Narrative Therapy: A Compassionate Approach to Exploring Substance Use

Jaya Roy, M.A., M.S.W., A.S.W. 

Stigma on substance use

Because of the immense stigma towards people struggling with substance abuse, it’s challenging to even ask the question if your relationship with a substance is healthy, unhealthy, or how it impacts your life. That shame and guilt can be so large it can prevent a person from asking these questions in the first place. Narrative Therapy is an approach that holds how we understand and make meaning of our lives is created by interactions with other people, culture, history, and more. By bringing attention to the construction of our understanding and meaning of our lives it offers us opportunity to reconstruct our own stories. It is an approach that is flexible, non-judge mental, and curious. In fact, one of the common sayings amongst Narrative therapist is that the “the problem is the problem, the person is not the problem” (Winslade, et al. 1997). This idea allows us to separate our sense of self from the problems we are experiencing which can offer opportunities to destigmatize the exploration of substance use. How the problem is defined is based on what you, as a person experiencing the problem, identify as your main challenge.

 

Identifying and externalizing the problem

Often times when working with people exploring their relationships to substances, we identify two problems: the physical or emotional dependence on the substance and the reason why you use the substance. To help gain further cognitive distance between your sense of self and the problem, we use a technique called externalizing the problem. You can refer to the problems in third person or give them names (e.g. “my substance abuse” becomes “the substance abuse” or Bob). Externalizing a problem helps us separate the person from the problem and with that, we are able to see you with all your complexities, history, strengths, values, culture, beliefs etc… and how all of these weave together to create the story of your relationship with the substance.

Your Story

With the rich and complex story we can build a deeper and more compassionate connection with yourself and identify what feels right to you, what doesn’t, and choose what your next steps can be. We can even explore the ways in which the complex story influences subconscious beliefs about yourself, life and choose to consciously solidify beliefs that are more humanistic, compassionate, and aligned with your values.

Taking back control

Narrative Therapy allows a flexible and compassionate way to explore and understand the roots of the problems. For most people misusing or abusing substances is not the problem or the only problem, but a way to cope with problems. The tricky thing about substances is that many times they become the driving force influencing your story, your desires, your wants and needs rather than you having autonomy to make decisions. With Narrative Therapy you can explore opportunities for ways you can practice your own agency and take back control of your story.

Resources/References

1. Monk, G. E., Winslade, J. E., Crocket, K. E., & Epston, D. E. (1997). Narrative therapy in practice: The archaeology of hope. Jossey-Bass.
2. Singer, J. A., Singer, B. F., & Berry, M. (2013). A meaning-based intervention for addiction: Using narrative therapy and mindfulness to treat alcohol abuse. In The experience of meaning in life (pp. 379-391). Springer, Dordrecht.
3. Winslade, J., & Monk, G. D. (2006). Narrative counseling in schools: Powerful & brief. Corwin Press.