Alcohol Abuse Advice

The Use of Narrative Therapy in the Transformative Work of Grief

Helen Keller has said that “the only way to get to the other side is to go through the door.”  This is certainly true in the work of transforming grief into healing and growth. This process involves allowing ourselves to feel the intense emotions of grief – sadness, anger, despair and other difficult emotions, as well as tapping into our internal strengths and external sources of support and ultimately finding new ways to stay connected to our departed loved ones.

Narrative therapy and has been used with a wide variety of difficulties and issues, including grief reactions.  The role of the narrative therapist is as collaborator or co-author with the client.  As such, the narrative therapist partners with the client to explore the stories that give meaning to the client’s life (White, 1995).  Carr (1998) describes the context of narrative therapy as follows:

Within a narrative frame, human problems are viewed as arising from and being maintained by oppressive stories which dominate the person’s life….Developing therapeutic solutions to problems, within the narrative frame, involves opening space for the authoring of alternative stories, the possibility of which have previously been marginalized by the dominant oppressive narrative which maintains the problem (p. 468).

Narrative therapy is thus an empowering vehicle for “re-authoring lives” (Carr, 1998, p. 468; White, 1995), in which the therapist takes the role of a partner or collaborator with the client, rather than an authority figure (Angell, Dennis & Dumain, 1999).. The narrative therapist partners with the client to create a safe place to feel the emotions of grief, and to explore the stories that give meaning to the client’s life. The use of narrative or story is a useful vehicle for making meaning and sense of difficult experiences in our lives, by allowing us to access alternative cognitions and gain self-knowledge… 

A narrative therapy tool that is often used in grief work is the use of written expression, such as journaling and letter writing.  This can be a powerful vehicle for expressing the emotions of grief and accessing the individual’s unique internal resources and strength, as well as a means of enforcing continuing bonds with the deceased and keeping him or her in the bereaved person’s life as an internalized source of strength and guidance. 

Accessing Spiritual Beliefs and Strengths through Narrative Therapy

The collaborative approach of the narrative therapist can be useful for accessing the client’s spiritual strengths by respectful inquiry into the client’s worldviews, including his or her beliefs before the loss, and how they may have changed since the loss, and discussing spiritual and existential issues that arise in this context. (Calhoun & Tedeschi, 2000, p. 167).

As one gets in touch on a deep level with his or her own suffering and resiliency in the face of that suffering, he or she can begin to get a panoramic view of the human condition and tap into his or her spiritual strength. Religious and spiritual beliefs have been observed to be one way in which individuals create meaning and a sense of order and purpose to the human condition, life and death, as well as creating an ongoing relationship with the deceased (Golsworthy & Coyne, 1999; Calhoun & Tedeschi 2000).

My Theoretical Perspective

The strength-based and holistic approach I use with my grieving clients, through the use of techniques of narrative and solution-focused therapy, is informed by my Buddhist practice.  In particular, I come to each session with my clients with the ground that each human being possesses inherent wisdom, or Buddha Nature, and that this wisdom can be called upon to access the individual’s strengths and resilience in times of suffering.  As Stephen Levine (1982) notes, grief fully experienced allows us to “plumb the depths” of our souls and to “touch something essential in [our] being….[W]hat is often called tragedy holds the seeds of grace” (pp. 85-86). Those “seeds of grace” are the basic goodness and inherent wisdom possessed by all, and it is my job as a collaborator or partner in the journey of grief to support my clients to get in touch with the strengths that they possess, but which may be obscured by the intensity of their feelings of helplessness and loss.  Through narrative therapy, including the use of literary and other creative forms of expression, clients are able to create some space around that intensity, which in turn gives them some perspective and hope for change and transformation. 

The broader perspective that can be reached through narrative therapy techniques can put the client in touch with both the uniqueness of his or her own loss, and the universality of grief and suffering.  Paradoxically, contemplating the universal truth of suffering can open us to acceptance and peace.  As His Holiness the Dalai Lama (1998) observes, “if we can transform our attitude towards suffering, adopt an attitude that allows us greater tolerance of it, then this can do much to help counteract feelings of mental unhappiness, dissatisfaction, and discontent” (p. 140).

Through allowing ourselves to experience and express our suffering, we can find a meaningful way to grow, transforming hopelessness into hope and possibility.  The use of journaling and other narrative therapy techniques can foster the realization that grief is an integral component of the human condition.  Through experiencing our own unique grief, we can tap into its universality, lessening our hopelessness and isolation, and deepening our connection with others and the human condition.  This is the transpersonal and transformative work of healing grief.

Clinical Application and Discussion

“Peggy”:  A Story of Abuse and Resilience
“Peggy” came to therapy to deal with her conflicting feelings after the recent death of her mother.  Peggy had been her mother’s caregiver in the last months of her mother’s life.  In our first session, Peggy recounted that her mother was an alcoholic, and that she has a history of alcohol abuse as well.  She also told me of the emotional abuse she experienced at the hands of her father, and her mother’s failure to protect her from that abuse. In addition, Peggy was experiencing distress about her conflicted relationship with her siblings – which is often exacerbated and magnified by the death of a key family member.

During our next session, I encouraged Peggy to tell me the story of her relationship with her mother, and how that relationship transformed from one of recrimination over her mother’s failure to protect Peggy from her father’s abuse to one of forgiveness and intimacy.  I was able to get Peggy in touch with the knowledge that her mother’s death does not mean she is no longer a source of support and strength for her. Peggy agreed with my suggestion, as her therapeutic partner, to write a letter to her mother to reinforce her continued attachment to her mother as a source of spiritual strength.

The process of writing the letter to her mother yielded some unexpected rewards for Peggy.  She surprised herself by her ability to not only acknowledge her continued love for her mother, but also to finally express anger toward her mother for her mother’s role in perpetuating the alcohol-fueled dysfunction in her family, and thus to let go of her family role of being the “good girl”.  Peggy was empowered by this newfound ability to express herself more authentically. 

A key narrative therapy intervention is to affirm the availability of the client’s social network to support his or her grief work.  Part of this process is learning who is a source of support, and who is not.  Peggy has excellent support from friends at her church who share her spirituality, and she realized that it would be far better to turn to them for support at this time, rather than to her family.  At the same time, I acknowledged and validated that giving up the hope that her family can be a source of support at this time was a secondary loss resulting in another experience of grief.  My acknowledgement of this fact was reassuring to Peggy and helped normalize her process.   In addition, I worked with Peggy to link her use of this strength and self-awareness in the past to her current circumstances.  She was thus able to see that she is not a victim of her family of origin, but rather, has some control over the course of her life and the process of her grief.

Peggy now has some tools for healing.  She knows on a core level the strengths she has to move forward.  She feels empowered by her mother’s continued supportive presence in her life and has a renewed faith in her spiritual strength and resiliency. 
Considerations for the use of Narrative Therapy

Despite my successful experience with the use of narrative therapy in accessing continued attachment as a source of strength in grief, other interventions may first need to be used before certain clients have the ability to fully experience the feelings of grief and transform them into healing and growth.   

My work with “Frank”, an eighty year old widower, is illustrative.  Frank’s wife “Paula” died after a long bout with dementia.  Frank reported that, despite a long and loving marriage, a byproduct of Paula’s dementia was extreme anger toward him. I attempted to do a life review with Frank to see if he could gain some perspective, but in telling the story of his life with Paula, he consistently berated himself.   I realized that a narrative therapy life review would have been counterproductive at that point, and that narrative therapy interventions would only be useful with Frank if he were able to let go of some of his distress and internalized self-blame.  I therefore used Gestalt techniques to work with Frank to release the power of his wife’s anger, and cognitive behavioral approaches to foster Frank’s self-care and self-esteem and to help him realize that he did not have to hold on to the blame and shame his wife had instilled in him.  I also helped Frank access other avenues of support, such as emotional support from his son, social support at the local senior center and a grief support group.   

As a result of continued work with Frank’s feelings of blame and shame and Frank’s availing himself of his sources of support, Frank became less distressed about feeling Paula’s presence.  He found that he was now able to tell the story of his life with Paula without internalizing her anger.  It was only after the use of other interventions that Frank was able to re-author his story, and he came to feel Paula’s presence in his life as his guardian angel.
Conclusion

Narrative therapy can be an effective tool for working with the emotions and grief and finding new meaning in one’s life.  The process of expression literally takes deep feelings out of the body, externalizing them so that they become workable. Through this process, grieving clients are able to see that they have some control over their lives, and can tap into their strengths and their inherent wisdom.  With my guidance as a partner on the path of healing grief, my clients can discover their unique strengths, resources and resiliency, deepen their spiritual beliefs, and enhance the meaning of their lives in the context of the human condition.

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