Plenary Address

Narrative Therapy Conference 20 August 2015

Elize Morkel

The introduction of Narrative Therapy and the South African context at the time

Narrative therapy was introduced to South Africans by psychologists Dirk and Elmarie Kotze who visited Dulwich Centre in 1989 to do training with Michael White. Michael White and David Epston made several visits to South Africa between 1992 and 2004 and conducted workshops in various centres in the country.

This was the time when Nelson Mandela was released from prison on 11 February 1990. The world watched in awe the remarkably peaceful transition from repression and injustice under apartheid to democracy and freedom that made possible our country’s first democratic election on 27 April 1994. As a white South African and Afrikaner I cried tears of shame and joy while watching on television the inauguration of Nelson Mandela as South Africa’s first democratically elected president on 10 May 1994. The question that haunted me was: How could this have happened? How was it possible that this great man, ‘vilified as a terrorist, and who eventually became one of the moral leaders of the world’ (Tutu 2004:8) had languished in jail for twenty-seven years? Apartheid was declared a crime against humanity by the United Nations. The violation of human rights during the apartheid era affected the different groups in South Africa in very different ways.

In 1995 the Truth and Reconciliation Commission (TRC) was assembled under the leadership of Archbishop Desmond Tutu and was seen to be a crucial component in the transition to full and free democracy in South Africa. The mandate of the commission was to bear witness to and record human rights abuses that occurred under apartheid between 1960 and 1994. The restoration of victims’ dignity and assistance with rehabilitation as well as the granting of amnesty to some of the perpetrators of crimes formed part of the process. The focus was on restorative justice instead of retributive justice. When public hearings started in 1996 media coverage was extensive. Later Tutu (1999:120) wrote that ‘no one in South Africa would ever again be able to say, “I did not know” and hope to be believed’. Antjie Krog (1998:32), Afrikaner poet and journalist, describes her experience as reporter at the TRC as follows:

Week after week; voice after voice; account after account. It is like traveling on a rainy night behind a huge truck – images of devastation breaking in sheets on the windscreen. You can’t see; and you can’t slow down or stop because then you will never get anywhere.

It is not so much the deaths, and the names of the dead, but the web of infinite sorrow woven around them.

As I listened to the stories told at the TRC I kept thinking: Where was I when all of this was happening to the majority of the people in my country? I made it my business to connect with black colleagues and to ask about their experiences in apartheid South Africa. The question that haunted me was: How is it possible that I was living and practicing as a psychologist in South Africa and yet my life was untouched by “’the web of infinite sorrow’’ woven by the stories of millions of people (the vast majority of South Africans) around me? Where did my people – white Afrikaner Christians – go wrong?

Narrative therapy provided lenses that generated hope and possibilities

2.1 Witnessing positions lens

Kaethe Weingarten a psychologist, narrative therapist, feminist, political activist and, at the time, associate professor at Harvard Medical School visited South Africa for the first time in 2000. The lenses that her extensive work on the effect of witnessing violence and violations in society provided me with have been invaluable in my personal search for answers and responses to the ‘’new’’ realities about our past and about the reality of my own position as it hit me during the time of political transition.

In her witnessing positions grid Weingarten (2003: 28) explains that there are four witness positions that arise from the intersection of two dimensions: awareness and empowerment (Figure 1). Position 1 on the grid would occur when a person is an aware and empowered witness to violence or violation (Weingarten 2010:11). People may move around in this grid as their awareness and position of empowerment changes over time, in different contexts and in different roles:

All of us, whichever role (victim, perpetrator, witness) we are currently in, can witness ourselves. We can become aware of what we see – witnessing ourselves as witnesses. We can become aware of what has happened to us – witnessing ourselves as victims. We can become aware of what we do to others – witnessing ourselves as perpetrators. More able to witness ourselves in each of these roles, we will be better able to witness others in each of these roles as well.

(Weingarten 2003: 26)

WITNESS POSITIONS

Let us look at Position 4: Disempowered and Unaware. Many black South Africans, like the farmworkers on the farm where I grew up, lived during apartheid witnessing their own lives of poverty, struggle and oppression, yet believing that this was just the way things were, not questioning or understanding the injustices of racial oppression – unaware. Some of these people were illiterate, unemployed or working for very meagre wages with very limited options and therefor disempowered. Another example would be the way in which many women believe that submission to men is God’s way and that their husbands’ abuse and oppression is something they have to bear/tolerate in silence. One could say that they are unaware of the oppression and also economically disempowered to take care of themselves and their children. This limits their options for an empowered response.Examples:

Position 3: Aware and Disempowered. Many of my black colleagues were powerfully aware of the injustices and oppression under the apartheid regime, but had no political power, limited economic power, very few educational opportunities and they were subjected to strict laws that put limitations on how they could respond to these injustices. As a privileged white person I became aware of the many ways that I benefit from the unjust system. When I wanted to do restitution and make things better, my privileged and separate life as white person, as well as my training in Western psychological models left me helpless and disempowered in my efforts to connect and give back. I experienced this period – of raised and often acute awareness and disempowerment – as extremely disheartening, uncomfortable and undermining of my confidence and hope for the future. Weingarten (2010: 12) acknowledges that people who witness violations or injustices often want to move from this position back to unawareness – a cognitively numbing strategy – but points out that the only relief comes from moving into the aware and empowered position (Position One on the grid).

Position 2: Unaware and Empowered

Position Two may be the position that is most dangerous to others. People who witness violence and violation, who are oblivious about what they are witnessing, but nonetheless respond as if they know what they are doing, will be misguided. Their actions will be ineffective at best and harmful at worst. The negative impact of witnessing from this position may be far-reaching, particularly if the person witnessing occupies a position of power or is perceived as having power. (Weingarten 2010:11)

I think we can all think of examples where people in positions of power have acted as authorities or experts on our lives while not understanding the first thing about our experiences. The harm and damage of such actions can be immense. I would say that some therapy done from this position could be described as harmful and even abusive.

Position 4: Aware and Empowered

This is the position that makes the most constructive action possible. Our levels of awareness can change constantly as our positions in society change, as we are exposed to different contexts, different stories and beliefs. Empowered responses can take on many different forms. The greatest gift of Narrative Practices to us, as South Africans, has been the provision of theoretical lenses that support a growing and constant raised awareness of the trauma that rage in our country. It also offers us practices which enable empowered responses to the trauma. .

2.2 Poststructuralist lens

Michael White (2002:35-36) refers to the importance of a classical analysis of traditional power within the therapeutic context. Apartheid South Africa provides us with a classic example of the operations of this traditional power, which is appropriated by certain individuals and groups and is exercised from the top-down to oppress, repress, limit, prohibit, impose and coerce the people who are subject to it. During apartheid it was the oppression of black people by a powerful white minority. This traditional power is also evident in, for example, the oppression of women and in the power relations of heterosexism and marginalization of gay, lesbian, bisexual, transgender and intersex people.

In the development of Narrative Therapy, White is more interested in the analysis of modern systems of power which, according to French philosopher Michel Foucault, has become the predominant system of power in the achievement of social control. White (2002:36) explains:

This is a power that recruits people’s active participation in the fashioning of their own lives, their relationships, and their identities, according to the constructed norms of culture – we are both a consequence of this power and a vehicle for it. By this account, this is a system of power that is particularly insidious and pervasive. It is a power that is everywhere to be perceived in its local operations, in our intimate lives and relationships. Foucault sought to illustrate the many ways that we live our lives on the inside of the web of power relations of this system of modern power, and to draw attention to the extent to which we have become its unwitting instruments.

For Foucault, ‘language is an instrument of power, and people have power in society in direct proportion to their ability to participate in the various discourses that shape that society’ (Freedman & Combs 1996: 37). Foucault argues that there is an inseparable link between knowledge and power. As the discourses of a society determine what knowledge is held true, right or proper in that society, so those who control the discourses control knowledge. At the same time, the dominant knowledge of a given society determines who will be able to occupy positions of power in that society (Freedman & Combs 1996: 37-38). For centuries in South Africa educated white male voices and experience have dominated the most powerful and influential domains of knowledge production – such as the government, academic institutions and the Church – and in the process, have marginalised and often excluded the poor, the uneducated, women and persons of colour. The professional disciplines of psychology, psychiatry, criminology and social work have played a key role historically in developing technology of modern power by categorizing and labelling people as normal and abnormal e.g. and on that basis people have been separated, sequestered and oppressed.

Within the narrative metaphor, the discourses of power that Foucault studied can be seen as historical, cultural meta-narratives (Freedman & Combs 1996: 38). People tend to internalize these dominant cultural narratives as they come to the conclusion that these narratives speak the ‘truth’ of their identities. In this way people are blinded by dominant narratives to the possibilities that other narratives might offer them. Foucault was particularly interested in how the ‘truth claims’ carried in the ‘grand abstractions’ of modern science constituted a discourse that dehumanised and objectified so many people (Freedman & Combs (1996: 39). Foucault believed that it was at the local sites of people’s lives that the practices of power were perfected and most evident and that it is because of this that power can have its global effects. He thus argued that efforts to transform power relations in a society must address these practices of power at the local level: at the level of the every-day, taken-for-granted social practices of people’s lives (White 1992: 137).

Michael White (2002: 36) explains that he found some of the implications of Foucault’s analysis of modern power significant and hopeful in terms of the problems for which people seek therapy. He points out that:

• Systems of power are rarely total in their effects. This means that examples of opposition to the relations of modern power and refusal of its requirements will always be present to be acknowledged, known and celebrated;
• If the operations of modern power is dependent upon people’s active participation as its instruments, then individuals are uniquely placed to challenge and to subvert the operations of modern power;
• If the operations of modern power are derived through the uptake of self and relationship practices that are first developed at the local level of culture, then people can contribute significantly to social change through the development of self- and relationship-forming practices that do not directly reproduce the constructed norms of contemporary culture;
• If the professional disciplines have played a key role in the phenomenon of modern power, then therapeutic practice can work on those practices that are ‘counter’ to the technology of modern power. This emphasizes the political aspect of therapeutic practice.

White (2002: 66) states clearly that the notion of ‘acts of refusal’ is linked to the idea that life and identity is constituted, not given, and that such refusals will be linked to possibilities that constitute life in other, more creative ways.

Michael White (2004: 71) discusses the revival of ‘internal state psychologies’ in the late 1960s and early 1970s and points out how ‘the notion of “essential self” was assigned an unquestioned status.’ These self-psychologies propose that there is a self to be discovered at the core of personhood. All expressions of life are seen to be either an expression of the essences of this core self or a manifestation of the repression or distortion of these essences. The self-psychologies are linked to cathartic injunction through an obligation to discover the ‘truth’ about who one is and to seek a life that is an authentic and accurate expression of this truth.

At the time of the revival of the internal state psychologies, some social sciences were going through what has been referred to as an ‘interpretive turn’. Meaning was placed at the centre of social enquiry:

With meaning at the centre, this new cultural anthropology took the focus of inquiry to the social construction of people’s realities. These were realities that were not radically derived through one’s independent construction of the events of one’s life, they were not the outcome of some privileged access to the world as it is or arrived at through some objective grasp of the nature of things. Rather, people’s realities were understood to be historical and social products, negotiated in and between communities of people and distributed throughout these communities. This was the case for identity as much as for any other construction; identity was understood to be a phenomenon that was dispersed in communities of people. (White 2004: 74)

An understanding developed that all meanings are linguistic and social achievements and that people give meaning to their experiences of life by taking these experiences into frames that render them intelligible (White 2004: 75). It soon became clear that people construct meaning by trafficking in stories about their own and other people’s lives and that those narrative structures provide the principal frame of intelligibility for everyday life experience. This is what White (1995: 13) means by ‘narrative as life’ which forms the basis of his work. The meanings derived in the process of interpretation are not neutral in their effects on our lives: they have real effects on what we do and the steps that we take. White and Epston (1990:12) propose that it is the story – or self-narrative – that determines which aspects of our lives are expressed. In this way we live by the stories that we have about our lives: they shape our lives and constitutes our lives.

2.3 The lens of liberation theologies

In South Africa faith communities used the Bible to justify apartheid, but others motivated from a Biblical perspective and played a very important role in the struggle against apartheid. The contextual and liberation theologies that developed locally made a powerful contribution to the struggle for liberation. Liberation theologies arise out of the pastoral realities of oppression and repression, where people are hurt, stripped of their dignity, broken by deadly economic and political forces, left resigned or crushed. Theologies of liberation are critical of dominant power and structures in their contexts; this includes amongst others, race, gender and economic oppression. They state their preferential option for those who are poor, oppressed, marginalised or outcast. (Cochrane 1994: 27). Theologies of liberation help Christians to understand liberating praxis and to find practical courses of action towards liberation. Its basic methodological characteristic is that it is ‘an inductive science ascending from the ground up.  It does not start from basic principles and then draw conclusions from them.’

It is highly significant that Dirk Kotze and Johann Roux started the Institute for Therapeutic Development with a contract to teach Narrative Therapy in a Master’s programme in the Department of Practical Theology at the University of South Africa. Through this teaching an integration of schools of thought such as post-structural theory, feminist post-structural theory, feminist theology and other contextual theologies happened with significant contributions from students to the praxis of care and social transformation in post-apartheid South Africa.

South Africa in 2015

In South Africa with its 54 million people and 11 official languages we face tremendous challenges.

Poverty

South Africa is one of the most unequal societies in the world, it is estimated that 10% of the population receive 50% of the income. Race remains the dominant factor in relation to income inequality in South Africa. In 2012, the average income for households headed by white people was 5.5 times more than black-headed household. (Stats SA, 2012b). The rich are still mainly white and the poor are almost all black, but the composition of the middle ground has shifted, with growth in the black middle class of 250% in eight years. In just eight years, the black middle class has grown from 1.6 million to 4.2 million adults (UCT Unilever Institute of Strategic Marketing, 2013).

Unemployment rates are between 25 and 35 % of the population depending on whether one counts as being unemployed discouraged workers who have given up looking for jobs. There is a direct correlation between education (both length and quality of education) and employment opportunities and wages earned. The educational system in South African is failing, especially black, children from impoverished communities. Formal statistics show that 7% of South Africans are illiterate, however it is estimated that this percentage is much higher as a result of poor literacy amongst people who have been exposed to poor education.

Racism

Racial prejudice is entrenched in the psyche of millions of South Africans. Within upper and middle-classes there is increased inter-racial contact, but limited inter-racial contact exists with poorer communities. Residential areas and schools are still largely segregated.

Sexism

Patriarchal ideology dominates all South African cultural and ethnical groups. South Africa has the unenviable record of having the highest recorded prevalence of violence against women in the world. It is estimated that one out of every two South African women has suffered or will suffer the trauma of rape and that one out of every four South African girls will have been sexually abused by the age of sixteen. Wife abuse is widespread, with an estimated one out of six women who is a victim of domestic violence. Victims of violence are not effectively supported by public services and insufficient professional services exist.

The violence of poverty is more likely to affect South African women. The feminization of poverty, or concentration of poverty among female-headed households, is the result of the fact that men are more likely to be in the labour force than women. It is particularly rural black women who are helpless, voiceless and dependant.

Crime and violence

Crime and violence remain extremely high in South Africa. This weekend we commemorated 3 years since the Marikana massacre where the police killed 44 striking mine workers at the Lonmin mines outside Rustenburg. Xenophobic attacks have increased since 1994. With each year that the violence remains so prevalent, the number of South Africans who have experienced or witnessed violence increases, and so does the extent of the national trauma. This has serious implications for our health system; our ability to live and work as a nation and our ability to raise a new generation of safe and healthy children.

AIDS, poverty, race and gender

An estimated 5.51 million (10.2%) of South Africans are living with HIV. The majority of people infected are black people in their prime. The pandemic is fuelled by sexual and economic subordination of women so that women make up 58 % of the adult population who are HIV positive in South Africa. Caring for children affected by HIV and AIDS poses a huge challenge.

Mental Health in South Africa

One third of all South Africans suffer from mental illnesses and 75% of them will not receive any kind of help. The Mental Health Federation of South Africa reports that more than 17 million people in South Africa are dealing with depression, substance abuse, anxiety, bipolar disorder and schizophrenia (the top 5 mental health diagnoses). The Department of Health spends only 4% of its budget on addressing this issue. There is a lack of support for nongovernment organizations and a scarcity of state healthcare professionals such as psychiatrist, psychologists and psychiatric nurses. Currently 85% of psychologists are in private practice, serving 14% of the population according to the Department of Health.

Doing hope: Empowered responses

The conference programme is rich in examples of how our work here in SA has been impacted by NT to assist in generating hopeful and empowered responses. I will be brief in my own reflections. I have been asking colleagues about the ways in which Narrative Practices have impacted them and their work.

The personal is the professional is the political

For many of us Narrative Therapy opened up ways of understanding our own position within the South African landscape. In the Narrative Therapy workshops and training we work with our own life stories and make an effort to work with the stories of discrimination and oppression (relating to race, poverty, gender, sexuality etc) on our personal lives in order to raise awareness that will benefit our professional work. We have been influenced by the work of the Just Therapy Group from NZ and many of us have become involved in advocacy work outside of our practices. We are convinced that being aware of gender-based violence (e.g.) and its effects on the lives of the women who consult us in our practices compels us to speak up against sexism and patriarchy in the wider society. The fact that Narrative Therapy is practised inter-disciplinary helps to break down professional elitism and contributes to richer discussions across disciplines and experiences.

South Africans are deeply religious with 80% declaring that they are practicing in religious communities. The Institute for Justice and Reconciliation report that, in 2014, SA’s indicated the highest confidence levels in religious institutions (67%) of all public institutions in the country. This high confidence was found across all racial groups. The influence of religion in informing popular discourse cannot be denied. Advocacy work from within these institutions remains vital.

Transforming therapeutic practice

Some colleagues have pointed out how everyone was white and Christian when they did their training as psychologists. Today, private practitioners consult with clients from a diversity of religious and racial backgrounds. NT teaches respect for client’s realities and sensitivity to cultural discourses, while providing skills to unpack that which clients find undermining and disempowering in their lives. This approach transcends culture and difference and helps us to over-come the fear of the Other as we join people in their lives –not as experts who pathologize or offer solutions, but to collaborate in uncovering hopeful possibilities. The de-centred position of the therapist and the sharpened listening for that which might indicate hopeful and preferred storylines give therapists an exciting, inspiring and hopeful place to stand in this work. We have learnt skills for listening and asking questions and becoming aware of the language that we use and its effect that has accelerated and added depth to therapeutic processes beyond what we ever thought possible. The teaching and writings of Johnella Bird has been powerfully influential in developing our acute listening and interviewing skills.

Moving beyond the consultation room

In order to address some of the grave injustice around service delivery in our professions and as acts of restitution for the ways in which white people have benefitted from the injustices of the past many of us have moved into communities on the margins of our middle-class existence to become involved in acts of healing and transformation. In communities where violence, poverty, illness, trauma and other social problems are over-whelming realities NT provides us with hopeful ways to engage. Dulwich Centre with their examples of community interventions, practices like outsider-witness groups and the powerful practices that honour the connections and agency of people even in the midst of despair support us in this work. Many of us volunteer our services to schools and our embodied participation has reached far beyond therapeutic conversations into becoming partners to developing the potential of learners and supporting staff. My practice of embodied participation through supervision and compassionate witnessing of the work of colleagues opened up the possibilities for inviting groups of family therapists from Norway to become aware and empowered witnesses and partners to the work. An ethic of risk (Sharon Welch) and a conscious choice to do Reasonable hope (Kaethe Weingarten) support us. A commitment to making the most of ONE conversation, making that a conversation into a conversation like the person has never had before, one that truly makes a difference while attending to agency in the small decisions and steps that the person can or has taken. The use of the written word has supported us greatly in extending the therapeutic impact where contact opportunities are limited and where complexities could become over-whelming.

Narrative therapy has also been taken to corporate and organizational settings with significant work being done e.g. in the volatile mining industry.

Being part of a community of Narrative Practitioners

The community of Narrative Practitioners are open to learning and sharing. Many express a relief to be with colleagues who are non-pathologizing and non-judgemental. We support one another in learning and we witness one another’s stories with warmth, compassion and respect. I trust that this is the spirit in which we will be the compassionate and appreciative witnesses of one another’s work in these two days of the conference.

This community of Narrative Practitioners have been blessed by the gifts of brilliant teaching by veteran teachers from around the world. Michael White, David Epston, Keathe Weingarten, Johnella Bird, Jill Freedman and Gene Combs, David Denborough and since last year Stephen Madigan have opened up new understandings and skills. Today I would like to call on Stephen Madigan, David Nylund and Jeff Zimmerman to join me for a moment. These men have each given up at least 10 days of their busy schedules to travel to SA to join us this week. They are volunteering their time to us – no teaching fees are charged!! This enabled us to have workshops and a conference with international input! Thank you so much!!!

In this audience is a teacher who has been responsible for teaching narrative practices in a psychology master’s course at the University of Fort Hare for many years. I would like to ask Judy Rankin to come to the front please. Would all her past-students please come forward so that you can be close to her. Judy, we would like to honour and thank you for the quality of work that you have done in East London. Whenever a colleague joins the consultation groups and they say that they had been trained by you, I feel blessed to have the input of someone who really understands social construction theory and who can do the work.

My hope for this conference is:

• That our awareness will be sharpened and our imagination for empowered responses will be stimulated.
• That the presenters will experience acknowledgement and support for your work through the respectful and compassionate witnessing of colleagues.
• Use the time to nurture one another and to strengthen warm and supportive connections within this special community of like-minded therapists so that we will go back to make a real difference in our beautiful land.

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