Integrating Existential and Narrative Therapy: A Theoretical Base for Eclectic Practice

7. The Nature of Psychological Dysfunction

105 7 The Nature of Psychological Dysfunction AN EXISTENTIAL/NARRATIVE DEFINITION OF DYSFUNCTION Drawing on existential and critical constructivist thinking, the integrative position being developed here holds that people create their own reality and structure it in narrative form at all levels of awareness . These stories are lived, and in the process of reflection, may also become focal mental content. This construction takes place in the context of a real but undefined world into which every person is thrust. Each person is, then, challenged to create a reality that fits within the context of that world and that also defines and permits achievement of concrete goals in living. This is a daunting task as it brings the person into confrontation with the existential givens. Making this task yet more complicated is the fact that living continually presents new challenges through time. As McAdams (1993) shows, there is a clear and necessary series of changes in a person’s narrative over a lifespan. Other narrative thinkers (e.g., Monk 1997) speak about the manner in which life constantly presents people with new challenges requiring changes in their stories. Existentialists (e.g., Heidegger 1962; Macquarrie 1972) discuss how individuals always live toward the future and are always moving beyond where they are at any given moment. Though they emphasize somewhat different aspects of the issue, each tradition makes clear that life is dynamic, constantly changing. Therefore, people must not only generate stories about many situations but must continually revise those stories. 106 Integrating Existential and Narrative Therapy Consider also that individuals cannot simply compose life narratives of any sort that they please for at least two reasons. One is because they exist as embodied individuals in a real though unstructured world. The second is because, given that people live with and toward others, other people must participate in their stories for them to constitute reality. Moreover, the reality that a person has created up to the point of any particular challenge has a “weight” to it. As reality it cannot simply be “wished away.” It can be changed within limits by making new choices, but recall that choices are actions in the world that change one’s reality slowly, in small steps over time. The point is that life is a constant series of challenges that can only be met by creating a different reality, a process that is usually slow, frightening, and not entirely under the person’s control. Yet, not to develop a new reality is to exist in a situation where one cannot achieve one’s goals. In such a situation it is normal, though still quite unpleasant, to experience sadness, anger, frustration, discouragement, a sense of helplessness; to express ideas and affects that seem odd or inappropriate to other people; and to engage somewhat repetitively in a variety of ineffectual behaviors. These affects and behaviors, when they become enduring features of the person’s life, are understood within this integrative perspective as the dysfunction, even though they are typical responses in the face of a challenge. From this perspective, the reason people cannot deal more effectively with challenges is not because their realities are somehow poorly made, reflecting bad storying skills; it is precisely because they are challenges—sets of events that go beyond, do not fit into the reality they have constructed, but call for a revision of that reality. Only when such challenges have been encountered will inidividuals’ stories show the various structural deficits detailed below. Mahoney (1991) has discussed how such periods of disruption or challenge, marked by negative affect and ineffectual behaviors, are as much an opportunity as a problem. But taking advantage of that opportunity by revising reality requires that people courageously encounter existential givens to create new meaning, communicate those meanings to others who may yet be functioning under the old reality, and recruit their participation in the new reality. When people are able to act courageously, that is, to refer to and carry forward lived experience, to think flexibly, to draw on the emotional support and The Nature of Psychological Dysfunction 107 ideas of others, and to take risks of other sorts, they are often able to successfully restory. The new stories may create a reality in which they are able to achieve their original goals or define new more attainable ones, thus experiencing success and satisfaction in living. The vast majority of people manage to meet life’s...