Part 3: Post-structuralism and psychotherapy
The desire to ”understand” and ”change”
are as symptomatic as they are revolutionary. (Spivak)
In the beginning of the 18th century, anyone who considered himself
at all civilized thought that – according to the Newtonian-Cartesian
paradigm – the universe is a complex mechanical system,
where matter moves in an infinite space according to certain basic
principles. Unchanging structures were thought to cover everything
from the cosmos to the behaviour of the tiniest small particles.
People also thought that the basic structures of the universe
could be studied objectively and that one day the human being,
as the crown of all creation, would use the power and control
related to this information for his own benefit.
Structuralist thinking spread fast into social sciences. Anthropologists,
linguists, sociologists and psychologists started to search for
the “inner structures” of people, families, societies,
and cultures, to explain action and behaviour. In psychology and
therapy, structuralism lead to an approach that assumes that there
is a deep structure formed by “self” within each person
and that behaviour is the manifestation expression of this deep
structure. When a person behaves in a positive way, it is because
of a good function in “inner self”. Negative behaviour,
on the other hand, is a sign of a disturbance in the core of the
One day, family therapist Harlene Anderson would write, ”According
to the modern point of view, psychotherapy is a technology. The
human being is a machine and the therapist a technician, who works
with broken machinery. He is the expert of human nature and behaviour;
a hero who liberates.” (Anderson, 1997) Lynn Hoffman, another
family therapist, would write, “Diagnostisizing and medicalizing
the problems in people’s lives might one day turn out to
be our biggest mistake.” (Hoffman, 2002) There are many
stories about how this still dominating discourse has affected
Questioning the taken-for-granted
The post-structuralist perspective offers, instead of one concise
truth, creative practices that open up new perspectives and look
for lost meanings. Narrative therapy, which is inspired by post-structuralism,
does not intend to reveal “the truth” or to reflect
“the world” like a mirror, but rather to create a
language and interaction, where people can join each other so
that the good and the real become described in a rich way. When
people are discussing what the most valuable things in their lives
are and what they have succeeded well in, new alternatives and
possibilities for action are born. These conversations are not
had to change anything; one is only opening up what has been hidden
behind the dominant problem story so far – and making it
Post-structuralism, which has influenced narrative therapy, is
derived from French critical philosophy. It challenges in many
ways the modernism-related structuralism of western science. Michel
Foucault and Jacques Derrida are particularly central thinkers
in this respect. The following table demonstrates some differences
between structuralist and post-structuralist perspectives regarding
therapy. The table was created by Leonie Thomas, a Vietnamese
family therapist working at Dulwich Center.
|According to structuralism…
|According to post-structuralism…
| A post-structuralist therapist…
|The goal is to search for “deep structures”
or “essential truths” concerning people.
||t is important to draw attention to the effects this search
for ”deep structures” or ”truths”
has on people. For instance, how professionals develop norms
for a good life.
||Supports people, so that they would not evaluate their lives
only by social norms.
|The study of ”deep structures” and ”essential
truths” is an objective activity.
||What we are looking for, what we believe in, and where we
come from all affect how we perceive things and what we find.
|| Questions ”objectivity”, ”expertise”
and “practices of interpretation”.
|A ”deep structure” (for example “self”)
defines a person’s life.
||Language and the way in which we use it are key elements
in how we define our lives.
||Questions the taken- for- granted ideas that are sustained
by our speech patterns.
|Our thoughts, problems, and qualities are linked to some
||Our thoughts, problems, and qualities are products of culture
and history. They are born within certain contexts throughout
|| Externalizes thoughts, problems and qualities in therapeutic
|Our identity is found in our inner self.
||Our identity is constantly being formed in our relationships
with people, institutes and wider power relations.
Assumes that every therapeutic conversation (to some
extent) shapes the identity of both the therapist and those
who consult with us.
Makes alternative stories richer with different reflective
Developes his work ethic by checking how therapeutic conversations
affect the people who participate in them.
| Our identities are always consistent.
||Our identity is constantly being made up in many (sometimes
||Assumes that our stories constitute our lives, and acts
in a way that allows for alternative identity stories to be
told in a rich way.
The road is made of the steps we take
What does a good theory consist of? It usually tells something
about reality, knowledge, language, and human beings by creating
practices, which we can use to change things either internally
or externally. A good theory refers to meanings, which make it
possible to join the world in a new way. In this sense, theories
are rather ways of using language than final explanations of the
nature of the truth.
In narrative therapy, there is no one specific theory about human
behaviour, personality, normative individual development, or the
causes of problems. If it has a theory at all, it is more a philosophical
theory about he nature of knowledge, the social constructing of
reality, and the creative potential of language. This view gives
us clues of how therapeutic conversation works as instruments
of change by organizing the brain and productive activity.
According to this view, 1) knowledge is always born in relationships.
We live in a world of meanings, which is constructed with the
help of language in a specific historical and social context.
2) Meanings form stories that give significance to our lives and
experiences. 3) Life is multi-storied. The people who come to
therapy live a life dominated by a so-called problem saturated
story, which often hides several other alternative meanings and
stories. 4) Narrative work does not attempt at solving anything,
but rather working together to construct alternative meanings
and experiences previously hidden by the problems. Described in
a rich way, these meanings and experiences can create a positive
space for new possibilities and actions.
Michael White, the most central creator of narrative therapy,
says, “There’s no theory, just talking about ideas!”
(White, 2003) He does not see the narrative method as a solid
therapy approach, but rather as an open process of development
that keeps changing. We create therapeutic approaches to strive
for certainty. Professionally, that means comfort and a privileged
position among people who think in the same way. Approaches create
orthodoxy through power practices that make differences into polar
opposites. Orthodoxy is born when belonging to something requires
similarity. (Bird, 2004) Instead of constructing solid therapeutic
models, we could also develop practices that emphasize constant
movement and finding something new.
I’m writing you this letter, because I promised to,
and because our meeting last Friday made an impression on me in
I rarely meet people of your age with such an open and functional
relationship with their mothers as you seem to have. What do you
think, how hopeful is your mother right now that you will find
your way out of all the problems you’re experiencing? How
about your father?
After you left, I was left thinking about how miserable the
effects of Anxiety in your life must feel and how much power it
has taken from you so far.
It was also great to hear about the three most important
things in your life: health, your desire to find a career where
people respect you as a person, and your decision to travel to
Australia and do something different and independent. What ways
of living do these wishes, values and dreams express? You said
that Anxiety is the opposite of all these things and that despite
everything, you have been eating because of the future and the
people you love. What do you think this says about You as a person
and the things that you, despite your problems, consider important
and are willing to defend? I wonder if you remember what your
life was like before the anxiety. What aspects of that life has
Anxiety managed to belittle the most? Are there sides of you that
you used to enjoy but that lately have been overlooked? What are
You told me that the picture or story that our society presents
of a ”normative” female body irritates you, because
you would like to achieve it to feel accepted and control your
body independently. On the other hand, you also feel how difficult
that would be in your situation, because you would also like to
eat because of the things that matter to you. You are truly in
the middle of a great internal conflict and it is possible that
this is exactly what your Anxiety feeds on.
Or what do you think?
I was also left wondering why problems with eating are more
common among women than men in our society. Who is the authority
that defines what a female body must be like? How does this defining
happen? What is the most effective way in which Eating Problems
often manipulate the most talented women of their generation?
I was also wondering if you ever live outside of your conflict
these days. What is your life like then? What is the colour of
You may answer these questions or leave them unanswered.
I believe that you know inside how you want to deal with this.
You may also choose to show this letter to your mother, or not
show it to her.
I’m looking forward to our next meeting.
I wrote the above letter to a 15-year-old girl, who consulted
me together with her mother. Tytti was concerned about her anxiety,
which was in connection with eating. She wanted to eat, so that
she would not cause concern in her family members, so that she
could be healthy and travel to Australia to work there one day.
At the same time she did not want to eat, so that she could look
like the women in the beauty ads and feel like her friends accept
her. She felt she was in a complete dead end in this situation.
Our meeting reminded me strongly of what Foucault calls ”the
micro-fascism of everyday life”. It also made me start to
ask: how am I using the power and authority included in my new
poststructuralist language? How could I deconstruct my current
desire to create poststructuralist discussions? Why am I using
my privileged position as a therapist to give voice to what Foucault
calls “subjugated knowledge”?
For some reason, I believe that Tytti also possesses the answers
to these questions.
Anderson, H. 1997: Conversation, Language and
Possibilities. Basic Books.
Bird, J. 2004: Talk that Sings. Therapy in new
linguistic key. Edge Press.
Hoffman, L. 2002: Family Therapy. An Intimate
Thomas, L. 2002: Poststructuralism and therapy
– what´s it all about? The International Journal of
Narrative Therapy and Community Work. No. 2.
White, M. 2003: International Narrative Training
Program 2002-2003. Dulwich Centre,