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Articles    H3'ed 3/21/11

Beyond Narrative Therapy: Day 11 of the Australian Journey

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Today is Sunday in Australia and we awoke early to drive to Warneet, a sleepy village near Phillip's Island, where we had previously built a sweat lodge which was still standing.   Our task was to provide a sweat lodge ceremony for some of the mental health therapists who had attended the previous day's workshop.   Much has been written about sweat lodges, and so, I will not repeat that here, except to say that it was a marvelous experience as it always is.   The Australians were particular frightened of the heat and our leader and Barbara did a marvelous job of reassuring them that the heat was not dangerous, that oxygen was plentiful, and that they wouldn't dehydrate and die.   They had heard about "the atrocity in Sedona" which was wrongly described to the world as a sweat lodge (even though CNN was told before releasing their story by a number of people, including Orval Looking Horse and me, that in no way was it a sweat lodge).   We explained that Sedona had consisted of over 50 people in a greenhouse covered with rubber in which the door was never opened between rounds and more than four rounds occurred.   We sincerely doubted that any traditional songs had been sung and doubted that the compassionate spirits had ever been called.   This reassured the locals.   Our leader told them that he had a strong sense of survival and was also a bit of a wuss, so if it were dangerous, he wouldn't have been there.   That made them laugh, which was the goal.   He heated 28 stones, but ended up using 7 for the first round, then four for the second round, four for the third round, and five for the final round.   Assisted by advice from Barbara, he did a good job bringing the people right up to their tolerance of the heat, but not beyond, and almost everyone stayed for the entire experience.   Two people left almost immediately, just as the first round was starting, and before the first song and before the first ladle of water had been put on the stones.   Everyone else stayed the entire time.   For more about the sweat lodge ceremony, I always recommend Raymond Bucko's book, The Lakota Ritual of the Sweat Lodge: History and Contemporary Practice (Lincoln: University of Nebraska Press, 1998), which is a sensitive and marvelous piece of anthropological participant-observer narrative-based research.

The post-sweat lodge conversation will be the topic of the remainder of today's blog because it sets the stage for further conversations on Monday about what next year's culture camp and other activities will involve.   From our conversations with indigenous people and with mainstream psychotherapists in Australia, we discovered a confusion about what is narrative and what is narrative practice and what is narrative therapy.   For most mainstream Australians, narrative therapy is what Michael White did and what is taught at the Dulwich Centre.   Many took workshops with Michael White and learned how to do what he did and told us, now what?   What comes after narrative therapy?   We understand that Michael was a wonderful and charismatic guy and have read a bit about his work and his ideas of externalizing problems, but had always seen Michael as one branch on a large tree and not as the entire tree.   I took a postgraduate diploma from Massey University in New Zealand in "Discursive Practices", and we actually didn't discuss Michael White at all.   There were many more narrative theorists and practitioners to consider.

So with deep respect to Michael White and with deep appreciation of his work and his contributions to psychology, I want to present the perspective that the narrative paradigm is much more than what he had to say (and much more than anything I could say).   The trunk of the tree, in my view, is what indigenous people have been doing with story for over 40,000 years.   Their practices are directly connected with ancient roots that wind their way down into the earth to tap into ancient wisdom traditions, some of which are not even known to the modern world.   When we say narrative, we are referring to this indigenous, ancient practice of understanding the world through story and as a story and understanding that we are all created from the stories that are told by the generations before us.   If we are storied beings, the task of human service professionals is to hear the stories that we are.   Generally speaking people don't listen to the stories of others.   Generally speaking, neuroscience shows that we listen long enough to grab a suitable personal story from our indexed collection of stored stories that seems "close enough" to the story we are hearing, so that we can tell that story back to the person who is telling us a story.   Narrative competence means developing the ability to listen longer and with less judgment and interpretation than what is common.   In the local language it is Gulpa Ngawal, or the Deep Listening.   Indigenous ethics is very similar to what has been written by the philosopher Levinas, who notes that the most ethical stance is to acknowledge the existence of Others.   When we do that, we realize that we must approach these others as people we do not understand.   We have to listen to them to explicate their language and what words mean to them, how they use those words, and what are their stories.   They may tell us these stories or they may perform them as forms of drama, song, or dance.   This understanding of the stories of others is in stark contrast to the usual practice of listening long enough to match a story and begin telling our own story often before the other person as finished his or her story.   This is because only we matter in that rendition of the world.   To let an Other matter is a radical ethical step.   This is requisite to the Deep Listening.

The narrative practices that are also indigenous are also strongly grounded in contemporary neuroscience.   This is where one of my favorite elders says, "Isn't it great that neuroscience is finally catching up with the Lakota!"   We know from Shank and Abelson that all information is stored in story form.   Story is the template in which knowledge is laid down in the brain.   Without that template, memory fails to be created.   We also know that story with its use of metaphor and symbol lights up every part of the brain.   Story engages the entire brain and not just one or two sections.   Story is inevitably performative for it engages the motor neurons who would act out the story did we not have the ability to disconnect those neurons from action.   Indeed, learning involves the creation of new synaptic pathways to compete with the old.   The more we follow, the new pathways, the weaker the old, less followed pathways become.   Learning, in a sense, is the creation of a path through the woods.   The more the path is followed, the easier it is to locate and to follow.   The less the alternate paths are followed, the more overgrown they become and the more the forest absorbs them.   Soon they cease to exist.   This is also how the brain works.   Neural pathways cease to exist from underuse.   Nothing is "unlearned".   There is only new learning.

The indigenous narrative version of this is the practice of offering good stories to people to potentially replace the other stories that are causing them suffering and pain.   Many of the traditional teaching stories are designed to do this -- to communicate a new set of values and beliefs which will aid the listener to the story.   In addition, when we do the deep listening, and truly understand the stories of other people, and, when we listen to the stories that all the people who know this person tell about them, then we are in a position to potentially influence those stories in a direction toward reducing experienced pain and suffering.   What I think some people didn't like about White's version of narrative therapy was the reliance upon the "clever therapist" to create a new story for the person, and the relative minimization of the importance of community in co-constructing new stories.   A new story only works if they audience accepts it and believes it and supports it.   If we try to perform a story that is unacceptable to our family and friends, we will not perform it for long.   This is why people with substance use problems have to find friends who do not have these problems if they wish to step out of a substance misusing community.   Creating new stories is a community process in which the stories that we all share are all also acknowledged.   This includes the stories of conquest, removal from land, removal of children, residential schools, and other forms of abuse.

I am suggesting that narrative practice is, in a sense the only form of practice, because it's all story.   Human life is lived, recalled, and celebrated in the form of story.   We can deny this, which is also a story.   Or we can embrace the diversity of stories that abound in the world and celebrate differentness.   When we recognize that everything we do is storied and involves story, then we can talk about the narrative aspects of medicine (narrative medicine) or psychotherapy as narrative practice.   It takes us beyond narrative therapy as one technique among many.   I can (and do), for example do cognitive-behavior therapy as a narrative practice.   I help people find the stories that support the beliefs that they hold, because everyone has a story or three to support the conclusions that he or she has made about the world.   Finding these stories and examining them is a shortcut to changing beliefs over standard CBT, because, just telling someone that she has funky beliefs is not actually as helpful as looking for the origins or creation stories to support those beliefs.   I do narrative medicine when I ask people why they think they have arthritis and what they think will help.   I try to couch my therapies within what they already believe will be useful.   I may tell them stories about other people who have gotten well to inspire them that they can too.

Non-indigenous people have been discovering the power of story.   Indigenous people have known this for centuries longer.   That's why indigenous people make excellent teachers of narrative practice and provide a richness that may not exist elsewhere.   Finding ways for indigenous people to teach human service providers how best to help them may be the next step in our cross-cultural journey.   Who knew!   No outside expertise was required.   Just the ability to listen and to ask questions to inspire people who have been downtrodden to celebrate their strengths, their resistance, their courageousness, and to be unafraid to emerge to teach the oppressors what we all need to know.

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
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