorder that it can be a useful tool therapy tool (p.100). The authors determined CCT can be helpful to PTSD sufferers due to its basis on Roger’s person-centered theory. Payne et al. (2007) note that like other modes of therapy, CCT identifies the need for “some form of exposure” but does so without using “exposure-based exercises” unlike c...
Narrative theory is underpinned by ideas of postmodernism, which makes an assumption that truth is subjective and embedded in stories or experiences of individuals (Connolly & Harms, 2013). Therefore, social workers who incorporate this theory wants to understand the ‘truths’ or ‘problems’ that people have constructed about themselves, depending on the context of their own experiences (Payne, 2006). Constructing stories about themselves and their experiences are part of meaning-making process. Each person’s experience of depression is personal and unique to them (dep. org). Witnessing and listening to people’s stories and validating their experiences such as impact of oppression and grief is important for recovery and to reclaim their lives
The premise of using narrative therapy in child focused problems is to allow the child to characterize the good in therapy by making the familiar strange and the strange familiar. In this study the idea of making the strange familiar is the process in which the child becomes conscious of their personal strength and capabilities. This article references the work of Michael White in narrative therapy; he believed his work was entirely a way to assist the person in building a strong personal story. A way to replace the old, possibly negative story they have already built; through the exploration of alternative personal stories in
Narrative therapy is therapy that consists of storytelling; the client tells their perspective of their own personal life to the clinician. The clinician then listens for the role that the client portrays himself as. This type of perception helps the therapist to listen to key points in the story to help the client know the issue is not a usual part of their character and change and re-author the story. Story telling gives “…meaning to circumstances in lives” (pp. 212). It is used as a form of community work and counseling and encourages people to rely on their own skill sets to minimize the problems that exist in their everyday lives. It holds the belief that a person’s identity is formed by experiences or narratives. The problem is seen as a separate entity from the person and a therapist can hel...
Using narratives to gain an insight into human experience is becoming an increasingly popular method of exploration. Assuming that people are in essence narrative beings that experience every emotion and state through narrative, the value of exploring these gives us a unique understanding. Narrative is thought to act as instrument to explore how an individual constructs their own identity (Czarniawska, 1997) and explain how each individual makes sense of the world around them (Gabriel, 1998). It may also give us an understanding into individual thought processes in relation to individual decision making practices (O’Connor, 1997). It is evident from studies such as Heider and Simmel (1944), that there appears to be an instinctive nature in people to introduce plots structures and narratives into all situations, with an intention to construct meaning to all aspects of life in its entirety. The value of narrative is that it is a tool that allows us to understand what it means to be human and gives us an insight into a person’s lived experience whilst still acknowledging their cultural and social contexts. Narrative is thought to be significance as it is ‘a fruitful organizing principle to help understand the complex conduct of human beings (p.49)’ (Sarbin, 1990) The construction of a person’s narrative is thought to be dependent on each person’s individual awareness of themselves and the circumstances that surround them. However, a debate to whether a person is able to formulate a valid narrative in the face of a mental illness such as schizophrenia has emerged. Sufferer’s symptoms are often thought to interfere with their abilities to perceive within a level deemed acceptable to their society’s norms and therefore the validity ...
In Narrative Exposure Therapy, the client works with a therapist to construct a detailed account of their life. This account or autobiography is recorded by the therapist at the end of the session. It is read back to the client at the beginning of the next session, when the client can correct the information that the therapist recorded. During the retelling of the recorded story and when discussing any traumatic event, the therapist asks for the client's current emotional, cognitive, physiological and
I learned that Narrative therapy helps a client to use their cognitive thinking by learning to look at a problem and themselves from a different perspective. Also, a narrative therapist helps the clients to build thinking positive with his/her own story. According to Nichols (2013), “Narrative therapist aren’t problem solvers. Instead, they help people separate themselves from problem-saturated stories (and destructive cultural assumptions) to open space for new and more constructive views of themselves” (p. 272). My understating of narrative therapy is that a client needs to stop being the victim/aggressor and be able to identify the problem as a problem. For example, I am always thinking
Additionally, we will discuss the process of trauma recovery and fight-flight responses e.g. some people when exposed to traumatic events have a natural recovery process of PTSD while others have a difficult time with recovery because something obstructs the natural process of PTSD. Therefore, treatment is important because it helps patients get "unstuck" (Resick & Monson, 2018). Another educational component I will focus on is educating the patient regarding the premise of cognitive theory as it relates to the client’s current interruption of the traumatic event based on his beliefs. For example, while growing up the client may have learned about the world and organized them in categories or beliefs which could have influenced his interruption
In an RCT in Uganda, Ertl and colleagues (2011) found that groups exposed to short-term, narrative-based trauma therapy experienced a greater reduction in PTSD symptoms than groups in academic catch-up programs, or on the waitlist, in as few as eight sessions. These results are corroborated by findings from an RTC in the Democratic Republic of Congo, in which a similar narrative-based treatment was used specifically for ex-combatants (Hermenau, Hecker, Schaal, Maedl, & Elbert, 2013). Hermenau and colleagues (2013) found that those who participated in the therapy showed reduced PTSD symptoms, as well as reduced contact with current combatants, which may promote community reintegration by reducing the likelihood that the child will return to the armed forces. Overall, these two studies suggest that individual
As people get older, they go through circumstances we all struggle through and cope through. Going through these things such as coming out gay, and my sister almost dying put me in counseling. Not everyone does counselling but counselling is a form of therapy to get through hard times. People as young as 14 years old struggle with their emotion, their personality and need some remedy to boost their audacity up. Many people just like me struggle coming out gay. My struggles helped me who I became and how i’m such a better person now.