Live Workshop: Developing Questions #6 – Reauthoring Conversations and Unique Outcomes.

About this Session

ebac6ae24e7dfef8b0bdf55db120b4acVSNT faculty Helene Grau, Stephen Madigan, David Marsten & David Nylund guide the membership into the mystery, beauty and complexities involved with developing Unique Outcome Questions and Reauthoring Conversations. The faculty comment and question on a narrative therapy session video clip of Stephen’s.


Date

May 8, 2020 at 9:00 am - 10:00 am

Pacific Time


Organizer

VSNT.live & the Vancouver School for Narrative Therapy

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Comments (7)

  1. Emily Doyle says:

    Thank you Stephen, David, David, and Helene for the meeting this morning!

    As you were engaged in conversation I kept circling back to what might support our practices of questioning authority, and the different levels at which we do so (even though that wasn’t the focus of the discussion today). I heard the importance of questioning a broad discourse of “love” and how the authority of this term can overshadow the embodied experience of loving and being loved. I love this example of a broad discourses that we take up, take in, and take for granted that we should be questioning in our practices and beyond. I hope we can spend some more time on “ethos” as we go!!

    Questioning authority casts a gaze on the ways that the dominant discourses are imposed in small (but big!!) ways in the everyday aspects of the work we’re doing in the questions that we ask as narrative therapists. Is there also space to consider (and question) how authority is exerted in the additional processes we engage in, in our practices of therapy? Specifically I’m thinking about how we are required to orient to organizational mandates and practices in which this authority is often taken for granted as it is built into broader systems. How do we balance the tension to “look here!!” and “focus on this!!” from an organizational perspective with what we have learned to value from a relational and curious position?

    I think about the everyday practices that are part of counselling in addition to the questions we ask when sitting with a client, and how they occasion our experiences of the person we are working with, as well as our relationship with the work we are doing. Written accounts of our work and our therapeutic relationships are an example…even at CFTC where our family therapy work is explicitly focused on interpersonal patterns vs. individualism, an “identified patient” who is 18 and under is required to collect in our referral process and on all of our documentation. From the official account of the work that is done at the Centre (as represented in numerical figures collected by funding agencies), there is no way back to understanding the work that is done within the therapeutic relationship, through the lens of the IP-Scope.

    More generally, there are activities we engage in that we might not questions (but that still have influence on our experience of our work and relationships). Like paperwork. When therapists are required to do an “intake” as part of organizational practice, there is an authority exerted in the categories to be completed (and those that are left out and deemed unimportant) and where this account of the person is stored. We are required by our licensing bodies to account for our work with clients in particular ways (case notes), we are required to retain records for long periods of time (which I don’t disagree with but these official accounts of our experience of others are often require to be couched in language of objectivity but are none-the-less subjective and can be enduring). There is so much invisible work that we do to “work around” how we can be required to represent our work that isn’t often discussed. So that in a structured interview we still manage to find ways to engage in a relationship rather than just fill out a form that constrains what is considered organizationally relevant, and in case notes we might still recognize our relationships despite the language of objectivity inviting us to remove ourselves. Am I off base to conceptualize these examples acts of authoritative aggression, and that my response or practicing differently is insubordinate?

    There are categorizations we are required to make and distinctions we are required to draw for many different purposes that are far beyond the front-lines of our practices and relationships, in addition to questioning the authority of broader discourses as it shows up discursively. I can’t help but question how this tacit authority influences and constrains – I know it is a work in progress for me to also be in relationship with how I have to both orient toward the social and institutional organization of counselling practices and what is required of me as a “professional”, and what I require of myself. I would love to unpack this a little more in future discussions, if there is space to do so.

    🙂 Emily

    1. Emily Doyle says:

      Additionally (sorry I didn’t include this before hitting “post comment”) – Stephen, I would love to hear any comments you (and others) might have on how you balanced these types of tension when working with (and accounting for work with) clients in a medical setting, as you have done beautifully in both the clip shared and your anti-anorexia work more generally.

      Thanks!!!

      1. VSNT says:

        Thanks Emily. Here is my quick response to your important broadening of todays discussion addressing just one of your questions you raise: “what might support our practices of questioning authority, and the different levels at which we do so (even though that wasn’t the focus of the discussion today)”.

        I suppose a first step might be to place one self on notice towards the ongoing practice of noticing the taken for granted actions of psychological authority. Since imbedded in our systems of mental health and Graduate Mental Health School institutions, as well as how these systems of thought are instituted in our practices of therapy, lays the contingent history and context of how these prominent discourses of authority became popular.

        However, Spotting the authority and Responding to the gaze and practice expectations of authority are perhaps two distinct actions where, a) Spotting may lead to an energetic unpacking/complaining of the discourse and/or late night bottles of wine with friends deconstructing these practices, and b) Responding in its best light offers up a reconstructive alternative. I guess I’m trying to say that deconstructing the authority of, for example Psychology, is the easy bit. Reconstructing an alternative is much more difficult – but I do believe this is where the creative and the fun lurks.

        I suppose what I’m trying to say is that within the operations of power/knowledge and where one sits within the social hierarchy, the responsibility to reconstruct alternatives and at the same time question the risks we are willing to take on behalf of the reconstruction (as a response to the deconstruction of what we notice) might be a valued practice that involves a look at the values and ethos of our work, ourselves and what our therapeutic intentions actually are. The question becomes: how far am I really willing to go with this reconstruction?

        Set within this context, the reconstructive action Michael White took in stepping the practice of therapy away from 100 years of psychological authority and present an alternative non-individualist politic of therapy is both mind blowing and hopeful it can be done. Thanks again Emily!

    2. David says:

      Thanks Emily for your post; it is packed full of great points! I will try to respond with some of my thoughts. I agree, Emily, that the organizational structures of requiring intake assessments and traditional case notes is a form of authoritative aggression. Increasingly, especially in the United States, the focus of mental health is on “outcome”, symptom checklists, and pathologizing case notes that have very little to do with the richness and art of the work with our clients and families. These forms with checklists and tracking symptoms remind me of Fitbit and MyFitnessPal.

      I see how stressed the therapists I supervised are in trying to complete the paperwork. And if they don’t do the paperwork on time or it’s not psychiatric-sounding enough, they are disciplined (as you say Emily that are seen as insubordinate). It’s overwhelming to respond back to these organizational practices given how these practices do not exist in isolation–it’s in the context of neoliberalism, managerialism, and the commodification of all aspects of life including mental health.

      What I can do as a supervisor, however, is have conversations with the therapists I supervise to help them situate these organizational practices within a larger cultural context. Perhaps they can resist these dominant practices by not internalizing the language of the paperwork and seeing it not as “truth”but a discourse. This may allow therapists to remain critical of these practices while still viewing the the pathologizing paperwork as a strategy for clients/families to access mental health care (such as me diagnosing a trans person with “Gender Dysphoria” so they can access healthcare).

      To resist the authoritative aggressions you refer to seems overwhelming–like trying to resist and overthrow neoliberalism. But perhaps we can resist in small/covert ways, not internalize the dominant mental health discourses as “truth” while simultaneously working towards ending these oppressive organizational practices.

      David

      1. VSNT says:

        I fully back your idea of “perhaps we can resist in small/covert ways, not internalize the dominant mental health discourses as “truth” while simultaneously working towards ending these oppressive organizational practices”. And I suppose these standing-up-to practices are easier done when we stand together,

  2. suzy.mackechnie says:

    I just want to say thank you so much for this series and the generous sharing of the work in the videos. I am hearing so much that I connect with that is helping me to hold onto the ethics and precision of questions my own practice. I’ve been doing narrative therapy for a long time but it’s not always been easy to connect with people with a similar passion and to be able to be part of this consideration of the details of the work, so regularly and in such an accessible way.

    1. VSNT says:

      Thanks Suzy. I echo what you are saying . . . I rarely speak with ‘civilians’ about the creative complexities surrounding the experience of sitting in the narrative therapy chair each day. And I’m OK with this. The Developing Questions series offers us the luxury of being surrounded by like minded therapists who can articulate and share the experience. I often transport the precision and creativity of these conversations directly into my practice. Cheers.

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