The San Francisco Examiner Interview,
JoAnn DePetro is the founder of the Center for Family Solutions in Walnut Creek, California. She is a marriage and family counselor who also teaches at John F. Kennedy University in nearby Pleasant Hill. The following is a top 10 Q&A with JoAnn on narrative therapy and its application to working with women experiencing struggles with addiction.
1. What are the main characteristics of a Narrative Therapy?
Narrative therapy is not an extension of traditional Freudian therapy. It has evolved from a philosophy of Postmodernism based somewhat on the work of the philosopher Immanuel Kant who rejected empirical thinking and embraced instead a new philosophy of Constructivist thinking. Simply put, empiricism holds that there is an objective TRUTH which can be learned, versus Kant’s idea that what we call ‘truth’ are useful hypotheses collaboratively agreed upon in a society, working premises if you will. More information, over time, uncovers more truth: eg. The world is flat was ‘true’ until we had more information about the world from a different knowledge. Narrative therapists are engaged in collaborating with the client about their ‘truth’ and seeing if that truth or story has been written by someone else. It could be the culture, ie, if you’re not thin as a woman, you are lower on the totem pole. So, we seek to act like archeologists, going into the world of the client, and understanding their world. Then, the therapist can engage in the art of asking useful questions that can open space for the client to question the ‘problem story’ they live. Client’s are invited then, to narrate an alternative story about themselves,often submerged under the weight of the problem story. Questions can be asked: Can you think of a time before addiction took such a hold on you, can you tell me a story about yourself from that time? Often clients start recalling times in their life that are unique to who they are outside the grip of the problem.
2. How is Narrative Therapy distinctive?
The answer to that question is quite complex, but to simplify: narrative therapy is based upon a persons’ story about herself and the world in which she lives. We posit that these ‘stories’ are like Kant’s constructivist theory-they are based upon multi-faceted life experiences, ie., family of origin, time in history, race, gender, economics, education and many more variables. Narrative therapy invites the therapist and the client to revisit these ‘truths’ about self not as static facts, but as accumulated beliefs. Narrative therapists seek to assist a client in deconstructing these embedded stories, painful, paralytic issues often brought to therapy, and begin to assist clients in reconstructing their own narrative through a lens that looks for competency,talents, and abilities versus trauma and pain. Also, its important to note that Narrative is a health, competency seeking model, not a diagnosing pathology model.
3. How can it be effective for women struggling with addiction?
I think whether you are a man or a woman, Narrative therapy seeks to eliminate the social stigma of addiction and explores the underlying pain which seeks addiction. The Mental Research Institute in Palo Alto says the addiction is the attempted solution which then becomes the problem. The underlying problem often gets bypassed and can later reappear in the from of new addictions or problems.
3b. Why is it important for anyone to be discerning when selecting the right therapist?
It’s very important to feel a good fit when choosing a therapist. One should inquire about their background, education, license, and most of all about their philosophy or model of therapy. We should all be informed about who we are choosing to guide us in therapy.
4. Can Narrative Therapy be helpful for women who are in addiction relationships, such as those who are excessively dependent?
Again, the question is very complex. So, my answer can only address so much of the issues involved. Nevertheless, the answer is YES. One must consider the cultural context, women who are financially dependent with children, for example, are balancing a complex issue of child protection and survival that often binds them to men in unhealthy ways. I recall talking with a woman who had just been discharged from a psychiatric hospital recovering from a suicide attempt after her husband left her. I remember her asking me if I worked with co-dependent women.
I asked her what she meant by using that term and she gave me all the correct answers from the then very popular book by Melody Beattie. But then I asked her what men who took advantage of these women would be called, what book would be written about then, and who would buy it! She laughed and we had a most successful therapy deconstructing the gender politics of co-dependency.
5. Can a therapist use Narrative therapy in conjunction with other forms of therapy?
Good question! Yes, of course they can. The caveat is that a combined therapy must not dilute the effectiveness of this non-pathologizing health/joy seeking approach. Eclecticism can be excellent, or an excuse for a therapist who lacks depth in understanding the model(s) she is using.
6. What got you interested in this kind of process?
As a young girl, I was mesmerized whenever I saw a plant or blade of grass push up from under concrete. So, my journey both as a teacher and a therapist over the last 40 years has been to find a way of working with people that has the HOPE of that blade of grass!
7. What are some of your success stories in using Narrative?
First, all of the success belongs to the client more than it belongs to me. It’s hard to come up with one story after so many years in practice.
I’ve worked in community mental health before going into private practice. Those clients coming out of psychiatric hospitals, marginalized in society were my best teachers for courage and hope and resilience. I can recall challenging one young man with the question of defining his problem so that we could develop a treatment strategy for him. He refused to say he had a problem. I used this ‘story’ he told me to as a sign of potential motivation. Thus, I said that if he didn’t have a problem, he couldn’t be in the treatment program. The idea I had was to see if he could find his way out of institutional living. We talked over some weeks about alternatives, and I discovered he had in interest in Eastern spirituality. I told him about a spiritual community nearby. This was a place where he could live without being diagnosed. To make a long story short, he went there, loved it and decided he wanted to live there. While there, he decided he wanted to go to India to meet the spiritual teacher. Towards this end, he got a job, held it, which was unique, and saved enough money to travel abroad. Years later he came back to thank me. He had become part of a useful community in which he fit, was happy, off medication, and still held a job. A good ending, we both thought.
8. Where can a therapist get training to use Narrative in their practice?
There are many good places in the Bay Area which you can find by doing a computer search. The Center for Family Solutions, which I co-founded almost 20 years ago offers such post-graduate training and internships. Interested persons can contact me there at 925-945-0167.
9. Why are some people responsive to Narrative therapy in healing addictions?
First, let me acknowledge there are many different paths to healing addictions responsibly. I think that the Narrative approach works, in the hands of a competent therapist, for many reasons. First, the social stigma involved in more traditional 12 step programs is not integral. At a 12 stop program the protocol is: my name is tom and I’m an addict. In narrative, we turn this around by saying instead: my name is tom, and I am fighting the influence of addictive substances. Addiction is a pernicious problem, organizing yourself as a therapist who works with a client as a team against the temptation of using substance to alleviate pain puts this problem in a different perspective. The client isn’t the problem, addiction is the problem, and the collaboration of the ‘team’ to fight against the temptation puts people in a more leveraged position or motivated position to outwit the problem. You can say to your client: Do you want alcohol to win or do you want to win? It seems to create motivation and a fellowship relationship with the therapist
10. What, in your own professional opinion, is the definition and cause of an addiction problem whether it be a substance or behavior?
When we stop and think about all the books, programs, models, written to deal with addiction, we can grasp the gravity and stubborn nature of this often fatal and life destroying problem. Ultimately, perhaps none of us know for certain. I do know that it is a problem that cuts across gender, race, economics, age, and education. My underlying hypothesis has to do with the mind/body/spirit connection. We humans are conscious animals, we suffer and we analyze our suffering. Pharmaceutical companies blast us through the media with chemical solutions to suffering, and now, prescription drugs such as oxycontin have become part of the addiction problem. The abuse of prescription drugs, which attempt to offer relief from suffering, are now part of the addiction landscape. I think we humans are in search for a quick solution to human suffering, and drugs do offer that. The backlash, ie. Hangover the next morning, gets minimized or bargained ( I won’t do that again, promise to myself), but then the pain yells and the promise gets lost until later.There is much more to say on this topic, and these are some basic ideas towards answering your question. I think that whether its substance or behavior, we get ourselves into habits which are hard to break and can obviously compromise and/or destroy the human organism.
11. Tell me about the Center for Family Solutions and what it offers for women seeking professional counseling. Therapy has gotten a bad rap as making things worse for someone. How can someone go about being in therapy in a way that is constructive for them rather than a dependency crutch?
The Center for Family Solutions was founded by myself and Lawrence Diller, MD nearly 20 years ago. Currently, Steve Sardella, MA, MFT and myself, JoAnn DePetro, MA, MFT are the co-directors. It is located at: 2099 Mt. Diablo Blvd., Ste 202, Walnut Creek, Ca. 94596. I can be reached at: 925-945-0167.
The Center is a private practice facility, and a training facility. Steve Sardella and I have been working with couples, individuals, families, and children for over 30 years. We have a playroom with a sand-tray, and my office has a one way mirror for supervision and training. I have also been active for several years, not currently, is doing executive coaching, and Organizational training, working for over 3 years with family owned business corporations. Our interns are available for lower fee clients and are supervised by either Steve Sardella or myself.
As for therapy getting a bad rap, I am all too aware of some of the problems that incompetent therapy can create. No matter what model a therapist uses, there is the issue of talent, competence, ethics that any potential client should inquire about. Potential clients should ask questions of the therapist as I stated earlier, and in an initial interview, continue this inquiry until they get a good feel for the therapist. Also, if you are not getting where you want to go in therapy, challenge the therapist, don’t just stay stuck.