A narrative perspective on externalizing the problem

A narrative perspective on externalizing the problem

The problem brought into the session by the client may be so entangled in the person's life that it may be very challenging for the therapist to remove "it" from the person. Narrative therapy offers a way for the therapist to create a breathing space between the client and their problem. A client who comes in and says, “I am depressed” has in fact identified completely with the problem without separation or boundaries. As the therapist makes initial attempts to externalize the problem, he or she may turn the client's statement around and ask, "How is depression affecting your life?" That is, the therapist begins by helping the client understand that they are not the problem; Instead, the problem is the problem. The therapist begins to sow the first seeds of separation.

Michael White, one of the founders of narrative therapy, states that when externalizing conversations with clients, the therapist engages in “four categories of inquiry” (White, 2007, p. 38). These four categories are:

1. Definition of the problem.

Using various methods (speaking, drawing, painting, re-enactment) an understanding of the client's immediate experience is to be gained.

2. What are the effects of the problem?

Next, it is determined what effects the problem has and in which areas of life the problem occurs (household, school, work, sports, etc.)

3. Impact assessment.

The third phase assesses the impact of the problem's activities. How does it affect the lives of the people affected by the problem and what plans does the problem have for them?

4. Are the future plans in order?

Finally, when developing an externalizing conversation, the therapist will ask the client whether the problem is present for him and whether his future is okay; or perhaps it is not okay (White, 2007, pp. 38-48).

Depending on the client's own perception, it may take some time before they are able to find answers to each of the categories. Nor can it be a linear process. The client may first describe their current situation and their fears for the future before understanding the full impact of the problem on their lives and those of their family members.

To further illustrate these categories, I draw on a few sessions with a client who, during our time together, exhibited aspects of depression that she identified as “The Hole.”

T: Can you describe what's going on for you?

C: I feel like I'm in a deep hole and can't get out.

T: I have my own idea of ​​what a deep hole looks like. Can you help me understand what yours looks and feels like?

C: Well... it's dark and deep... like midnight, every day; all day. I can't see anything; It's cold and lonely in the hole. I can't climb up or see a way out; although there are rugged rocks all the way to the top. There is no way out. I'm frustrated that I can't do anything about it and no one knows where I am.

Here the client has described feeling isolated, seemingly surrounded by darkness, and frustrated that he cannot help but get out of the situation. The client's near-experience definition describes the day-to-day, present experience of their problem. The client also drew a chart to illustrate the spiraling lows of its impact.

The following comment described the impact on his behavior.

T: How does this affect you? Sitting in this dark hole?

C: I can't stand it... I drink until I write myself off every weekend just to escape. I don't want to be alone so I go out with buddies and get ravaged to numb myself and not think about it.

T: If you do this regularly, every weekend, does that help you cope with The Hole?

C: Yes, it does. It makes me forget...until I wake up the next morning with a hangover and realize nothing has changed. I don't want to talk to anyone. I just want to be thrown back in the trash and forget it's there.

As the client began to evaluate the impact of The Hole on her life, the client reported that it served to alienate her from her partner and children so that The Hole could not be figured out, confronted, or questioned. Although the heavy drinking was initially limited to weekends, it began to creep into the week and affect her performance at work.

Finally, I wanted to find out if it was okay for The Hole to influence his relationships; either within his family circle, his circle of friends or his work relationships.

T: So, are you okay with being away from your family and friends while you try to hide The Hole?

C: No, it's not. I hate that I can't talk to them and tell them what's going on. I can see what it's doing to us. I'm not sure how they'll take it. I'm always up to date, sorting things for everyone, but I can't do that anymore.

The client went on to describe his preferred way of life, which he described as “sunshine.” Sunshine was all about family, communication and true connection. This was something The Hole didn't like as it would mean the possible end of its existence.

Externalizing conversations is just the beginning of the journey to solving the client's problem. It leaves the space needed to examine and evaluate. Once the client is no longer rooted and identified with the problem, they can take a step back to examine and evaluate the impact of the problem and begin to identify alternatives for their life (White, 2007, p. 61).

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