Theoretical Framework and Application: Postmodernism
Postmodernism can be called the major philosophical theory that determines the contemporary era. It is based on the idea that there is no absolute truth and our world, just like our reality, is composed of various details. The reality itself can not exist without personal observation and is relative. It is not strange that such philosophical approach was applied in psychiatric practice. In the current essay an attempt to describe the theory of the postmodern approach and practical application of this theoretical framework to the case study of Margarita will be made.
The main issues that the postmodern therapy deals with are deconstruction of the traditional beliefs and analyzing their impact on the life of an individual. Among the most popular questions that are asked by postmodern therapists is the nature of mental health or what is the success. The key notion in the postmodern therapy is deconstruction. In the psychiatric sense it is supposed to mean the traditional values that are regarded as the absolute truth. For example, the assumptions like if the person does not move from his/her parents’ house when he/she is a teenager, it is a sign of a lose. Another example is that if a woman in her late 30s is not married and does not have children, she is ugly or has an awful character. The main goal of the postmodern therapy is to understand whether such assumptions are true for the client and to help him/her understand that it is not necessary to live the traditional life imposed by the society, if it does not make him/her happy. It is crucial to remember that using the authority of the professional counselor is prohibited, because the client needs to understand by him/herself what should be changed in his/her life. That is why there can not be any advice from the experts.
The postmodern therapy is divided into two main types, which are the narrative therapy and the solution-focused therapy. The solution-focused therapy is characterized by increased attention to understanding the ways of escaping the already existing problem rather that assessing its roots. The main branch of the postmodern approach to therapy is the narrative one. According to it, the specific behavioral patterns and thoughts that bother the client are evaluated in the context of the story the client has created for him/herself, and his/her culture (Winslade 2000)
During the course of the solution focused brief therapy or SFBT the psychotherapeutic effect is achieved by means of asking the client a series of individually constructed questions and analyzing the responses to them. Such method was developed on the basis of the Wittengensteinian philosophical thought and constructionist way of thinking. It was created by the group of American social workers from the Milwaukee Brief Family Therapy Center with Insoo Kim Berg and Steve de Shazer in the head. The solution-focused therapeutic approach was developed through long observations of the lives of the control group and recording their sessions of therapy. That is why it is possible to state that the theory was developed in the inductive way (Berg, de Shazer 1994).
The narrative therapy was introduced by David Epston, the social worker from New Zealand, and his Australian colleague Michael White. It was developed in the 1970s-1980s in Australia and gained popularity in the United States only from 1990s, after the book that described the main principles of the narrative approach was published. Before that the theory was probated in smaller groups.
Both the narrative approach and the solution-focused approach share the same beliefs. Among the most important issues that form the basic assumptions of the solution-focused and narrative approaches are the beliefs that the main experts in the problems are the clients themselves, all stories that people tell the counselors are of particular meaning to understanding the problem, and there is no absolute truth as well as there is no absolute reality (White, Epston 1990).
According to the point of view of counselors who practice solution-focused therapy, people are initially able to construct alternative ways to improve their living, to create solutions by themselves. They are resourceful, competent enough to cope with their problems and healthy. The counselors help the clients to understand their strong sides and to start using their potential in the most effective ways. According to the main principle of the narrative approach to the therapy every client and his/her story is unique, just like his/her cultural background (Berg 1994).
The therapeutic relationship between the client and the counselor can be described as liberal. Both during the narrative and the solution-focused therapy the counsel is working with the client without imposing his/her authority and expert advice. It is supposed that the therapy is the collaboration, when all ideas, strengths and weaknesses of the client are accepted. The position of the counselor is that only the client is the expert of his/her life. Such naiveté stance is considered to help the clients mobilize their inner resources in order to cope with the problem. The clients interpret the life experience they had and on the basis of understanding what are their strong sides they try to construct the ways out of their problems. It is also necessary to mention that the counseling process supposes that there are no interpretations, predictions and pathologizing from the “expert”. It helps the client to feel the sense of agency and to improve his/her experience in integrating into the society (Greenberg 2001).
This theory aligns with my own philosophy, values, and views of the therapeutic process greatly. To start with, postmodernism is the dominant way of thinking nowadays and it is implicitly present in all aspects of our lives. I do not feel that there is objective point of view and absolute reality, because every person is the unique universe, and their choices in life depend upon a great variety of circumstances that are to be examined by counselor. The postmodern approach to therapy activates positive thinking, because it is considered that there are no wrong answers to the questions. In fact, many people suffer from being unable to give the right answer to life problems, and it makes them feel frustrated and depressed as the result. In addition, such approach can be helpful for diverse populations, as it is liberal enough not to despise even the problems that seem to be minor form objective point of view. In fact, there is no objective point of view and it makes the theory applicable to all people.
Margarita is suffering from anger outbursts towards her husband, is working hard on the work that requires much responsibility, has problems with socializing, and in addition has two small children, who require attention and care. She is deeply depressed and lives in the state of constant stress, that is why it is crucial to start working on her priorities for change in her life. The postmodern approach will be used for it and it might be efficient to combine both the narrative and the solution-focused therapy to achieve good results.
It is possible to set the following goals to work on with Margarita. The narrative part of therapy should include new details. I plan to ask Margarita to describe her major life experiences that we have already talked about in a fresh new language. It might be useful in looking at her experience from a different perspective and that might help Margarita change the usual way in which she thinks of her life. It is possible to assume that the client does not pay enough attention to her children and husband, because she is constantly working, and might lead to deep dissatisfaction with her family life.
Then, the solution-focused part of the therapy will include four goals. The first is to set the atmosphere of mutual respect, affirmation, inquiry and dialogue. It is crucial to set this goal every session, because it is difficult for Margarita to talk freely about her most intimate problems. The second step is to ask Margarita so-called miracle questions that are the indispensable part of the solution-focused therapy. Margarita is supposed to imagine what her life might be like if she had no problems that bother her and it will make the goals she wants to achieve more clear. Then, Margarita needs to set her own preferences and goals she has been thinking about after the previous counseling session. The last goal that might be achieved during the fourth session, is analyzing how to combine her desires with societal expectations and standards without stress.
The techniques that will be used in the case of Margarita are oriented on future and need to solve problems. There is no need to ask about the reasons that have led to such nervous breakdown. The first technique is to externalize the problems she has, as it helps to talk about them more specifically. Then, it is necessary to understand what unused resources and strengths Margarita has. For example, it is possible to emphasize that she is an intelligent woman with good work, full family and healthy children, that can make her happy.
Questions technique will be also used. Miracle questions (imagining life without problems), exception questions (when there were no such problems?), scaling questions (what was done during therapy?) might help Margarita pay attention to details. Homework will be used as the way to re-think her life from another perspective.
It is possible to assume that the strengths of using the postmodern approach and narrative?problem-solving theories with Margarita prevail upon limitations. It is necessary to keep in mind that Margarita’s second child was born only a year ago and her active work apart from home makes her nervous as the mother. She might also suffer from postpartum depression. Though, the strength of this approach are evident. Margarita is a rational and intelligent woman, who is able to analyze everything by herself. She needs postmodern counseling with respectful alternative questions to look at her life situation from a different perspective. Her problems are not considered to be of psychiatric character and does not make a client an ill person. According to this approach, it is crucial to start thinking more freely and more positively, without paying that much attention to strict social norms and expectations of the others. The essence of the depression and anger outbursts Margarita has might be her reaction to the numerous expectations that the society has. For example, she is used to thinking that she is a strong modern feminist woman who has to work hard and have many friends who adore her. She is also a young woman who has two children and a husband, and so she has to be a good mother and a good wife. The nature of being a good mother, wife and successful worker are vague, and it might lead to constant stress.
Berg, I. K., de Shazer, S. (1994). Making numbers talk: Language in therapy, in Friedman, S. (Ed.) (1993). The new language of change: Constructive collaboration in psychotherapy. New York: Guilford.
Berg, I. K. (1994). Family based services: A solution-focused approach. New York:Norton.
Greenberg, G. R., Keren, G. and Alanna D. (2001). Solution-focused therapy. A counseling model for busy family physicians. Canadian Family Physician, 47, 52-76.
White, M., Epston, D. (1990). Narrative means to therapeutic ends. New York: WW Norton.
Winslade, J., Monk, G. (2000) Narrative Mediation: A New Approach to Conflict Resolution. San Francisco: Jossey-Bass.