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

11. Internal Meaning-Making Processes in Ongoing Treatment

248 11 Internal Meaning-Making Processes in Ongoing Treatment THE IMPORTANCE OF PROCESS AS A GUIDE IN TREATMENT Existential/narrative therapy can be described as a series of interactions between clients and therapists in which therapists listen empathically and with curiosity to their clients’ stories and respond so as to engage with the clients in co-creating new, more empowering stories about their clients’ problems. In other words, understood in existential /narrative terms, psychotherapy is a special meaning-making opportunity, an opportunity to concentrate upon challenging old stories by contextualizing them, and to participate in the cocreation of new stories, including one’s story of oneself as a maker of meaning. As has been discussed in the two preceding chapters, therapy begins with the development of a story about the therapeutic process that provides the client and therapist with a shared, if general, understanding of what they are attempting to accomplish, how they will try to accomplish it, and what each can expect from the other person as they work toward this goal. Although developing that story may involve direct, verbal negotiation about these issues, the bulk of the shared story about the therapeutic work is co-created, as are most important stories in any person’s life, through action followed by personal reflection as client and therapist talk about the client’s concerns and occasionally about what is happening between them, rather than through development of a formal plan. Internal Meaning-Making Processes 249 Although the shared story of how their work together will proceed is not complete until treatment is concluded, it is typical for the client and therapist to reach some agreement on the basic, procedural issues fairly early in their contact. Once a workable, albeit incomplete, shared story of their work together is achieved, what then? In simplest terms, the client and therapist put more of their energy into a detailed examination of the client’s problem-saturated stories and overarching self-narrative by engaging in those actions that the client and therapist understand—on the basis of their shared story of treatment—to be likely to help the client engage in fresh meaning-making. Such a description points at but leaves unanswered the most interesting and important questions for the practicing therapist: “What do I listen for in order to grasp my clients’ own stories—to appreciate the lived world of my clients?” and “What do I do and when do I do it to help clients engage in fresh meaning-making, open possibilities, evaluate options, and implement those they choose?” From the therapist’s perspective, the answers to those critical questions depend upon understanding the client’s story fully enough to appreciate how personal and social meaning-making processes are creating a world in which the client’s options are restricted. Therapists need to draw upon their understanding of the processes of meaningmaking and the shared story of change to identify opportunities that are likely to be meaningful to their clients for changing. Therefore, it is useful to examine the processes of meaning-making, introduced in general terms in chapter 5, in more detail. Doing so will provide a basis for understanding the manner in which indicators of these processes can be used by the therapist to guide the crafting of activities in therapy that the client is likely to be able to use to change, ideas that will be developed in chapter 13. As discussed in detail throughout the first half of this book, the existential/narrative approach understands meaning as arising from both internal and social meaning-making processes. Though these processes are constantly co-occurring and influencing one another, they are conceptually distinct. The distinction between internal and social meaning-making processes was considered by Neimeyer (2000) and later by Watts and Phillips (2004) in their discussion of “relational constructivism.” The important point is that it is possible to distinguish conceptually between meaning-making processes occurring within clients as they work with events and information 250 Integrating Existential and Narrative Therapy and those processes occurring between clients and others. These two types of processes are interwoven in daily living, and both make important contributions to the stories clients live. Nevertheless, in a reflective setting such as psychotherapy, it can be useful to examine these processes separately, and indicators of each of these two broad types of meaning-making processes can serve as important guides for the therapist and client...