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Emotion-focused and narrative therapies

"Those who do not have the power over the story that dominates their lives - the power to retell it, reexperience it, deconstruct it, joke about it, and change it as times change - truly are powerless because they cannot think new thoughts."   Salman Rushdie 

Tomorrow our little East of Scotland Emotion-Focused Therapy (EFT) support group have agreed to look at the overlap between EFT and Narrative Therapies.  I have written about our meetings a couple of times before - see "Therapeutic cross-breeding: EFT's approach to self-interruption splits applied to outdated coping modes in schema therapy" and "Unfinished business": emotion-focused therapy and "empty chair work".  These are just a couple of the many blog posts on this website that link with EFT and several of these posts have looked at the integration of EFT and Narrative Therapy.  Examples include "Emotion-focused therapy workshop series (third post): narrative therapy and trauma processing", "Angus & Greenberg's book "Narrative in emotion-focused therapy" (1st post): context", "Angus & Greenberg's book "Narrative in emotion-focused therapy" (2nd post): narrative types & modes", "Angus & Greenberg's book "Narrative in emotion-focused therapy" (3rd post): narrative modes & phases" and "Angus & Greenberg's book "Narrative in emotion-focused therapy" (4th post): facilitating narrative change processes".

In the first of these posts (written in early 2012), I said: "Les Greenberg & Lynne Angus's book "Working with narrative in emotion-focused therapy: changing stories, healing lives" came out just last year.  The book description comments "In psychotherapy, as in life, all significant emotions are embedded in important stories, and all significant stories revolve around important emotional themes. Yet, despite the interaction between emotion and narrative processes, emotion-focused therapy (EFT) and narrative-informed therapies have evolved as separate clinical approaches. In this book, Lynne Angus and Leslie Greenberg address this gap and present a groundbreaking, empirically based model that integrates working with narrative and emotion processes in EFT. According to Angus and Greenberg's narrative-informed approach to EFT, all successful psychotherapy entails the articulation, revision, and deconstruction of clients' maladaptive life stories in favor of more life-enhancing alternatives ... Engaging, in-depth case studies ... illustrate how the model can be applied to treatment of depression and emotional trauma."  Mm ... I like the comment "successful psychotherapy entails the articulation, revision, and deconstruction of clients' maladaptive life stories in favor of more life-enhancing alternatives".  I'm less convinced by their use of the description "empirically based model" I would have thought that implied a bedrock of outcome research, that hasn't happened so far and may never do so.  Having said that, there is encouraging emerging work that is relevant - for example last year's paper by Vromans & Schweitzer "Narrative therapy for adults with major depressive disorder: improved symptom and interpersonal outcomes".

And the more I think about it, the more seriously I am attracted to this territory.  I'm a huge fan of our attempts to use evidence-based approaches when we try to help our clients.  Compassion calls out for us to be as effective as we can be in relieving suffering and good science helps us distinguish what's genuinely useful from what's hogwash.  There can easily be problems though with this evidence-based medicine (EBM) approach.  Like Mulla Nasruddin and his lost keys, we can look very thoroughly but in the wrong place - see for example November's post "Psychotherapists & counsellors who don't monitor their outcomes are at risk of being both incompetent & potentially dangerous".  There's a real surge in energy for narrative-based approaches as a way to humanise, balance and increase the helpfulness of EBM.  There are many recent papers highlighting this hope - examples include "The marriage of evidence and narrative: scientific nurturance within clinical practice", "Narrative and psychiatry" and "Narrative vs evidence-based medicine--and, not or"A whole issue of the journal "Psychotherapy Research" last year explored a variety of relevant narrative-based approaches, and last month's British Journal of Psychiatry featured a major review article "Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis".  Its abstract reads "Background: No systematic review and narrative synthesis on personal recovery in mental illness has been undertaken. Aims: To synthesise published descriptions and models of personal recovery into an empirically based conceptual framework.  Method: Systematic review and modified narrative synthesis.  Results: Out of 5208 papers that were identified and 366 that were reviewed, a total of 97 papers were included in this review. The emergent conceptual framework consists of: (a) 13 characteristics of the recovery journey; (b) five recovery processes comprising: connectedness; hope and optimism about the future; identity; meaning in life; and empowerment (giving the acronym CHIME); and (c) recovery stage descriptions which mapped onto the transtheoretical model of change ... Conclusions: The conceptual framework is a theoretically defensible and robust synthesis of people's experiences of recovery in mental illness. This provides an empirical basis for future recovery-oriented research and practice."  Narrative approaches are very much flourishing!"

More to follow ... 

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