Externalizing Conversations in Narrative Therapy (Module 10)

Narrative Therapy: Externalizing Conversations

• Context and orientation

  • This is the final mini-lecture of module 10, focusing on one major strategy in narrative therapy: externalizing conversations.
  • Narrative therapy is a postmodern therapeutic modality that gained attention in the late 1980s. Key developers include Michael White (Australia) and David Epston (New Zealand), though many others contributed to its development and various perspectives within narrative practice.
  • The approach is described as fresh and invigorating, valuing innovation and creativity, aligned with philosophical underpinnings introduced earlier in the course.
  • Externalizing conversations are broad and foundational within narrative practice, and readers/listeners are encouraged to explore further to understand narrative therapy in more depth and how it differs from other modalities.
  • Critics argue that narrative therapy can be difficult, complex, and time-consuming to grasp, potentially requiring years to understand its intentions and methods. This lecture emphasizes the need to shift mindsets from modern to postmodern ways of thinking about people and problems.

• Postmodern shift and critiques of the medical model

  • The transition from modern to postmodern thinking about people and problems is challenging because socialization has long favored a medical-model view of human nature and problems.
  • While not claiming the medical model is inherently wrong, the speaker argues that relying exclusively on the medical model is limiting and may contribute to labeling people as overly medicalized and stigmatized.
  • The aim is to develop alternative ways of working that empower people, reduce medicalization, and lessen stigma while acknowledging psychological and sociological dimensions.
  • Narrative therapy posits that complexity is inevitable: practitioners must shift their worldviews about the nature of people and problems, moving away from a single explanatory lens and toward recognizing people as capable and agentic beings.
  • Environmental and societal forces are often more active in limiting possibilities than individuals’ intrinsic tendencies.
  • Narrative therapy adopts a sociological/anthropological lens and is attentive to social justice, inequity, and inequality within societies, making attending to these issues part of the practitioner’s task.
  • The approach is framed as highly respectful and aimed at promoting a strong sense of agency in people.

• Core stance of narrative therapy

  • Narrative therapists strive to separate the person from the problem to minimize stigma and blame.
  • People are viewed as the experts of their own lives; the therapist does not prescribe a single path or action to improve circumstances.
  • This mini-lecture centers on the strategy of externalizing conversations, but it is acknowledged that externalizing is just one of many strategies in narrative therapy.
  • Time constraints aside, the emphasis is on understanding how externalizing fits into the broader practice of narrative therapy.

• Externalizing conversations: background and purpose

  • Central idea: there are dominant social forces and everyday language that repeatedly convey that problems reside within people, leading to an internalized view of being “the problem.”
  • Language often labels people as problematic, reinforcing the belief that problems are part of one’s identity.
  • This internalization can diminish agency, as people focus on the problem’s effects rather than their capabilities and solutions.
  • Everyday problem-solving happens constantly (e.g., lateness, hunger, anxiety, deadlines) but people often fail to recognize their own skills and strategies that mitigate these problems.
  • Environments can contribute to pushing problems onto individuals, reinforcing the belief that the person is the problem.
  • The overarching objective is to liberate people from the view that they themselves are the problem; this aligns with Michael White’s famous maxim: "the person is not the problem. The problem is the problem."
  • Externalizing aims to shift the person’s perspective so that the problem is seen as something outside or separate from the self, enabling a new relationship with the problem.

• How externalizing works (mechanism and intent)

  • The intent is to separate the problem from the person and reposition it so the person can view the problem as external to their core identity.
  • This can help the person gain a sense of control over the problem rather than allowing the problem to dominate or define them.
  • Example provided: a person who says, “I am a very nervous person,” is guided to gradually view themselves as influenced by nervousness, rather than being defined by nervousness.
  • The shift allows the person to develop a new, alternative relationship with the entity called nervousness, potentially reducing its control over behavior and decisions.
  • The approach enables the development of new stories where the person can take actions and make choices in relation to the problem with greater autonomy.

• Illustrative example and video reference

  • A simple illustrative case is the "black dog" story used by the World Health Organization to convey externalizing concepts.
  • The lecture invites watching a video (video part 1 followed by a part 2 later) to illustrate what it is like to talk about problems in an externalized way.
  • After viewing, students are encouraged to continue with the second part to explore redefining a new way of relating to the problem.

• Practical implications and broader relevance

  • Externalizing conversations align with a broader commitment to social justice and equity by challenging internalized stigma and the labeling of people as their problems.
  • By focusing on the problem as something that can be managed or changed, clients may experience increased agency and empowerment.
  • The approach supports clients in recognizing and leveraging exceptions and strengths when dealing with problems, which can contribute to more resilient coping strategies.

• Connections to practice, ethics, and real-world relevance

  • Narrative therapy’s emphasis on agency, respect, and client expertise supports ethical practice that avoids imposing a fixed path on clients.
  • The sociological lens foregrounds the impact of social context, power, and inequality on individuals’ problems, encouraging practitioners to consider systemic factors in treatment.
  • Externalizing is presented as a foundational yet not exclusive tool; practitioners are encouraged to explore other narrative strategies to facilitate change.

• Reading and viewing recommendations

  • Read further into narrative practice to understand its distinctiveness from other modalities.
  • Engage with externalizing practice through practical demonstrations and case studies, including watching the Black Dog video by the WHO.

• Closing note

  • The lecturer reiterates that externalizing is a key approach but not the only strategy in narrative therapy, and that understanding the broader framework—postmodern, sociological lens, social justice orientation—will enhance effectiveness and reduce stigma in working with clients.