Journal December 2025 Release - Flipbook - Page 11
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It was a common practice for patients who woke in the small hours of the night to
find the duty sister for a chat. Joanna was coherent, awake, witty, and clearly
astute. Her demeanour was unexpected, considering the information provided in
the handover report. She told me the condensed version of her life; that she had
been struggling with mental health issues since the age of sixteen, in and out of
psychiatric clinics. She briefly mentioned that she had spent six months a year on
average hospitalized in the past eight years. She soon became disinterested in her
“story”; one I expect she must have repeated many times before to mental health
care providers. Instead, she turned her attention to my book. “What are you
reading?” she asked.
“Oh! This book! It is an introduction to narrative therapy”, I responded.
She took the book from my desk and paged through it with growing interest.
Somehow puzzled, she asked: “So what is narrative therapy?”
Even now, I hate that question. How does one describe these rich, emergent,
collaborative, culturally-relevant practices in a nutshell?
“Well,” I tried to explain, “in this approach, the person is the expert on his or her
own life. The person is not the problem, the problem is the problem.” She looked
at me, clearly confused.
“It’s called externalizing the problem...”
“Externalizing the problem!” she exclaimed. “I’ve been trying for years for
somebody to understand what is wrong with me. Every time I get sick, it’s as if
there is a broken toaster in my soul that nobody can reach or fix. They keep
adding diagnoses to the already long list of diagnoses I have! How do you
externalize a problem like mine?”
I tried to explain: “Well, theoretically, narrative practitioners want to meet their
client outside of clinically diagnosed problems. For example, I would have loved to
meet you as Joanna the person first before the Joanna who is regularly admitted
to clinic, struggling with survival and suicide.”
We playfully externalized depression and wondered what its voice might sound
like and what it might say to a person. What might depression’s intentions be for
An Apprenticeship in Extremis
Journal of Contemporary Narrative Therapy, December 2025 Release, p. 5-44.
www.journalnft.com
