Grief Therapy and the Reconstruction of Meaning: From Principles to Practice

Viewed from a constructivist perspective, grieving is a process of reconstructing a world of meaning that has been challenged by loss. Although most people successfully navigate bereavement and retain or return to pre-loss levels of functioning, a significant proportion struggle with protracted grief, and are unable to find meaning in the wake of an unsought transition. For these individuals, constructivist therapists have a number of strategies at their disposal that foster meaning making and help clients reestablish a coherent self-narrative that integrates the loss, while also permitting their life story to move forward along new lines. After reviewing theory and evidence that scaffolds this constructivist conceptualization, this article draws on excerpts of therapy with two bereaved clients to illustrate how narrative retelling, therapeutic writing, a focus on metaphorical language, and the use of visualization can all be viable strategies in helping individuals reconstruct meaning in the wake of bereavement.     

Narrative Child Family Therapy

In this article, child family therapy is presented as a hermeneutic activity shaped by an interest in the evolving narrative. Over brief, analytic play interviews, the therapist documents a child's narrative understanding of the presenting family problem. This allows psychological meaning to be jointly constructed in therapeutic conversation with the child and family. The idea of play as narrative integrates child psychotherapy into recent social constructionist thinking in family therapy. The article also discusses how narrative therapists can use prior theory and training.     

意义疗法的理论、方法与技术:基于存在积极心理学的视角

意义疗法是以存在积极心理学为理论基础,以构建个体生命意义为目的,实现生活正负两极性的动态平衡,从而解决其心理困扰获得心理治愈与成长的一种整合性心理咨询与治疗方法。起源于Frankl意义学说的意义疗法是通往人类美好生活的路径,它源于对苦难生活所隐含意义的本质认识。在理论上,意义疗法以意义定向看世界为中心,以意义管理理论和双系统模型为支架; 在方法上,为保障意义获得,应遵循8个基本问题和12条原则,充分发挥意义源的作用,实现意义获得的双路径统一; 在技术上,灵活采用趋向性(PURE)策略、回避性(ABCDE)策略、以及双视角双通道策略或其它策略的整合。意义疗法因包含了精神成分而超越了心理动力学和个体心理学等传统心理治疗方式。未来研究还需明确意义疗法整合了哪些流派的具体方法和技术,细化意义疗法主要的技术与策略的操作步骤,考察成熟幸福感量表在中国文化下的适用性,以及充分整合质性与量化研究方法检验意义疗法在中国的适用性     

Some Historical Conditions of Narrative Work

Written to honor the immense contribution of Michael White as a leader in the development of narrative therapy, this historical essay contrasts the origins of psychoanalysis, family therapy and narrative therapy. Changes in the understanding of therapeutic strategies, methods of training and supervision, styles of leadership, the involvement of audiences in the therapeutic and training processes, and conceptions of the nature of the mind are described. A style of direct demonstration of methods, especially of the formulation of questions, is important in narrative work. The central master-role of the therapist in analysis and family therapy is replaced in narrative work by eliciting local knowledge, and the recruitment of audiences to the work. This is consistent with narrative therapy's "de-centered" image of the therapist.     

Towards a common ground in psychoanalysis and family therapy: on knowing not to know

In this paper a common ground between psychoanalysis and family therapy is discussed in terms of postmodern theorizing in both disciplines. Recent systemic, narrative or social constructionist thinking in psychoanalysis and a psychoanalytic turn in family therapy offers the possibility of a shared epistemology. This is described in terms of a critical not-knowing stance which allows for the therapist's/analyst's contribution of meaning, interpretation and knowledge in therapeutic conversation. Here the holding of not knowing and knowing together provides a narrative container for personal meaning and thinking to develop. This 'knowing not to know' is what a postmodern psychoanalysis has in common with family therapy: both are ways of being with persons to help them develop and hold their own knowing. This therapeutic process is illustrated in a clinical vignette of narrative child family therapy.
For what one knows does not belong to oneself.
(Marcel Proust, Remembrance of Things Past , p. 898)     

A Narrative Approach to Supporting Students Diagnosed With Learning Disabilities

Students diagnosed with learning disabilities experience many challenges that school counselors may address through narrative therapy. Narrative therapy is a postmodern, social constructionist approach based on the theoretical construct that individuals create their notions of truth and meaning of life through interpretive stories. This article identifies potential challenges students diagnosed with learning disabilities encounter, provides an orientation to narrative therapy, and offers a case example illustrating the application of narrative therapy with this client population.     

Redefining the Meaning of Negative History in Times of Sociopolitical Change: A Social Creativity Approach

This article explores the role negative history plays in political discourse on crisis management and how times of sociopolitical change in turn influence the strategies that can be employed to write a positive historical charter. Choosing Germany as a case study, we analyzed how political leaders negotiate Germany's narrative and political role during the European “refugee crisis” in speeches (n = 332) held between 2015 and 2018. Applying a combination of corpus-based and qualitative narrative analysis, we found that the context of a crisis is used to attach new meaning to Germany's role in World War II. By focusing on the lessons learned from history and pointing out the parallels between the current crisis and sociopolitical developments that took place 80 years ago, Germany is presented as the ideal advocate for a free and united Europe, a narrative that legitimizes its advancingly dominant role within the EU and beyond. The analysis demonstrates how times of change can facilitate social creativity strategies for nations whose past is dominated by negative history, with implications for the theory of identity management.     

Reading Against the Lines: Resisting Foreclosure in Therapy Discourse

In this article, it is noted that poststructural ideas can be useful tools in fostering reflexivity and creativity for clinicians. By examining the process of meaning construction, clinicians can detach from repetitive interpretations of therapy discourse that lead to conversational closure. Four strategies for guiding a reading of family therapy interaction are presented: incitement to discourse, deconstruction, normativity, and the cultural grid of intelligibility. These strategies are used to describe examples of marital therapy discourse. By learning to read therapy as discourse, clinicians may critically examine how meaning is constructed and use that awareness to foster therapeutic conversations.     

“Giving Back to Society What Society Gave Us”: Altruism,Coping, and Meaning Making by Two Refugee Communities in South Australia

We aimed to explore how refugee people utilised their coping resources and strategies to find meaning in their past and present experiences. Using an experience‐centred narrative approach, we analysed the stories of 24 former refugees from two African countries resettled in South Australia. Data analysis revealed altruism and helping behaviour as a prominent and recurring theme of participants' narrated lives. This meta‐theme encompassed four subthemes: (a) surviving war and exile, (b) adapting to Australian society, (c) reaching back home, and (d) meaning making through religious beliefs. Helping, cooperating, and sharing were entwined with participants' coping strategies and meaning making of experience. Participants' socio‐historical, cultural, and religious context influenced the interpretations of their experiences. Taken together, our findings identified a counter narrative in refugee mental health research beyond trauma and psychopathology. Specifically, we have shown that when the refugee experience is also accompanied by situational contingencies such as receiving help and being called upon to help, together with evaluations such as empathy, identification with suffering, and gratitude, people can be motivated to help others. Future research is needed to explore how altruism and helping behaviour can promote healing from trauma, alleviate distress of separation, and ameliorate acculturation stress among diverse refugee populations.     

Innovative moments and poor outcome in narrative therapy

Aims: To analyse a poor outcome case of narrative therapy with a woman victim of intimate violence. Method: The Innovative Moments Coding System: version 1 was applied to all sessions to track the innovative moments (i‐moments) in the therapeutic process. I–moments are the narrative details that occur in psychotherapeutic conversations that are outside the influence of the problematic narrative. This research aims to describe the processes involved in the stability of meanings in psychotherapy through a dialogical approach to meaning making. Findings: Contrarily to what usually occurs in good outcome cases, re‐conceptualization i‐moments are absent. Moreover, two specific types of i‐moments emerged with higher duration: reflection and protest. Qualitative analysis showed that the potential meanings of these i‐moments were surpassed by a return to the problematic narrative. Conclusion: The therapeutic stability seems to be maintained by a systematic return to the problematic narrative after the emergence of novelties. This process was referred from a dialogical perspective as a mutual in‐feeding of voices, one that emerges in the i‐moment and another one that supports the problematic narrative, which is maintained by an oscillation between these two types of voices during therapy.     

A narrative social constructionist approach to therapeutic empathy

The concept of empathy has been a centrol conceptual element in approaches to counselling and psychotherapy that emphasise exploration of meaning in the context of a facilitative relationship. However, the existing literature on therapeutic empathy lacks theoretical coherence. a narrative social constructionist perspective represents a theoretical approach that enables the integration of diverse strands of clinical observation and research into the creation of empathic understanding in counselling. From a social constructionist position, therapeutic empathy can be understood as a relational process, a step-by-step co-construction by counsellor and client of the life-narrative of the client. In this paper, the Barrett-Lennard (1981) cyclical model of empathy is used as a fremework for examining the counsellor and client actions, strategies and tasks that constitute empathic engagement around the task of emploring and re-authoring life-narratives. Constructionist analysis of the cultural origins of the concept of empathy suggest some limitations of this way of conceptualising what happens in therapy. The implications of these ideas for theory, training and research are discussed.     

Using a Narrative Metaphor: Implications for Theory and Clinical Practice

The evolution of family therapy from a cybernetic metaphor to a narrative metaphor has led us to think differently about therapy, about clients, and about ourselves as therapists. In this article we pursue how this different way of thinking has informed a theoretical understanding of a narrative therapy approach and consequently has opened space for different ways of working clinically. We begin by tracing the evolution to narrative; we consider the implications of social constructionism and its political effects; and we complete the discussion by focusing on narrative theory. We then show how the clinical work follows logically and is coherent with the theoretical considerations. We describe, and illustrate with clinical examples, an innovative approach to working with couples and families with adolescents. In this work we pay attention to the larger cultural stories, including gender constructions, and to personal stories that persons have created to make meaning out of their experience as they interact with one another in a reciprocal meaning-making process. Interventions focus on externalizing the problem narrative that is influencing the client(s), mapping the effects of the problem pattern and/or the totalizing view persons might have of others, and creating space for client(s) to notice preferred actions and intentions. Finally, we close the loop by asking questions of ourselves and others about the effects of working from a narrative metaphor.     

Warriors,authors and baseball coaches: the meaning of metaphor in theories of family therapy

This article examines the metaphors family therapists use in their theories to reveal aspects of the theories which are not explicitly stated, using Whitaker's symbolic experiential therapy, Minuchin's structural therapy and White's narrative therapy as examples. Such examination, drawing on social constructivist understandings of metaphor and meaning making, reveals that Minuchin's metaphors of family as organism and therapist as artist and warrior emphasize the family as relatively holistic and the therapist as relatively interventionist. In contrast, Whitaker's metaphor of family as ecological system or team and therapist as coach emphasizes the interdependence and context sensitivity of the family and relative powerlessness of the therapist to impose change. Finally, White, reflecting his explicitly post‐structural commitment, uses the metaphor of therapy as a journey undertaken with a map and as therapy as an act of re‐narrating a story.     

Innovative Moments as Developmental Change Levels: A Case Study on Meaning Integration in the Treatment of Depression

Innovative moments are alternative meanings to the problems expressed by clients and are organized into three levels. This study analyzes if these levels are not only change markers related to symptomatology outcomes, but also gradual steps in meaning development. A thematic analysis was carried out in a case of depression treated with narrative therapy. Results revealed three themes that evolved from level 1 to level 3. Levels 1 and 2 corresponded to one specific theme and almost all level 3 integrated different themes (polythematic). Level 3 innovative moments might be an integrative bridge allowing the construction of a more adaptive meaning framework.     

学校不同群体的阅读信念对记叙文意义建构的影响

采用问卷调查的方法,考察学校三类群体(初中生、大学生、教师)的阅读信念(reading belief)对记叙文意义建构的影响。结果发现:(1)学校三类群体对记叙文的意义建构不同:在表层信息上,教师和大学生显著优于初中生,教师和大学生之间水平相当;而在整体理解上,教师显著优于大学生和初中生,而且大学生也显著优于初中生;(2)在初中阶段,传递信念对记叙文意义建构起主导作用;(3)在大学阶段,互动信念对记叙文意义建构起主导作用。     

Toward a Developmentally Informed Narrative Therapy

Narrative approaches to psychotherapy emphasize the impact of the stories or narratives we construct on our reality and behavior. However, little effort has been made to elucidate how individuals' differential capacities for meaning-making influence the process of re-storying lives. The present article introduces to family therapy a model of the changing nature of individuals' ability to create meaning. The model, referred to as developmental-constructivism ( 10 ), suggests that, in addition to contextual factors, individual differences in the capacity for organizing experience will influence therapeutic efforts to generate new and more adaptive narratives. The model is also presented as a heuristic for comparing and integrating two influential approaches to narrative therapy: the externalizing approach of Michael White and the solution-focused approach of Steve de Shazer.     

Awakening: Career Opportunities After the Storm

Immediately following natural disasters, basic needs are provided; however, the long‐term needs of individuals are neglected. The narrative approach (Brott, 2001; Cochran, 1997) to career counseling is offered as a method to assist survivors of natural disasters to tell their story and create new meaning related to their career paths.     

Narrative of “Here-and-Now”: Cancer Survivors in a Group Psychotherapy Using SCT® (Systems-Centered Therapy)1,2

This study focused on “here-and-now” narrative and examined the process of group psychotherapy for cancer survivors using systems-centered therapy (SCT). In contemporary society, cancer survivors have a vital need for psychological support, and group psychotherapy and peer support are used as part of this need. In most of these interventions, participants are encouraged to speak freely and share their experience of cancer. This generally means speaking about “there-and-then” experience. It has been argued that one reason that narrative therapy produces a psychological effect is that the meaning of an experience changes when the experience is spoken about. SCT differs significantly from other group interventions in that it requires participants to talk about their here-and-now experience through the format of SCT's “functional subgrouping.” Functional subgrouping requires participants to listen, reflect, and build on similarities in their experience. In this study, we qualitatively examined how participants' experiences unfolded in the SCT group by directly addressing the group process. The study findings revealed that even though the participants did not directly share their cancer experiences in the group, they experienced an inexplicable sense of connectedness that had a positive psychological effect on them. They also experienced deep emotions through talking while using the SCT narrative style. In the process, the effects of the SCT narrative were discussed.     

Narrative Intervention in Interethnic Conflict

This article is rooted in a narrative approach to interethnic conflict which treats them principally as competing stories. On this basis, we examine experimental strategies for narrative intervention in interethnic conflict and potential tools for their reconciliation. Narrative intervention is understood here as a set of actions to identify and disseminate narratives that can reduce negative emotions and attitudes and promote reconciliation between members of conflicting groups. In terms of new solutions, we suggest a method of “Progressive Narrative Transformation” whose key element is the establishment of common points of contact between conflicting narratives and their gradual transformation such that they may converge into a new narrative accepted and shared by both sides. We present different kinds of narratives to evaluate attitudes and emotions among Azerbaijanis, including people displaced from their homes by conflict. Analyzing responses to a “common suffering” narrative, we registered that individuals and groups are able to keep sympathetic attitudes, even implicitly, toward their opponents. Results might enable scholars in conflict resolution and reconciliation to learn how to develop strategies that take advantage of these attributes of the human mind.