Therapy

Powerful Texts: The Potent Techniques of Postmodern Therapy

You don’t hear much about postmodern therapy. Maybe you should.

Posted May 06, 2020

Pixabay
Source: Pixabay

Postmodernism, per Encyclopedia Britannica, is “a late 20th-century movement characterized by broad skepticism, subjectivism, or relativism.” Postmodernist thought has emerged largely as a challenge to the idea of ‘objectivity’ as pertains to scientific explanations of reality. It argues that we don’t simply perceive reality as it is but rather actively construct it in our minds. That construction will inherently depend on the mind tools, habits, and structures we have developed. Those, in turn, are dependent on our cultural and personal experiences

Postmodernism argues that people’s knowledge of the world develops in a social context, and that much of what we perceive as objective facts or natural categories is in fact socially constructed. Postmodernism therefore disputes the existence of any scientific, philosophical, social, or religious ‘Truth’ that can apply similarly to everybody. Rather, different individuals and groups may possess their own truths.

For the postmodernists, knowledge is a social artifact, the product of ‘discourse’—the written and spoken interactions between certain people at certain historical times. Language, in this view, doesn’t merely describe our world but rather shapes and constructs it.

Facts, in this view, are merely interpretations, none of which hold any inherent claim to truth or value above any other. Whether a certain form of understanding becomes dominant and accepted is largely a function of social processes, not of some objective superior value inherent in the form itself. Thus, what passes for ‘truth’ in society reflects the values of the socially powerful.

For example, the reason we regard science highly is because scientific discourse has overtime become a dominant form of comprehension and understanding in our culture, not because science is inherently superior to other ways of finding ‘truth.’ Data, after all, don’t collect, observe, and interpret themselves. People do these things, and people’s judgments and decisions in this context are inherently subjective and biased in favor of their values and worldview. 

Since its emergence in academia in the 80s and 90s, post-modernism has come under all manner of criticism. Critics argue that postmodernism pretends to be profound but is in fact merely obscure; they argue that, for all its flaws, modernism—with its notion of objectivity, its tools of science, and its vision of progress—actually gets stuff done, and thus rejecting it wholesale amounts to throwing the baby out with the dirty bathwater; they note how treating everything as discourse and every interpretation as equally worthy amounts to chaos, an inane flattening of our lived experience (Nina Simone is no better than you singing in the shower), and the erasure of the pragmatically useful difference between expertise and ignorance (who would you want to fix your car?). Finally, they point out that, to the extent that it preaches against abstract truth and unique value, postmodernism preaches against its own implicit claim to capture truth and hold value. 

Such criticism notwithstanding, postmodernist thought, with its emphasis on language, dialogue, and subjectivity, has given rise to some fruitful developments in the field of psychotherapy. Two of the most influential have been Narrative Therapy and Solution-Focused Therapy. Both of these therapies view language as the means by which we construct (and can deconstruct) our identities and our sense of the social world. Both approaches eschew diagnostic labeling and focus on what’s going right and on clients’ unique subjective experience.

Narrative Therapy, developed by Michael White and David Epston argues that people make sense of their lives by ‘storying’ their experiences. Stories consist of events linked in sequence across time according to a plot. Events do not have inherent or fixed meanings outside of these narratives. In constructing the life story, we shape, in essence, our identity. Now, only a fraction of experienced events can be woven into our stories. So the individual has to decide which aspects of the situation to include in the narrative and what meaning to ascribe to them.

As we go through life, we develop stories about ourselves by picking certain events and threading them together into ‘dominant narratives.’ However, dominant narratives are often insufficient to account for the dynamic complexity and uniqueness of individual lives. They may be like highways—which make any journey safer and more efficient, but also boring and impersonal. Our dominant narratives may also over time become ill-adapted to changing circumstances, or be broken and twisted into incoherence by some traumatic event that violates the old story structure.

Narrative therapy looks to create new personal narratives that represent our freedom and agency by considering ‘unique outcomes,’ those aspects of our experience that fall outside the dominant story. The goal is to deconstruct (take apart) the dominant story, examine alternative narratives, and ultimately construct rich rather than impoverished personal narratives.

One technique used in this process is called Externalizing the Problem. This means that instead of labeling yourself as the problem (“I’m an angry person”), you define yourself as someone who’s dealing with a problem (I’m a person who struggles with the problem of anger”). With externalizing, the problem is regarded as socially constructed, placed not within individuals but outside of them, existing largely as a product of their cultural, historical, and personal experiences. The problem is not who you are, it’s what you’re dealing with.

Solution-focused therapy, developed by Milwaukee psychotherapists Steve De Shazer and Insoo Kim Berg in the late 1970s, focuses on finding out what works for different types of people, rather than focusing on what works for different types of problems. One of the original insights of these therapists was that “the solution to a problem is found in the ‘exceptions,’ or those times when one is free of the problem or taking steps to manage the problem.” This approach thus seeks to discover strengths and coping resources, helping the client to do more of what works. It asks questions such as: “How have you kept things from being worse?” and looks at pre-treatment variations in symptoms to unearth clues about effective coping.

The therapist inquires about the client’s ‘Preferred Future’—their goals and plans, exploring specifically when, where, with whom, and how pieces of that preferred future are already happening. One question that is often helpful in clarifying goals is ‘The Miracle Question:’ “If a miracle happened tonight and the problem was solved, what would be the first thing you’d notice that would indicate that a miracle had occurred?”

Based on this information on the client’s existing strengths, resources, coping strategies and goals, the therapist and client look to devise specific, measurable positive steps towards enacting solutions. ‘Scaling Questions’ are often used for that purpose: “On a scale from 1-10, with 10 being totally problem-free, where are you today? What would it take to move from a 3 to a 4 over this next week?”

Rather than focusing on pathology or giving diagnostic labels, therapists instead look for what clients are doing that is already working and encourage them to continue in that direction. Several techniques are useful in facilitating this process. For example, ‘The Formula First Session Task’ asks the client: “Between now and the next time we meet, I want you to observe what happens that you want to continue to have happen.” The ‘Exception Questions’ ask: “When do you not have the problem?” and, “What do you do that is different then?”

You don’t have to enter therapy to use the questions and techniques described above. These are useful tools for anyone looking to guard and improve their mental health. Look at the story you’re telling yourself about yourself. Can you revise it into a richer, more accurate, coherent, and life-affirming one? Look at those times during the day or week when whatever ails you retreats, when you feel suddenly or momentarily well—can you learn something from these moments about what works? Can you then do more of that?

There you go.