Therapy Approaches

Narrative Therapy: Separating People from Their Problems

Narrative therapy helps people see their problems as separate from themselves and build richer, preferred stories about their lives.

On this page
  1. What Is Narrative Therapy?
  2. Origins of Narrative Therapy
  3. Foundational Concepts
  4. Core Therapeutic Techniques
  5. The Therapeutic Stance
  6. Clinical Applications
  7. Key Questions in Narrative Therapy
  8. Research and Evidence
  9. Strengths and Limitations
  10. Integration with Other Approaches
  11. Practical Example: Working with "Worthlessness"
  12. Self-Application: Narrative Practices
  13. Conclusion
  14. Frequently asked questions
  15. Sources

Narrative therapy is a collaborative form of psychotherapy, developed by Michael White in Australia and David Epston in New Zealand in the 1980s, that helps people separate themselves from their problems and "re-author" the stories they tell about their lives. Its best-known principle is that "the person is not the problem; the problem is the problem." Rather than treating people as defined by a diagnosis or difficulty, narrative therapists help them notice overlooked moments of strength, connect with their values, and build preferred stories about who they are.

Narrative therapy is widely used in family therapy, community work and counseling, particularly with children and families. Its research base is smaller than that of approaches such as CBT, a point covered below. This guide explains its origins, key ideas, techniques, uses, evidence and limitations.

What Is Narrative Therapy?

Narrative therapy is based on the idea that our lives are multi-storied - we live by the stories we tell about ourselves and our experiences. These narratives powerfully shape identity, relationships, and future possibilities. When dominant stories emphasize problems, limitations, or pathology, they constrain what we believe is possible.

Narrative therapy doesn't deny real problems or suffering. Instead, it questions problem-saturated narratives that dominate a person's identity, obscuring strengths, values, and alternative storylines. Through collaborative conversation, individuals develop richer, multi-layered accounts of their lives that create space for change.

Origins of Narrative Therapy

Michael White, a social worker and family therapist at the Dulwich Centre in Adelaide, and David Epston, a family therapist in Auckland, developed narrative therapy through the late 1970s and 1980s. Their 1990 book Narrative Means to Therapeutic Ends introduced the approach internationally. White's later book Maps of Narrative Practice (2007) set out its main conversational "maps." White died in 2008; the Dulwich Centre continues to publish and train practitioners.

The approach grew out of family therapy, especially the work of anthropologist Gregory Bateson, but drew heavily on ideas from outside psychology: the French philosopher Michel Foucault's analysis of how power and "expert knowledge" shape identity, psychologist Jerome Bruner's work on narrative as a way of making meaning, and anthropologist Barbara Myerhoff's "definitional ceremonies." Narrative therapy belongs to a broader group of postmodern and collaborative therapies, alongside solution-focused therapy.

Foundational Concepts

Social Constructionism

Narrative therapy draws from social constructionist philosophy, which holds that meaning is created through social interaction and cultural context rather than objective truth. Our understanding of "depression," "good parenting," or "success" is culturally shaped. This perspective questions dominant cultural narratives (about gender, race, ability, worth) that may oppress individuals.

The Person Is Not the Problem

A cornerstone principle: externalization separates the person from the problem. Rather than "I am depressed" (identity-level statement), narrative therapy frames it as "Depression is affecting my life" (external influence). This subtle shift creates breathing room - if the problem isn't who you are, it's something that can be addressed.

Unique Outcomes and Exceptions

Even in problem-dominated stories, there are moments when the problem had less influence - times of resilience, coping, or values-aligned action. These "unique outcomes" or "sparkling moments" provide evidence for alternative storylines and become seeds for re-authoring.

Re-authoring Conversations

The therapeutic process involves helping people develop preferred narratives - stories that better reflect their values, strengths, and hopes. This isn't creating fiction but amplifying less-heard aspects of lived experience.

Core Therapeutic Techniques

Externalizing Conversations

Linguistic techniques that separate person from problem:

  • "When did Anxiety first show up in your life?"
  • "How does Depression try to convince you of things?"
  • "What tactics does the Eating Disorder use to maintain control?"

This isn't semantic game-playing - externalization reduces shame and blame, creates agency (you can fight the problem), and opens curiosity about the problem's influence rather than totalizing identity statements.

Application: For a child labeled "the angry kid," externalizing might ask: "How does Anger trick you into doing things you later regret? When have you been able to stand up to Anger?"

Deconstructive Listening

Narrative therapists listen for:

  • Gaps and contradictions: Where the dominant story doesn't fit all experiences
  • Absent but implicit: Values and hopes implied by what troubles someone (distress about isolation implies valuing connection)
  • Cultural discourse: Broader societal narratives shaping personal stories (perfectionism reflects cultural messages about worth)
  • Unique outcomes: Exceptions to problem-saturated accounts

Re-authoring Conversations

A structured process of developing alternative narratives:

Step 1: Landscape of Action

Plot events in sequence - when did you first notice this strength? What happened next? Who witnessed it? This creates temporal coherence and substance to the alternative story.

Step 2: Landscape of Identity

Explore meaning - what does this action say about what matters to you? How does it connect to your values? What does it reveal about the person you're becoming?

Example: A teenager who stood up to peer pressure didn't just perform an action (landscape of action) - this reflects values around authenticity and courage (landscape of identity), connecting to a preferred identity.

Definitional Ceremonies and Outsider Witnesses

Involving carefully selected others to witness and reflect on a person's re-authored story. This might include:

  • Family members, friends, or colleagues who've observed the person's strengths
  • Support group members who resonate with the journey
  • Reflecting teams who offer responses to the person's story

Witnesses don't give advice or praise - they share what resonated, what moved them, and connections to their own experiences. This amplifies alternative stories through social witnessing.

Therapeutic Documents

Written records that counteract problem-saturated documentation:

  • Letters: Therapists write letters summarizing sessions, highlighting strengths and unique outcomes
  • Certificates: Documenting achievements (freedom from fear, reclaiming voice)
  • Declarations: Statement of values, commitments, or intentions
  • Leagues: Memberships in communities of shared identity (survivors, resisters)

These documents provide tangible evidence of alternative stories and can be revisited during difficult times.

Remembering Conversations

Connecting with significant figures (living or deceased) who recognized preferred qualities. Questions might include:

  • "What would your grandmother say about how you handled this challenge?"
  • "What did your best friend see in you that helped you see it yourself?"
  • "Who from your past wouldn't be surprised by this strength you're showing?"

This locates identity within relational context and draws on internalized supportive relationships.

Mapping the Influence Questions

Two-directional exploration:

Problem's influence on the person:

  • "How does Depression affect your relationships?"
  • "What areas of life has Anxiety claimed?"
  • "How does the Problem want you to think about yourself?"

Person's influence on the problem:

  • "When have you not given in to Depression's demands?"
  • "How have you pushed back against Anxiety's rules?"
  • "What stops you from believing everything the Problem says?"

This mapping reveals agency even within problem-dominated contexts.

The Therapeutic Stance

Not Knowing Position

The therapist takes a genuinely curious stance rather than expert position. The client is the expert on their life; the therapist is expert in asking questions that facilitate new perspectives. This challenges traditional hierarchical therapeutic relationships.

Collaboration

Therapy is co-creation rather than treatment applied to a passive patient. Clients participate in determining conversation direction, choosing which stories to thicken, and deciding what matters.

Political Awareness

Narrative therapy recognizes that personal problems often reflect broader social injustices - racism, sexism, heteronormativity, ableism, economic inequality. "The problem is the problem" extends to oppressive cultural narratives, not just individual psychology.

Clinical Applications

Depression

Rather than locating depression solely inside the person, narrative therapy explores Depression as an external influence with tactics and effects. This does not deny biological contributions or the value of other treatments. Questions might map when Depression's voice is loudest, what it says, and importantly, when the person has resisted its claims. Alternative stories of resilience, connection, and meaning-making are thickened.

Trauma and PTSD

Trauma can create totalized victim identities that obscure survival, resistance, and growth. Narrative therapy acknowledges the reality of trauma while exploring how people responded with agency (even if limited), what values motivated survival, and how meaning has been made of suffering. Re-authoring doesn't minimize harm but prevents trauma from defining entire personhood.

Eating Disorders

Externalizing "Anorexia" or "Bulimia" as entities with agendas separate from the person creates space to examine the disorder's lies and tactics. David Epston and colleagues developed "anti-anorexia/anti-bulimia leagues," communities of people resisting the disorder. Eating disorders carry serious medical risks, so narrative work is typically one part of multidisciplinary care that includes medical monitoring.

Family Conflict

Rather than identifying a problem child or dysfunctional system, narrative family therapy externalizes the problem affecting the family. "How does Conflict divide you?" replaces "Who's to blame?" This unites family members against a common enemy rather than each other.

Identity Development

Often used with individuals navigating identity questions - adolescents, LGBTQ+ individuals, immigrants, people in life transitions. Narrative therapy helps examine inherited stories about who one should be versus developing authentic self-narratives.

Grief and Loss

Remembering conversations help maintain connection with deceased loved ones through "continuing bonds" (see grief and loss) rather than traditional "letting go" narratives. The question becomes: "How can this person's influence continue in positive ways?" rather than "How do I move on?"

Key Questions in Narrative Therapy

Externalizing Questions

  • "When did [Problem] first recruit you?"
  • "What tactics does [Problem] use to maintain influence?"
  • "How does [Problem] affect your relationships?"

Unique Outcome Questions

  • "When was a time you didn't give in to [Problem]?"
  • "How did you manage to do that?"
  • "What does this tell you about yourself?"

Preference Questions

  • "Is this what you want for your life?"
  • "How does this fit with your values?"
  • "What kind of relationship do you want with [person/activity]?"

Story Development Questions

  • "Who would not be surprised by this strength?"
  • "How does this connect to other times you've shown courage?"
  • "What might this mean for your future?"

Research and Evidence

Narrative therapy has a modest research base. Its developers were skeptical of standardized diagnosis and measurement, and the approach is hard to manualize, so far fewer controlled trials exist than for CBT or interpersonal therapy. Available evidence includes:

  • Depression: small studies, such as Vromans and Schweitzer's 2011 study of adults with major depression, reported improvements in depressive symptoms after about eight sessions, but lacked control groups.
  • Children and families: small trials and case series suggest benefits for children's behavioral difficulties and family conflict, often using externalizing techniques.
  • Qualitative research: many studies describe meaningful changes in how people understand their identities and problems.
  • Systematic reviews: reviews generally conclude that results are promising but that more rigorous, larger trials are needed.

The approach's emphasis on social justice and cultural context has made it popular in cross-cultural and community settings, including work with Aboriginal Australian communities and in post-conflict settings, though this popularity is not the same as controlled evidence of effectiveness.

Strengths and Limitations

Strengths

  • Empowering: Positions client as expert, reducing power differential
  • Non-pathologizing: Focuses on strengths and context rather than diagnosis
  • Culturally sensitive: Questions dominant cultural narratives and honors diverse stories
  • Flexible: Applicable across ages, cultures, and presenting concerns
  • Reduces shame: Externalization combats self-blame and stigma

Limitations

  • Abstract language: Concepts can seem complex; effective practice requires training
  • May not suit everyone: Some prefer direct advice or structured interventions
  • Limited crisis intervention: Best for longer-term work, less suited to acute crisis
  • Research gaps: Needs more quantitative outcome studies
  • Can minimize biology: While honoring context, biological factors also matter

Integration with Other Approaches

Narrative therapy isn't mutually exclusive with other modalities. It can complement:

  • CBT: Externalizing automatic thoughts as "Anxiety's voice" can enhance cognitive restructuring
  • Mindfulness: Creating distance from thoughts aligns with both approaches
  • Trauma therapies: re-authoring can sit alongside trauma-focused treatments such as EMDR
  • Family systems: Structural or strategic interventions can be framed narratively

Practical Example: Working with "Worthlessness"

Traditional approach might ask: "Why do you feel worthless? When did this start? What evidence do you have against this thought?"

Narrative approach might explore:

  • "When did Worthlessness start whispering lies to you?"
  • "What does Worthlessness want you to believe about yourself?"
  • "When has Worthlessness had less influence - even briefly?"
  • "What does your resistance to Worthlessness say about what matters to you?"
  • "Who in your life has seen something different than what Worthlessness claims?"
  • "If you could write a different story about your worth, what would it include?"

Through such questions, the person isn't identified as fundamentally worthless requiring cognitive correction, but rather engaged in resisting an oppressive narrative, with evidence of alternative storylines amplified.

Self-Application: Narrative Practices

Name the Problem

Instead of "I'm anxious," try "Anxiety is showing up." Notice how this small shift creates separation and possibility.

Interview the Problem

Journal about the problem as if it's a character: What does it want? When is it strongest? What are its tactics? This externalizes and clarifies.

Find Unique Outcomes

Identify times the problem had less influence. What was different? What did you do? What does this reveal about your capacity?

Thicken Alternative Stories

Write about moments reflecting your preferred identity. Who witnessed them? What do they mean? How do they connect to your values?

Re-author Your Story

If you could tell your life story emphasizing resilience, values, and growth rather than problems and failures, what would you include? This isn't denial but choosing which storyline to amplify.

These are general reflective exercises rather than therapy. If problems feel overwhelming or persistent, talking with a trained professional is worthwhile; see our guide to finding a therapist.

Conclusion

Narrative therapy offers a profoundly respectful, hopeful approach grounded in the truth that our lives are bigger than our problems, we are more than our diagnoses, and the stories we tell matter. By separating person from problem, honoring cultural context, and amplifying overlooked strengths and values, narrative practices help people reclaim authorship of their lives.

In a culture that often reduces people to labels, pathologizes normal suffering, and imposes narrow definitions of acceptable identity, narrative therapy's insistence that people are the experts on their own lives and that problems don't define personhood offers a distinctive and respectful alternative, even as its evidence base continues to develop.

The stories we tell shape the lives we lead. Narrative therapy helps ensure those stories reflect not just our struggles, but our strengths, values, hopes, and the full richness of our multi-storied existence.

Frequently asked questions

What is externalization in narrative therapy?

Externalization means talking about a problem as something separate from the person, for example 'when Anxiety shows up' instead of 'I am an anxious person.' This reduces shame and blame, makes it easier to examine how the problem operates, and helps people notice times they have resisted it. It is especially popular with children, who often enjoy naming and outwitting a problem.

What are unique outcomes?

Unique outcomes are moments when the problem had less influence than usual, such as a day when Worry did not stop someone from going to school. Narrative therapists ask detailed questions about these exceptions to show that the problem does not tell the whole story. They become the starting points for building an alternative, preferred story about the person's life.

Is narrative therapy evidence-based?

Narrative therapy has some supporting evidence, mostly from small studies, case series and qualitative research, with encouraging results for depression and for children and families. It has far fewer randomized controlled trials than CBT or interpersonal therapy, so it is usually described as promising rather than established. Narrative Exposure Therapy, a different approach for PTSD, has stronger trial evidence.

How is narrative therapy different from CBT?

CBT typically helps people identify and test unhelpful thoughts and change behaviors, often using structured worksheets and homework. Narrative therapy does not aim to correct thoughts; it explores the stories people live by, separates the person from the problem, and develops alternative stories based on values and overlooked strengths. Some therapists combine elements of both.

Who can benefit from narrative therapy?

Narrative therapy is used with children, adolescents, adults, couples, families and communities, and is often chosen when people feel defined by a label or a problem. It may suit people who value a collaborative, non-expert stance. People who want direct advice, or who are dealing with conditions where other treatments have stronger evidence, may prefer or need other approaches.

Sources

  1. White, M., & Epston, D. (1990). Narrative Means to Therapeutic Ends. W. W. Norton.
  2. White, M. (2007). Maps of Narrative Practice. W. W. Norton.
  3. Morgan, A. (2000). What Is Narrative Therapy? An Easy-to-Read Introduction. Dulwich Centre Publications.
  4. Vromans, L. P., & Schweitzer, R. D. (2011). Narrative therapy for adults with major depressive disorder: Improved symptom and interpersonal outcomes. Psychotherapy Research, 21(1), 4–15.
  5. Schauer, M., Neuner, F., & Elbert, T. (2011). Narrative Exposure Therapy: A Short-Term Treatment for Traumatic Stress Disorders (2nd ed.). Hogrefe.
  6. Freedman, J., & Combs, G. (1996). Narrative Therapy: The Social Construction of Preferred Realities. W. W. Norton.

About this page. Written and reviewed by the iPsychology Editorial Team using peer-reviewed research, textbooks and guidance from bodies such as the APA, NIMH, NHS and WHO. Content is educational and is not a substitute for professional advice. Spotted an error? Let us know.