1 00:00:05,996 --> 00:00:07,943 - Some goals for today would be that 2 00:00:07,943 --> 00:00:10,334 you leave with a beginning understanding 3 00:00:10,334 --> 00:00:12,725 of some key ideas for narrative therapy. 4 00:00:12,725 --> 00:00:15,117 You'll learn about how to apply this theory 5 00:00:15,117 --> 00:00:18,386 in a range of ways with young people, that I'll try to 6 00:00:18,386 --> 00:00:21,655 provide a range of examples, of how I've used these ideas 7 00:00:21,655 --> 00:00:24,367 in group, with people of different ages, 8 00:00:24,367 --> 00:00:26,894 with home based work, with school based work, 9 00:00:26,894 --> 00:00:28,495 with a range of settings. 10 00:00:28,495 --> 00:00:32,466 And also, I hope that you'll ask questions if there's things 11 00:00:32,466 --> 00:00:35,869 that as you listen, they feel like it's a good fit for 12 00:00:35,869 --> 00:00:37,971 the people that you work with, that are wondering about, 13 00:00:37,971 --> 00:00:40,486 in particular, some other people you're working with. 14 00:00:40,486 --> 00:00:42,867 I'd love to have those questions throughout the day, 15 00:00:42,867 --> 00:00:46,246 and we'll have consultation time at the end today. 16 00:00:46,379 --> 00:00:49,185 And so then you'll leave, ultimately, with a beginning 17 00:00:49,185 --> 00:00:52,853 understanding of how to apply these ideas to your work. 18 00:00:52,865 --> 00:00:54,488 To go ahead and get started, you have a copy 19 00:00:54,488 --> 00:00:58,428 of today's schedule, and as I talked about, there're a range 20 00:00:58,428 --> 00:01:01,196 of different kind of activities. 21 00:01:01,519 --> 00:01:04,431 So, in terms of this morning, what we'll talk about, 22 00:01:04,431 --> 00:01:06,633 in terms of slides, I'll talk a little bit about 23 00:01:06,633 --> 00:01:08,668 the definition of narrative therapy, for those who might 24 00:01:08,668 --> 00:01:10,303 not be familiar with it. 25 00:01:10,303 --> 00:01:13,674 The context, the historical context of how it entered 26 00:01:13,674 --> 00:01:16,810 through theoretical frameworks within social work. 27 00:01:16,810 --> 00:01:19,261 Some of the underlying assumptions. 28 00:01:19,799 --> 00:01:22,553 So I try to do that without talking about what's similar, 29 00:01:22,553 --> 00:01:25,586 or different from other theories, that people might not, 30 00:01:25,586 --> 00:01:26,820 you know, know about. 31 00:01:28,866 --> 00:01:30,590 There can be a lot of ways that people can use 32 00:01:30,590 --> 00:01:34,294 pieces of narrative therapy, or other kinds of ideas. 33 00:01:34,294 --> 00:01:36,630 I think most people practice eclectically today, 34 00:01:36,630 --> 00:01:39,969 and so, my hope would be is that, you have a sense of this 35 00:01:39,969 --> 00:01:42,439 theory as a stand alone theory as you leave today, 36 00:01:42,439 --> 00:01:45,305 but also maybe some ideas about pieces that you might 37 00:01:45,305 --> 00:01:49,275 use in your work, with your existing frameworks. 38 00:01:50,293 --> 00:01:53,713 A little bit about, you know, 39 00:01:53,713 --> 00:01:57,117 this is a theory that relies heavily on some postmodern 40 00:01:57,117 --> 00:02:00,220 ideas about how language creates meaning. 41 00:02:00,220 --> 00:02:04,692 A little bit about how people come to understand themselves 42 00:02:04,692 --> 00:02:07,497 in the world, and their either experience 43 00:02:07,497 --> 00:02:09,295 with problems, et cetera. 44 00:02:10,002 --> 00:02:12,801 A big concept that I would like you to leave today, 45 00:02:12,801 --> 00:02:15,750 is the idea of externalizing problems, 46 00:02:16,181 --> 00:02:18,539 that we'll talk about this morning, and that's probably 47 00:02:18,539 --> 00:02:21,107 the singular idea, that is most 48 00:02:21,107 --> 00:02:23,176 known about narrative therapy. 49 00:02:23,852 --> 00:02:26,316 But we'll spend a lot of time on that this morning, 50 00:02:26,316 --> 00:02:29,985 as well as having you practice with each other 51 00:02:30,284 --> 00:02:32,418 around that idea. 52 00:02:35,485 --> 00:02:36,891 I'll also do a live interview, and we'll look 53 00:02:36,891 --> 00:02:39,659 at transcripts, so that idea might be clear. 54 00:02:40,428 --> 00:02:41,695 So, a definition. 55 00:02:41,695 --> 00:02:43,231 And every now and then, I'll have a slide that has 56 00:02:43,231 --> 00:02:46,933 way too much information on it, for which I apologize. 57 00:02:46,933 --> 00:02:50,446 But this is the definition that comes up, a website of 58 00:02:50,446 --> 00:02:54,241 Dulwich Center in Australia, which is where a lot of narrative 59 00:02:54,241 --> 00:02:56,543 ideas came to fruition. 60 00:02:57,244 --> 00:02:58,645 And so it's, "Narrative therapy isan approach to 61 00:02:58,645 --> 00:03:00,614 "counseling and community work. 62 00:03:00,614 --> 00:03:03,016 "It centers people as the experts in their own lives, 63 00:03:03,016 --> 00:03:05,752 "and views problems as separate from people." 64 00:03:05,809 --> 00:03:10,590 We'll spend a lot of time on that idea this morning because 65 00:03:15,271 --> 00:03:18,431 these sentences are long, but have a lot of different ideas 66 00:03:18,431 --> 00:03:20,300 that we'll explore over the day. 67 00:03:21,034 --> 00:03:23,870 It assumes that people have many skills, competencies, 68 00:03:23,870 --> 00:03:26,673 beliefs, values and commitments and abilities that will 69 00:03:26,673 --> 00:03:28,275 assist them to reduce the influence 70 00:03:28,275 --> 00:03:30,510 of the problems in their lives. 71 00:03:30,911 --> 00:03:32,545 The word narrative is referred to as the emphasis 72 00:03:32,545 --> 00:03:35,548 that is placed upon the stories of people's lives, 73 00:03:35,548 --> 00:03:38,151 and the differences that can be made, to the particularly 74 00:03:38,151 --> 00:03:41,454 tellings and re-tellings of these stories. 75 00:03:42,088 --> 00:03:47,088 One of the things that I think about, is after beginning 76 00:03:48,228 --> 00:03:50,797 to study narrative therapy-- 77 00:03:50,797 --> 00:03:52,165 And I actually realize, I should introduce myself 78 00:03:52,165 --> 00:03:53,734 and tell you a little bit about how I 79 00:03:53,734 --> 00:03:55,868 learned about narrative therapy. 80 00:03:56,202 --> 00:04:01,202 kind of attention, different level of attention to 81 00:04:02,109 --> 00:04:05,546 the role of language, in conversations with people. 82 00:04:05,546 --> 00:04:10,546 And how it is significant, if someone comes to us 83 00:04:12,927 --> 00:04:16,857 who's experiencing a tremendous amount of depression. 84 00:04:17,672 --> 00:04:22,463 To have a conversation where I am asking, to try to 85 00:04:22,463 --> 00:04:23,934 understand the ways-- 86 00:04:23,934 --> 00:04:27,436 I mean, it's really important in any kind of collaborative 87 00:04:27,436 --> 00:04:29,135 or strength-based, or any kind of work, 88 00:04:29,135 --> 00:04:32,205 that we do have a good sense of the effects of a problem 89 00:04:32,205 --> 00:04:33,741 in people's lives. 90 00:04:33,741 --> 00:04:35,075 But I have often-- 91 00:04:35,075 --> 00:04:37,815 I've worked in in-patient psychiatry for a long time, 92 00:04:37,815 --> 00:04:42,015 and so a lot of initial questions I used to have, 93 00:04:42,719 --> 00:04:43,955 went into something like depression. 94 00:04:43,955 --> 00:04:45,519 I would be looking for all the different areas 95 00:04:45,519 --> 00:04:48,622 of functional impairment, so I would be asking questions 96 00:04:48,622 --> 00:04:51,458 exploring, and looking for different kinds of ways that 97 00:04:51,458 --> 00:04:53,626 symptoms appeared in people's lives, 98 00:04:53,626 --> 00:04:55,395 such as, "How is your appetite?" 99 00:04:55,395 --> 00:04:59,218 But really sort of, trying to get a full picture 100 00:04:59,218 --> 00:05:04,218 by exploring what I knew to be known deficits, 101 00:05:04,571 --> 00:05:06,006 that might come up in people's lives 102 00:05:06,006 --> 00:05:07,941 in response to depression. 103 00:05:07,941 --> 00:05:11,778 How it can be a very different kind of question and 104 00:05:11,778 --> 00:05:14,648 conversation, to start a conversation. 105 00:05:14,648 --> 00:05:16,383 You know, if I know that someone has had a 106 00:05:16,383 --> 00:05:18,084 history of depression. 107 00:05:20,360 --> 00:05:22,190 If I know that someone had a history of depression in 108 00:05:22,190 --> 00:05:25,191 their lives, to ask a question like, "How is it that you 109 00:05:25,191 --> 00:05:27,421 "have responded to the depression before?" 110 00:05:27,421 --> 00:05:30,697 Or, "How have you overcome this depression in the past?" 111 00:05:30,697 --> 00:05:34,382 Already, from that initial question, I probably will get 112 00:05:34,382 --> 00:05:36,703 a sense of, you know-- 113 00:05:36,703 --> 00:05:39,922 At the end of the day, I get a lot of the same information, 114 00:05:39,922 --> 00:05:43,573 but from the get-go, if I'm asking for people for their 115 00:05:43,573 --> 00:05:47,939 knowledge of what they're doing, in response to some of 116 00:05:47,939 --> 00:05:50,375 the ways of depression in their life, it's just, 117 00:05:50,375 --> 00:05:53,386 from the get-go, a different kind of conversation. 118 00:05:53,386 --> 00:05:55,021 So that's what they mean, a little bit about, 119 00:05:55,021 --> 00:05:57,124 the differences that can be made in the particular 120 00:05:57,124 --> 00:05:59,559 telling and re-tellings of a story. 121 00:06:03,542 --> 00:06:05,799 Narrative therapy, what the work looks like, 122 00:06:05,799 --> 00:06:08,334 it involves ways of understanding stories, 123 00:06:08,980 --> 00:06:11,705 and re-telling them in-- 124 00:06:12,864 --> 00:06:14,074 Over the course of therapy. 125 00:06:14,074 --> 00:06:16,350 We'll spend a lot of time on that today. 126 00:06:16,350 --> 00:06:18,778 And it's a way of working, that's interested in the history 127 00:06:18,778 --> 00:06:21,649 of broader context, on what's impacting people's lives 128 00:06:21,649 --> 00:06:23,818 and the politics of therapy. 129 00:06:23,818 --> 00:06:27,021 So, one of the things that we'll speak to in 130 00:06:27,021 --> 00:06:30,991 a minute is, I was originally very drawn to these ideas, 131 00:06:30,991 --> 00:06:34,827 because it does-- 132 00:06:34,843 --> 00:06:38,532 There's no sense that therapy, or the therapeutic room 133 00:06:38,532 --> 00:06:40,500 is a neutral environment. 134 00:06:40,667 --> 00:06:44,037 It very much understands links between problems 135 00:06:44,037 --> 00:06:48,442 in people's lives, and the, you know, social problems 136 00:06:48,442 --> 00:06:53,280 and different kinds of experiences. 137 00:06:53,280 --> 00:06:56,850 And so, the way that someone is experiencing, 138 00:06:56,850 --> 00:07:01,287 for example, anorexia nervosa, in their lives, 139 00:07:01,287 --> 00:07:04,724 is also going to be very much, probably, linked to their 140 00:07:04,724 --> 00:07:07,827 understanding of maleness or femaleness in their lives, 141 00:07:07,827 --> 00:07:11,598 and the certain kinds of expectations around 142 00:07:11,598 --> 00:07:14,300 gender roles or identity. 143 00:07:15,268 --> 00:07:16,703 For example. 144 00:07:16,970 --> 00:07:18,453 In terms of a historical context, 145 00:07:18,453 --> 00:07:21,241 about when did these ideas really emerge? 146 00:07:21,794 --> 00:07:25,812 I think there was a book published in 1990, that really 147 00:07:26,488 --> 00:07:28,415 became an international, like-- 148 00:07:29,983 --> 00:07:33,052 Mood narrative therapy from an idea that was popular 149 00:07:33,052 --> 00:07:37,193 in Australia and New Zealand, which is where the two primary 150 00:07:37,193 --> 00:07:41,528 authors live, or lived. 151 00:07:42,196 --> 00:07:47,196 So it really then hit the larger family therapy circuit. 152 00:07:50,789 --> 00:07:54,774 At any rate, these ideas, coming within the field of 153 00:07:54,774 --> 00:07:57,510 family therapy, where connected to a lot of emerging 154 00:07:57,510 --> 00:07:59,245 ideas at the time. 155 00:07:59,245 --> 00:08:02,883 This was right around the time where solution focused 156 00:08:02,883 --> 00:08:07,421 therapy was popular within the United States. 157 00:08:07,421 --> 00:08:11,438 Also, ideas of social constructivism. 158 00:08:11,438 --> 00:08:16,438 Or ways of really thinking about how different kinds of 159 00:08:20,333 --> 00:08:23,703 ideas that we thought of as, sort of, 160 00:08:26,286 --> 00:08:30,643 intrinsic or biological in people, where ideas like race 161 00:08:30,643 --> 00:08:32,395 and racism were beginning to be seen 162 00:08:32,395 --> 00:08:33,980 as a social construction. 163 00:08:33,980 --> 00:08:37,417 It was not so much the genetic differences between people, 164 00:08:37,417 --> 00:08:41,254 but rather how we, in our society, had constructed 165 00:08:41,254 --> 00:08:44,390 or understood race and racism. 166 00:08:45,458 --> 00:08:48,561 These ideas were really emerging, and really entering 167 00:08:48,561 --> 00:08:50,803 the therapy room in different ways. 168 00:08:50,931 --> 00:08:54,834 It was through the 1980s, for example, in the US that gender 169 00:08:54,834 --> 00:08:58,771 and feminism, really entered into family therapy. 170 00:09:00,073 --> 00:09:03,509 Also, in the world, particularly in Scandanavia, 171 00:09:03,509 --> 00:09:05,578 reflecting things were beginning to be introduced 172 00:09:05,578 --> 00:09:07,714 in family therapy. 173 00:09:07,714 --> 00:09:10,917 This is something that is taught now within most 174 00:09:10,917 --> 00:09:14,279 graduate schools of social work, in terms of-- 175 00:09:14,279 --> 00:09:17,939 And also schools of marriage and family therapy, 176 00:09:17,939 --> 00:09:20,093 other counseling approaches. 177 00:09:20,093 --> 00:09:24,564 It's really hit a point of mainstream popularity. 178 00:09:26,134 --> 00:09:29,536 Although it originally came through the family theory 179 00:09:29,536 --> 00:09:34,536 and family therapy, that realm, it's done equally 180 00:09:35,275 --> 00:09:38,678 as much with individuals, as it is with families 181 00:09:38,678 --> 00:09:39,846 in other context. 182 00:09:39,846 --> 00:09:43,349 I got my Masters here in Smith, and so, was trained with 183 00:09:43,349 --> 00:09:45,184 psycho-dynamic approaches. 184 00:09:45,184 --> 00:09:49,122 I really was thinking a lot about expl-- 185 00:09:49,122 --> 00:09:50,823 And particularly in a medical setting 186 00:09:50,823 --> 00:09:52,859 of working of inpatient psychiatry. 187 00:09:52,859 --> 00:09:57,859 As I look to define what depression was in people's lives, 188 00:09:58,097 --> 00:10:02,402 I had a pre-determined set of questions, or ways of thinking 189 00:10:02,402 --> 00:10:05,505 or conceptualizing what depression would be, that I 190 00:10:05,505 --> 00:10:09,442 would ask, really, about different kinds of symptom sets. 191 00:10:09,442 --> 00:10:12,512 We know what markers are for depression, and its impact 192 00:10:12,512 --> 00:10:13,716 in terms of-- 193 00:10:13,716 --> 00:10:15,851 So I would be asking about anhedonia, I would be asking 194 00:10:15,851 --> 00:10:17,383 about appetite, sleeping. 195 00:10:17,383 --> 00:10:21,624 And by putting these limitations on my conversations, 196 00:10:21,624 --> 00:10:26,624 I was really, not only perhaps limiting my understanding 197 00:10:28,094 --> 00:10:30,831 of the effects of depression on someone's life, 198 00:10:30,831 --> 00:10:33,633 but I was also coming to define how that person might 199 00:10:33,633 --> 00:10:37,337 experience depression in their life, and particularly 200 00:10:37,337 --> 00:10:41,374 by going through DSM criteria. 201 00:10:42,214 --> 00:10:45,845 So, how the conversations might be a little bit different-- 202 00:10:45,845 --> 00:10:50,750 And I hope that going through and seeing some of 203 00:10:50,750 --> 00:10:52,485 the sample questions, or other things. 204 00:10:52,485 --> 00:10:55,054 Where I've strayed from that, is really-- 205 00:10:55,592 --> 00:10:58,438 Because those kinds of questions, they're not wrong, 206 00:10:58,438 --> 00:11:03,438 but it's really privileging my ways of thinking, 207 00:11:04,481 --> 00:11:08,668 and my training, in a certain body of knowledge 208 00:11:08,668 --> 00:11:10,770 with the DSM, in terms of-- 209 00:11:12,231 --> 00:11:14,974 It's privileging my expertise, my professional expertise 210 00:11:14,974 --> 00:11:17,177 around the idea of depression. 211 00:11:19,638 --> 00:11:22,215 Instead, these different kinds of conversations aren't 212 00:11:22,215 --> 00:11:26,786 going to stray much away from that, from the very beginning, 213 00:11:26,786 --> 00:11:31,558 to get a very personalized account of depression 214 00:11:31,558 --> 00:11:32,826 in someone's life. 215 00:11:32,826 --> 00:11:35,161 And so that, yes, that might involve things like 216 00:11:35,161 --> 00:11:37,797 differences with appetite, or sleep, or other 217 00:11:37,797 --> 00:11:42,034 kinds of things, but I may hear much more about, what's more 218 00:11:42,034 --> 00:11:45,872 painful about the experience that someone's going through 219 00:11:45,872 --> 00:11:47,240 right now, is... 220 00:11:50,826 --> 00:11:54,317 Their very particularly account of loneliness, for example, 221 00:11:54,793 --> 00:11:59,793 might be what is most painful to them. 222 00:12:04,572 --> 00:12:07,862 Really trying to step away from my knowledge, 223 00:12:07,862 --> 00:12:10,631 but much more into their experience of something, 224 00:12:10,631 --> 00:12:12,699 which is just a little bit of a shift, 225 00:12:12,699 --> 00:12:15,001 of really giving someone the lead. 226 00:12:15,001 --> 00:12:17,937 As we'll talk about, throughout the day, just from the 227 00:12:17,937 --> 00:12:20,578 very beginning, in even assessment conversations, 228 00:12:20,578 --> 00:12:24,477 has so much... 229 00:12:26,526 --> 00:12:29,048 Even quick interactions that I might have had with someone 230 00:12:29,048 --> 00:12:32,219 initially on a psychiatric unit, you have-- 231 00:12:32,219 --> 00:12:34,454 And I could think about treatment, follow up, 232 00:12:34,454 --> 00:12:36,956 or other kinds of things, even if I wasn't going to be 233 00:12:36,956 --> 00:12:39,292 continuing with that person. 234 00:12:40,194 --> 00:12:41,327 We're so different. 235 00:12:42,061 --> 00:12:45,264 If a person is able to conceptualize their own experience 236 00:12:45,264 --> 00:12:47,567 with depression and really hone in on, 237 00:12:49,012 --> 00:12:51,637 "What's so overwhelming for me, is the intensity of 238 00:12:51,637 --> 00:12:53,406 "the loneliness that I feel." 239 00:12:53,406 --> 00:12:56,175 As opposed to me talking about how they're eating 240 00:12:56,175 --> 00:12:57,792 and sleeping, and other kinds of things. 241 00:12:57,792 --> 00:13:01,314 It just also helps them think about the steps 242 00:13:01,314 --> 00:13:03,883 that they might take in their own life or-- 243 00:13:04,188 --> 00:13:05,718 You know, part of the-- 244 00:13:05,771 --> 00:13:07,320 And we'll get into this more today. 245 00:13:08,457 --> 00:13:13,457 As people are talking about their own experience of 246 00:13:14,195 --> 00:13:17,363 what's painful, part of what I listen for, 247 00:13:17,363 --> 00:13:21,668 is the other side of the story. 248 00:13:21,668 --> 00:13:23,703 Is the flip version of the coin. 249 00:13:23,703 --> 00:13:26,206 If someone is talking about an experience of 250 00:13:26,206 --> 00:13:30,014 acute loneliness, what they're not talking about is 251 00:13:30,014 --> 00:13:33,347 the knowledge that they have of connection, or a value that 252 00:13:33,347 --> 00:13:35,081 they have of connection. 253 00:13:36,127 --> 00:13:39,619 That idea that, somewhere in their life exp-- 254 00:13:39,619 --> 00:13:43,689 Part of what makes the loneliness so acute in this moment, 255 00:13:43,689 --> 00:13:47,194 is the knowledge and history of feeling a different kind of 256 00:13:47,194 --> 00:13:49,963 way of being, in relation to the world. 257 00:13:50,029 --> 00:13:53,500 Or a desire, or a wish, to have something that, 258 00:13:53,500 --> 00:13:56,035 perhaps, has never been accessible to them. 259 00:13:56,035 --> 00:13:58,504 And so, when we medicalize-- 260 00:14:00,088 --> 00:14:02,008 I mean, there's nothing necessarily wrong about 261 00:14:02,008 --> 00:14:07,008 medicalizing a diagnosis, but if we put the depression 262 00:14:07,680 --> 00:14:10,884 inside someone in defining a problem in relation 263 00:14:10,884 --> 00:14:13,419 to symptoms, treatment is a lot-- 264 00:14:15,357 --> 00:14:17,995 What a person can do in relation to treatment, 265 00:14:17,995 --> 00:14:20,092 other than taking a medication, 266 00:14:20,092 --> 00:14:23,462 is rendered largely invisible. 267 00:14:23,462 --> 00:14:28,234 If a person has a clear sense from their own way or 268 00:14:28,234 --> 00:14:31,170 articulating and forming a problem, it really-- 269 00:14:31,170 --> 00:14:34,407 What it is about this depression that's most overwhelming, 270 00:14:34,407 --> 00:14:38,678 is how profoundly lonely I feel in the world right now. 271 00:14:38,705 --> 00:14:42,315 And our conversations, not only will be about medications, 272 00:14:42,315 --> 00:14:44,784 will be about other things that might be helpful, 273 00:14:44,784 --> 00:14:48,754 but are also really focused on the specificity of a person's 274 00:14:48,754 --> 00:14:52,925 hopes or desires, in relation to connection with others. 275 00:14:52,925 --> 00:14:55,261 The history of that, what knowledge they have, 276 00:14:55,261 --> 00:14:57,897 have they ever built community before, what friendships 277 00:14:57,897 --> 00:14:59,165 are they missing? 278 00:14:59,165 --> 00:15:00,199 You know, other kinds of things. 279 00:15:00,199 --> 00:15:02,134 It makes a lot more visible steps that they might 280 00:15:02,134 --> 00:15:06,772 take in their own life, to take a stand against 281 00:15:06,772 --> 00:15:10,477 the depression in some way, by highlighting what their 282 00:15:10,477 --> 00:15:12,411 preferences or hopes are. 283 00:15:12,411 --> 00:15:14,480 They have a different kind of vision of a road forward 284 00:15:14,480 --> 00:15:18,584 of steps that they might take, that's a little bit different 285 00:15:18,584 --> 00:15:22,555 from having the effects conversation, about other ways 286 00:15:22,555 --> 00:15:24,624 that they feel downtrodden, 287 00:15:24,624 --> 00:15:26,492 by the experience of depression. 288 00:15:26,492 --> 00:15:28,961 Too many of those kind of conversations, turning up 289 00:15:28,961 --> 00:15:31,364 the volume on those kinds of conversations, 290 00:15:31,364 --> 00:15:35,034 makes it difficult for people to have energy or strength, 291 00:15:35,034 --> 00:15:37,470 to step forward in relation to that particular 292 00:15:37,470 --> 00:15:38,571 kind of experience. 293 00:15:38,571 --> 00:15:40,573 But also, how can agency practice shift? 294 00:15:40,573 --> 00:15:41,941 Because there's not going to be-- 295 00:15:43,048 --> 00:15:45,278 You know, there still are ways that we need to come up with 296 00:15:45,278 --> 00:15:49,015 a medical diagnosis, in order to be reimbursed for services. 297 00:15:49,015 --> 00:15:52,351 It's really thinking increasing about what are 298 00:15:52,351 --> 00:15:53,793 both (mumbling) ways. 299 00:15:53,793 --> 00:15:56,923 What are ways that I write treatment goals, for example, 300 00:16:00,953 --> 00:16:05,465 that both can be paid for, but that maybe are also 301 00:16:05,465 --> 00:16:06,933 reflective of some-- 302 00:16:06,933 --> 00:16:10,336 that are very individualized in some ways, strengths-based. 303 00:16:10,345 --> 00:16:13,005 What's really interesting is I do feel like-- 304 00:16:15,081 --> 00:16:16,316 You know, although it's difficult, 305 00:16:16,316 --> 00:16:20,546 narrative therapy is difficult to research in a way that-- 306 00:16:21,562 --> 00:16:23,719 To get good evidence based outcomes. 307 00:16:23,719 --> 00:16:26,452 Increasingly, there's so many trends, for example, 308 00:16:26,452 --> 00:16:29,255 with wrap around in children and adolescent services, 309 00:16:29,255 --> 00:16:34,244 with different kinds of initiatives with the recovery model, 310 00:16:34,244 --> 00:16:37,897 that is really becoming more prevalent in mental health 311 00:16:37,897 --> 00:16:39,633 nationally, and also with 312 00:16:39,633 --> 00:16:43,502 National Institute of Health grants, there just have been 313 00:16:43,502 --> 00:16:48,502 different initiatives, within the National Organization 314 00:16:49,342 --> 00:16:51,944 of Psychiatry, for example. 315 00:16:51,944 --> 00:16:55,014 Social work values, through NASW are very much connected 316 00:16:55,014 --> 00:16:57,116 to a lot of these ideas of strength based 317 00:16:57,116 --> 00:16:59,518 empowerment and collaboration. 318 00:16:59,518 --> 00:17:02,788 But there's a real trending, I think nationally, to this. 319 00:17:02,788 --> 00:17:06,726 I know I am consulting right now with a psychiatric 320 00:17:06,726 --> 00:17:10,429 hospital in the area, and they're looking at everything from 321 00:17:10,429 --> 00:17:14,834 forms to the training, so everyone on the unit is trying 322 00:17:14,834 --> 00:17:17,469 to think about and talk about problems in these ways. 323 00:17:18,371 --> 00:17:19,471 The child welfare. 324 00:17:19,972 --> 00:17:22,308 So DCF within Massachusetts has a great 325 00:17:22,308 --> 00:17:25,912 consultant with Bill Madsen, who's really working to 326 00:17:26,464 --> 00:17:29,315 train folks to work on family vision. 327 00:17:29,315 --> 00:17:33,319 Like family plans for well being, and visions of 328 00:17:33,319 --> 00:17:37,356 well being, and identifying protective and risk factors. 329 00:17:37,356 --> 00:17:40,077 So there's just a real shift in the way things 330 00:17:40,077 --> 00:17:42,528 are talking about, that it may take some time, 331 00:17:42,528 --> 00:17:47,301 but I hope in this really difficult practice culture 332 00:17:47,301 --> 00:17:48,167 that we're in-- 333 00:17:48,167 --> 00:17:49,970 You know, (mumbling) right now, that there is some 334 00:17:49,970 --> 00:17:51,337 trending there, there is-- 335 00:17:51,337 --> 00:17:54,310 There a lot of cracks in the pavement, with little flowers 336 00:17:54,310 --> 00:17:57,377 and weeds growing through in this way, so I feel 337 00:17:57,377 --> 00:17:58,946 quite hopeful about it. 338 00:18:01,017 --> 00:18:03,549 I think that we're getting at some of these things in 339 00:18:03,549 --> 00:18:06,153 the conversation, which why I always like conversation 340 00:18:06,153 --> 00:18:09,289 and extended examples during PowerPoint. 341 00:18:10,181 --> 00:18:12,057 But some underlying assumptions. 342 00:18:12,057 --> 00:18:13,660 We'll talk about these. 343 00:18:14,906 --> 00:18:17,563 They're a little abstract, as I end this slide 344 00:18:17,563 --> 00:18:18,831 and the next slide. 345 00:18:18,831 --> 00:18:21,067 I think we will really them more during the day. 346 00:18:21,067 --> 00:18:23,335 There's some packets over there. 347 00:18:24,403 --> 00:18:28,211 Is a postmodern understanding, or a construction of 348 00:18:28,211 --> 00:18:33,211 the self, is really this idea that, although our biology 349 00:18:34,714 --> 00:18:38,285 is important in shaping in many ways, really understand 350 00:18:38,285 --> 00:18:42,221 the self as something in relation to other people. 351 00:18:42,221 --> 00:18:44,624 That all learning is social relational. 352 00:18:44,624 --> 00:18:48,461 If I were to ask you to think of one adjective, 353 00:18:48,461 --> 00:18:51,564 to describe yourself, like if you just almost 354 00:18:51,564 --> 00:18:52,898 have one in your head. 355 00:18:53,599 --> 00:18:56,702 Can people shout them out so I know there's not just 356 00:18:56,702 --> 00:18:58,570 a pause where you're being like ... 357 00:18:59,038 --> 00:19:02,175 So like, smart, kind, good listener. 358 00:19:02,175 --> 00:19:04,877 What other kinds of things might people be thinking? 359 00:19:05,945 --> 00:19:06,779 Verbal, okay? 360 00:19:06,779 --> 00:19:08,413 Empathic. 361 00:19:09,415 --> 00:19:10,816 Gentle, okay. 362 00:19:10,950 --> 00:19:12,286 So-- What? 363 00:19:12,286 --> 00:19:13,486 Honest, okay. 364 00:19:13,486 --> 00:19:15,488 So each of these understandings... 365 00:19:15,488 --> 00:19:18,057 If you think about it a little bit with the history, 366 00:19:18,057 --> 00:19:20,192 and it's hard to do without mainly more of 367 00:19:20,192 --> 00:19:25,030 a conversation, is that, you might be able to 368 00:19:25,030 --> 00:19:26,659 think of a time in the last week. 369 00:19:26,659 --> 00:19:29,635 You know, why, for example, did you think of gentle, 370 00:19:29,635 --> 00:19:31,337 or verbal, or empathic. 371 00:19:31,706 --> 00:19:33,372 Right now as opposed to another time. 372 00:19:33,372 --> 00:19:36,079 So there might be a time, just even in the last 373 00:19:36,079 --> 00:19:39,144 three days, where someone you're having a 374 00:19:39,144 --> 00:19:41,781 conversation with may have re-enforced that idea about 375 00:19:41,781 --> 00:19:44,883 that was the type of person that you were. 376 00:19:45,584 --> 00:19:48,187 Over time, that would be connected to other kinds 377 00:19:48,187 --> 00:19:50,771 of stories and experiences. 378 00:19:50,771 --> 00:19:53,859 But how we come to understand any one thing about ourself, 379 00:19:53,859 --> 00:19:57,162 is through the linked sequence of events. 380 00:19:58,163 --> 00:19:59,933 I'm going to go ahead and go to the blackboard example 381 00:19:59,933 --> 00:20:03,703 of this, because this also really talks about many of the 382 00:20:03,703 --> 00:20:06,172 other things on this slide, so you'll get the X's 383 00:20:06,172 --> 00:20:09,274 on future slides, and we'll just skip through them. 384 00:20:09,475 --> 00:20:11,143 But I do feel like this is really important, 385 00:20:11,143 --> 00:20:14,112 in the understanding of narrative therapy. 386 00:20:14,513 --> 00:20:16,815 So it's really thinking about how we come to any 387 00:20:16,815 --> 00:20:19,285 understanding of ourselves, so any of the adjectives that 388 00:20:19,285 --> 00:20:23,456 you just listed, are because of individual events 389 00:20:23,456 --> 00:20:26,225 that are linked together over time. 390 00:20:26,225 --> 00:20:30,462 So, a training example that I, Otu Asmorgan, 391 00:20:30,462 --> 00:20:33,065 who was a teacher of mine in Australia, 392 00:20:34,787 --> 00:20:37,436 is the good driver story. 393 00:20:37,436 --> 00:20:38,938 It's just a nice neutral one. 394 00:20:39,676 --> 00:20:42,007 So, the details of this are actually true, 395 00:20:42,007 --> 00:20:44,610 in terms of my own understanding of myself 396 00:20:44,610 --> 00:20:46,323 as a good driver, but I feel like it's a good neutral 397 00:20:46,323 --> 00:20:49,049 example, of a part of of my identity that I am not 398 00:20:49,664 --> 00:20:52,018 terribly invested in, so I can share the things that 399 00:20:52,018 --> 00:20:54,886 are inside and outside of this story. 400 00:20:55,220 --> 00:20:58,357 So true story is that, on the day that I got my 401 00:20:58,357 --> 00:21:02,461 driver's license, back when I was 16.5 years old, 402 00:21:02,461 --> 00:21:06,732 the person who was working for the state of Illinois 403 00:21:06,732 --> 00:21:10,036 as the driving instructor, to take me on a road test, 404 00:21:10,036 --> 00:21:13,172 so I was the best new driver of the day. 405 00:21:13,172 --> 00:21:14,740 So that was the first feedback. 406 00:21:14,740 --> 00:21:17,510 Also, my mother had been a lot more nervous when my 407 00:21:17,510 --> 00:21:19,611 sister learned to drive, than when I did. 408 00:21:19,611 --> 00:21:21,814 So, I had a sense that I might be a good driver, 409 00:21:21,814 --> 00:21:25,184 but having this person from the state of Illinois 410 00:21:25,184 --> 00:21:28,387 certify me as a good driver was really meaningful. 411 00:21:30,255 --> 00:21:33,559 Then a little bit from then, very early on, 412 00:21:34,266 --> 00:21:37,162 I started qualifying for a good driver's discount, 413 00:21:37,162 --> 00:21:39,364 which my parents were quite appreciative of. 414 00:21:41,266 --> 00:21:44,603 As I got older and went to college, we'd go on road trips 415 00:21:44,603 --> 00:21:46,172 and other things with friends. 416 00:21:46,172 --> 00:21:49,241 Friends had no problem, ever, with me borrowing their 417 00:21:49,241 --> 00:21:51,043 car or driving. 418 00:21:51,043 --> 00:21:54,079 Among trips, I'd noticed with pride that people would 419 00:21:54,079 --> 00:21:56,374 feel comfortable sleeping in the car, if I was taking 420 00:21:56,374 --> 00:21:58,083 a late night shift. 421 00:21:59,852 --> 00:22:02,188 As I got older, that very same trend continued, 422 00:22:02,188 --> 00:22:04,890 as my friends started to have young children, and I thought, 423 00:22:04,890 --> 00:22:06,492 "Hey, someone's going to let me drive with 424 00:22:06,492 --> 00:22:08,260 "their infant in the car? 425 00:22:08,260 --> 00:22:10,195 "I must be a good driver." 426 00:22:13,098 --> 00:22:16,168 And, for many, many years, I continued to qualify for 427 00:22:16,168 --> 00:22:18,170 good driver discounts. 428 00:22:19,840 --> 00:22:23,909 So, overall, because of a bunch of individual things that 429 00:22:23,909 --> 00:22:26,646 have happened, I really came to understand myself as 430 00:22:26,646 --> 00:22:28,613 a good driver. 431 00:22:28,981 --> 00:22:31,417 But why this is important is with any story, 432 00:22:31,417 --> 00:22:34,987 or understanding about ourselves, there are things that 433 00:22:34,987 --> 00:22:38,613 we are discarding, or not including in the story. 434 00:22:38,613 --> 00:22:42,694 And so, not to pick on any of the people who shared examples, 435 00:22:42,694 --> 00:22:45,331 but there have probably been times that you have 436 00:22:45,331 --> 00:22:47,363 not been emphatic (laughs). 437 00:22:47,363 --> 00:22:51,138 Or not been gentle, or been quiet, or other things in 438 00:22:51,138 --> 00:22:53,939 response to some of the examples that you read. 439 00:22:53,939 --> 00:22:55,741 And just like you can look at the bored-- 440 00:22:55,741 --> 00:22:59,011 And actually, there's a lot of non-good driver 441 00:22:59,011 --> 00:23:00,648 things than good driver. 442 00:23:00,648 --> 00:23:03,716 So for example, this guy never would have thought I was the 443 00:23:03,716 --> 00:23:06,720 best driver of the day if he had asked me to parallel park. 444 00:23:06,720 --> 00:23:09,288 But thankfully, even though that was a requirement 445 00:23:09,288 --> 00:23:13,258 for your license, he didn't ask me, so (exhales). 446 00:23:13,525 --> 00:23:16,528 And that's relevant, because I'm blind in one eye, 447 00:23:16,528 --> 00:23:19,666 so my depth perception, even though I can test and 448 00:23:19,666 --> 00:23:22,201 I'm visually okay, there are things that I don't 449 00:23:22,201 --> 00:23:23,769 do particularly well. 450 00:23:23,769 --> 00:23:25,771 I mean, I've compensated. 451 00:23:25,771 --> 00:23:28,841 Now no one's ever going to lend me their car in this room. 452 00:23:28,841 --> 00:23:31,977 But I have lived in the same house for 10 years, 453 00:23:31,977 --> 00:23:35,281 and I have a long very straight driveway, and I just think 454 00:23:35,281 --> 00:23:37,382 I'm constant entertainment for the neighbors, 455 00:23:37,382 --> 00:23:40,719 because when I reverse, I'm like (reversing noises). 456 00:23:41,811 --> 00:23:45,275 I zig-zag, and have to pull forward and back for something 457 00:23:45,275 --> 00:23:46,771 that's really 30 feet. 458 00:23:46,771 --> 00:23:49,394 So, they do not think I'm a very good driver. 459 00:23:49,394 --> 00:23:50,997 In fact, they probably call their children in 460 00:23:50,997 --> 00:23:53,331 the minute they see my garage door open. 461 00:23:55,701 --> 00:23:57,703 I also haven't qualified for the good driver discount 462 00:23:57,703 --> 00:24:00,839 for many years, because I've had a speeding ticket 463 00:24:00,839 --> 00:24:03,408 and a fender bender, in the last five years. 464 00:24:03,408 --> 00:24:06,912 So overall, there's as much evidence that I'm not a 465 00:24:06,912 --> 00:24:10,081 good driver, as I am a good driver. 466 00:24:10,110 --> 00:24:12,151 But, I'm going to continue to believe that 467 00:24:12,151 --> 00:24:13,719 I'm a good driver. 468 00:24:13,719 --> 00:24:15,754 What's relevant is-- 469 00:24:16,861 --> 00:24:19,558 So what we hold on to, has a lot to do with 470 00:24:19,558 --> 00:24:23,195 some of our values, how important something is in 471 00:24:23,195 --> 00:24:24,864 our life, or anything else. 472 00:24:24,864 --> 00:24:28,033 But this idea of life being composed of stories, 473 00:24:28,033 --> 00:24:29,935 and that there's always the existence of the 474 00:24:29,935 --> 00:24:33,439 outside stories, as well as the dominant story of the time. 475 00:24:33,439 --> 00:24:36,137 And to being really one of the most fundamentally 476 00:24:37,214 --> 00:24:39,745 underpinning ideas in narrative therapy. 477 00:24:39,745 --> 00:24:42,447 So when you were asking me about the conversation of 478 00:24:42,447 --> 00:24:45,933 depression on a psychiatric setting, you know, 479 00:24:45,933 --> 00:24:47,387 I just happened to land on loneliness. 480 00:24:47,387 --> 00:24:50,156 But that's not ... 481 00:24:50,156 --> 00:24:53,159 If we slow down a conversation, it wouldn't be unusual 482 00:24:53,159 --> 00:24:56,295 for maybe someone to talk about their loneliness as being 483 00:24:56,295 --> 00:25:01,066 really what they experience as most painful for depression. 484 00:25:01,600 --> 00:25:02,834 And so that is then-- 485 00:25:03,001 --> 00:25:06,535 What I bring to it is, there may be lots of many stories 486 00:25:06,535 --> 00:25:09,759 about loneliness recently, but for someone to know 487 00:25:09,759 --> 00:25:14,482 that loneliness, whether it be an advantage or disadvantage 488 00:25:14,482 --> 00:25:17,816 of such a dualistic way of thinking, is to say that, 489 00:25:18,369 --> 00:25:20,986 what someone's dominant experience is, is there's also 490 00:25:20,986 --> 00:25:25,291 probably when they're really talking about it with pain, 491 00:25:25,291 --> 00:25:28,861 there must be experiences or connection in their history. 492 00:25:28,861 --> 00:25:32,064 They're just not as well connected in this moment, 493 00:25:32,064 --> 00:25:34,866 or they're not as experienced in that moment. 494 00:25:36,301 --> 00:25:41,173 This may not be so different from other kinds of ways 495 00:25:41,173 --> 00:25:45,210 of working, but ever people are-- 496 00:25:45,210 --> 00:25:48,614 I have young people often coming to me with 497 00:25:51,504 --> 00:25:53,952 a range of problems, like anger problems, for example. 498 00:25:53,952 --> 00:25:54,853 But there's also-- 499 00:25:54,853 --> 00:25:57,389 I always love the conversations with teenagers. 500 00:25:57,389 --> 00:26:01,960 I worked in residential for a long time, and someone gets 501 00:26:01,960 --> 00:26:04,162 in trouble for something, and then they get me as their 502 00:26:04,162 --> 00:26:06,298 therapist, and they're like, "Beth, you have no idea. 503 00:26:07,728 --> 00:26:10,505 "It's true, I yelled at the staff and I said these things. 504 00:26:10,505 --> 00:26:13,606 "What I wanted to do was throw the chair, and I really had 505 00:26:13,606 --> 00:26:15,207 "much worse things that I was thinking of." 506 00:26:15,207 --> 00:26:18,444 Well, it's so good to know that you had a filter. 507 00:26:20,330 --> 00:26:23,582 It's so often people are making choices, even if their 508 00:26:23,582 --> 00:26:26,718 choices are still not at a level that we want. 509 00:26:26,718 --> 00:26:30,422 But I also feel like, beginning to highlight. 510 00:26:30,422 --> 00:26:34,026 So in that moment, not to let someone off the hook for 511 00:26:34,026 --> 00:26:36,762 what they did, but to say, "Okay. 512 00:26:38,438 --> 00:26:40,566 "Six months ago, you probably would've thrown the chair 513 00:26:40,566 --> 00:26:43,001 "and said the absolute worst things that you thought of. 514 00:26:44,215 --> 00:26:47,641 "How did you discern that doing what you decided to do, 515 00:26:47,641 --> 00:26:49,241 "would be a better option?" 516 00:26:49,608 --> 00:26:51,743 So really helping people focus in those moments, 517 00:26:51,743 --> 00:26:55,314 about some of the decisions or knowledges that were at play, 518 00:26:55,314 --> 00:26:57,716 as well as other kinds of times, where they stayed 519 00:26:57,716 --> 00:26:59,585 in great behavioral control. 520 00:26:59,585 --> 00:27:02,521 And as you begin to highlight what it was that they knew, 521 00:27:02,521 --> 00:27:05,405 or did, or consequences they were able to think of, 522 00:27:05,405 --> 00:27:09,128 or other kinds of things in that moment, one can begin to, 523 00:27:09,574 --> 00:27:14,366 once it's very well detailed, begin to connect this other 524 00:27:14,366 --> 00:27:17,436 themes and gradually over time, come up with this 525 00:27:17,436 --> 00:27:22,436 competing story, and people's sense of this. 526 00:27:22,574 --> 00:27:23,909 Because if we-- 527 00:27:26,211 --> 00:27:29,288 Okay, I'm going to give another example, from actually 528 00:27:29,288 --> 00:27:32,150 the inpatient unit, where I'm doing some consulting. 529 00:27:36,722 --> 00:27:40,659 There is a young boy who's on the unit right now, 530 00:27:40,659 --> 00:27:44,863 about five years old, who spent the first two years of 531 00:27:44,863 --> 00:27:48,834 his life in a very abusive-- 532 00:27:52,571 --> 00:27:54,806 Just, a house that was characterized-- 533 00:27:54,806 --> 00:27:57,176 I'm sure there were loving exchanges, 534 00:27:57,176 --> 00:27:59,644 and things that happened. 535 00:27:59,644 --> 00:28:01,972 But a lot of abuse and neglect, to the point where the state 536 00:28:01,972 --> 00:28:06,151 intervened, terminated parental rights, and placed this 537 00:28:06,151 --> 00:28:08,119 child in foster care. 538 00:28:08,635 --> 00:28:11,423 The first foster home, the child ended up 539 00:28:11,423 --> 00:28:13,620 experiencing some abuse. 540 00:28:13,620 --> 00:28:17,162 Was put in a second foster home, that ended up looking to be 541 00:28:17,162 --> 00:28:19,358 a permanency placement, where there was a very 542 00:28:19,358 --> 00:28:23,769 strong and lovely connection with the mother and the child. 543 00:28:23,769 --> 00:28:27,852 However, circumstances emerged in that foster parent's life, 544 00:28:27,852 --> 00:28:31,209 where they had to terminate their plans to 545 00:28:31,209 --> 00:28:32,778 go ahead with the adoption. 546 00:28:32,778 --> 00:28:36,181 And so he ended up in care. 547 00:28:36,314 --> 00:28:38,250 At this current time, he's been in different levels 548 00:28:38,250 --> 00:28:43,250 of institutional care, largely locked psychiatric units, 549 00:28:44,159 --> 00:28:46,158 for about two years. 550 00:28:46,158 --> 00:28:48,675 And so one can begin to think, if we think about 551 00:28:48,675 --> 00:28:51,997 just what we know about attachment, or connections, or 552 00:28:51,997 --> 00:28:56,997 the significance of early relationships, that this young 553 00:28:57,770 --> 00:29:00,371 child's behavior has really-- 554 00:29:02,648 --> 00:29:05,907 He's really lost a sense of trust in others, he has a lot 555 00:29:05,907 --> 00:29:10,907 of volatile, violent, impulsive behaviors. 556 00:29:11,717 --> 00:29:16,717 It's very hard for him to trust, struggles with structure, 557 00:29:17,756 --> 00:29:19,257 struggles with certain-- 558 00:29:19,257 --> 00:29:22,327 I think that he has experienced his life, if you think about 559 00:29:22,327 --> 00:29:27,199 it from his perspective, as being so horribly unpredictable. 560 00:29:27,199 --> 00:29:30,102 And it's terrifying to try to make any attachments 561 00:29:30,102 --> 00:29:34,439 with adults, because even as his time in inpatient settings, 562 00:29:34,439 --> 00:29:37,542 the minute he might become close, or begin to rely 563 00:29:37,542 --> 00:29:41,213 on staff members, boom, without any clear way that 564 00:29:41,213 --> 00:29:45,260 he would understand it, things have shifted, 565 00:29:45,260 --> 00:29:48,286 and he's suddenly in a new environment, with new adults. 566 00:29:49,287 --> 00:29:52,057 And so, we can project and think about all the different 567 00:29:52,057 --> 00:29:55,927 kinds of impacts, or ways of learning and knowing the world, 568 00:29:55,927 --> 00:29:58,997 that this could have without some kind of intervention, 569 00:30:00,735 --> 00:30:01,967 in a long term way. 570 00:30:01,967 --> 00:30:05,337 It's so important that we apply all that we know, and that 571 00:30:05,337 --> 00:30:09,240 we think about, how can we help him with symptom management? 572 00:30:09,254 --> 00:30:11,710 What kind of way of thinking about him diagnostically, 573 00:30:11,710 --> 00:30:12,945 would be important. 574 00:30:12,945 --> 00:30:15,883 Really also, social workers thinking about what kind of 575 00:30:15,883 --> 00:30:18,383 placement plan would make sense. 576 00:30:18,383 --> 00:30:21,453 But what I've also begun to work with staff in the hospital, 577 00:30:21,453 --> 00:30:23,288 is also, you know-- 578 00:30:24,749 --> 00:30:28,026 As I ask staff stories, his behavior is pretty frustrating, 579 00:30:28,026 --> 00:30:30,428 and lots of time, he might be on a one to one. 580 00:30:30,428 --> 00:30:33,598 And I could get lots of different stories from them about 581 00:30:34,151 --> 00:30:36,801 the challenges in working with this young man. 582 00:30:37,954 --> 00:30:40,004 Oh, he's not a young man, he's a boy. 583 00:30:40,305 --> 00:30:41,840 The challenges of working with this boy. 584 00:30:42,486 --> 00:30:44,442 But also, then I heard some stories 585 00:30:44,442 --> 00:30:46,244 that were very different. 586 00:30:46,978 --> 00:30:49,314 Like one day, I was doing a training. 587 00:30:49,314 --> 00:30:53,185 The over night nurse said that, that very morning, 588 00:30:55,553 --> 00:30:57,456 he had woken up ear-- 589 00:30:57,456 --> 00:31:00,525 He wakes up very, very early in the morning. 590 00:31:01,648 --> 00:31:02,694 But he had decided-- 591 00:31:02,694 --> 00:31:05,230 Like she was taking his vitals and he said, 592 00:31:05,230 --> 00:31:07,632 "Okay, now I'm going to take your blood." 593 00:31:07,632 --> 00:31:09,601 And he said, "Give me your arm." 594 00:31:10,354 --> 00:31:12,337 He was doing the clean up. 595 00:31:12,337 --> 00:31:15,507 He's had his blood levels taken early in the morning, 596 00:31:15,507 --> 00:31:19,444 because I think he's on maybe some Lithium at this time. 597 00:31:20,336 --> 00:31:25,317 And so, he cleaned her arm, he said, "Okay," he had a pen. 598 00:31:25,317 --> 00:31:27,052 He said, "This isn't going to hurt a bit." 599 00:31:27,498 --> 00:31:29,321 And like, I guess she made some kind of face, he said, 600 00:31:29,321 --> 00:31:30,956 "No, no, please don't worry. 601 00:31:30,956 --> 00:31:33,192 "I'm really not going to hurt you." 602 00:31:33,192 --> 00:31:36,962 And he took her blood very carefully with a pen. 603 00:31:37,729 --> 00:31:40,398 And I thought, here's something, this kid, 604 00:31:40,398 --> 00:31:42,267 the stories, what he-- 605 00:31:42,400 --> 00:31:47,272 If we can imagine, how does he understand himself right now. 606 00:31:47,372 --> 00:31:51,309 He probably has some very negative self-esteem, 607 00:31:51,309 --> 00:31:56,309 or self-understandings, from all the ways the rug has 608 00:31:56,881 --> 00:31:59,351 possibly has been pulled out of him, and out of his control. 609 00:31:59,351 --> 00:32:02,328 And how could he not understand the world in any other 610 00:32:02,328 --> 00:32:05,556 kind of way, than it was his fault, or that he might take 611 00:32:05,556 --> 00:32:09,628 it personally with the abuse, with other kinds of things. 612 00:32:09,628 --> 00:32:13,198 The ways that he has been individually targeted in the past. 613 00:32:13,365 --> 00:32:15,600 I thought, "If every single time." 614 00:32:16,369 --> 00:32:19,538 What I would want this nurse to do in the future, be like, 615 00:32:19,538 --> 00:32:22,841 "How did you know that I was scared? 616 00:32:22,841 --> 00:32:25,150 "What did you see in my face? 617 00:32:25,150 --> 00:32:28,180 "How did you know that squeezing my hand, and telling me 618 00:32:28,180 --> 00:32:31,216 "something gentle would be affirming?" 619 00:32:31,786 --> 00:32:36,222 When we began to talk about what kind of knowledge 620 00:32:36,222 --> 00:32:40,001 or skills, or what kind of way would he-- 621 00:32:40,801 --> 00:32:43,628 What kind of impact would it have, for him to verbalize 622 00:32:43,628 --> 00:32:45,497 his knowledge in that way? 623 00:32:47,957 --> 00:32:51,636 One time not so much, but if every single staff member 624 00:32:51,636 --> 00:32:54,854 who interacted with him during the day, began to listen for 625 00:32:54,854 --> 00:32:58,710 things that really helped to highlight his 626 00:32:58,710 --> 00:33:02,614 knowledge in relationships, the ways that he was good at 627 00:33:02,614 --> 00:33:04,849 responding to people, how responsive 628 00:33:04,849 --> 00:33:06,951 and attentive he could be. 629 00:33:06,951 --> 00:33:10,488 First of all, as we began to ask him how he knew to do 630 00:33:10,488 --> 00:33:14,626 these things, or how appreciated that was, the chances are-- 631 00:33:14,626 --> 00:33:17,229 It's sort of, you take a behavioral model, and it's like, 632 00:33:17,229 --> 00:33:19,998 you're kind of beginning to shape behavior, right? 633 00:33:19,998 --> 00:33:23,868 But you're also beginning to shape his identity, because if 634 00:33:23,868 --> 00:33:26,638 he's beginning to understand himself more as someone who's 635 00:33:26,638 --> 00:33:29,674 good at relationships, someone who people like to be around, 636 00:33:29,674 --> 00:33:31,543 someone who's nurturing. 637 00:33:32,250 --> 00:33:35,449 All of those things are just the very things, that I want to 638 00:33:35,449 --> 00:33:38,884 turn up the volume on in an intervention with a young 639 00:33:38,884 --> 00:33:42,721 child who is going forward and hopefully can make 640 00:33:42,721 --> 00:33:46,094 a connection in a foster care type of setting. 641 00:33:46,291 --> 00:33:49,867 This is a child where because of the paucity of relationships 642 00:33:49,867 --> 00:33:53,799 and sort of attachment issues in his life, if we can really 643 00:33:53,799 --> 00:33:57,169 highlight those skills, abilities and strengths, 644 00:33:57,169 --> 00:33:59,404 that's going to have a lot more-- 645 00:34:01,003 --> 00:34:02,941 You know, really talking about that he has that ability 646 00:34:02,941 --> 00:34:05,610 to do things, because I get alarmed, in having worked 647 00:34:05,610 --> 00:34:08,914 inpatient settings for a long time, how quickly kids can 648 00:34:08,914 --> 00:34:13,351 attribute behavior change, or strengths or skills, 649 00:34:13,351 --> 00:34:15,563 or abilities, to medication. 650 00:34:15,563 --> 00:34:17,534 "Oh, it's the Lithium that did that." 651 00:34:17,534 --> 00:34:20,826 I'm pretty sure that the Lithium didn't help him-- 652 00:34:20,826 --> 00:34:24,262 It may have helped with some up and down impulsivity, 653 00:34:24,262 --> 00:34:27,299 but it wasn't the Lithium that had him noticing that the 654 00:34:27,299 --> 00:34:28,900 nurse's face was a little scared, to have this-- 655 00:34:28,900 --> 00:34:30,601 You know, this kid is often violent with a pen, 656 00:34:30,601 --> 00:34:32,971 getting ready to take your blood with the pen, it's like, 657 00:34:32,971 --> 00:34:35,706 "Am I really going to have my blood taken with the pen?" 658 00:34:36,373 --> 00:34:40,478 The fact that he noticed her distress in that moment, 659 00:34:41,092 --> 00:34:44,581 offered soothing words, that's not a result of-- 660 00:34:44,581 --> 00:34:47,886 A medication isn't doing that, that speaks to some kind of 661 00:34:47,886 --> 00:34:50,188 knowledge or experiences of life. 662 00:34:50,487 --> 00:34:53,725 So if you think, within a milieu environment, if you 663 00:34:53,725 --> 00:34:57,595 people could be attuned to really listening for particular 664 00:34:57,595 --> 00:35:00,265 kinds of things, and responding to different kinds 665 00:35:00,265 --> 00:35:03,203 of things, that that does really have great impact 666 00:35:03,203 --> 00:35:05,403 on a person's behavior. 667 00:35:05,403 --> 00:35:10,175 So this gets back to these ideas about, life is composed 668 00:35:10,175 --> 00:35:12,244 of multiple stories, the good driver stories 669 00:35:12,244 --> 00:35:14,446 and the bad driver stories. 670 00:35:15,080 --> 00:35:18,016 As a therapist, or in a milieu treatment setting, 671 00:35:18,016 --> 00:35:21,920 we're really going to try to connect and create a 672 00:35:21,920 --> 00:35:26,452 dominant story, or at least an equivalent story, 673 00:35:26,452 --> 00:35:31,452 that would be preferred as identified as the client, 674 00:35:31,930 --> 00:35:34,999 or really, people in this unit, I don't think that this 675 00:35:34,999 --> 00:35:37,569 young boy could identify that, "Yes, I like to be 676 00:35:37,569 --> 00:35:41,406 "thought of as a more nurturing, or emphatic, 677 00:35:41,406 --> 00:35:42,807 "or relational person." 678 00:35:42,807 --> 00:35:45,345 But really to know that this is something where there's 679 00:35:45,345 --> 00:35:49,280 probably great deficit in his understanding of himself, 680 00:35:49,280 --> 00:35:51,483 and how helpful that could be, to strengthen 681 00:35:51,483 --> 00:35:55,186 that understanding, before he goes to a next placement. 682 00:35:55,186 --> 00:35:59,224 Because if he really can learn more about how he knows 683 00:35:59,224 --> 00:36:02,096 about trust, how he knows about relationships, that's going 684 00:36:02,096 --> 00:36:04,596 to serve him well, in whatever setting he's in. 685 00:36:09,718 --> 00:36:14,105 I'm going to just, being aware of time, talk a little bit-- 686 00:36:16,105 --> 00:36:18,810 Just skip ahead through some of these slides, 687 00:36:18,810 --> 00:36:21,279 but I'm happy to talk more about them at the break, 688 00:36:21,279 --> 00:36:23,014 or at other times. 689 00:36:26,652 --> 00:36:28,887 This is an idea that there's different kinds of positions 690 00:36:28,887 --> 00:36:31,358 or ways that we can be, in response to people. 691 00:36:31,358 --> 00:36:34,520 I've talked a little bit about expertise. 692 00:36:34,520 --> 00:36:36,995 Who has the expertise in the relationship. 693 00:36:38,841 --> 00:36:41,332 So, an idealized narrative therapy relationship would be 694 00:36:41,332 --> 00:36:42,433 this de-centered-- 695 00:36:42,433 --> 00:36:45,770 And I feel like a weather person on the stories. 696 00:36:46,004 --> 00:36:48,506 So this de-centered and influential position. 697 00:36:48,740 --> 00:36:52,443 The reality is for any of us, that I often would be flowing in 698 00:36:52,443 --> 00:36:56,296 many of these categories within any single therapy session 699 00:36:56,296 --> 00:36:58,416 or conversation with people. 700 00:36:58,416 --> 00:37:00,585 But ideally, I want to try to be 701 00:37:00,585 --> 00:37:02,420 de-centered and influential. 702 00:37:02,420 --> 00:37:06,457 So de-centered means, specifically, that I want to privilege 703 00:37:06,457 --> 00:37:10,429 the client or family's knowledges and experiences of life, 704 00:37:10,429 --> 00:37:12,764 over my own. 705 00:37:12,764 --> 00:37:15,200 I want to be influential, in that all the knowledge 706 00:37:15,200 --> 00:37:17,736 I have, so going back to that depression interview, 707 00:37:17,736 --> 00:37:22,507 all the knowledge I have about how many people 708 00:37:22,507 --> 00:37:26,110 experience depression, both in a medical way, and all the 709 00:37:26,110 --> 00:37:28,246 conversations that I've talked with. 710 00:37:28,246 --> 00:37:31,617 I am always going to be generating hypotheses. 711 00:37:33,170 --> 00:37:35,853 But I think that, that de-centered idea is that any kind of 712 00:37:35,853 --> 00:37:39,691 hypothesis that I generate, or interpretation that I'm 713 00:37:39,691 --> 00:37:43,094 thinking about, I'm going to propose in a way that, 714 00:37:43,094 --> 00:37:46,965 it is more tentative, it is more exploratory, 715 00:37:46,965 --> 00:37:49,601 and that truly, if a person says no, that, that's not a good 716 00:37:49,601 --> 00:37:52,537 fit for them, I'm going to take them at their word, 717 00:37:52,537 --> 00:37:57,108 and not assume that my professional training or experience 718 00:37:57,108 --> 00:38:00,178 gives me more knowledge and experience at life, 719 00:38:00,208 --> 00:38:01,613 to their life. 720 00:38:01,613 --> 00:38:03,548 So they're the experts on their life. 721 00:38:03,548 --> 00:38:05,884 So, I want to stay influential, and that I'm 722 00:38:05,884 --> 00:38:08,720 generating hypotheses, that I'm using all the knowledge 723 00:38:08,720 --> 00:38:11,122 and experience and training that I have in my 724 00:38:11,122 --> 00:38:14,025 thought process, but I really think of myself more as a 725 00:38:14,025 --> 00:38:17,129 consultant or a facilitator, in the work, 726 00:38:17,129 --> 00:38:19,130 than I do as an expert. 727 00:38:19,130 --> 00:38:20,741 I think of the person and people that I am working 728 00:38:20,741 --> 00:38:22,667 with more as experts. 729 00:38:22,667 --> 00:38:25,637 The centered and influential, is, I think, how we're 730 00:38:25,637 --> 00:38:28,873 often training within this field, to take a position. 731 00:38:28,873 --> 00:38:30,842 And it's like, "Well gosh, I paid all the money for 732 00:38:30,842 --> 00:38:33,344 "the degree and for the training, licensing, 733 00:38:33,344 --> 00:38:36,953 "for my continuing education, that it all needs to 734 00:38:36,953 --> 00:38:38,083 "come up for something." 735 00:38:38,083 --> 00:38:40,251 And I think a lot of people do come to us, 736 00:38:40,251 --> 00:38:42,854 desperate for our expertise. 737 00:38:42,854 --> 00:38:45,356 Most people, when they come in, walk through the door, 738 00:38:45,356 --> 00:38:49,093 they're looking to us to have the answers to the questions 739 00:38:49,093 --> 00:38:50,428 that they may have. 740 00:38:51,074 --> 00:38:52,130 So it's not-- 741 00:38:52,130 --> 00:38:57,070 It's more that I don't want to de-value that position. 742 00:38:57,070 --> 00:38:59,604 And I think that many people feel comfortable and do 743 00:38:59,604 --> 00:39:03,207 incredibly, amazing work practicing from that position. 744 00:39:03,207 --> 00:39:06,978 But I also feel like, my experience from practicing 745 00:39:06,978 --> 00:39:10,716 in that position is that for me personally, 746 00:39:10,716 --> 00:39:13,918 it's led to a lot more burn out. 747 00:39:13,918 --> 00:39:17,922 When I become an expert in a person's life, I come to have 748 00:39:17,922 --> 00:39:20,291 ideas and things, like I'm working harder 749 00:39:20,291 --> 00:39:24,162 than this person is on their treatment, and particularly 750 00:39:24,162 --> 00:39:26,898 around risk behaviors. 751 00:39:28,328 --> 00:39:31,770 I remember there was someone who, I really struggled, 752 00:39:31,770 --> 00:39:34,906 and couldn't get into a de-centered position with through-- 753 00:39:34,906 --> 00:39:38,843 But they had very high risk suicidal behaviors, 754 00:39:38,843 --> 00:39:41,079 and were very dependant on me. 755 00:39:41,079 --> 00:39:45,583 And I felt like it was this incredible burden, that I 756 00:39:45,583 --> 00:39:48,519 somehow ended up taking up, in relation to the work 757 00:39:48,519 --> 00:39:52,624 that was so exhausting, that somehow I felt that if they 758 00:39:52,624 --> 00:39:56,161 took action against their life, it would be really my fault, 759 00:39:56,161 --> 00:39:57,962 because I didn't have the right answer, 760 00:39:57,962 --> 00:40:00,264 or I didn't do something the right way. 761 00:40:00,264 --> 00:40:02,767 And this was when I first moved from in-patient 762 00:40:02,767 --> 00:40:06,404 to out-patient work, and I just felt so overwhelmed 763 00:40:06,404 --> 00:40:09,741 and unknown in that work, and so responsible 764 00:40:09,741 --> 00:40:11,543 for how the shoe would be. 765 00:40:11,543 --> 00:40:12,944 It's the same thing with residential. 766 00:40:12,944 --> 00:40:14,378 It's like, if the kids are doing well, 767 00:40:14,378 --> 00:40:16,775 you're a great therapist. 768 00:40:16,775 --> 00:40:20,320 If the kids are struggling, it's your fault. 769 00:40:21,120 --> 00:40:24,022 I think that there are ways that there can be 770 00:40:24,022 --> 00:40:27,692 tremendous joys in practicing from a centered position, 771 00:40:27,692 --> 00:40:30,061 particularly if the people that you are working with 772 00:40:30,061 --> 00:40:31,778 are doing well, and you feel like you get 773 00:40:31,778 --> 00:40:33,264 some of the credit for that. 774 00:40:33,264 --> 00:40:36,301 But I think the downside, and maybe I'm just the 775 00:40:36,301 --> 00:40:40,805 worst therapist, but the downside is that when people 776 00:40:40,805 --> 00:40:44,342 are struggling or not doing so well, it's like, 777 00:40:44,342 --> 00:40:45,809 oh you have to take a certain 778 00:40:45,809 --> 00:40:47,945 amount of responsibility for that as well. 779 00:40:47,945 --> 00:40:51,449 So I feel like the more de-centered but influential I've 780 00:40:51,449 --> 00:40:54,523 been able to stay, you know, really helping people to see 781 00:40:54,523 --> 00:40:57,455 how their choices, their decisions, their knowledge and 782 00:40:57,455 --> 00:41:01,134 skills has more impact than anything else on their behavior. 783 00:41:01,134 --> 00:41:05,096 How actively I work, also to de-center my expertise by 784 00:41:05,096 --> 00:41:08,332 connecting people to communities of support, as opposed to 785 00:41:08,332 --> 00:41:12,637 allowing myself to become that cherished source of support 786 00:41:12,637 --> 00:41:15,441 for someone, has been so helpful. 787 00:41:17,086 --> 00:41:19,410 Centered and non-influential, whoo. 788 00:41:19,410 --> 00:41:21,813 I work a lot with adolescents, and I can just tell you, 789 00:41:21,813 --> 00:41:24,148 it's so easy to get in this position, like how you 790 00:41:24,148 --> 00:41:25,950 know you're in that position 791 00:41:25,950 --> 00:41:27,785 when you feel a lecture coming. 792 00:41:29,968 --> 00:41:32,623 Or particularly around a risk (mumbling) or a behavior 793 00:41:32,623 --> 00:41:33,631 you're worried about. 794 00:41:34,538 --> 00:41:36,894 There's use of self that can be effective, and then 795 00:41:36,894 --> 00:41:38,763 there's use of self where you're just like, 796 00:41:38,763 --> 00:41:42,290 "Man, I am just being another ineffective lecturing adult 797 00:41:42,290 --> 00:41:43,668 "with this young person." 798 00:41:43,668 --> 00:41:48,668 When they have tuned out so beautifully in my presence, 799 00:41:48,874 --> 00:41:50,274 I know that I've gotten into a centered 800 00:41:50,274 --> 00:41:52,510 and non-influential place. 801 00:41:52,810 --> 00:41:56,881 And similarly, I think that it's equally easy to get into 802 00:41:56,881 --> 00:41:59,918 a de-centered and non-influential place of-- 803 00:42:01,610 --> 00:42:04,689 And then it's like, that might be the worst overall 804 00:42:04,689 --> 00:42:07,291 feeling in the work that I've ever had. 805 00:42:07,291 --> 00:42:09,539 It's sort of, like, where you're in a swamp with 806 00:42:09,539 --> 00:42:11,963 other people, and everyone's like, "Where's the guide?" 807 00:42:13,916 --> 00:42:17,135 It's just, where you feel really lost, and there's not 808 00:42:17,135 --> 00:42:18,271 a sense of direction. 809 00:42:18,271 --> 00:42:20,838 And there's moments where I think of, "Will a real 810 00:42:20,838 --> 00:42:23,541 "therapist please come into the room right now?" 811 00:42:23,541 --> 00:42:26,010 Like, "What would a real therapist do in this situation?" 812 00:42:26,010 --> 00:42:28,045 It's when I've gone to a de-centered 813 00:42:28,045 --> 00:42:29,714 and non-influential point. 814 00:42:29,714 --> 00:42:31,479 I've talked about this, in terms of, 815 00:42:32,987 --> 00:42:34,285 different kinds of stories. 816 00:42:34,285 --> 00:42:37,421 I do feel like, what's helpful is you're beginning to 817 00:42:37,421 --> 00:42:41,525 try out new kinds of ideas, is that, for example, 818 00:42:41,525 --> 00:42:43,863 with that young boy on the in-patient unit that I 819 00:42:45,431 --> 00:42:47,833 talked about, although he's five years old, 820 00:42:47,833 --> 00:42:52,833 that dominant story of a lack of self worth 821 00:42:53,538 --> 00:42:55,840 or not being good at things, being a failure, 822 00:42:55,840 --> 00:43:00,310 or however he would verbalize those kinds of understanding 823 00:43:00,310 --> 00:43:05,216 about himself, that is going to be a very strong, 824 00:43:05,216 --> 00:43:08,419 well-established storyline in his life. 825 00:43:08,419 --> 00:43:11,156 And so, it really will take effort and some time, 826 00:43:11,156 --> 00:43:14,027 of turning up the volume on other things, and through lots 827 00:43:14,027 --> 00:43:17,128 of different people, to create something that can compete 828 00:43:17,128 --> 00:43:20,331 with that automatic identity conclusion 829 00:43:20,331 --> 00:43:21,599 or negative way of thinking about himself. 830 00:43:21,599 --> 00:43:24,869 So I think about it so often when I read things in 831 00:43:24,869 --> 00:43:26,738 the literature, any theoretical approach, 832 00:43:26,738 --> 00:43:28,373 because I really do-- 833 00:43:28,373 --> 00:43:31,809 I teach first year practice and other kinds of survey 834 00:43:31,809 --> 00:43:34,478 courses, where you talk about a lot of different kinds of 835 00:43:34,478 --> 00:43:36,247 theoretical approaches. 836 00:43:36,923 --> 00:43:40,952 But what I really noticed is, when you read about an 837 00:43:40,952 --> 00:43:43,354 approach in the literature, no matter what it is, 838 00:43:43,354 --> 00:43:45,756 it seems like it's easy and successful. 839 00:43:45,756 --> 00:43:48,793 And really work is much messier, and protracted, 840 00:43:48,793 --> 00:43:53,097 and harder to gain inroads, but I think it's helpful to 841 00:43:53,097 --> 00:43:57,035 have the knowledge, that as you are trying to help someone 842 00:43:57,035 --> 00:44:00,271 arrive in a different way of understanding themselves 843 00:44:00,271 --> 00:44:02,340 or a situation, no matter what you approach, 844 00:44:02,340 --> 00:44:04,975 it just does take time, and you really need to build up 845 00:44:04,975 --> 00:44:07,922 something that can contest with that 846 00:44:07,922 --> 00:44:10,080 dominant story or understanding. 847 00:44:12,090 --> 00:44:13,351 All right. 848 00:44:15,902 --> 00:44:20,902 So one of the things that I have liked about 849 00:44:21,225 --> 00:44:26,225 narrative therapy is that it does connect to larger social 850 00:44:26,464 --> 00:44:29,734 discourses, or that's another way of saying, just the 851 00:44:29,734 --> 00:44:34,734 kind of different ways that societal influences impose 852 00:44:35,573 --> 00:44:38,209 different kinds of rules or behavioral expectations 853 00:44:38,209 --> 00:44:39,844 on us in some way. 854 00:44:40,736 --> 00:44:44,015 And so, one of the things that I think can be a downside 855 00:44:44,015 --> 00:44:47,952 around something like pathologizing, or coming internal or 856 00:44:47,952 --> 00:44:51,522 more medical-based understandings, is the different kinds 857 00:44:51,522 --> 00:44:55,259 of ways, for example, I talked a little bit about how it's 858 00:44:55,259 --> 00:44:57,361 harder to know how to go forward. 859 00:44:57,361 --> 00:44:59,797 If someone is saying, "I am depressed," and we're really 860 00:44:59,797 --> 00:45:02,925 taking about it in a medical way, that keeps that problem 861 00:45:02,925 --> 00:45:06,337 located inside of them, it's much harder for people to know 862 00:45:06,337 --> 00:45:09,306 the steps that they might take about the problem. 863 00:45:09,306 --> 00:45:12,811 If they're talking more in a very experience near way, 864 00:45:12,811 --> 00:45:15,212 no matter what our approach is, you know, if you're 865 00:45:15,212 --> 00:45:17,748 talking more about their acute loneliness, and their hopes, 866 00:45:17,748 --> 00:45:20,251 and their dreams, or how life used to be different 867 00:45:20,251 --> 00:45:23,521 and what they're longing for, there's much clearer 868 00:45:23,521 --> 00:45:26,623 way forward, in terms of what they might do. 869 00:45:27,291 --> 00:45:31,195 Similarly, I think the world is not a level 870 00:45:31,195 --> 00:45:35,278 playing field for people, and as we talk about problems 871 00:45:35,278 --> 00:45:39,304 in a way that doesn't link it to larger systemic 872 00:45:39,304 --> 00:45:44,304 issues of oppression, it becomes harder to see or understand 873 00:45:45,910 --> 00:45:47,878 what those influences are. 874 00:45:47,878 --> 00:45:52,450 I think it's harder to have a conversation about how racism, 875 00:45:52,450 --> 00:45:56,520 or sexism, or homophobia, or ableism, or ageism 876 00:45:56,520 --> 00:46:00,058 might be impacting someone's experience 877 00:46:00,058 --> 00:46:05,058 of loneliness, or a sense of what they might do to go 878 00:46:05,429 --> 00:46:07,965 forward into the world, to have it be 879 00:46:07,965 --> 00:46:09,934 aligned with their hopes. 880 00:46:10,518 --> 00:46:13,004 But when you talk about it in an external way, or when you 881 00:46:13,004 --> 00:46:15,606 ask particular questions about the influence 882 00:46:15,606 --> 00:46:19,577 of such factors, and help people make those connections, 883 00:46:19,577 --> 00:46:22,179 I think it can be really useful. 884 00:46:23,179 --> 00:46:27,651 I know that there were a couple different op-ed pieces 885 00:46:27,651 --> 00:46:30,518 in the New York Times, just in the last week, that I thought 886 00:46:30,518 --> 00:46:34,191 did a really nice job of taking an individualized incident. 887 00:46:34,191 --> 00:46:39,191 One was about the Trayvon Martin case, and it was a 888 00:46:39,197 --> 00:46:43,200 op-ed piece by Charles Blow, about how the system 889 00:46:43,200 --> 00:46:45,153 failed Trayvon Martin. 890 00:46:45,153 --> 00:46:50,153 And another was about a Supreme Court of Iowa decision about 891 00:46:51,110 --> 00:46:56,110 a dental hygienist who was fired, because of her 892 00:46:56,514 --> 00:47:00,551 physical attractiveness, and how the Supreme Court 893 00:47:00,551 --> 00:47:05,551 of Iowa upheld the decision, that her attractiveness-- 894 00:47:06,590 --> 00:47:10,329 The dentist who fired her was saying that her presence 895 00:47:10,329 --> 00:47:14,798 in his office was putting marriage at risk, because he was 896 00:47:14,798 --> 00:47:16,100 tempted to have an affair. 897 00:47:16,100 --> 00:47:19,937 And so, the Supreme Court upheld that decision, so this is 898 00:47:19,937 --> 00:47:24,937 a really interesting article about "lookism." 899 00:47:25,643 --> 00:47:29,113 Or, just the effects of, are we really focusing our 900 00:47:29,113 --> 00:47:31,682 energy on the wrong place? 901 00:47:31,682 --> 00:47:35,986 We're focusing on a physical characteristic of 902 00:47:35,986 --> 00:47:40,357 attractiveness, as opposed to really critiquing this idea 903 00:47:40,357 --> 00:47:44,028 of how others' perceptions of beauty. 904 00:47:44,028 --> 00:47:47,631 In this case particularly, linking it to gender and 905 00:47:47,631 --> 00:47:49,233 patriarchy and the male gaze. 906 00:47:49,233 --> 00:47:51,208 You know, why is that-- 907 00:47:51,208 --> 00:47:53,705 The fact that they didn't overturn that. 908 00:47:53,705 --> 00:47:55,706 It's an interesting op-ed piece. 909 00:47:55,706 --> 00:48:00,512 I thought, what was nice about both of those editorials 910 00:48:00,512 --> 00:48:05,149 was that it was a great example of taking something from 911 00:48:05,149 --> 00:48:07,485 an individualized way, and putting it within a 912 00:48:07,485 --> 00:48:10,021 larger systemic context. 913 00:48:10,021 --> 00:48:15,021 For the Trayvon Martin op-ed piece, it was on racism. 914 00:48:15,026 --> 00:48:18,796 For the other piece, it was on sexism. 915 00:48:18,796 --> 00:48:21,832 I think that they are interesting reads, just help-- 916 00:48:21,832 --> 00:48:24,135 Remember to make those links. 917 00:48:24,135 --> 00:48:26,771 I feel like in that way, narrative therapy is very 918 00:48:28,447 --> 00:48:31,308 connected to these ideas, and those politics do 919 00:48:31,308 --> 00:48:33,210 come into the therapy room. 920 00:48:33,210 --> 00:48:35,346 And in that way, I also feel like-- 921 00:48:35,346 --> 00:48:38,015 That's one of the reasons I have always been proud to 922 00:48:38,015 --> 00:48:41,118 be a social worker, in terms of, it's not that we have 923 00:48:41,118 --> 00:48:45,422 a perfect history by any shape of the imagination, but how 924 00:48:45,422 --> 00:48:49,760 social justice is an important part of NASW, 925 00:48:49,760 --> 00:48:53,268 as we think about what our role is in the world. 926 00:48:54,231 --> 00:48:57,301 Okay, so I know there were some people who had some 927 00:48:57,301 --> 00:48:59,570 understanding about what external-- 928 00:48:59,570 --> 00:49:01,703 You know, about narrative therapy before coming in. 929 00:49:01,703 --> 00:49:04,220 And I'm guessing that maybe you had heard 930 00:49:04,220 --> 00:49:06,076 about externalizing before. 931 00:49:06,076 --> 00:49:07,878 I think one of the things that he might have said is, 932 00:49:07,878 --> 00:49:11,682 "The problem is the problem, the person is not the problem." 933 00:49:11,682 --> 00:49:14,485 So often I hear persons being talked about as problems 934 00:49:14,485 --> 00:49:16,620 within agency context where I work. 935 00:49:17,050 --> 00:49:20,291 But also, how oftentimes people come in talking 936 00:49:20,291 --> 00:49:22,726 about themselves and the problem too, it's like, how do 937 00:49:22,726 --> 00:49:24,294 people describe a problem. 938 00:49:24,294 --> 00:49:26,730 Generally it's, "I am depressed, I am anxious." 939 00:49:26,730 --> 00:49:29,567 So take away from the influence or the effects that a 940 00:49:29,567 --> 00:49:33,037 diagnosis has had on someone's life, but I think that so 941 00:49:33,037 --> 00:49:36,140 often, these people come to us, problems have 942 00:49:36,140 --> 00:49:38,308 come to define them. 943 00:49:38,308 --> 00:49:42,379 I think a lot about family work with young kids. 944 00:49:42,379 --> 00:49:45,215 It's like, so often, sometimes it can be overwhelming 945 00:49:45,215 --> 00:49:48,782 to have initial family sessions, where it's like "that child 946 00:49:48,782 --> 00:49:52,857 "is the problem," and is the reason for all the problems 947 00:49:52,857 --> 00:49:56,164 in the family, and it's just like, "How can I shift 948 00:49:57,056 --> 00:50:00,330 "the conversation some way, where we can try to understand 949 00:50:00,330 --> 00:50:02,679 "this in a different kind of context?" 950 00:50:02,679 --> 00:50:05,470 And it's the same thing with individuals who-- 951 00:50:07,376 --> 00:50:09,006 Because if you lose yourself behind a-- 952 00:50:09,006 --> 00:50:11,942 If a diagnosis, or something, or any kind of problem has 953 00:50:11,942 --> 00:50:14,578 taken over, it doesn't need to be a diagnosis. 954 00:50:14,578 --> 00:50:17,349 It's very then hard for that person to find themselves, 955 00:50:17,349 --> 00:50:19,713 to figure out what might be important to them, 956 00:50:19,713 --> 00:50:21,686 or what they might want different in their life, 957 00:50:21,686 --> 00:50:25,522 because it becomes quite easy to be a passive-- 958 00:50:26,757 --> 00:50:29,059 Well, to be a passenger to whatever the problem is, 959 00:50:29,059 --> 00:50:31,028 and the problem ends up guiding all of the ways 960 00:50:31,028 --> 00:50:32,930 forward in your life. 961 00:50:33,530 --> 00:50:36,934 So, overall, externalizing tends to-- 962 00:50:36,934 --> 00:50:39,470 They seek to separate the person from the problem. 963 00:50:40,454 --> 00:50:41,975 Also recognize that the people, 964 00:50:41,975 --> 00:50:43,874 the stories that people tell about their lives 965 00:50:43,874 --> 00:50:46,009 are shaping of their identity. 966 00:50:46,009 --> 00:50:49,014 And so it sounds like the person that you are working with, 967 00:50:49,014 --> 00:50:51,982 the way they would describe their life right now 968 00:50:51,982 --> 00:50:55,152 probably would be dominated by this bipolar story, 969 00:50:55,152 --> 00:50:57,221 and less about who they are. 970 00:50:59,144 --> 00:51:02,427 It's funny, if you attend to the language in those moments, 971 00:51:06,887 --> 00:51:09,022 people will be telling stories about the problem, 972 00:51:09,022 --> 00:51:13,670 almost instead of saying, "I," it's just interesting 973 00:51:13,670 --> 00:51:15,773 as people get into this position. 974 00:51:16,507 --> 00:51:19,076 So, "Externalizing conversations employ a range 975 00:51:19,076 --> 00:51:21,879 "of techniques," there can be different kinds of 976 00:51:21,879 --> 00:51:24,915 sequencings of questions, it can be very subtle. 977 00:51:24,915 --> 00:51:26,384 I mean, lots of times, people will ask me, 978 00:51:26,384 --> 00:51:29,162 "What if a person isn't interested in the idea?" 979 00:51:29,162 --> 00:51:31,155 It's not something I say, "Okay, we're going to have 980 00:51:31,155 --> 00:51:32,823 "an externalizing conversation now." 981 00:51:32,823 --> 00:51:35,826 No, but lots of times, I might just be doing-- 982 00:51:37,241 --> 00:51:38,963 Like, I've shifted my language to the point where I 983 00:51:38,963 --> 00:51:41,716 would be talking about the bipolar. 984 00:51:42,885 --> 00:51:46,870 So it can be a very small shift of language. 985 00:51:48,454 --> 00:51:51,675 Like, "When the influence of the bipolar-- 986 00:51:51,675 --> 00:51:53,978 "When influence of bipolar is around, what do you find 987 00:51:53,978 --> 00:51:57,148 "yourself doing or thinking, that might be different?" 988 00:51:57,148 --> 00:51:59,416 To really just try to do things-- 989 00:52:00,154 --> 00:52:02,386 "What does this problem have you thinking about 990 00:52:02,386 --> 00:52:04,021 "yourself right now?" 991 00:52:04,621 --> 00:52:08,091 So anyway, influence of "range of questions and techniques, 992 00:52:08,660 --> 00:52:10,961 "that seek a comprehensive account of the role of the 993 00:52:10,961 --> 00:52:14,364 "problem in a person's life, as well as a fuller description 994 00:52:14,364 --> 00:52:16,967 "of a person's life as separate from the problem. 995 00:52:16,967 --> 00:52:20,571 "In sum, the process of externalizing seeks to reify that, 996 00:52:20,571 --> 00:52:21,939 "'the person is not the problem, 997 00:52:21,939 --> 00:52:23,673 "'the problem is the problem.'" 998 00:52:24,174 --> 00:52:26,744 One of the things in externalizing conversations too, 999 00:52:26,744 --> 00:52:29,713 is that it-- 1000 00:52:32,883 --> 00:52:35,167 Sometimes you might start out with a conversation about a 1001 00:52:35,167 --> 00:52:39,190 particular problem or issue, and I think particularly 1002 00:52:39,190 --> 00:52:41,993 lower level problems, when you guys will do an 1003 00:52:41,993 --> 00:52:44,161 externalizing conversation, where I ask you to pick 1004 00:52:44,161 --> 00:52:47,598 education size problem to externalize. 1005 00:52:47,598 --> 00:52:51,803 And so, I know that, for example as I worked with students 1006 00:52:51,803 --> 00:52:54,838 or if I think about things that I have externalized in exercises, 1007 00:52:54,838 --> 00:52:58,208 There have been things that have surprised me. 1008 00:52:58,442 --> 00:52:59,810 One of the steps in it-- 1009 00:52:59,810 --> 00:53:03,579 We'll talk about the steps right now, is... 1010 00:53:07,517 --> 00:53:09,553 To arrive at a statement of position. 1011 00:53:09,553 --> 00:53:12,790 So sometimes, people will start to talk about a problem 1012 00:53:12,790 --> 00:53:16,161 and its effects in their life, and they may end up coming 1013 00:53:16,161 --> 00:53:18,228 to the conclusion that the problem has actually been more 1014 00:53:18,228 --> 00:53:20,264 helpful than they originally think. 1015 00:53:20,264 --> 00:53:23,533 It may come to a re-naming or a certain kind of thing. 1016 00:53:24,609 --> 00:53:28,872 But, I have had students, for example, who have started 1017 00:53:28,872 --> 00:53:31,041 with an idea of procrastination. 1018 00:53:32,378 --> 00:53:36,714 But really, as they really began to sort out what it 1019 00:53:36,714 --> 00:53:39,617 was that they were talking about, it really, 1020 00:53:39,617 --> 00:53:42,386 maybe became connected to some ideas that they had 1021 00:53:42,386 --> 00:53:47,024 about value, or quality, or different kinds of ways 1022 00:53:47,024 --> 00:53:50,228 that they wanted to engage with their work, that they 1023 00:53:50,228 --> 00:53:51,810 really appreciated about themselves. 1024 00:53:51,810 --> 00:53:54,331 So it wasn't the procrastination was all bad all of 1025 00:53:54,331 --> 00:53:57,367 a sudden, it really had some values embedded in it, 1026 00:53:57,367 --> 00:53:59,670 that they really felt were important. 1027 00:53:59,670 --> 00:54:01,438 And that helped them understand why it was very 1028 00:54:01,438 --> 00:54:05,042 difficult for them to think about changing that behavior, 1029 00:54:05,042 --> 00:54:06,810 or some of their habits around paper writing 1030 00:54:06,810 --> 00:54:08,312 and other kinds of things. 1031 00:54:08,312 --> 00:54:11,582 At the end of the day, that client is really the expert. 1032 00:54:11,582 --> 00:54:14,936 So I know, when I have taught before, people may 1033 00:54:14,936 --> 00:54:17,587 think about something like AA. 1034 00:54:18,263 --> 00:54:21,658 To describe oneself as an alcoholic, that's a really 1035 00:54:21,658 --> 00:54:26,081 totalizing account, but actually, for folks who 1036 00:54:26,097 --> 00:54:29,499 may use that as a way of describing themselves, it can be 1037 00:54:29,499 --> 00:54:31,902 an incredibly helpful account. 1038 00:54:31,902 --> 00:54:35,472 Part of it is getting the detail and the descriptors, 1039 00:54:35,472 --> 00:54:37,574 and it sounds like that person that you're working with, 1040 00:54:37,574 --> 00:54:41,712 the way that it's changed over time, is a story that has 1041 00:54:41,712 --> 00:54:43,985 changed incredibly with meaning. 1042 00:54:43,985 --> 00:54:47,618 And I think that AA is a really interesting popular example, 1043 00:54:47,618 --> 00:54:50,421 because often, the ways that that story shifts, 1044 00:54:50,421 --> 00:54:53,023 or the ways that that identity is understood. 1045 00:54:53,023 --> 00:54:57,036 It isn't a thinly described, "I am an alcoholic." 1046 00:54:57,436 --> 00:55:00,664 It is actually a process of telling stories 1047 00:55:00,664 --> 00:55:03,734 with an audience witness your story, and your 1048 00:55:03,734 --> 00:55:07,971 evolving story, where that identity gets constructed. 1049 00:55:07,971 --> 00:55:11,009 And so there's a way in which, even though, sometimes the 1050 00:55:11,009 --> 00:55:13,945 language doesn't necessarily fit with what I'm talking about 1051 00:55:13,945 --> 00:55:18,916 in sort of a totalizing, pejorative account of someone. 1052 00:55:18,916 --> 00:55:23,916 I think that actually, if we ask someone who's immersed 1053 00:55:24,030 --> 00:55:27,491 in the experience, where they have found AA to be 1054 00:55:27,491 --> 00:55:29,993 very supportive, and have come to the conclusion of 1055 00:55:29,993 --> 00:55:33,712 using these kinds of labels, to really ask them at 1056 00:55:33,712 --> 00:55:38,602 different times, more about what that meaning is, 1057 00:55:38,602 --> 00:55:42,072 and how that has been helpful or not helpful, 1058 00:55:42,072 --> 00:55:44,609 as a way to understand themselves in the world. 1059 00:55:45,224 --> 00:55:46,943 I think you can get a really rich 1060 00:55:46,943 --> 00:55:48,946 account of that understanding. 1061 00:55:48,946 --> 00:55:50,741 So in some ways that does fit. 1062 00:55:50,741 --> 00:55:55,318 One of the things that I think are often-- 1063 00:55:55,338 --> 00:55:58,477 When you think about what to externalize, 1064 00:56:02,676 --> 00:56:05,644 there's lots of questions that come up, so I think that 1065 00:56:07,736 --> 00:56:09,242 one of the things-- 1066 00:56:09,332 --> 00:56:12,269 With the transcript example that I looked at, I particularly 1067 00:56:12,269 --> 00:56:14,971 chose an example with anger problems, in particular, 1068 00:56:14,971 --> 00:56:17,741 because I think sometimes, as people think about separating 1069 00:56:17,741 --> 00:56:22,012 a person from a problem, there's a worry, and I think it's 1070 00:56:22,012 --> 00:56:25,820 a good worry, to think about I don't want to-- 1071 00:56:29,327 --> 00:56:31,955 If there's any kind of behavior that's causing harm 1072 00:56:31,955 --> 00:56:34,658 to anyone else, I don't want to separate a person from 1073 00:56:34,658 --> 00:56:37,795 a problem in a way, that they are not being accountable 1074 00:56:37,795 --> 00:56:40,931 for their actions, against that might be harmful 1075 00:56:40,931 --> 00:56:42,793 towards other people. 1076 00:56:42,793 --> 00:56:45,068 And so, that's when you ask, "Well, how do I know 1077 00:56:45,068 --> 00:56:46,570 "what to externalize?" 1078 00:56:47,246 --> 00:56:51,808 And really thinking about, "And what are the effects 1079 00:56:51,808 --> 00:56:53,010 "of externalizing? 1080 00:56:53,010 --> 00:56:55,779 "And how am I to engage in the process of separation?" 1081 00:56:56,702 --> 00:56:59,249 If someone's doing anything that's harmful for others 1082 00:56:59,249 --> 00:57:01,485 in a way that holds them accountable. 1083 00:57:06,483 --> 00:57:07,858 One of the things that I think is helpful to 1084 00:57:07,858 --> 00:57:10,494 think about, about externalizing problems, 1085 00:57:10,494 --> 00:57:12,996 is this understanding of, what are the differences between 1086 00:57:12,996 --> 00:57:15,633 internal state understandings of problems, and external 1087 00:57:15,633 --> 00:57:17,424 state understandings of problems. 1088 00:57:17,424 --> 00:57:20,337 And so, internal state understandings about a problem, 1089 00:57:20,337 --> 00:57:23,273 their negative identity, conclusion or strengths, 1090 00:57:25,596 --> 00:57:28,360 can be more richly described than other kinds of things. 1091 00:57:28,360 --> 00:57:33,360 So, describing things that have been internalized. 1092 00:57:34,418 --> 00:57:36,687 So people are-- like the bipolar for example, 1093 00:57:36,687 --> 00:57:38,021 and your example. 1094 00:57:39,251 --> 00:57:41,558 When people have come to understand themselves as 1095 00:57:41,558 --> 00:57:45,495 a problem, or it's obscuring in some way, I think can be-- 1096 00:57:45,495 --> 00:57:46,863 Those are really nice things to target, 1097 00:57:46,863 --> 00:57:48,998 as a way of externalizing. 1098 00:57:49,719 --> 00:57:52,102 Effects can be the actions that people have taken, 1099 00:57:52,102 --> 00:57:55,633 beliefs or values, as I've talked about, social oppression 1100 00:57:55,633 --> 00:57:57,974 and its role becomes more visible. 1101 00:57:57,974 --> 00:58:01,711 And this fits with other narrative practices, in that 1102 00:58:01,711 --> 00:58:05,215 it can be a launching point for c-- 1103 00:58:05,215 --> 00:58:08,552 It can be that initial externalizing, and where one ends up 1104 00:58:08,552 --> 00:58:11,856 might be this initial story, and the creation of a new story 1105 00:58:11,856 --> 00:58:15,092 or there can be other ways, or pieces. 1106 00:58:15,392 --> 00:58:18,825 It can also just provide a new understanding of 1107 00:58:18,825 --> 00:58:20,564 how to go forward. 1108 00:58:20,564 --> 00:58:21,698 I think of-- 1109 00:58:23,767 --> 00:58:25,835 I use the example of, I don't know if other people 1110 00:58:25,835 --> 00:58:30,207 are looking, particularly families with younger children. 1111 00:58:30,207 --> 00:58:33,944 I think particularly, anyone who's ever used play 1112 00:58:33,944 --> 00:58:36,646 therapy techniques, I think that this process of 1113 00:58:36,646 --> 00:58:39,416 externalizing can dovetail really nice;y with what 1114 00:58:39,416 --> 00:58:44,416 people are probably already doing, because it can really-- 1115 00:58:47,168 --> 00:58:49,192 Whereas a lot of the questions that I'll have in 1116 00:58:49,192 --> 00:58:52,195 our exercise we'll do together, are really much more 1117 00:58:52,195 --> 00:58:54,864 geared towards adolescence and adult ways of thinking. 1118 00:58:54,864 --> 00:58:57,534 There's beautiful and playful ways you can do this 1119 00:58:57,534 --> 00:58:58,792 with young children. 1120 00:58:58,792 --> 00:59:02,539 So I think of some in-home family work that I did, 1121 00:59:02,539 --> 00:59:06,743 where I was with a child who drew a picture-- 1122 00:59:06,743 --> 00:59:08,845 It's not uncommon for people to draw a picture 1123 00:59:08,845 --> 00:59:13,116 of their problems, so kids can do that really lovely. 1124 00:59:13,116 --> 00:59:14,486 And we did a one-- 1125 00:59:14,486 --> 00:59:18,588 A Wild West or FBI, but you want to do Wild West when 1126 00:59:18,588 --> 00:59:20,690 working with kids because you don't want to introduce 1127 00:59:20,690 --> 00:59:22,525 the FBI most wanted posters for kids. 1128 00:59:23,632 --> 00:59:27,798 We did a Wild West wanted poster on this angry monster, 1129 00:59:27,798 --> 00:59:29,966 that she began to externalize. 1130 00:59:29,966 --> 00:59:31,802 At first the mom was like, "Really? 1131 00:59:31,802 --> 00:59:33,837 "Are we going to be doing this?" 1132 00:59:33,837 --> 00:59:36,473 But to really, this kid could-- 1133 00:59:36,473 --> 00:59:40,010 Once the angry monster was out there, a very colorful 1134 00:59:40,010 --> 00:59:43,921 picture of a warm fuzzy, but multicolored. 1135 00:59:43,921 --> 00:59:46,417 And it wasn't such a warm, fuzzy, this angry monster. 1136 00:59:51,155 --> 00:59:53,382 She could really identify the times when the angry 1137 00:59:53,382 --> 00:59:56,359 monster was most likely to come around, and this was 1138 00:59:56,359 --> 00:59:58,462 important information for the wanted poster bulletin. 1139 00:59:58,462 --> 01:00:01,064 She and her mom could notice that transition times 1140 01:00:01,064 --> 01:00:06,064 were particularly hard, so bed time, after school. 1141 01:00:06,803 --> 01:00:09,012 There were a lot of different kinds of conditions or 1142 01:00:09,012 --> 01:00:11,943 circumstances, when that angry monster was much more 1143 01:00:11,943 --> 01:00:13,777 likely to show themselves. 1144 01:00:13,943 --> 01:00:17,314 When it became, not that the child had such angry issues, 1145 01:00:17,314 --> 01:00:20,450 but there was an angry monster at loose around the house, 1146 01:00:20,450 --> 01:00:24,421 the mom was also able to acknowledge that her stress level 1147 01:00:24,821 --> 01:00:27,324 could contribute to the presence of the angry monster, 1148 01:00:27,324 --> 01:00:31,027 when she was wasn't able to listen as well, or lost 1149 01:00:31,027 --> 01:00:34,197 some of her patience, the angry monster was much more 1150 01:00:34,197 --> 01:00:37,356 likely to rear its ugly head, and really begin to 1151 01:00:37,356 --> 01:00:40,170 be tantruming, or other things around the house. 1152 01:00:40,170 --> 01:00:43,373 So once we first drew a picture, and then describe what 1153 01:00:43,373 --> 01:00:47,010 that angry monster would do that was problematic. 1154 01:00:48,302 --> 01:00:50,614 It wasn't what the angry monster would do, it would be 1155 01:00:50,614 --> 01:00:53,596 what the angry monster was convincing that young girl to do. 1156 01:00:53,596 --> 01:00:55,085 It was the girl's behaviors. 1157 01:00:55,085 --> 01:00:58,321 Angry monster wasn't tantruming, the girl was, but it was 1158 01:00:58,321 --> 01:01:00,857 also a different conversation when its externalized, 1159 01:01:00,857 --> 01:01:04,060 of, "Have you ever been boss of the angry monster, 1160 01:01:04,060 --> 01:01:07,597 "or is the angry monster always the boss of you?" 1161 01:01:07,998 --> 01:01:11,853 And she could say, "Well, maybe my monster is often 1162 01:01:11,853 --> 01:01:13,269 "the boss of me. 1163 01:01:13,269 --> 01:01:16,072 "I haven't been the boss very often. 1164 01:01:16,887 --> 01:01:18,675 "Like one time, I did this. 1165 01:01:19,505 --> 01:01:20,810 "And another time, I did this." 1166 01:01:20,810 --> 01:01:22,846 It's, again, when she's not the one with all the 1167 01:01:22,846 --> 01:01:25,482 anger issues, she could think about the times when she 1168 01:01:25,482 --> 01:01:28,618 was able to take a stand against the anger in her life. 1169 01:01:32,817 --> 01:01:34,858 Bless this mother, because she initially was like, 1170 01:01:34,858 --> 01:01:39,263 "Who is this in-home therapist arriving with their crayons? 1171 01:01:39,263 --> 01:01:41,267 "And how is this possibly going to be helpful?" 1172 01:01:41,267 --> 01:01:43,733 But, I just had talked to her a little bit about what 1173 01:01:43,733 --> 01:01:46,970 we might do ahead of time, ask her if she would be 1174 01:01:46,970 --> 01:01:49,539 willing to try this out for a week or two. 1175 01:01:49,539 --> 01:01:52,275 So we made some wanted posters, and posted them up in 1176 01:01:52,275 --> 01:01:54,378 different places around the house, where that angry monster 1177 01:01:54,378 --> 01:01:56,346 was most likely to come around. 1178 01:01:56,346 --> 01:01:58,715 And it just gave them both, again, a different kind 1179 01:01:58,715 --> 01:02:01,618 of language, to talk about the problem about like, 1180 01:02:01,618 --> 01:02:03,086 "Honey, could you-- 1181 01:02:03,086 --> 01:02:05,188 "I would really appreciate it if you could stand up 1182 01:02:05,188 --> 01:02:06,790 "to the angry monster right now. 1183 01:02:06,790 --> 01:02:08,024 "I think the angry monster's beginning to be 1184 01:02:08,024 --> 01:02:09,392 "the boss of you." 1185 01:02:09,726 --> 01:02:10,960 It was like a way-- 1186 01:02:10,994 --> 01:02:13,430 Just like we often talk to parents about-- 1187 01:02:13,430 --> 01:02:15,098 You talk about the behavior, and it's like, 1188 01:02:15,098 --> 01:02:17,534 "It's not you, honey, it's your behavior." 1189 01:02:17,534 --> 01:02:21,371 All these kinds of ways, it just is another way. 1190 01:02:23,078 --> 01:02:26,109 She also could have some ideas of things that they could do, 1191 01:02:26,555 --> 01:02:31,448 that were useful, in terms of steps that they could take 1192 01:02:31,448 --> 01:02:33,850 together against the angry monster's influence. 1193 01:02:33,850 --> 01:02:37,554 And then that angry monster, after about a month 1194 01:02:37,554 --> 01:02:39,956 and a half, did move out of the home. 1195 01:02:39,956 --> 01:02:42,025 I think it got to be so ineffective, it went to go 1196 01:02:42,025 --> 01:02:45,228 find another child to bother (laughs). 1197 01:02:45,228 --> 01:02:47,864 But it was really helpful, because we also could talk about 1198 01:02:47,864 --> 01:02:51,301 what were the conditions that were present, that the 1199 01:02:51,301 --> 01:02:55,338 angry monster was not a problem at school, for this child. 1200 01:02:55,338 --> 01:02:58,007 It was really particularly some things that were 1201 01:02:58,007 --> 01:03:00,677 happening at home, so it was also way of beginning to 1202 01:03:00,677 --> 01:03:04,403 talk about those environments, in a way that 1203 01:03:04,403 --> 01:03:06,683 I think the mother felt that she wasn't being judged. 1204 01:03:08,436 --> 01:03:12,555 It can be hard, depending on how you're referred to treat-- 1205 01:03:14,960 --> 01:03:17,460 I think it can be relieving, that this kind of way 1206 01:03:17,460 --> 01:03:20,230 of working can also really actively shift away 1207 01:03:20,230 --> 01:03:22,185 from ideas of mother blame, or other kinds of ways 1208 01:03:22,185 --> 01:03:23,900 that people might be-- 1209 01:03:23,900 --> 01:03:26,069 It's such a different way of talking about a problem, 1210 01:03:26,069 --> 01:03:29,138 that I think that people aren't feeling 1211 01:03:29,138 --> 01:03:31,340 judged in the process. 1212 01:03:35,694 --> 01:03:37,614 This internal versus intentional state, 1213 01:03:37,614 --> 01:03:39,782 problems or understanding. 1214 01:03:40,250 --> 01:03:43,353 Internal state understandings of problems really thinks 1215 01:03:43,353 --> 01:03:48,353 about things in more biological drives, or things are 1216 01:03:48,791 --> 01:03:52,762 motivated by certain needs that might be met or unmet. 1217 01:03:53,254 --> 01:03:56,702 Different kinds of deficits, traits or attributes. 1218 01:03:56,702 --> 01:03:59,736 Intentional state understandings is what we might work 1219 01:03:59,736 --> 01:04:02,639 towards as we create a different kind of story, but they're 1220 01:04:02,639 --> 01:04:07,639 reflections of personal agency, and so purposes, hopes, 1221 01:04:07,844 --> 01:04:10,313 commitments, dreams, values, beliefs. 1222 01:04:12,605 --> 01:04:14,083 Those are the types of things, when I think about that 1223 01:04:14,083 --> 01:04:16,953 I may be de-centered and that I'm really trying to pull 1224 01:04:16,953 --> 01:04:18,955 forth people's expertise. 1225 01:04:19,631 --> 01:04:24,160 But I am influential in that all of us ask questions, 1226 01:04:24,160 --> 01:04:29,160 and are listening and responding to certain things. 1227 01:04:29,599 --> 01:04:32,035 Like, I am always listening or responding. 1228 01:04:32,035 --> 01:04:34,938 I have tremendous biases that I bring into the room, 1229 01:04:34,938 --> 01:04:36,673 where I'm really listening for 1230 01:04:36,673 --> 01:04:38,809 reflections of personal agency. 1231 01:04:38,809 --> 01:04:41,778 So, out of all the things that I could repond to about 1232 01:04:41,778 --> 01:04:44,447 the angry monster's presence, 1233 01:04:44,447 --> 01:04:47,884 I really want to hear them both talk about what they 1234 01:04:47,884 --> 01:04:50,120 know about it, when its around. 1235 01:04:50,120 --> 01:04:52,755 What knowledge or skills they've had, in relation to 1236 01:04:54,554 --> 01:04:56,059 reducing its influence. 1237 01:04:56,059 --> 01:04:58,395 I am going to be listening for very particular kinds 1238 01:04:58,395 --> 01:05:00,930 of things, and all of the things that I'm most 1239 01:05:00,930 --> 01:05:03,333 listening for, are going to be reflective 1240 01:05:03,333 --> 01:05:05,368 of personal agency states. 1241 01:05:05,412 --> 01:05:06,936 Does that make sense? 1242 01:05:06,936 --> 01:05:08,605 Personal agency states I think are 1243 01:05:08,605 --> 01:05:10,940 intentional state understandings. 1244 01:05:10,940 --> 01:05:13,910 I am not going to be thinking about problems 1245 01:05:13,910 --> 01:05:16,713 or conceptualizing them, in a way-- 1246 01:05:19,804 --> 01:05:24,087 About unmet needs of, an automatic or out of 1247 01:05:24,087 --> 01:05:25,888 an awareness understanding. 1248 01:05:27,087 --> 01:05:31,494 I want to really focus on people's awareness by asking 1249 01:05:31,494 --> 01:05:34,130 questions about knowledge or skills, it really is about 1250 01:05:34,130 --> 01:05:37,600 bringing something into people's awareness. which is really 1251 01:05:37,600 --> 01:05:42,600 how unconsciousness is really thought of. 1252 01:05:43,406 --> 01:05:45,408 It's really about healing happens as the 1253 01:05:45,408 --> 01:05:47,243 unconscious becomes conscious. 1254 01:05:47,243 --> 01:05:51,114 This is not that different, in that I', really wanting 1255 01:05:51,114 --> 01:05:54,117 people to have more awareness about-- 1256 01:05:54,947 --> 01:05:57,720 If I'm asking about, what are the conditions that the 1257 01:05:57,720 --> 01:06:00,723 angry monster is more likely to have influence? 1258 01:06:00,723 --> 01:06:05,723 What they are is identifying quite actively 1259 01:06:06,669 --> 01:06:11,534 situations or moments that are more likely to have 1260 01:06:11,534 --> 01:06:13,871 things come into play. 1261 01:06:16,578 --> 01:06:19,943 It's the same data set, one way of understanding 1262 01:06:19,943 --> 01:06:23,246 of looking at this snap shot of a moment, might be 1263 01:06:23,246 --> 01:06:28,246 that due to fatigue at the end of the day, a parental 1264 01:06:28,851 --> 01:06:33,851 figure has less patience, and is really trying to 1265 01:06:34,457 --> 01:06:36,393 move forward with structure and bed time, 1266 01:06:36,393 --> 01:06:38,995 because with the knowledge that, that is what's best 1267 01:06:38,995 --> 01:06:41,030 for the child in that moment. 1268 01:06:42,030 --> 01:06:45,435 But the child is feeling like they just need 1269 01:06:45,435 --> 01:06:46,803 attention on one issue. 1270 01:06:46,803 --> 01:06:47,837 It could be an unmet-- 1271 01:06:47,837 --> 01:06:49,806 You can look at it, and really clear;u understand it's 1272 01:06:49,806 --> 01:06:52,546 an unmet need for attention, or patience, or a something 1273 01:06:52,546 --> 01:06:56,152 in that moment, that then causes this behavior of a 1274 01:06:56,152 --> 01:06:59,282 wild tantrum to come into play. 1275 01:07:00,066 --> 01:07:02,985 But another way of understanding it is if they can verbalize 1276 01:07:02,985 --> 01:07:07,295 and describe things, and children can do this in language 1277 01:07:07,295 --> 01:07:12,295 that is accessible to them, it's just another way of 1278 01:07:13,463 --> 01:07:16,766 applying some words to things that may already be 1279 01:07:16,766 --> 01:07:17,875 familiar with people, 1280 01:07:17,875 --> 01:07:19,938 but I just think are helpful to understand about, 1281 01:07:19,938 --> 01:07:21,727 to just really-- 1282 01:07:21,727 --> 01:07:25,575 I'm pulling for awareness and knowledge, and talking about 1283 01:07:25,575 --> 01:07:27,376 what's important to them in their life. 1284 01:07:27,806 --> 01:07:29,979 And I think that... 1285 01:07:37,196 --> 01:07:41,324 It's perfectly okay to have less patience 1286 01:07:41,324 --> 01:07:43,059 at different moments of the day. 1287 01:07:43,059 --> 01:07:46,896 I also feel like, really understanding the value 1288 01:07:46,896 --> 01:07:51,896 of patience, or how, if one could just extend, just a little 1289 01:07:52,246 --> 01:07:54,303 bit more in that moment, sometimes that can be enough 1290 01:07:54,303 --> 01:07:58,608 to transition, or to avoid a temper tantrum, even if that-- 1291 01:07:58,608 --> 01:08:01,844 Things shift, as different kinds of understanding come to 1292 01:08:01,844 --> 01:08:06,004 people's awareness about needs and other things. 1293 01:08:06,004 --> 01:08:08,351 It's just a different way of conceptualizing. 1294 01:08:08,351 --> 01:08:10,252 I don't think I'm being too clear. 1295 01:08:10,587 --> 01:08:12,589 I can move on, but does anyone have a particular question 1296 01:08:12,589 --> 01:08:16,759 that I might help clarify that further? 1297 01:08:19,162 --> 01:08:21,163 On this slide, I have things that talk about internal 1298 01:08:21,163 --> 01:08:24,374 state understandings, and intentional state understandings. 1299 01:08:24,374 --> 01:08:27,737 And I feel like, thank you, because I know I'm flying 1300 01:08:27,737 --> 01:08:30,006 through a lot of these slides. 1301 01:08:30,006 --> 01:08:35,006 For me, I really think about this slide, as fitting 1302 01:08:35,211 --> 01:08:39,782 into my own internal process of thinking, and listening, 1303 01:08:39,782 --> 01:08:41,850 and formulation. 1304 01:08:41,850 --> 01:08:46,573 So, in many ways, this gets back to the earlier type of 1305 01:08:46,573 --> 01:08:50,259 question about, if I have a certain kind of way 1306 01:08:50,259 --> 01:08:54,497 of conceptualizing something, that is more with an internal 1307 01:08:54,497 --> 01:08:55,631 state understanding. 1308 01:08:55,631 --> 01:09:00,631 So, if we go back to thinking about traditional ways 1309 01:09:01,270 --> 01:09:04,240 that I had talked about depression, for example, 1310 01:09:04,240 --> 01:09:06,108 which would be much more about 1311 01:09:08,876 --> 01:09:10,546 internal state understandings. 1312 01:09:10,546 --> 01:09:13,549 I don't want to remove something that might be a very real 1313 01:09:13,549 --> 01:09:17,118 biological component, but I feel like there's a lot of 1314 01:09:17,118 --> 01:09:19,788 other ways that I might have understood it, in terms of 1315 01:09:19,788 --> 01:09:24,788 deficit, so really, this might be an expression of something 1316 01:09:25,395 --> 01:09:29,966 that had happened in the past, that might be out of 1317 01:09:29,966 --> 01:09:31,000 people's awareness. 1318 01:09:31,000 --> 01:09:34,303 So more an unconscious state, or-- 1319 01:09:35,938 --> 01:09:40,076 And it's not that I'm not exploring for things that are 1320 01:09:40,076 --> 01:09:41,810 out of people's awareness. 1321 01:09:41,810 --> 01:09:44,281 Like again, it's not necessarily so different, but I'm 1322 01:09:44,281 --> 01:09:48,518 not exploring people's relational history, to look at 1323 01:09:48,518 --> 01:09:51,087 patterns of deficit or-- 1324 01:09:52,764 --> 01:09:55,892 I'm not necessarily looking for something in that way. 1325 01:09:55,892 --> 01:09:59,990 And again, the tricky part about this, is I do feel like 1326 01:09:59,990 --> 01:10:04,990 at all times, people have the same set of experiences. 1327 01:10:05,134 --> 01:10:07,603 It's like the data set is the same, but just 1328 01:10:07,603 --> 01:10:10,573 how I'm then constructing the conversation. 1329 01:10:10,573 --> 01:10:13,009 I'm not going to have them describe their experience, 1330 01:10:13,009 --> 01:10:17,213 in terms of a history of disappointments, or losses, 1331 01:10:17,213 --> 01:10:19,348 or other kinds of things, because I feel like if 1332 01:10:19,348 --> 01:10:22,852 I am turning up the volume, or if I am exclusively 1333 01:10:22,852 --> 01:10:25,521 listening to solely those types of accounts, 1334 01:10:25,521 --> 01:10:28,591 that ends of being shaping of people's experiences. 1335 01:10:28,591 --> 01:10:31,360 If they're talking about what they haven't gotten 1336 01:10:31,360 --> 01:10:35,932 repeatedly over time, even if that is something that's true. 1337 01:10:35,932 --> 01:10:40,236 Or if I come to understand it as something like-- 1338 01:10:42,338 --> 01:10:44,574 The sequence of disappointments is this idea about 1339 01:10:44,574 --> 01:10:47,678 repetition compulsion, like they sort of being driven 1340 01:10:47,678 --> 01:10:51,181 to do something that's not fully in their awareness. 1341 01:10:51,688 --> 01:10:54,717 It's not that, that is necessarily a wrong idea. 1342 01:10:54,717 --> 01:10:57,120 I think that, that can be a very helpful way, 1343 01:10:57,120 --> 01:10:59,289 in conceptualizing our understanding of things 1344 01:10:59,289 --> 01:11:00,623 to a certain degree. 1345 01:11:00,623 --> 01:11:03,559 But I also feel like, in my conversations with people, 1346 01:11:03,559 --> 01:11:06,912 I'm really thinking about, what are the effects of 1347 01:11:06,912 --> 01:11:09,767 describing experience in ways that 1348 01:11:09,767 --> 01:11:11,969 are very deficit oriented. 1349 01:11:11,969 --> 01:11:13,837 Like if, you know you just feel like-- 1350 01:11:15,636 --> 01:11:19,608 We'll talk a lot also in the afternoon about, I've come 1351 01:11:19,608 --> 01:11:23,512 to understand, for example, in responding to trauma. 1352 01:11:24,542 --> 01:11:27,985 I really am having less effects conversation. 1353 01:11:27,985 --> 01:11:29,585 I'm spending lot less time. 1354 01:11:29,585 --> 01:11:32,455 I want to move pretty quickly, often, from normalizing 1355 01:11:32,455 --> 01:11:35,725 conversations, I feel like there can be something that 1356 01:11:35,725 --> 01:11:39,262 is actually very helpful, and powerful, 1357 01:11:39,262 --> 01:11:42,698 and acknowledging of people in some ways, to do something 1358 01:11:42,698 --> 01:11:45,234 like a conversation about diagnosis. 1359 01:11:45,234 --> 01:11:48,137 Or if people are talking about distress 1360 01:11:48,137 --> 01:11:50,940 they're experiencing in relation to flashbacks 1361 01:11:50,940 --> 01:11:52,746 or something like that. 1362 01:11:53,499 --> 01:11:56,979 To hear that other people also have intrusive thoughts 1363 01:11:56,979 --> 01:12:00,439 about past and painful experiences is helpful, 1364 01:12:00,439 --> 01:12:04,987 because people are feeling very not normal. 1365 01:12:05,455 --> 01:12:08,557 Part of what they want is that assurance, or community 1366 01:12:08,557 --> 01:12:11,961 of others, who are having these kinds of experiences. 1367 01:12:11,961 --> 01:12:15,965 But I don't want to linger in conversations that are 1368 01:12:19,918 --> 01:12:23,439 promoting the normalcy of people's passive 1369 01:12:23,439 --> 01:12:26,208 experiences or responses. 1370 01:12:26,208 --> 01:12:29,111 I don't know, I just going to follow this to the end. 1371 01:12:29,111 --> 01:12:31,781 With the trauma conversation, I would really then want to 1372 01:12:31,781 --> 01:12:36,685 get much more about what was distressing to the person 1373 01:12:36,685 --> 01:12:39,422 about having those intrusive thoughts or memories. 1374 01:12:39,422 --> 01:12:41,023 Was there a particularly-- 1375 01:12:41,023 --> 01:12:46,023 Again, particular value, dream, sense of, if I think about 1376 01:12:49,037 --> 01:12:51,367 people talking about experiences of being abused 1377 01:12:51,367 --> 01:12:55,638 as a child, not only what were the effects of what 1378 01:12:55,638 --> 01:12:59,110 they experienced, but what was it, what kind of values 1379 01:12:59,110 --> 01:13:03,913 or ideals, or hopes, or beliefs that were 1380 01:13:03,913 --> 01:13:07,149 foundationally important, were transgressed? 1381 01:13:07,149 --> 01:13:09,819 Because I also think that when it becomes also a 1382 01:13:09,819 --> 01:13:12,922 conversation about those beliefs, other kinds of 1383 01:13:12,922 --> 01:13:16,859 commitments that they've made, in response to that 1384 01:13:16,859 --> 01:13:21,263 kind of experience of trauma that they have experienced. 1385 01:13:21,263 --> 01:13:24,567 There becomes more of a sense of purpose about-- 1386 01:13:25,876 --> 01:13:30,639 The fact that you have chosen a career in child advocacy. 1387 01:13:30,639 --> 01:13:35,639 The fact that you're now working in DCF, would that be-- 1388 01:13:35,780 --> 01:13:37,580 Would that commitment that you've made in your professional 1389 01:13:37,580 --> 01:13:40,282 life, be a reflection of-- 1390 01:13:40,649 --> 01:13:42,918 In some ways, it can-- 1391 01:13:43,777 --> 01:13:46,288 The value of yours that was transgressed, when you were 1392 01:13:46,288 --> 01:13:51,288 abused as a child, what are some of the ways that, 1393 01:13:51,527 --> 01:13:54,386 that value continues to be expressed in your present life? 1394 01:13:54,386 --> 01:13:58,501 It's been expressed in your choice of work, and your 1395 01:13:58,501 --> 01:14:02,438 advocacy, and your valuing of children's safety and lives. 1396 01:14:02,438 --> 01:14:05,574 I just think that there can be a way that's very different, 1397 01:14:05,574 --> 01:14:10,574 than to look solely at effects of what was done to, 1398 01:14:11,447 --> 01:14:12,381 or ways that-- 1399 01:14:12,381 --> 01:14:15,677 But again, it highlights the activity or response. 1400 01:14:15,677 --> 01:14:16,585 Is that helpful? 1401 01:14:16,585 --> 01:14:19,822 So whether it be with the depression about the value 1402 01:14:19,822 --> 01:14:24,194 of connection, the value of certain kinds of relationships, 1403 01:14:24,194 --> 01:14:25,061 and the-- 1404 01:14:25,845 --> 01:14:29,031 Which is really what's fueling the pain of loneliness. 1405 01:14:29,784 --> 01:14:31,371 I would really want to-- 1406 01:14:31,371 --> 01:14:33,035 It's a different kind of thing, to talk about 1407 01:14:33,035 --> 01:14:36,505 people's dreams and knowledge and experiences, 1408 01:14:36,505 --> 01:14:40,543 and hopes for connections, as opposed to purely on-- 1409 01:14:41,250 --> 01:14:45,281 And yet, you can't move to these more happy thoughts. 1410 01:14:45,281 --> 01:14:49,461 I feel like there's a great article on solution focused 1411 01:14:49,461 --> 01:14:52,588 therapy, that I have used in teaching, that I just feel 1412 01:14:52,588 --> 01:14:55,024 is really helpful for any kind of strengths-based 1413 01:14:55,024 --> 01:14:56,058 and collaborative theory. 1414 01:14:56,058 --> 01:14:57,193 You can't move-- 1415 01:14:57,869 --> 01:14:59,962 It calls it, solution force therapy. 1416 01:14:59,962 --> 01:15:03,999 I really feel like the people who sit with us, if we move 1417 01:15:03,999 --> 01:15:08,104 too quickly to any kind of fix, no matter what our approach 1418 01:15:08,104 --> 01:15:11,507 or solution, before we fully understand the problem, 1419 01:15:11,507 --> 01:15:13,409 it's not going to work. 1420 01:15:13,409 --> 01:15:15,544 Like, if we start asking questions real quickly, like, 1421 01:15:15,544 --> 01:15:17,680 "How will you know if you woke up and the problem 1422 01:15:17,680 --> 01:15:18,714 "was all gone?" 1423 01:15:18,714 --> 01:15:20,015 People are like, "You don't even know what the problem 1424 01:15:20,015 --> 01:15:20,916 "is to begin with. 1425 01:15:20,916 --> 01:15:23,586 "How can we be wishing it away, at this point?" 1426 01:15:25,155 --> 01:15:28,557 I think that it is important, so it might be, 1427 01:15:28,557 --> 01:15:31,871 even initially, that I'm tracking potential hopes 1428 01:15:31,871 --> 01:15:33,429 to explore later. 1429 01:15:33,429 --> 01:15:35,831 I do really want to hear the effects, but I don't want 1430 01:15:35,831 --> 01:15:38,480 to linger and have too many questions solely about 1431 01:15:38,480 --> 01:15:43,105 effects, or having types of conversations that locate 1432 01:15:43,105 --> 01:15:47,943 people's responses, or take things for granted. 1433 01:15:50,680 --> 01:15:55,674 Oh, it's by Nylund and Corsiglia. 1434 01:16:00,556 --> 01:16:04,193 and it's Becoming Solution Forced. 1435 01:16:04,860 --> 01:16:07,563 It's focus is crossed out and forced in therapy. 1436 01:16:09,516 --> 01:16:11,700 That should be enough key words to get you there. 1437 01:16:13,869 --> 01:16:15,137 You can email me, and I could potentially 1438 01:16:15,137 --> 01:16:17,306 send it to you as well. 1439 01:16:22,334 --> 01:16:25,247 There is often a sequencing of questions in externalizing 1440 01:16:25,247 --> 01:16:29,118 that, one doesn't necessarily need to go in order, 1441 01:16:29,118 --> 01:16:31,854 but it can be helpful to do a flow in order, 1442 01:16:31,854 --> 01:16:36,225 because it just makes more sense, 1443 01:16:36,225 --> 01:16:38,227 as one who's answering the questions. 1444 01:16:38,227 --> 01:16:42,064 So, characterizing the problem, and the negotiation of 1445 01:16:42,064 --> 01:16:44,433 a personalized and specific definition of a problem 1446 01:16:44,433 --> 01:16:45,501 or concern. 1447 01:16:45,501 --> 01:16:47,102 So that one, when I talked about the name, 1448 01:16:47,102 --> 01:16:49,772 The Angry Monster, that was something as I had them 1449 01:16:49,772 --> 01:16:54,743 describe the effects of what was initially anger problems, 1450 01:16:54,743 --> 01:16:58,113 or tempter tantrum, it became to be described initally 1451 01:16:58,113 --> 01:16:59,982 as The Angry Monster. 1452 01:16:59,982 --> 01:17:01,850 Another example that came up during the break, 1453 01:17:01,850 --> 01:17:06,850 was using a rational recovery model, talking about 1454 01:17:07,642 --> 01:17:09,892 substance abuse as The Beast. 1455 01:17:12,891 --> 01:17:14,930 And thinking about the beast gives a little bit of space 1456 01:17:14,930 --> 01:17:18,835 about the beast's influence in one's thinking or actions. 1457 01:17:18,835 --> 01:17:21,570 The next part is about naming the effects or influence 1458 01:17:21,570 --> 01:17:22,671 of the problem. 1459 01:17:22,671 --> 01:17:25,110 This might be the ways that, when the problem is around, 1460 01:17:25,110 --> 01:17:28,210 how is that influencing people's beliefs about themselves, 1461 01:17:28,210 --> 01:17:31,547 actions that they're taking, other kinds of things. 1462 01:17:31,547 --> 01:17:36,151 I've used other kinds of therapies, or like, cognitive 1463 01:17:36,151 --> 01:17:38,854 behavioral therapy, for example, when I talked about 1464 01:17:38,854 --> 01:17:40,465 something like thought distortions, 1465 01:17:40,465 --> 01:17:42,525 or the effects of things. 1466 01:17:42,525 --> 01:17:45,561 Sometimes I've talked with teenagers about, to help them 1467 01:17:45,561 --> 01:17:48,089 think about the ways that depression 1468 01:17:48,089 --> 01:17:50,232 impacts their thinking or cognitions. 1469 01:17:50,232 --> 01:17:51,300 I've talked about... 1470 01:17:56,253 --> 01:17:58,374 Imagine walking to the cafeteria in high school, 1471 01:17:58,374 --> 01:18:01,177 and as you walk in, there's a table of your friends, 1472 01:18:01,177 --> 01:18:04,890 and they all burst out into laughter, when you arrive. 1473 01:18:04,890 --> 01:18:07,549 On some days, you know someone's told a good story 1474 01:18:07,549 --> 01:18:10,853 or joke, you walk over and you hear what 1475 01:18:10,853 --> 01:18:12,187 they're talking about. 1476 01:18:12,187 --> 01:18:14,790 And other days, you're equally 100% sure that they are 1477 01:18:14,790 --> 01:18:17,293 laughing about you, and you might 1478 01:18:17,293 --> 01:18:18,953 have some thoughts to that. 1479 01:18:18,953 --> 01:18:20,763 Like, "Oh, I have a bad outfit on." 1480 01:18:22,024 --> 01:18:24,533 And really, to help them then think about what triggers 1481 01:18:24,533 --> 01:18:27,649 might be, what was the sensitivity that 1482 01:18:27,649 --> 01:18:29,204 has them equally sure. 1483 01:18:29,204 --> 01:18:31,673 And it's helpful to then have them begin to think about 1484 01:18:31,673 --> 01:18:33,144 both ways of thinking. 1485 01:18:33,144 --> 01:18:36,045 In this way, I think that you can talk about, 1486 01:18:36,045 --> 01:18:38,847 when the depression is around, what does that have you 1487 01:18:38,847 --> 01:18:41,683 convinced about yourself, in a different kind of way? 1488 01:18:41,683 --> 01:18:45,287 But with anything, before I would externalize anything, 1489 01:18:45,287 --> 01:18:47,649 part of these first part of the questions, as you're 1490 01:18:47,649 --> 01:18:52,261 naming the effects or the influence, is to-- 1491 01:18:52,261 --> 01:18:54,696 I don't know if I would start with externalizing 1492 01:18:54,696 --> 01:18:57,066 sexual offending, for example. 1493 01:18:57,066 --> 01:18:59,035 It might be a different kind of-- 1494 01:18:59,865 --> 01:19:02,938 My preliminary conversations with someone would be a little 1495 01:19:02,938 --> 01:19:06,241 bit about their relationship to that label. 1496 01:19:06,241 --> 01:19:08,977 Like, are there ways that it served them well? 1497 01:19:08,977 --> 01:19:10,546 Are there ways that it hasn't? 1498 01:19:10,546 --> 01:19:13,449 Are there ways that it fits with values that they have? 1499 01:19:13,449 --> 01:19:15,184 This is any label or diagnosis. 1500 01:19:15,184 --> 01:19:17,686 Like a certain sort of controversial to use for example 1501 01:19:17,686 --> 01:19:20,789 in this moment, but ways that it fits maybe, or maybe not. 1502 01:19:20,789 --> 01:19:22,991 Fits with this value, or ways that it doesn't. 1503 01:19:22,991 --> 01:19:24,193 You know, who-- 1504 01:19:25,993 --> 01:19:29,132 As they come to think about that, that is who they are, 1505 01:19:31,870 --> 01:19:32,668 what has been-- 1506 01:19:32,668 --> 01:19:35,071 How have they experienced that as problematic? 1507 01:19:35,071 --> 01:19:38,474 How does it not fit with who they are? 1508 01:19:38,474 --> 01:19:41,610 How does it fit, also, with a part of their history, 1509 01:19:41,610 --> 01:19:43,652 or behaviors that they've had. 1510 01:19:45,344 --> 01:19:48,016 I think, particularly, as people are transitioning, 1511 01:19:48,016 --> 01:19:51,120 or other kinds of things, I think that I actually like 1512 01:19:51,120 --> 01:19:54,023 to use the example of sexual (mumbling), because I think it 1513 01:19:54,023 --> 01:19:57,593 speaks to the range of complexities that fit with that, 1514 01:19:57,593 --> 01:20:00,596 because no one is holding any one label. 1515 01:20:00,596 --> 01:20:02,165 And certainly the folks that you're working with, 1516 01:20:02,165 --> 01:20:05,452 are not solely sexual perpetrators. 1517 01:20:05,452 --> 01:20:09,838 It can be very easy to see why the external world has 1518 01:20:09,838 --> 01:20:12,233 really tried to collapse that, and have that become 1519 01:20:12,233 --> 01:20:14,243 their total identity. 1520 01:20:14,243 --> 01:20:17,046 And so I do feel like it would be a series of many 1521 01:20:17,046 --> 01:20:21,750 conversations over time, to highlight who they understand 1522 01:20:21,750 --> 01:20:25,816 themselves to be, outside of that identity, or organization. 1523 01:20:27,635 --> 01:20:30,692 What it is that they value, or other kinds of things. 1524 01:20:30,692 --> 01:20:31,627 I don't want to take-- 1525 01:20:31,627 --> 01:20:34,886 We're not talking about any kind of perpetrating, 1526 01:20:35,747 --> 01:20:37,933 you know, behavior that's harmful of others. 1527 01:20:37,933 --> 01:20:40,137 I also feel like it's really-- 1528 01:20:40,137 --> 01:20:42,571 So part of that, is to really expand their identity 1529 01:20:42,571 --> 01:20:46,975 away from that label, to help them stand in a different 1530 01:20:46,975 --> 01:20:49,978 place, other than that identity, because that will allow 1531 01:20:49,978 --> 01:20:53,482 a different kind of community way of being in engagement. 1532 01:20:53,482 --> 01:20:54,950 Of course there's always-- 1533 01:20:54,950 --> 01:20:57,560 When people have done things that are harmful 1534 01:20:57,560 --> 01:20:59,721 to other people, it's like, I don't want to just only 1535 01:20:59,721 --> 01:21:03,592 have my conversations outside of the problem, as if 1536 01:21:04,499 --> 01:21:06,895 it's a cotton candy world, and everything's going to be 1537 01:21:06,895 --> 01:21:08,430 okay if we only talk about the best of 1538 01:21:08,430 --> 01:21:11,033 all of ourselves, and sort of ignore the worst. 1539 01:21:13,463 --> 01:21:17,673 I think that as we talk about issues of risk, and risk that 1540 01:21:17,673 --> 01:21:19,883 involves any kind of harm towards people in any way, 1541 01:21:19,883 --> 01:21:22,811 whether that be sexual perpetration, or child abuse, 1542 01:21:22,811 --> 01:21:26,348 any kind of physical or emotional violence of different kinds, 1543 01:21:26,348 --> 01:21:31,023 I think that there's ways of exploring the violence. 1544 01:21:33,334 --> 01:21:36,025 Also, just very carefully, where you're looking at 1545 01:21:36,025 --> 01:21:41,025 people's actions, decision making, experiences, 1546 01:21:41,396 --> 01:21:42,731 that might contribute. 1547 01:21:42,731 --> 01:21:45,701 This is where the broader social ideas 1548 01:21:45,701 --> 01:21:48,804 also, really come into play, what are the ideas about 1549 01:21:48,804 --> 01:21:53,676 the way that masculinity, or femininity, are in the world, 1550 01:21:53,676 --> 01:21:58,363 that might create conditions, or invitations for people to 1551 01:21:58,948 --> 01:22:02,201 express themselves in certain ways, or other ways. 1552 01:22:02,201 --> 01:22:04,753 There are a couple books that I think about. 1553 01:22:06,953 --> 01:22:09,625 There's a book by Alan Jenkins, 1554 01:22:09,625 --> 01:22:12,761 called Invitations To Responsibility, that talks 1555 01:22:12,761 --> 01:22:15,498 specifically about working with men who've perpetrated 1556 01:22:15,498 --> 01:22:18,467 sexual violence against women in narrative ways. 1557 01:22:18,467 --> 01:22:23,373 There's also another person who I would keep an eye out for, 1558 01:22:23,373 --> 01:22:26,308 who lives in Eastern Canada, and does some of the most 1559 01:22:26,308 --> 01:22:29,945 creative and amazing work I've seen with male perpetrators 1560 01:22:29,945 --> 01:22:32,548 of abuse, and I've been hoping to help publish more 1561 01:22:32,548 --> 01:22:33,882 and more for years. 1562 01:22:33,882 --> 01:22:35,284 His name is Art Fischer. 1563 01:22:38,575 --> 01:22:40,864 I think that there are a lot of interesting writers. 1564 01:22:41,494 --> 01:22:45,427 That almost is a day in itself, about ways of, how do I 1565 01:22:45,427 --> 01:22:47,463 hold people accountable-- 1566 01:22:47,463 --> 01:22:51,199 Both expand the identity outside of this negative thing, 1567 01:22:51,199 --> 01:22:54,971 which is true for any potential diagnosis, but also 1568 01:22:54,971 --> 01:22:56,772 particularly around issues of risk. 1569 01:22:56,772 --> 01:23:00,009 Working with ways that are empowering to them, but also 1570 01:23:00,009 --> 01:23:02,678 acknowledging of the risky behavior. 1571 01:23:03,431 --> 01:23:06,965 But really, it is similar in that you are really pulling out 1572 01:23:06,965 --> 01:23:10,152 values, looking at social interest, social influences, 1573 01:23:10,152 --> 01:23:14,465 but also continuing to hold people accountable 1574 01:23:14,465 --> 01:23:18,727 for harm that they've done towards others, 1575 01:23:18,727 --> 01:23:19,961 and thinking about-- 1576 01:23:19,961 --> 01:23:22,864 There's really, also, a lot of interesting-- 1577 01:23:22,864 --> 01:23:25,434 We're not even talking about some of the community 1578 01:23:25,434 --> 01:23:26,802 work aspects. 1579 01:23:26,802 --> 01:23:29,313 There's been some really fascinating... 1580 01:23:29,313 --> 01:23:31,973 There's some strong connections between narrative therapy 1581 01:23:31,973 --> 01:23:34,243 and restorative justice movements. 1582 01:23:34,766 --> 01:23:38,247 And so, really thinking a lot about, what are ways 1583 01:23:38,247 --> 01:23:42,151 of reparations, in terms of thinking about harm 1584 01:23:42,151 --> 01:23:44,486 and reintegration of people in community. 1585 01:23:44,486 --> 01:23:48,023 So, really thinking about if people are coming out 1586 01:23:48,023 --> 01:23:50,492 of any kind of prison, or institution, 1587 01:23:50,492 --> 01:23:52,094 or other kinds of ways, where they've been 1588 01:23:52,094 --> 01:23:54,323 separated from their behaviors. 1589 01:23:54,323 --> 01:23:57,699 What are the ways that we, in the outside community 1590 01:23:57,699 --> 01:24:00,736 and helping community, can also really work at 1591 01:24:00,736 --> 01:24:02,571 partnering with the community, 1592 01:24:02,571 --> 01:24:04,334 with folks who are re-entering it. 1593 01:24:04,334 --> 01:24:08,243 How can they return-- 1594 01:24:08,243 --> 01:24:10,512 Because we know that-- 1595 01:24:11,327 --> 01:24:14,049 I know as a social worker, and I would imagine that 1596 01:24:14,049 --> 01:24:18,275 other people might share, the sense that it's really about 1597 01:24:18,305 --> 01:24:19,788 people are less-- 1598 01:24:19,788 --> 01:24:22,458 Like, if you are not marginalized, but really given full 1599 01:24:22,458 --> 01:24:26,061 membership back in society as you come back in the world, 1600 01:24:28,905 --> 01:24:31,187 you would be more likely to be able 1601 01:24:31,187 --> 01:24:33,355 to fully participate in some ways. 1602 01:24:34,895 --> 01:24:37,072 I think that a lot of restorative justice movement think 1603 01:24:37,072 --> 01:24:41,376 a lot about reparation conversations, and really re-entry 1604 01:24:41,376 --> 01:24:43,478 back into the world. 1605 01:24:50,555 --> 01:24:53,054 How's this going, so far, if I may just do a check? 1606 01:24:53,054 --> 01:24:54,256 I'm always so aware. 1607 01:24:54,256 --> 01:24:59,256 I can lose focus sometimes when I teach, if I get too 1608 01:25:00,146 --> 01:25:02,033 too new to the clock in what I originally planned. 1609 01:25:02,033 --> 01:25:04,467 I feel like by the end of the day, I can really make sure 1610 01:25:04,467 --> 01:25:06,468 that we get to material, but is this going okay 1611 01:25:06,468 --> 01:25:08,470 for all of you so far? 1612 01:25:09,037 --> 01:25:11,640 Would anyone be courageous enough to say, "No, it wasn't!" 1613 01:25:11,640 --> 01:25:13,208 Okay, all right. 1614 01:25:15,744 --> 01:25:17,979 No, but these are great questions, thank you. 1615 01:25:19,214 --> 01:25:22,384 But in the externalizing, as I said the characterization 1616 01:25:22,384 --> 01:25:25,220 of a problem, and looking at the effects and influences 1617 01:25:25,220 --> 01:25:28,840 of the problem, revealing its tricks and tactics, 1618 01:25:29,247 --> 01:25:30,926 I think what's so helpful to always remember 1619 01:25:30,926 --> 01:25:34,497 and keep in mind too, is that for so many folks, 1620 01:25:34,497 --> 01:25:36,798 before something became a problem in their life, 1621 01:25:36,798 --> 01:25:40,702 it was really, it had its purpose. 1622 01:25:40,702 --> 01:25:42,737 Or worked well enough, or it was a friend. 1623 01:25:42,737 --> 01:25:45,907 So we're talking about this idea of the beast, if you think 1624 01:25:45,907 --> 01:25:49,111 about this within rational recovery, if you think about 1625 01:25:49,111 --> 01:25:51,546 the beast as maybe being a representation of a way of 1626 01:25:51,546 --> 01:25:55,350 describing a history of substance abuse. 1627 01:25:55,750 --> 01:25:59,588 You know, there will be a time, when using or drinking 1628 01:25:59,588 --> 01:26:01,757 might have been really helpful around 1629 01:26:01,757 --> 01:26:03,492 some social anxiety issues. 1630 01:26:03,492 --> 01:26:06,061 Like, it might have promoted connection, or been 1631 01:26:06,061 --> 01:26:07,662 connected with values. 1632 01:26:07,662 --> 01:26:12,305 Most problems, if you trace the history, there can be some 1633 01:26:12,305 --> 01:26:15,904 ambivalence, or change hasn't happened easily, 1634 01:26:15,904 --> 01:26:19,008 because there's a mixed history of things that were maybe, 1635 01:26:19,008 --> 01:26:22,277 at one point, positive, and then had become more negative. 1636 01:26:22,277 --> 01:26:24,980 So think about issues, look at the naming, effects, 1637 01:26:24,980 --> 01:26:27,682 or influence of the problem, and its tricks and tactics. 1638 01:26:27,682 --> 01:26:30,619 It can be exploring a complicated history. 1639 01:26:30,619 --> 01:26:33,588 It's sort of like, that friend who you're like, 1640 01:26:34,634 --> 01:26:35,857 kind of have a mixed really-- 1641 01:26:35,857 --> 01:26:37,158 Who hasn't always been so, you know like-- 1642 01:26:37,158 --> 01:26:39,461 It's a conflict, most problems have pretty 1643 01:26:39,461 --> 01:26:43,464 complicated histories in their relationships with people. 1644 01:26:44,735 --> 01:26:47,168 What becomes important, and I think is really critical 1645 01:26:47,168 --> 01:26:50,106 for change, is that evaluating the effects, influences 1646 01:26:50,106 --> 01:26:54,109 the person, this again, where you're centering the person 1647 01:26:54,109 --> 01:26:56,945 as the expert, where they have to evaluate the effects, 1648 01:26:56,945 --> 01:27:00,183 and end up making a statement in relation to the problem. 1649 01:27:00,183 --> 01:27:01,917 So, going back to the years that I worked 1650 01:27:01,917 --> 01:27:05,773 on inpatient units, it would really be absolutely 1651 01:27:05,773 --> 01:27:09,926 not uncommon, for an adolescent to be hospitalized 1652 01:27:09,926 --> 01:27:11,994 for self harming behaviors. 1653 01:27:11,994 --> 01:27:14,429 Self injurious behaviors of some kind. 1654 01:27:15,566 --> 01:27:19,769 Often times, family, school, everyone would really 1655 01:27:19,769 --> 01:27:23,972 define the problem as these self injurious behaviors, 1656 01:27:23,972 --> 01:27:25,807 and they were very worrisome. 1657 01:27:25,807 --> 01:27:29,010 And I agree, they were very worrisome behaviors. 1658 01:27:29,010 --> 01:27:31,580 But often, I would be sitting with a young person, 1659 01:27:31,580 --> 01:27:34,449 and they would have a very different idea of what 1660 01:27:34,449 --> 01:27:35,884 the problem was. 1661 01:27:37,607 --> 01:27:40,223 They would say, "Well, these self injurious behaviors 1662 01:27:40,223 --> 01:27:42,724 "are not such a big deal to me. 1663 01:27:42,724 --> 01:27:46,396 "In fact, they're the most useful way that I have 1664 01:27:46,396 --> 01:27:50,198 "come up with to date, to manage my emotions, or feelings. 1665 01:27:50,951 --> 01:27:54,869 "There is a physiological effect that I experience." 1666 01:27:54,869 --> 01:27:57,239 They wouldn't necessarily say it in these words, 1667 01:27:57,239 --> 01:28:01,343 but their experience of cutting, releasing endorphins, 1668 01:28:01,343 --> 01:28:04,946 or other kinds of experience that really were biolog-- 1669 01:28:04,946 --> 01:28:07,496 Or really had some kind of biological feedback in them, 1670 01:28:07,496 --> 01:28:09,751 that was helpful, and that, "I'm not willing to 1671 01:28:09,751 --> 01:28:12,153 "change these behaviors at this time." 1672 01:28:12,153 --> 01:28:15,323 Or anyone who's ever worked in mandated treatment, 1673 01:28:15,323 --> 01:28:17,359 which is a lot of treatment with adolescents, 1674 01:28:17,359 --> 01:28:18,694 but certainly on a unit. 1675 01:28:19,432 --> 01:28:21,229 People can be really smart. 1676 01:28:21,967 --> 01:28:25,667 If a kid gets in an the patient unit, and knows that in 1677 01:28:25,667 --> 01:28:29,137 order to leave, they need to say, "Yes, yes, yes, yes." 1678 01:28:29,137 --> 01:28:31,639 Or, "No, I won't cut," "No," this. 1679 01:28:32,439 --> 01:28:36,111 "Yes my coping skills are reading, writing in my journal 1680 01:28:36,111 --> 01:28:37,579 "and listening to music." 1681 01:28:37,579 --> 01:28:40,415 Like whatever the common things that we tell 1682 01:28:40,415 --> 01:28:41,916 work with teenagers. 1683 01:28:41,916 --> 01:28:44,386 They can say the right things to get out, 1684 01:28:44,386 --> 01:28:47,122 but if you're really thinking about changing behavior, 1685 01:28:47,122 --> 01:28:49,924 it's important that as we work with this system, 1686 01:28:49,924 --> 01:28:52,427 that we have a shared understanding of what the 1687 01:28:52,427 --> 01:28:54,262 problem is in the first place. 1688 01:28:54,262 --> 01:28:55,764 And so, I do-- 1689 01:28:55,764 --> 01:28:58,545 When we talk about a characterization of the problem, 1690 01:28:58,545 --> 01:29:00,335 it has to be something that would fit with 1691 01:29:00,335 --> 01:29:02,103 all parties involved. 1692 01:29:02,103 --> 01:29:04,373 I want to honor the school and parent's opinion, 1693 01:29:04,373 --> 01:29:07,575 but I also know that if I define the problem solely 1694 01:29:07,575 --> 01:29:09,544 in that way, that young person is not going to 1695 01:29:09,544 --> 01:29:12,614 be motivated to take any steps towards changing that 1696 01:29:12,614 --> 01:29:17,152 relationship to the self harm that they have in their life. 1697 01:29:18,013 --> 01:29:19,721 But you know what, lots of times, young people 1698 01:29:19,721 --> 01:29:23,225 find it problematic, the adults meddling. 1699 01:29:24,209 --> 01:29:26,528 The lack of privacy might be a result. 1700 01:29:26,528 --> 01:29:30,065 The fact that they've been hospitalized against their will, 1701 01:29:30,065 --> 01:29:33,035 and that they don't have privacy in a hospital setting. 1702 01:29:33,035 --> 01:29:35,971 So it hasn't been uncommon, for me to take, then, 1703 01:29:35,971 --> 01:29:38,873 the issue that is related to the self harming behavior 1704 01:29:38,873 --> 01:29:42,477 about the loss of privacy and independence, 1705 01:29:42,477 --> 01:29:45,781 that might come for some young people. 1706 01:29:45,781 --> 01:29:49,417 It wouldn't be uncommon, during the times that I've 1707 01:29:49,417 --> 01:29:52,220 worked at the hospital, that upon discharge, 1708 01:29:52,220 --> 01:29:54,389 a young person might need to visit their primary 1709 01:29:54,389 --> 01:29:57,358 care provider once a week, to have a body check. 1710 01:29:57,358 --> 01:29:59,728 We might remove it from the tension between the parent 1711 01:29:59,728 --> 01:30:03,565 regularly checking the child wasn't cutting in places 1712 01:30:03,565 --> 01:30:06,501 that were under clothes, because that really was causing 1713 01:30:06,501 --> 01:30:09,271 a lot of problems in a parent-child relationship. 1714 01:30:09,271 --> 01:30:11,172 But the fact that they would have to go to the doctor 1715 01:30:11,172 --> 01:30:15,477 and be looked at, would be considered problematic. 1716 01:30:15,477 --> 01:30:17,045 Or the fact that they weren't allowed to have their 1717 01:30:17,045 --> 01:30:19,013 bedroom door closed at home anymore. 1718 01:30:19,013 --> 01:30:21,416 They might be willing, or, you know-- 1719 01:30:21,416 --> 01:30:23,352 Or that their parents might be searching the room 1720 01:30:23,352 --> 01:30:25,320 a couple times a week for sharps. 1721 01:30:25,320 --> 01:30:28,689 And different kinds of safety plans were put in place. 1722 01:30:29,158 --> 01:30:31,926 Young people might be very motivated, to try to get their-- 1723 01:30:32,710 --> 01:30:35,196 Well maybe it would be worthwhile to try to find 1724 01:30:35,196 --> 01:30:39,267 some other ways of managing intense emotions, if they 1725 01:30:39,267 --> 01:30:42,036 could then earn the capacity to close their door, 1726 01:30:42,036 --> 01:30:43,638 or other kinds of things. 1727 01:30:43,905 --> 01:30:46,808 So part of it sometimes, in the naming effects 1728 01:30:46,808 --> 01:30:48,943 particularly, and working with systems where there's 1729 01:30:48,943 --> 01:30:51,847 very different understandings of the problem, you can 1730 01:30:51,847 --> 01:30:56,317 get to a way of describing, or coming up with a way, 1731 01:30:56,317 --> 01:30:59,921 a conceptualization of a problem, that really fits with 1732 01:30:59,921 --> 01:31:02,290 everybody's goals and needs, 1733 01:31:02,290 --> 01:31:05,553 and then treatment really will become a lot more successful. 1734 01:31:06,507 --> 01:31:09,998 Okay, so there are some examples and you have these 1735 01:31:09,998 --> 01:31:12,700 in some of your work sheets, but because you can get 1736 01:31:12,700 --> 01:31:15,303 into pairs, I think it'll be helpful. 1737 01:31:15,303 --> 01:31:17,682 But, "The first part of externalizing a conversation, 1738 01:31:17,682 --> 01:31:19,847 "seeks to have a person consulting us 1739 01:31:19,847 --> 01:31:21,843 "name the problem as they understand it." 1740 01:31:23,135 --> 01:31:25,925 Lots of times, I feel like the best way to get at this, 1741 01:31:25,925 --> 01:31:28,390 is to start with a story. 1742 01:31:29,366 --> 01:31:31,961 "Can you describe a time when this problem was around, 1743 01:31:31,961 --> 01:31:34,857 "so I might have a better understanding of your experience?" 1744 01:31:34,857 --> 01:31:37,036 You know, "What name might you give this belief?" 1745 01:31:37,036 --> 01:31:39,940 And again, this goes back to your question, Tuva, 1746 01:31:39,940 --> 01:31:41,470 about like-- 1747 01:31:42,193 --> 01:31:45,178 From the beginning, that internal states versus 1748 01:31:45,178 --> 01:31:47,441 intentional states, a lot of these things from 1749 01:31:47,441 --> 01:31:51,212 the beginning, I have my bias and my conceptualization 1750 01:31:51,212 --> 01:31:56,212 as I'm answering intentional state understandings of things. 1751 01:31:57,140 --> 01:32:00,114 So, what name might you give this belief. 1752 01:32:00,114 --> 01:32:02,190 That's very different from asking a question that 1753 01:32:02,190 --> 01:32:05,594 might be reflective more of an internal state understanding. 1754 01:32:06,855 --> 01:32:08,101 That's the danger, if you ask a question, 1755 01:32:08,101 --> 01:32:10,634 I'll keep coming back to it, over the course of the day. 1756 01:32:11,392 --> 01:32:13,464 "Is there a particular time or place, where this 1757 01:32:15,524 --> 01:32:17,844 "blank," or whatever they're naming it, "has more or less 1758 01:32:17,844 --> 01:32:18,947 "of an influence in your life? 1759 01:32:18,947 --> 01:32:20,546 "Can you give me an example?" 1760 01:32:20,546 --> 01:32:23,371 For some people, maybe younger people, and sometimes 1761 01:32:23,371 --> 01:32:27,578 other people, I think that so often, we can listen to 1762 01:32:27,578 --> 01:32:29,980 the way that people put language to things. 1763 01:32:29,980 --> 01:32:33,147 I think so many of us automatically do minor shifts 1764 01:32:33,147 --> 01:32:36,064 towards the ways that people talk-- 1765 01:32:36,064 --> 01:32:39,127 The different kinds of metaphors that people use. 1766 01:32:39,127 --> 01:32:40,089 I know I can always-- 1767 01:32:40,089 --> 01:32:43,491 I'm not a real visual person, so I often wouldn't come 1768 01:32:43,491 --> 01:32:47,675 up with a lot of visual metaphors, but if people are very-- 1769 01:32:48,582 --> 01:32:51,733 You discuss things in sort of image, or that kind of thing, 1770 01:32:51,733 --> 01:32:54,569 I'm much more likely to work in that way with people, 1771 01:32:54,569 --> 01:32:56,346 or other kinds of metaphors. 1772 01:32:56,346 --> 01:32:57,207 I think we all do that. 1773 01:32:57,207 --> 01:32:59,790 But, just for some people, this idea of 1774 01:32:59,790 --> 01:33:01,710 externalizing this problem were a person, 1775 01:33:01,710 --> 01:33:04,312 what kind of person would do this sort of thing? 1776 01:33:04,312 --> 01:33:05,953 What would it look like, sound like? 1777 01:33:06,845 --> 01:33:09,886 The next part of exploring the effects and influence 1778 01:33:09,886 --> 01:33:12,630 in "multiple domains in a person's life, where the problem 1779 01:33:12,630 --> 01:33:15,425 "might have influence, as well as its tricks and tactics." 1780 01:33:15,425 --> 01:33:17,816 Things like a lot of you will be trying this 1781 01:33:17,816 --> 01:33:19,460 in the next half hour. 1782 01:33:19,460 --> 01:33:22,274 If we ask a question that people start to answer, 1783 01:33:22,274 --> 01:33:25,545 "I don't know," I've asked too big of a question. 1784 01:33:25,545 --> 01:33:29,816 And so, one thing that I might do 1785 01:33:29,816 --> 01:33:34,188 and this sort of fits with the learning model. 1786 01:33:34,880 --> 01:33:38,124 Learning model by Lev Fakosky, for people who know 1787 01:33:38,124 --> 01:33:40,328 developmental theory, is something that underpins. 1788 01:33:40,328 --> 01:33:44,223 There would be an idea between, sometimes to get people 1789 01:33:44,223 --> 01:33:47,067 to a naming, it helps to do a mis-naming. 1790 01:33:49,559 --> 01:33:53,883 I actually feel like, when I work with young people 1791 01:33:54,776 --> 01:33:57,868 who I tend to think of, just as a group, 1792 01:33:57,868 --> 01:34:00,477 or less abstract, and more concrete. 1793 01:34:01,046 --> 01:34:03,510 See if I wanted to try this question, and they said, 1794 01:34:03,510 --> 01:34:04,649 "I don't know." 1795 01:34:04,649 --> 01:34:08,717 It would be like, if I knew that they liked, 1796 01:34:09,993 --> 01:34:12,154 I don't know, a particular Disney movie or something. 1797 01:34:12,154 --> 01:34:17,154 Whatever I knew to be within the realm of characters of life, 1798 01:34:19,246 --> 01:34:20,596 I might do something like, 1799 01:34:20,596 --> 01:34:22,468 "Would it be this type of character?" 1800 01:34:22,468 --> 01:34:24,805 Anything I could name. 1801 01:34:24,805 --> 01:34:28,299 I would try to offer a variety of examples, like three 1802 01:34:28,299 --> 01:34:32,109 or four examples, and then always add something else. 1803 01:34:32,109 --> 01:34:36,371 Because I think that so often, this idea of mis-naming 1804 01:34:36,371 --> 01:34:40,208 versus naming, it's just like offering a little scaffolding. 1805 01:34:40,208 --> 01:34:43,723 If I give any of the rest, however I'm trying to find 1806 01:34:43,723 --> 01:34:47,259 a word in conversation, and we're struggling for word 1807 01:34:47,259 --> 01:34:51,717 finding with an attentive listener, so I'm trying to 1808 01:34:51,717 --> 01:34:54,865 remember something and the other person knows, for example, 1809 01:34:54,865 --> 01:34:57,502 it seems to be some kind of fruit that I'm trying 1810 01:34:57,502 --> 01:34:58,568 to think about, they might say, 1811 01:34:58,568 --> 01:34:59,873 "Banana, apple, orange." 1812 01:35:00,534 --> 01:35:02,339 Trying to offer that to me, it's like, 1813 01:35:02,339 --> 01:35:03,431 "Oh no, it was kiwi." 1814 01:35:03,431 --> 01:35:07,076 And so often, how we come to a particular knowing, 1815 01:35:07,076 --> 01:35:09,977 is when people offer us examples that are, maybe, 1816 01:35:09,977 --> 01:35:11,651 close or far way. 1817 01:35:11,651 --> 01:35:16,178 And so, I think about that a lot, not only in trying 1818 01:35:16,178 --> 01:35:20,058 narrative questions in therapy, but it's not always-- 1819 01:35:20,888 --> 01:35:22,651 I don't know if we can get-- 1820 01:35:22,651 --> 01:35:25,799 Sometimes, it's very much about a particular stance 1821 01:35:25,799 --> 01:35:27,892 that someone's taking in relation to therapy. 1822 01:35:27,892 --> 01:35:30,058 First place, again, that I'm influenced by my 1823 01:35:30,058 --> 01:35:31,368 work with adolescents. 1824 01:35:31,368 --> 01:35:33,671 Sometimes, I might get an, "I don't know," just because 1825 01:35:33,671 --> 01:35:37,765 of a really good stance of, "Look, I'm really not interested 1826 01:35:37,765 --> 01:35:39,640 "in doing this kind of work." 1827 01:35:39,640 --> 01:35:41,805 And other times, it's really a genuine I don't know, 1828 01:35:41,805 --> 01:35:45,440 like I've asked a question that is too abstract or out of 1829 01:35:45,440 --> 01:35:48,576 the realm that people can imagine, so what I want to do 1830 01:35:48,576 --> 01:35:51,479 is ask-- 1831 01:35:52,955 --> 01:35:55,428 I want to make my question smaller in some way, 1832 01:35:55,428 --> 01:35:58,065 so I might offer different kinds of choices, 1833 01:35:58,065 --> 01:35:59,892 but always with an "or something else." 1834 01:35:59,892 --> 01:36:01,435 Or I might offer-- 1835 01:36:01,435 --> 01:36:03,664 There are other ways that I might try to make 1836 01:36:03,664 --> 01:36:05,270 my questions smaller. 1837 01:36:05,530 --> 01:36:07,606 So I would think of that as an example, and if it still 1838 01:36:07,606 --> 01:36:09,836 feels like, "Oh, this isn't a good fit." 1839 01:36:14,358 --> 01:36:16,704 I feel like the joy about learning many different 1840 01:36:16,704 --> 01:36:19,787 theoretical approaches or the joy of practicing in 1841 01:36:19,787 --> 01:36:22,319 an eclectic way and drawing off of many different kinds 1842 01:36:22,319 --> 01:36:24,145 of ideas to create our own voice, 1843 01:36:24,145 --> 01:36:26,982 is that we try something else. 1844 01:36:26,982 --> 01:36:30,197 But I do feel like, especially as I'm trying out 1845 01:36:30,197 --> 01:36:32,365 something new, its helpful to not-- 1846 01:36:32,365 --> 01:36:36,532 So we can give up too easily on ideas too, and so one 1847 01:36:36,532 --> 01:36:38,167 thing to do is really to make it a little bit smaller 1848 01:36:38,167 --> 01:36:39,636 in the moment. 1849 01:36:39,961 --> 01:36:42,130 Or even to get into specifically, 1850 01:36:42,130 --> 01:36:44,009 what kind of voice do they have? 1851 01:36:44,009 --> 01:36:48,171 Do they have like a dark voice? 1852 01:36:48,369 --> 01:36:49,478 Do they speak a certain way? 1853 01:36:50,093 --> 01:36:53,044 I used to have a kid, when I first started to work, 1854 01:36:53,044 --> 01:36:56,992 who he engaged in what I would call Accent Therapy. 1855 01:37:01,252 --> 01:37:04,426 I could tell about how he was viewing a problem 1856 01:37:04,426 --> 01:37:07,366 or an issue, because he watched a lot of inappropriate 1857 01:37:07,366 --> 01:37:11,664 movies at home, so he would talk like a mobster 1858 01:37:11,664 --> 01:37:13,692 in some incidences. 1859 01:37:15,568 --> 01:37:17,832 This was many years ago, and he talked with a Minnesota 1860 01:37:17,832 --> 01:37:20,937 accent for the most scary or evil character. 1861 01:37:20,937 --> 01:37:22,612 I was like, "Well, where did that come from?" 1862 01:37:22,612 --> 01:37:24,812 And I was a little sensitive, because I had just been 1863 01:37:24,812 --> 01:37:26,741 living in Minnesota, and I didn't think it was in 1864 01:37:26,741 --> 01:37:28,722 my language, but it turns out, 1865 01:37:28,722 --> 01:37:30,322 he had watched the movie, Fargo. 1866 01:37:30,322 --> 01:37:32,510 It's like an elementary school student learning the 1867 01:37:32,510 --> 01:37:35,356 wood chipper, and all the other images from that movie 1868 01:37:35,356 --> 01:37:39,479 really made the Minnesota accent be the most scary 1869 01:37:39,479 --> 01:37:41,333 thing that he could imagine. 1870 01:37:41,333 --> 01:37:43,392 So it was sort of helpful. 1871 01:37:43,392 --> 01:37:45,203 So there's just different ways of working with 1872 01:37:45,203 --> 01:37:47,464 different people that can be helpful. 1873 01:37:48,896 --> 01:37:53,173 I love those ways of really making it, because it's-- 1874 01:37:54,080 --> 01:37:56,479 Whether we call that externalizing, or something else, 1875 01:37:56,479 --> 01:38:00,391 it really had that same intention or effect of a way that 1876 01:38:00,391 --> 01:38:03,017 a child could put language to an experience, 1877 01:38:03,017 --> 01:38:05,713 and name it as something that's different than themselves. 1878 01:38:05,713 --> 01:38:07,788 And it is the power of the naming. 1879 01:38:07,788 --> 01:38:09,926 I think that, that's the power that-- 1880 01:38:09,926 --> 01:38:12,627 I guess that also goes back to that quadrant 1881 01:38:12,627 --> 01:38:15,463 of centered or de-centered, that we're more centered, 1882 01:38:15,463 --> 01:38:17,303 we're the ones that really owns that power 1883 01:38:17,303 --> 01:38:18,804 in doing the naming, 1884 01:38:18,804 --> 01:38:21,811 But with something like externalizing, or reaching for these 1885 01:38:21,811 --> 01:38:25,385 intentional state understandings, we're really sharing 1886 01:38:25,385 --> 01:38:27,973 that power of the naming, or giving that power of 1887 01:38:27,973 --> 01:38:30,082 the naming to the people who are in the room. 1888 01:38:30,082 --> 01:38:34,183 And so, in your example, when you're having folks use 1889 01:38:34,183 --> 01:38:37,551 different colors, or use different locations, or talk about, 1890 01:38:37,551 --> 01:38:40,316 "How can I bleed this color in more?" 1891 01:38:40,316 --> 01:38:42,863 It's really about, they're getting to do what the 1892 01:38:42,863 --> 01:38:45,537 naming is, that their problem is experiencing, as well as 1893 01:38:45,537 --> 01:38:47,964 what the naming is, about ways around it. 1894 01:38:47,964 --> 01:38:49,665 And so I think it's just a beautiful example, 1895 01:38:49,665 --> 01:38:51,072 and thanks for sharing your work. 1896 01:38:51,079 --> 01:38:52,227 Yeah. 1897 01:38:53,508 --> 01:38:56,238 So these are different kinds of questions. 1898 01:38:57,930 --> 01:39:00,481 It's a little bit of a different kind of way 1899 01:39:00,481 --> 01:39:02,041 to think about a problem of, you know, 1900 01:39:02,041 --> 01:39:03,652 "Does the Angry Monster--" 1901 01:39:03,652 --> 01:39:06,071 I don't think I would ask that particular seven 1902 01:39:06,071 --> 01:39:10,574 year old, but, you know, "What does the Angry Monster do 1903 01:39:10,574 --> 01:39:12,790 "to enforce a set of rules, or code of conduct? 1904 01:39:12,790 --> 01:39:16,759 "What does it have you doing at different times of the day? 1905 01:39:16,759 --> 01:39:17,990 "What do you think that says, about what the 1906 01:39:17,990 --> 01:39:20,554 "Angry Monster's intentions are for your life? 1907 01:39:22,491 --> 01:39:24,171 "Do you have the same hopes as the problem? 1908 01:39:24,171 --> 01:39:26,144 "Does the problem have the same hopes for you?" 1909 01:39:26,144 --> 01:39:28,096 So I feel like these kinds of questions 1910 01:39:28,096 --> 01:39:30,968 can be really useful. 1911 01:39:31,672 --> 01:39:34,309 Also, you have more effects and influence. 1912 01:39:34,309 --> 01:39:36,378 Another thing that we'll go into, in the afternoon, 1913 01:39:36,378 --> 01:39:40,374 is that as you're re-structuring a new story, we'll talk 1914 01:39:40,374 --> 01:39:43,418 a lot about how there's meaning questions 1915 01:39:43,418 --> 01:39:46,116 and action questions, and you can begin to look 1916 01:39:46,116 --> 01:39:48,858 back at some of these externalizing questions, sometimes in 1917 01:39:48,858 --> 01:39:50,918 the narrative literature, for those who had 1918 01:39:50,918 --> 01:39:53,320 experience, or reading these might be called, 1919 01:39:53,320 --> 01:39:56,034 landscape of identity, meaning questions, 1920 01:39:56,034 --> 01:39:57,568 or landscape of action. 1921 01:39:57,568 --> 01:40:00,106 But again, as you're exploring the effects of 1922 01:40:00,106 --> 01:40:03,544 the problem, I always ask questions that explore people's 1923 01:40:03,544 --> 01:40:06,412 beliefs, or understandings of themself. 1924 01:40:06,412 --> 01:40:08,810 Like that young boy on the inpatient unit who 1925 01:40:08,810 --> 01:40:11,784 experiences himself as a failure. 1926 01:40:11,784 --> 01:40:14,987 Part of what we're externalizing or amplifying is 1927 01:40:14,987 --> 01:40:16,923 different kinds of ways of understanding 1928 01:40:16,923 --> 01:40:19,825 himself relationally, but also focusing a lot on 1929 01:40:19,825 --> 01:40:21,248 what he's doing. 1930 01:40:21,248 --> 01:40:23,350 Like, the actions, about, "How did you know? 1931 01:40:23,350 --> 01:40:25,598 "Did you see something in my face? 1932 01:40:25,598 --> 01:40:27,329 "How did you know to squeeze my hand?" 1933 01:40:27,329 --> 01:40:30,200 Those kinds of things, to really do a balance, 1934 01:40:30,200 --> 01:40:33,069 of both the doing and the thinking. 1935 01:40:33,069 --> 01:40:37,941 I know that for me, I love living up here in the world 1936 01:40:37,941 --> 01:40:40,375 of beliefs, thinking, and actions. 1937 01:40:40,375 --> 01:40:43,911 I just love that realm, and I've been really-- 1938 01:40:43,911 --> 01:40:45,517 And this has been helpful in my work, to think also, 1939 01:40:45,517 --> 01:40:47,812 more about lots of people, and more do-ers, 1940 01:40:47,812 --> 01:40:50,417 and thinkers and experiencers of life. 1941 01:40:50,417 --> 01:40:52,857 And to really balance my questions, and not always 1942 01:40:52,857 --> 01:40:57,327 go, sort of, what my trends or tendencies might be. 1943 01:40:59,711 --> 01:41:02,968 So then where you get to, is to have people take 1944 01:41:02,968 --> 01:41:04,537 a statement of position. 1945 01:41:04,537 --> 01:41:07,673 And so, by the time you've looked at effects, 1946 01:41:07,673 --> 01:41:09,797 sometimes people are a bit ambivalent. 1947 01:41:09,797 --> 01:41:11,512 Sometimes, people are really-- 1948 01:41:11,512 --> 01:41:13,372 It seems really like they've come-- 1949 01:41:13,372 --> 01:41:15,679 They're really clear that it's a negative something. 1950 01:41:15,679 --> 01:41:17,378 And so then I might say something like, "Well it may 1951 01:41:17,378 --> 01:41:19,083 "seem obvious, but I want to check in with you, 1952 01:41:19,083 --> 01:41:23,056 "to see if the Angry Monster has been something that 1953 01:41:23,056 --> 01:41:24,424 "has been helpful, unhelpful, 1954 01:41:24,424 --> 01:41:25,787 "or a bit of both in your life." 1955 01:41:25,787 --> 01:41:27,190 Or, like the self harm. 1956 01:41:27,190 --> 01:41:30,062 This is a great one for that self harm example, 1957 01:41:30,062 --> 01:41:31,425 with the adolescent. 1958 01:41:31,425 --> 01:41:34,789 The parents, the school, are going to identify self harm 1959 01:41:34,789 --> 01:41:36,603 as being very problematic. 1960 01:41:37,387 --> 01:41:40,405 But the first time around with that adolescent, 1961 01:41:40,405 --> 01:41:42,243 if I know that I can actually-- 1962 01:41:42,243 --> 01:41:45,410 They'll have described in these conversations, the ways that 1963 01:41:45,410 --> 01:41:48,080 the self harm has been very helpful to them. 1964 01:41:48,664 --> 01:41:51,338 When they get the idea, they can really do a lot of 1965 01:41:51,338 --> 01:41:56,016 identifying about what kinds of circumstances, or events, 1966 01:41:56,016 --> 01:41:59,013 or things, or emotional state, they might be in, 1967 01:41:59,013 --> 01:42:03,395 when they turn to, for example, cutting themselves. 1968 01:42:04,179 --> 01:42:07,199 But, they might not be wanting to change. 1969 01:42:07,199 --> 01:42:10,432 I think about couple people that I've mentioned, who've had 1970 01:42:10,432 --> 01:42:11,973 problems with substance abuse. 1971 01:42:11,973 --> 01:42:15,309 Think about motivational interviewing, for example, 1972 01:42:15,309 --> 01:42:18,273 as someone might see there's a lot of overlapping values 1973 01:42:18,273 --> 01:42:21,014 and similarities and ideas in narrative therapy. 1974 01:42:21,014 --> 01:42:23,249 And motivational interviewing, for folks who are 1975 01:42:23,249 --> 01:42:25,372 familiar with it, is something where you really are 1976 01:42:25,372 --> 01:42:28,542 listening for, and targeting the ambivalence, 1977 01:42:28,542 --> 01:42:29,880 in people's statements. 1978 01:42:29,880 --> 01:42:32,024 And as you explore that ambivalence, 1979 01:42:32,024 --> 01:42:33,619 you're really thinking-- 1980 01:42:33,619 --> 01:42:37,689 You're getting underlying values and hopes, and then 1981 01:42:37,689 --> 01:42:40,418 helping people move along the stages of change. 1982 01:42:40,418 --> 01:42:44,568 And I do feel like, there can be a similar (mumbling) 1983 01:42:44,568 --> 01:42:46,271 in looking at their statement of position. 1984 01:42:46,271 --> 01:42:48,672 It's sort of a way of exploring that. 1985 01:42:51,032 --> 01:42:54,910 And then, asking them to justify it, because that's always-- 1986 01:42:55,540 --> 01:42:57,547 I don't know, I think this is important for everyone, 1987 01:42:57,547 --> 01:43:01,115 but also, working in that context of a lot of mandated 1988 01:43:01,115 --> 01:43:03,845 treatment and inpatient, it's like, asking that second 1989 01:43:03,845 --> 01:43:05,546 level of question, of not-- 1990 01:43:05,546 --> 01:43:07,622 Just that I need to make sure you're not just saying 1991 01:43:07,622 --> 01:43:09,119 what you think you want to hear. 1992 01:43:09,119 --> 01:43:11,997 Can you really support your statement of position, 1993 01:43:11,997 --> 01:43:15,000 by helping me explain it in a way that like, you know-- 1994 01:43:15,000 --> 01:43:17,434 And why you value this particular way, 1995 01:43:17,434 --> 01:43:19,066 or that particular way?