‘Loitering with intent’ on different stories
‘Loitering with intent’ on different stories
Issue 43 – February 2015Author: Jon Crossley (contact via firstname.lastname@example.org)
- The ideas or stories that we hold about ourselves provide the scripts from which we act
- There are countless other stories that we can tell about ourselves (and others)
- Helping individuals and families to tell different stories about themselves creates possibilities for alternative ways of acting and being
Implications for practice
- Have conversations with service users and families which do not focus solely on problems and difficulties
- Ask about the strengths and capabilities of individuals and families
- ‘Loiter with intent’ on these alternative stories
A dominant idea is just one perspective of manyThroughout its history, family therapy has challenged the prevailing approaches in mental health, for example shifting the attention from individuals to families in clinical practice. A more recent challenge has been the shift to a social constructionist philosophy1. Social constructionism is interested in how language affects the way we understand and respond to the world. It argues that our use of language leads to some ideas being understood by society as ‘fact’ or ‘truth’, while other ideas are ignored and overlooked. As we observe from history, the ideas that are seen as ‘true’ and ‘correct’ often change over time and across cultures. Social constructionism reminds us that our current ideas are not the essential ‘facts’ about a situation, but one perspective that has become dominant2. With regard to mental health and distress, one of the current dominant ideas (often viewed as ‘fact’) is psychiatric diagnosis. The diagnostic idea is to categorise the experience of distress into an ever-increasing number of separate labels. This creates the perception of many different types of mental illness which are distinct from everyday experience3. There are several alternative ideas about the nature of distress, which are potentially more helpful for the people who are being labelled. One example is the continuum idea, which argues that distress that is currently understood as mental illness is a heightened and more extreme form of everyday experience4. This idea normalises the experience and allows us as helpers to draw on our own experience to understand someone’s distress, even if it initially appears unusual and distinct.
Identifying strengthsThe social constructionist philosophy of dominant and marginalised ideas can be very helpful when working with families and individuals. It highlights the danger of constructing a very narrow account that only focuses on problems and trivialises or discounts other perspectives, for example about accomplishments or abilities. As the philosopher Marquard5 emphasises, “it is necessary for human beings to have not only one unique history or story, or a few of them, but many of them. For if they had only one unique history or story, they would be utterly in the power and at the mercy of this sole history or story. Only when they have many histories or stories are they freed, relatively, from each story by the other ones”. Care is therefore required with language around diagnosis. Describing somebody as a ‘schizophrenic’ defines them according to the problems of ‘schizophrenia’. They are then at the mercy of the story of schizophrenia, which will provide the script from which they understand their experience and act. It would seem important therefore to ‘tread lightly’ when referring to diagnoses, and recognise that this is only one story or idea about the person. Similarly, with regard to assessment, it is important to recognise that this is actually a process of constructing an account of the individual or the family. The questions asked are not only collecting information, but also creating a story of the individual or family for the service, which will set the agenda for the work. If we only ask about problems, it is likely we will create a problem focused account of the individual or family (maybe even seeing some family members as the problem). If we also ask about strengths and capabilities, we increase the chance of developing alternative or additional stories about competence and interests. Assessment can therefore be a significant intervention6.
‘Loitering with intent’ on different storiesWhen problem focused accounts have become dominant, it can be helpful to challenge these by looking for occasions when the family or the person has acted differently7. As these occasions do not fit with the current dominant story, they are typically ignored and overlooked. For example, if a problem focused account is held of someone being selfish, the moments when the person has acted in a generous or caring manner will be overlooked. Narrative therapy is one approach that is particularly interested in spending time with families and individuals talking about these moments. It is emphasised that this process should not be rushed, as both the family and the person “is stepping into unfamiliar ground, beginning to speak about themselves in ways that crackle with warmth within their frozen sense of self. Like recovering frost-bitten flesh, this process takes time… gentle, curious time” 8. This process is often not straight forward, as there are several obstacles to developing alternative accounts. Our current circumstances, including our material and social environments, limit the possibilities for acting differently and therefore the range of stories that can be told. Individuals and families may also find it difficult to identify and recognise occasions where they have acted differently. Even when such moments of difference are spotted, they may remain trivialised and discounted as they do not fit with the dominant account. It is necessary therefore to spend time, or “loiter with intent” on moments that do not fit with the dominant account8. Being curious about moments of difference, about how they happen and when they occur, can be helpful. As moments of difference are recognised and talked about, new stories can be gradually developed and extended, which provide alternative scripts for the person or family to act upon. Living out these marginalised stories, in different situations, allows the ideas to develop further9. Opportunities therefore need to be available for individuals to live new stories. But this process often begins by firstly having the chance to tell (and loiter on) a different story.
- Paré, D.A. (1995). Integrating family and individual perspectives of families and other cultures: the shifting paradigm of family therapy. Family Process, 34, 1-19.
- Gergen, K.J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40, 266–275.
- Bentall, R.P. (2003). Madness explained. Penguin: London
- British Psychological Society Division of Clinical Psychology (2014). Understanding Psychosis and Schizophrenia. Leicester: BPS.
- Marquard, O. (1991). In Defense of the Accidental: Philosophical Studies. New York: Oxford University Press.
- Madsen, WC (1999). Collaborative therapy with multi-stressed families: from old problems to new futures. Guilford: New York
- White, M. (2007). Maps of narrative practice. New York: Norton.
- Schubert, K. (2007). On narrative therapy: re-writing the stories of our lives. www.dulwichcentre.com.au
- Freedman, J. & Combs, G. (1996). Narrative Therapy: the social construction of preferred realities. Norton: New York
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