Narrative Therapy And Its Impact On Mental Health - Essay Example

Narrative Therapy Introduction Narrative therapy was first begun in hospitals with psychiatric patients. As it is defined by the scholars, narrative represents is the therapeutic use of communication for people who went thought disease, stress, or faced serious problems in live, and for people who seek the development of their personality (McKenzie 2005). But since the early days of the profession the practice of narrative therapy and approach to narrative therapy in mental health has evolved. The desire of the patients to express their selves via forms of narrative has been investigated by many scholars ((McKenzie 2005, White, M., & Epston, D. 1990, Smith, C., & Nylund, D. 1997). Overview of narrative therapy Process of narrative making within the context of a psychotherapeutic relationship can facilitate a positive change within the individual, it can facilitate development of communication skills, and it can help the individual develop a positive self-image. Narrative therapy can provide a social interactive experience where the autistic individual can learn to use their potential to express and explore feelings. Narrative therapy can provide the autistic patient the safe environment where communication can take place, where patients can lower some of their rigid defenses raised against any type of communication. Additionally, narrative therapy provides a means for the patient to express feelings. The role of problems and problem solving Narrative therapy addressed to treatment has some specific features that are necessary to be taken into account for it to be successful. It is necessary to remember that a person may not realize that he was abused. He may feel it in a vague way, or he may realize it but be afraid to talk. He is to be encouraged to talk, an atmosphere should be friendly and calm. It is necessary to assure a person that speaking out will be helpful for him, it will serve for his protection. It is inadmissible to make any judgments or somehow comment his speech. The person should see that the specialist takes his words seriously, that he is understood. Person psychiatrists state that “people who are listened to and understood do much better than those who are not. The response to the disclosure of sexual abuse is critical to the persons ability to resolve and heal the trauma of sexual abuse” ((Nichols & Schwnarrativez) It is necessary to tell the person that his speaking out is a right thing to be done. In case abuser is a person closed to this patient, the he may feel a sense of guilt for non-keeping the secret. The patient may feel fear if he was threatened by the abuser or in case he is afraid of being punished by someone from his family. It is necessary to assure the person that he is not guilty of sexual abuse. Many people suppose that they caused abuse by their behavior or consider it to be a form of punishment for their negative behavior in the past. The specialists should offer protection to patient, and assure him that all necessary steps to provide future abuse will be taken. All people that were abused tell that they want to avoid abuse in future, but many of them do not want their family to be destroyed or a close adult to be imprisoned as well. There are special social services that offer various options in such cases. There are special programs that will make the effect of criminal prosecution against one of the family members on the rest of family minimal. (Nichols & Schwnarrativez) The role of the narrative therapist in the counseling process A general purpose of narrative therapist in case with abuse is to get the people and their parents or other relatives who care about them involved into discussion of what had happened, and understand the meaning of experience that had appeared as the result of the negative experienced caused by being sexually abused. When narrative therapy is implemented by a professional, the person and his relatives have the possibility to define and discuss the outcomes that may have happened after experience of sexual abuse, which may cause negative effect on their lives. Discussion is also aimed at providing the person and his relatives with the possibility to find out in what cases they could withstand or control abuse effects. All types of narrative therapy derive from social constructivism. As the specialists note, “the emphasis on working with people is not limited to achieving a life free from the effects of abuse. Rather, it is important to re-author with people a preferred way of organizing their experience and identifying preferred ways of living.” (White & Epston, p. 46) Those children and adults who went through sexual abuse have obtained experience of exploitation and violation (Adams-Westcott & Dobbins ). It is necessary to see how the person interprets the case of abuse he had, and his interpretation significantly influence the notion he has about himself in his mind: “as a result of abuse, or others’ reactions to the abuse disclosure, these youngsters are at risk of developing a ‘victim story,’ dominated by the abuse and its effects that can serve to further disempower them” (Durrant & Kowalski, qtd in Smith & Nylund). Narrative therapist should help people overcome their abuse, challenge the possibility of abuse domination and create their own style of perception towards their past experience. Limitations Narrative therapy approach does not insist that all those children who faced sexual abuse will perceive their future experience through the scope of abuse domination. There are multiple factors that influence the impact of abuse on personality. For instance, the support and understanding from surrounding people helps children realize that they are not guilty of what had happened to them, and that their emotions related to their abuse, and their subsequent behavior style is understood by the adults. (Parry & Doan) A possibility of being dominated by abuse that a person may have is determined by various factors. Reaction of the adults to the information about abuse directly influences patient’s view of abuse experience and its consequences. Definite types of adult reaction may strengthen the domination of abuse the patient’s experiences. Durrant and Kowalski provide the following example of such influence: “the young person may be experiencing feelings and behaviors that are out of control. Others may react to the presenting effects or symptoms of sexual abuse in a harsh or negative manner, further reinforcing the person’s negative feelings about himself or herself. A viscous cycle may develop that perpetuates the experience of powerlessness and self-hate”. (qtd in Smith & Nylund, p. 178) Such factor as the activity of various systems of social services, either legal or medical may positively or negatively influence person’s notion about himself. Psychologists Adams-Westcott & Dobbins state that negative influence is probable: “Unfortunately, the involvement of the welfare systems may inadvertently result in the patients’ feeling further traumatized and result in “secondary victimization” (qtd in Smith & Nylund, p. 200). Despite numerous attempts made by these organizations in order to make these people friendlier, many children say they feel worse when they are asked to describe in detail what happened to them again and again, or when they testify in a court. The notion of a patient about himself is also defined by expectations of a cultural background. Social expectations and social concepts concerning what being a female or male means define patient’s emotions toward abuse and the results of this experience. Besides, idea that this assault had a sexual nature also modifies the notion that the person creates about himself. “Interpreting their experience within a cultural story that views abuse as ‘violence’ rather than ‘sex’ may allow these young people to experience more understanding and less blame and shame from themselves and others (Adams-Westcott & Isenbart, 1996, p.113).” For instance, the word “sexual” is recommended to be replaced with other word that will not focus attention on the sexual aspect of the matter. Besides, feminists state that sexual abuse is an attempt to prove one’s power, thus the case of sexual abuse is to be treated as the violence, rather that an attempt to express sexuality of an individual. Personal Opinion Conversations in which the person expresses his emotions and feelings are the central in the process that is aimed at destroying a negative dominant. As soon as the specialist heard that a person in the process of storytelling revels that his viewpoint is dominated by abuse he experienced, the specialists has a possibility to see what the main points the person fights with are. Then it is necessary to externalize negative feelings with the help of special questions that are aimed at externalizing negative experience. Externalizing is an approach to therapy that encourages people to objectify and at times personify the problems that they experience as oppressive. In this process, the problem becomes a separate entity and thus external to a person or relationship that was ascribed as the problem (White & Epston, 1990, p. 38). The notion of “internalized language” is also important for understanding narrative therapy. Internalized language is implemented to determine the skills, features and talents that lead to progress within the personality. There are situations when the person cannot define his positive features or unique capabilities. In this case he is advised to find a person from the real life, such as a relative or a teacher, who may inspire this person by his positive qualities and talents. Performing the experience of the person chosen in play is one of the procedures included into narrative therapy. It helps the patient see himself through the eyes of the person he chose as an example, and thus experience himself more positively. The procedure of internalizing and externalizing patient’s experience is aimed at changing the story of negative experienced together with this patient (White & Epston, 1990). Making up positive stories includes providing a therapy background, which reveals both outside and inside a therapy room. It is necessary that the person speak about the changes he makes with the people that are important to him in his real life in order to prevent secrecy and denial and to show other people that he should be acted in a way that will support a positive story (White & Epston, 1990). If it is possible, the parents are to be involved into therapy procedures together with children. Giving the parents a possibility to take narrative in activities with their children that help externalize the outcomes of the abuse case helps parents understand that the behavior of their children is temporary. In case it is impossible to involve the parents, they may be replaced with other people that are close to this particular individual and have trusting relations with him. Sometimes, other specialists are invited to take narrative in the sessions that are aimed at review of negative experience, it “provides an opportunity to update them about patient’s achievements and challenges, and can help them support individual preferences”, as stated by Adams-Westcott & Dobbins (qtd in Smith & Nylund, 1997, p. 155) The commentators speak about increasing tendency of giving more significance to honesty and openness. It is necessary to stop the secrecy which imprisons a person, they state. In case a person hides all his emotions and shares them with nobody, the consequences of sexual abuse experience may be awful. Sometimes children do not want to reveal abuser because this is a close person and they want to protect him. This issue is widely discussed by the specialists, as well as the media. Conclusion Conversation is the most important in narrative therapy but intervention is carried out on the experience level. The purpose of the specialist in narrative therapy is to help the person to make up a live experience in his everyday life. This experience is aimed at making up a positive notion of himself for each particular person. The specialists in narrative therapy use various kinds of expressive narrative. As the result of the process people learn how to express their emotions and impressions of their previous experience, how to detach from their negative experience and problems, and make up more positive stories. When a person’s view of himself is defined by abuse, it prevents him from objective estimating their capabilities, talents and competencies. Intervention helps people detach from negative ideas and find more positive experience in the present and past (Smith & Nylund, 1997). Works Cited McKenzie, A. 2005. Narrative-Oriented Therapy with Children who Have Experienced Sexual Abuse. Envision: The Manitoba Journal of Person Welfare. Volume 4, Number 2 Nichols, M., & Schwnarrativez, R. 1998. Family therapy: Concepts and methods. (4th Ed.) Boston: Allyn Bacon. Smith, C., & Nylund, D. 1997. Narrative therapies with children and Adolescents. New York: Guilford Press. White, M., & Epston, D. 1990. Narrative means to therapeutic ends. New York: W.W. Norton & Company. Adams-Westcott, J., & Isenbart, D. 1996. The politics of recovery from person sexual abuse. Journal of Systemic Therapies, 15(1), 13-30. Freedman, J., & Combs, G. 1996. Narrative therapy: The social construction of preferred realities. New York: W.W. Norton & Company. Madigan, S. 1996. The politics of identity: Considering community discourse in the externalizing of the internalized problem conversations. Journal of Systemic Therapies, 15(1), 47-62. Parry, A., & Doan, R.E. 1994. Story revisions: Narrative therapy in the post modern world. New York: Guilford Press Sachsenmaier, S. Investigating Person Sexual Abuse Allegations: Do Experts Agree on Anything? 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