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Case Studies in Couples Therapy THEORY-BASED APPROACHES

Edited by David K. Carson and Montserrat Casado-Kehoe

New York london

Contents

Series Editor's Foreword ............................................................................................. xi

Introduction: Couple Therapy in Contemporary Society and a Theory-Based Case Study Approach ............................................................................................. xxvii

Preface ..................................................................................................................... xiii Acknowledgments ...................................................................................................... xv About the Editors .....................................................................................................xvii Contributors ..............................................................................................................xix

David K. Carson and Montserrat Casado-Kehoe

1. PREPARE/ENRICH Program for Premarital and Married Couples ......... 1 Amy Olson-Sigg and David H. Olson

2. Preparing Couples for Marriage: The SYMBIS Model... ............................ 13 Les Parrott and Leslie Parrott

3. Lessons Learned From Recruiting Diverse Couples for Clinical Research on Relationship Education.............................................................. 29 Marcie Pregulman, Shauna Rienks, Howard J. Markman, Martha Wadsworth, Lindsey Einhorn, and Erica Moran

4. Adlerian Therapy With Couples ..................................................................... 41 Patricia A. Robey and Jon Carlson

5. Working With Couples From a Psychodynamic Perspective Using Cognitive Maps ................................................................................................. 53 Albert Brok

6. Object-Relations Therapy With Couples ....................................................... 65 Carl Bagnini

7. Integrated Intergenerational Couple Therapy .............................................. 79 David M. Lawson

8. Cognitive Behavior Therapy With Couples ................................................... 93 Jan Dickson, Frank M. Dattilio and Lisa Cherrington

9. Cognitive-Beha\'ioral Couple Therapy: Multiple Couple lllustrations and Comparisons............................................................................................ 109 Terence Patterson

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viii Contents

10. Ecosystemic Structural Therapy With Couples .......................................... 121 Marion Lindblad-Goldberg, Edward A. Igle, and Steven Simms

11. Problem-Solving Brief Therapy: The Palo Alto Approach to Working With a Latino Couple..................................................................................... 133 Karin Schlanger

12. Mental Research Institute's Brief Therapy Approach to Couple Therapy ........................................................................................................... 145 Barbara Anger-Dfaz and Katharina Anger

13. Strategic Couple Therapy.............................................................................. 161 Wendel A. Ray and lana P. Sutton

14. A Path to Wholeness: Couple Therapy Within the Satir Model ............... 177 Jean A. McLendon and lames Robert Bitter

15. Emotionally Focused Couple Therapy: A Military Case Study ................ 191 Kathryn D. Rheem, Scott R. Woolley, and Susan M. Johnson

16. Imago Relationship Therapy .......... ............................................................... 205 Harville Hendrix and Mo Therese Hannah

17. Imago Couple Therapy and the Relational Paradigm................................ 217 Wade Luquet

18. Creative/Experiential Therapy With Couples............................................. 229 David K. Carson and Montserrat Casado-Kehoe

19. An Application of PragmaticlExperiential Therapy for Couples ............. 249 Paul Weiss, Brent Atkinson, Ahna Holzinger-Young, and Anna Larsen

20. Group-Oriented Experiential Couple Therapy: An Adventure-Based Approach ......................................................................................................... 263 J. Paul Burney

21. Solution-Focused Brief Couple Therapy ...................................................... 275 Thorana S. Nelson

22. Narrative Therapy With Couples ................................................................. 289 Paul Gallant and Ilene Strauss

23. Collaborative Couple Therapy: Turning Fights Into Intimate Conversations............ ...................................................................................... 303 Daniel B. Wile

IX Contents

24. Collaborative Therapy With Couples........................................................... 317 Susan B. Levin and Diana Carleton

25. Gottman Method Couple Therapy: From Theory to Practice .................. 331 Robert J. Navarra and John Mordechai Gottman

26. Affective Reconstruction: An Integrative Couple Treatment Applied to Parental Bereavement ............................................................................... 345 Molly F. Gasbarrini and Douglas K. Snyder

27. Integrated Couple Therapy: A Family Developmental Approach to the Treatment of Couples Incorporating Psychoanalytic and Systemic Models ............................................................................................. 357 Michael D. Zentman

28. The Hope-Focused Approach to Couple Enrichment and Counseling ..... 369 Jennifer S. Ripley, Everett L. Worthington, Jr., and Vickey L. Maclin

Index .................................................................................................................. ...... 383

22 Narrative Therapy With Couples

Paul Gallant and Ilene Strauss

This chapter is the authors' interpretation of the theoretical and practical contribu-tions of Michael White in what has come to be known as narrative therapy and can be found in the abundant articles, chapters, and books that are part of his legacy (White, 1989, 1997, 1999, 2000, 2004, 2007a; White & Epston, 1990; Vodde & Gallant, 2002). The intention is to demonstrate that ideas from the narrative therapy approach are particularly suited to couples work through its multi perspective stance and its recognition that there are many perceived truths and many possible accounts of the same experience (Payne, 2006).

Narrative therapy is an optimistic and invigorating orientation that allows for curiosity and collaboration on the part of the therapist. The primary thrust of nar-rative therapy is the importance of focusing on meanings or interpretations clients have of life events and not simply on the events themselves (Polkinghorne, 2004). In the authors' view, what makes this work refreshing and revitalizing is the focus on the human capacity to tell stories, how people live out the stories they have of themselves and others, and the construction of their identities and senses of self through these creations. As Polkinghorne noted (2004, p. 61), "The purpose of narrative therapy is to assist people in changing the narrative meaning they have given to their own lives from one that is restrictive and victimizing to one that opens possibilities and is empowering." Much of narrative therapy is derived from Michael's belief that problems are not inherent in individuals but are brought about in the context of their cultures. He believed that people derive the meanings of their lives from stories that come about in their social contexts, and that these stories can be reauthored.

Narrative Therapy Assumptions and Treatment Goals Goals for treatment in the narrative therapy approach for working with couples come from the core assumptions that form the foundation of Michael White's work. In his numerous workshops, trainings, and publications, Michael stressed the importance of collaboration; paying attention to clients' grand narratives of culture, race, class, and ethnicity; externalizing conversations; and the multistoried nature of people's lives.

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290 Case Studies in Couples Therapy: Theory-Based Approaches

Collaboration In narrative therapy, goals are coconstructed within the collaborative conversations between the couple and the therapist. Remaining decentered, yet influential (White, 2007b, 2007c), the therapist has the responsibility as an interviewer to respect that the couple decides the focus of the conversation and defines the problems to be addressed. It is through staying decentered in conversations with couples that the therapist is able to give priority to their wisdom and skills, so that they may set the direction of the work. Being influential refers to the responsibility of the therapist to ask the kinds of questions and offer reflections that support couples in bringing forth the intentions they have for themselves and their relationships, and highlighting their knowledge and skills that are available to address their goals and concerns.

Grand Narratives Like other poststructuralists, White views reality as being socially constructed. The emphasis is on the narrative quality of a couple's experience and the ways in which people organize their lives around particular meanings they ascribe to their experi-ences (White & Epston, 1990). However, itis important to note that White's focus was also on the power relations and social forces that constitute such narratives. White was concerned with the oppressive effects of grand narratives that are embodied in dominant discourses and in cultural practices. It is in this area that White built upon the ideas of Michel Foucault (1979). In therapy, these are the "shoulds" that are hid-den in the "constant droning background murmur of cultural discourse" (Winslade, 2008). Just one example in many cultures is the idea that a man should be the head of the household. Therefore, a key element of narrative therapy is to remain sensitive to the effects of discourse on a couple's relationship, particularly those cultural practices that have the effect of objectifying one's partner in the relationship and the objectify-ing of one's self (White, 2004).

Externalizing Conversations White believed that people can become agents of power as well as suffer the effects of power exerted over them. In collaboration with David Epston, he devised a process that serves the purposes of deconstruction, which they referred to as "externalizing the problem." According to White (1989), externalizing is a process of questioning that encourages persons to "objectify and at times personify the problems that they experience as oppressive" (p. 5). The goal is to separate the person or couple from the problem in such a way as "to make the problem the problem" (White, 1989, p. 5) rather than identifying a person or a relationship as the problem. For example, a couple who present with the problem, "We are always in conflict," are invited into a conversation wherein Conflict becomes viewed as a force, separate from the couple, that has occupied the couple and recruited them into a conflict-saturated view of themselves and their relationship. Questions such as "In what ways is Conflict affect-ing your relationship?" and "How were you able to control Conflict so you could come here today?" may be used in conversation. This externally situated focus on Conflict may allow the couple to mobilize counterforces of strengths, resistance, and personal

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hopes that exist within each partner. Extemalization extends to revealing those social forces whose interests lie in maintaining such personification.

White and Epston (1990) focused on the empowering effects of rejecting such nega-tive self-narratives and challenging the authority of those grand narratives. Hence, White and Epston appeared to have used Foucault's (1979) analysis of the "prac-tices of power" (p. 76) to help couples undo the influences of those dynamics in their relationship. Those who are not familiar with the concept of narrative therapy may struggle to appreciate that it is a self-contained practice model with the basic goal of pursuing this form of social justice (Gallant, 2008).

Life as Multistoried Dimension A core assumption of narrative therapy is that people usually present one-dimen-sional stories of their lives when consulting a therapist. They have negative and thin conclusions about their identity and their relationship, and think the future will be a reproduction of the past. White (2007a) offers that life has a multistoried dimension and that many of the stories of peoples' lives are not visible to them. He believed it is the job of the therapist to build a scaffold through the clients' ques-tions, making it possible to get into the other, uncharted stories of their lives. In this context of exploration, people feel acknowledged and get in touch with their knowledge and skills, and they become fascinated with the neglected aspects of their own lives. Through this process, people are able to come up with ideas on how to move forward.

In one of Michael's last presentations in North America (White, 2007b), he included the following in his opening remarks:

If we can get onto some of the thin traces of these subordinate story lines of peoples' lives, if we can support them in the rich development of those thin traces so the subordinate story lines come out of the shadows, people find themselves suddenly standing in another territory of identity. They begin to experience other conclusions about their value, and about their worth. So a sense of worth displaces a sense of worthlessness. A sense of competence displaces a sense of incompetence.

Case Study Treatment Process: Early Phase Presenting Issues and Difficulties Diane and Ira requested individual and marital therapy with the first author. Diane ini-tiated the first couple's meeting, concerned about her husband being socially isolated, shutting people out of his life, and feeling generally depressed. Diane explained that the smallest things seemed to upset him. For example, she stated he is an extremely neat and tidy person and becomes angry when she leaves things around the house. The situation had her convinced that Ira had personal problems and needed help.


Background Information The couple had been together for 10 years and married for the past 3 years. They both were in their early 308 and did not have children. Both of their parents were immigrants to the United States from their native Colombia. They explained that their families had different cultural practices and expectations, particularly when it came to religion.

Diane described growing up in a family of privilege. Her father was a successful businessman and her mother had a maid who assisted with housework and child rear-ing. Diane became a social worker supervisor and administrator, said she loves her job, and is proud of her career accomplishments.

Ira described a more difficult upbringing in his family life, with a struggle to make ends meet financially and conflict with parents. After high school, Ira went to work in the home construction business. He eventually owned his own flooring company. Ira described his one sibling, an older brother, as extremely antisocial, living with his par-ents and having difficulty finding employment. Ira employs his brother when there is enough work for both. Ira has held onto a longtime goal of becoming a police officer.

Assessment and Case Conceptualization The couple had a desire to improve their relationship and strengthen their marriage; however, they were concerned about the increasing frequency of arguments and the increasing sense of isolation and depression with Ira. They both wanted to have chil-dren, but were concerned about the lack of stability in their relationship. Ira claimed that Diane looked down upon him, regretted marrying him, and was very demanding. He stated that he felt no support for his dream ofchanging careers. Diane believed that Ira had low self-esteem, was extremely critical of her, and showed less and less affec-tion. Both perceived that the other's family contributed to their marital problems.

Treatment Goals Ira and Diane stated their goals were: (1) to receive help for Ira to feel less depressed, and (2) to decrease the amount of conflict and arguments between them. The thera-pist's goals involved attending to these goals by employing narrative therapy prac-tices. The overall goal was to participate in rich story development (White, 2007a) of the couple's life through the deconstruction of the dominant plot of the couple as conflicted, of their being troubled persons, and of their situation being unstable. The process involved generating a conversational partnership with Ira and Diane in which dominant stories were deconstructed and new storylines of each person's self and the relationship emerged. Techniques from narrative therapy were employed, including discovery of unique outcomes, externalizing the problem, and exploring hopes and intentions for their lives. These techniques and others are demonstrated in the follow-ing session segments.

During a 1993 conference in Atlanta, GA, Michael White spoke about the first step of therapy having to do with opening couples to break free and challenge the interactional patterns that are impoverishing their relationship. The second step is to work with couples to help them generate alternative patterns of interactions and

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alternative stories about their relationships that bring with them preferred effects in their lives and relationships. This notion is based on his idea that how we see our-selves in relationships is not fixed, but that it is merely the meaning the couple makes of these patterns. The understanding and meanings people have of themselves and of their relationships are created through language and society, and these meanings can be changed, deconstructed, and reconstructed through different ways of engage-ment in the telling of stories. Therefore, Michael explained that he had couples share alternative stories about their relationships that would bring about preferred effects in their lives.

Michael stated that in asking couples to tell him about what they were most inter-ested in talking about in the session, they usually responded by describing certain concerns. Concerns are usually cast in terms of problems. Often these problems have seemed to the couple to be relatively immoveable and relatively insoluble. At times, couples reach a point where they believe that these problems actually speak the truth of their relationship with each other and who they are as people. For too many cou-ples, the problems appear to reflect certain, maybe inherent, flaws in a relationship as well as certain negative qualities that are intrinsic to the characters of the partners. Michael stated it was particularly apparent when their problems were long standing and the couple had resisted many efforts to modify them.

An Example of Externalizing the Problem According to White (2007a), externalizing makes it possible for people to experience an identity that is separate from the problem; the problem becomes the problem, not the person. In this session, the author asked the couple about the conflict they were experi- encing by attempting to externalize it in order for Diane and Ira to see that the conflict is the Problem and not either of them. Arguments are externalized in this segment:

Paul: So arguments creep in sometimes? Or you were saying frustration? Ira: Yeah, sometimes. Paul: Things show up? Diane: Yeah . Ira: Yeah. Paul: Yeah, do arguments come around a lot in your relationship? Ira: Sometimes ... but for stupid things. About things that shouldn't be argued

about. Paul: Yeah? Ira: You know, after we think about it, we say we argued about something stupid. Diane: (nods her head yes) Right, right. Ira: Yeah, it's not worth it, you know. Paul: It is almost like a habit. Diane: It could be. Paul: What would you call this issue that you are struggling with? What is getting in

the way of your being in a place where you can really feel ready to have children and go on in a way that you would be happy with?

Diane: I thought about that. .. I don't know what's wrong. Paul: Ira, what would you call it?

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Ira: I really don't know. Paul: I mean, is it disagreement? Diane: I think it is disagreement, and a lot of things. Um, I think he is used to get-

ting the say in whatever he wants always ... when Ira says something, his parents just hide and do whatever he wants ... in my household it was totally different.

Paul: So you come out of different lifestyles. I mean, you are from the same culture with a lot of richness that is unique to your culture. But in terms of your styles with how men and women are together, you came from different kinds of experiences.

Diane: Yeah. Paul: And are those different life experiences getting in the way here? Diane: Melting it together.

Treatment Process: Middle Phase White (1993) explained that his next step is to engage the couple in exploring some of the effects of the problem on their relationship and on their lives. Therefore, when a couple comes to therapy and states that they have a conflict-oriented relationship, White would likely ask questions about how the problem had been interfering in their relationship, and about how it had been limiting their interactions with each other.

Additionally, White (1993) asked about how the problem had been affecting the perceptions that the partners had of themselves and of each other. In other words, he really wanted to know what the problem had talked them into about themselves and about each other. He also asked about whether or not the problem had the partner say-ing and doing things that went against his/her better judgment. If this was the case, he requested they give him some details about what they believed to be their better judgment. He encouraged couples to evaluate the real effects of the problem and then to justify this evaluation. He asked the partners if they were comfortable with the effects of the problem or not. He also explored which of the effects were most distress-ing to them.

White often found that the problem had, among other things, distanced the partners from each other, and he wanted to know if this was a positive or a negative thing. He

:j knew some partners wanted to be very close and some partners preferred to have I I some distance. He was not assuming to know whether the problem was problematic

or not. He asked them to share their thoughts with him about why they judged these effects to be so negative, and about why they thought these effects were so disadvanta-geous to their relationship and their personal lives.

Michael explained that it was very important that space be provided for couples to take a clear position on the problem and its effects on their relationship. Otherwise, the therapeutic efforts would likely be run on the evaluations and justifications of the therapist. Hence, in therapy, the therapist explores the effects of the problem and identifies the processes of the recruitment that determine the negative "truths" the partners have arrived at, and assists couples in noticing that these problems no longer speak to these couples about the identity of their relationship or about their personal identities. These partners then experience the possibility of a relationship and per-sonal identity that is apart from the problem. Michael explained that when couples

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experienced the possibility of alternative ways of viewing the problem, they were then able to explore new possibilities for their relationship.

In the exploration of the effects of the problem on a relationship, couples will always speak of an event, idea, or experience that doesn't fit with the dominant story about a partner or about the relationship. According to White (2007a, p. 61), "Re-authoring conversations invite people to continue to develop and tell stories about their lives, but they also help people to include some of the more neglected but potentially signi ficant events and experiences that are 'out of phase' with their dominant story lines." In the segment that follows, the therapist is privileging an alternative story of changes the couple have made together. The new story line is that they are a couple who will accommodate. Through this conversation, the therapist helps to bring out the evi-dence of this accommodation, in order to thicken this story.

Michael emphasized that people regularly present their lives as if they were single-storied. He advocated training ourselves to listen for traces of subordinate storylines. There are always traces of these stories, he asserted. He was constantly on the lookout fur points of entry to these subordinate stories so that they could become known, and emerge from the shadows of dominant stories so that they could become more visible.

White also spoke about change. He did not advocate that therapists should aim to produce change. Instead, he argued that change was happening all the time in people's lives. People are constantly constituting and reconstituting their lives. Thus, the therapist's job is to join in both recognizing these changes and developing signifi-cance around them.

Paul: There are a number of things that Diane has noticed that you have changed. I started this discussion by asking what have you noticed? And you said, "Nothing, really," and then you began to say you have done many things and made many adjustments ... you know, just to accommodate, and then you started to talk about Ira's adjustments. So it sounds like there have been some.

Ira: (looks at Diane) What about the church thing? Paul: Oh, that was another one. Diane: Oh, well that's been like a positive change, then a negative change, then a

positive change. Because he did go to church. Yeah, that was it. Ira: But you know it's kind of difficult for me to go to Catholic church because of the

things they say and the things they do. Things I see that I don't, you know, I don't agree with.

Paul: But you went for Diane, right? Ira: Yes. Paul: Right, it wasn't about the church; you did it for her because that was important

to her. Ira: Yes, I really didn't want to be there, but I went for her. Paul: Mmmm, yeah. Diane: I was surprised. I sat on the aisle ... the first 20 minutes he was playing with

the baby and making him laugh then ... he walked the baby outside. It was a surprise because I would usually be the one doing it. I'm grateful that he did that and went to church for me, because usually Sundays I go by myself. That's also been a fight.


Paul: And yes, I'm also writing down "open to counseling" because you had said . .. it was a while that you wanted Ira to come with you to see someone, but (looking toward Ira) you did. You came, and that's another sign of accommodating.

Ira: Yes (nods his head). Paul: So you are a couple who accommodate? Ira: (nods yes) Diane: (nods yes) Paul: What do you think that says about you as a couple? That on both sides you can

look at the changes that are occurring. There are some things you wish were different, no question about it. That you wish the other person was different, but there is already in your three years of living together, there is accommodation that has already taken place. Are you surprised with that, that there is a list on both sides?

Ira: (Diane looks to Ira to answer) Yeah, it's just very difficult to see the changes, unless you start talking about it.

Paul: Yeah. Ira: Unless things come out, you really don't see the difference; you just think it's the

same thing over and over and over. It's like nothing is changing until you stop and start to realize and you talk about it.

Paul: Yeah, so what do you think that says about you as a couple? Diane: That we are willing to work together. Long enough to drive each other crazy

... nah (looks at Ira and laughs). Paul: Yeah, yeah, well we haven't got to that point yet, have we? Ira: (nods his head) No, not yet. Paul: No, no, but willing to work together to try to make things work. Do you think

that would describe you as a couple? Ira: Yeah.

Michael described another step in his work, which was to ask questions that helped bring forth the context of these experiences that the couple found prob-lematic. He stated that most interactions or relationship patterns that couples get locked into are patterns that they didn't dream up for themselves; that is, they did not radically create or invent them. "You may have seen sometimes that couples are very adversarial in their interactions upon separation. It is not that they dreamed up that relationship pattern. There is a whole process involved that inevitably recruits them into very adversarial ways of dealing with these things" (White, 1993). Michael observed that many of these patterns were familiar or were cultural in nature, and that these were actually shaping their couple rela-tionship. Indeed, they determined the accounts the partners had of each other. Michael suggested that the familiar and the cultural nature of these patterns could be brought forth with questions like the following: "How did you get recruited into these ways of interacting with each other? Could you tell me about that?" He called these recruitment questions. Or, "Have you witnessed these patterns of interaction in other couples?"

It is of paramount importance to explore the effects of the problem in this way and identify the processes of the recruitment that determine the negative "truths" the

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partners arrived at about their relationship and about who they were as persons. The result may be that these problems no longer speak to these couples about the iden-tity of their relationship or about their personal identities. Indeed, the partners might experience the possibility of a relationship and personal identity that was apart from the problem.

An Example of Meaning Making Narrative therapy works with the idea that there are no facts; there are just different meanings that can be made from an event. "Rather, this therapy is associated with the proposition that the meanings that people derive in these acts of interpretation are determined by the interpretive resources that are available to them, and further, that these meanings are negotiated in communities of people and within the various terms and institutions of culture" (White, 2000, p. 9). The following segment attempts to show people engaged in creating new meaning by expressing their preferred ways of being together. Diane noticed changes with Ira and developed a new story of their relationship through new meanings.

Diane: I wanted to show you that I am grateful that it happened. Ira: (interrupts) Notice it ... just don't, just don't ... you know. Paul: Don't what? Don't what, Ira? Ira: Don't like, you know, uh, like a little kid, you know (moves his arms around,

starts speaking in baby voice). "You did something good. Here is a treat. Let me give you a kiss."

Diane: Oh, I wasn't. Oh, okay. Ira: See the good things that I do; don't think that I am never changing. Diane: (moves to hold his hand) Okay, when I do something good, I like to be treated

like a little kid. Ira: Oh, and that's you. Diane: So go ahead, just so you know, go ahead and do that to me. Paul: So you don't like to be '" Ira: Sometimes she is like, too ... how do you say it? Diane: I am very affectionate. Ira: I used to be very affectionate, but it's rubbing off. I don't know Why. Paul: You lost your interest in being affectionate? Ira: Not just with her, but with everybody. Paul: Really? Ira: Even my parents and my sister say that, before, I used to always be giving kisses

and hugs. Now I am just not like that much anymore. I guess it just went away.

Paul: Do you miss it? Ira: Everyone starts saying you are so like this and you are so like that ... you know,

too much kisses (looks to wife). How do you say bobosa? Diane: There is no English word. A bobosa is just someone who is so affectionate

that you can't stand it, you know? Paul: Was he like that? Diane: Never to me, because to me that is an impossible point.


Ira: In the beginning? Diane: In the beginning you were extremely jealous. I would not call that bobosa. Ira: Oh, okay, that is something else. Didn't I change? Diane: Yes! Ira: Oh, okay then. I was tremendously jealous. Diane: When we first started going out. I was 19 ... Paul: (interrupts) I think you, I have to stop for a second ... because you have men-

tioned several things that youhave noticed really changing in Ira. Diane: (puts her head back and starts laughing out loud) Oh, okay, yes, yes. (nods her

head) Yes, yes, the jealousy. Paul: Do you remember what they were? The last thing was the jealousy. Diane: The last thing was jealousy; he is no longer jealous. Paul: And the one just before that? He is being accommodating around your parents,

your parents being able to watch their show. Diane: Oh yes, that was yesterday, yes. Paul: What would you call that-sacrificing, able to, willing to? What would you

call that? Diane: I would say to share. Ira: (looks at Diane) Accommodating. Diane: Accommodating and thinking of others. Accommodating would be fine. Paul: Oh, thinking of others. Ira: (looks at Diane) I actually called John (looks at Paul) ... John's my brother ...

when we first came here I was not even talking to my brother; I was very negative about things. You know.

Clients as Experts White (2007a) encouraged clinicians to write down the exact words that people use. He spoke of this as decentering himself. He made an ethical point about the many ways in which therapists are centered in therapeutic conversations and his need to keep working to decenter himself in order to invite a person to take up agency in his or her life.

Paul: Now we can't name what it is that you guys want to get out of your relationship so you are able to move on in your life.

Ira: I think maybe it is probably more me than her. I mean, she has her things, but I probably have more problems than she does.

Paul: What makes you say that? ' Ira: I guess from what I hear from people. I have bad anger problems or I don't like

dealing with people ... If you do something bad to me, I say fine, but twice-that's it, I don't talk to you.

Paul: You cut things off? Ira: Yeah. Paul: You forgive someone once but not a second time. Is that right? Ira: Right. Paul: Is that a good thing or a bad thing? Ira: It's not a good thing. I feel like it's not right. You know that I am like that.

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Paul: Is that something you would like to change? Ira: Yeah. Paul: (looks at Diane) What does that mean to you to hear your husband say that? Diane: Wow. I am going to cry right now.

Treatment Process: late Phase Overview of Termination and The couple and therapist worked together for eight sessions. Diane and Ira decided to end the work at this point, stating they felt their goals had been achieved. They indi-cated that they had decided to pursue getting pregnant and starting a family. Diane also felt especially supported by Ira in relation to his increasing involvement with her in church activities. She stated that she felt his commitment to the marriage and to parenthood. Ira expressed that he could feel Diane's support for his pursuing a career as a police officer. She was pleased that she had worked through her fears of having a gun in the house and the dangers of this occupation.

The therapist made a telephone follow-up call one year after termination. He spoke with Ira, who stated that life was going well for them. Ira mentioned he went through the lengthy process of applying to the local police department. He did not pass the final tests, but after initial disappointment, Ira was able to accept his fate. He gave up his flooring business and was working for the city in building maintenance and pleased with his new job. Ira stated that Diane was very busy in her work and contin-ued to love her job. They were still trying to get pregnant.

Conclusion Therapist's Reflections/Commentary on the Case It is the therapist's perception that the couple benefited from joining with a third person, that they came to view and accept the idea that the Problem was the Problem, and that Ira was not a person with problems inherent to his character. They appeared to benefit from sharing the effects of the stressors in their lives (i.e., their concerns about the influence of their in-laws on their relationship, effects of depression, feeling a lack of fulfillment). They both appeared invigorated by the exploration and expansion of the stories of commitment each felt to the other, of their hopes for the marriage and their future, and the amount of caring expressed by their partner.

The therapist noted that he could have made further use of the technique of repositioning in sessions. This involves interviewing one person in the presence of the other, e.g., assigning one person to listen and take notes while the partner was being interviewed, and then turning and interviewing the other person about the experience of listening in on the conversation. In the therapist's previous work with couples, this has proved invaluable in reducing conflict in the room between couples and offered practice in the skill of listening intently.


Implications for Training and Supervision Michael White encouraged participants in his workshops to continually practice the skills associated with the narrative therapy approach. He promoted the study of his own writing and the teaching of those philosophers and theorists from whom he drew inspiration. Michael also strongly encouraged therapists and trainees to tape their work whenever possible so that they could present their work and share it with others in super-vision. He believed that it is in the attempt to copy the style, manner, and technique of others that clinicians succeed in developing their own unique modes of practice.

As in the practice of narrative therapy, Michael believed strongly that supervision should also focus on the rich story development of the supervisee. Russell (2010) noted that narrative supervision can be viewed as a collaborative, negotiated process interested in assisting supervisees to connect with what they give value to in their work and in appreciating the intentions they have for a particular person or persons they are working with, and for their work in general. Supervision provides the space for the exploration, naming, and externalizing of those forces of depletion and stress that attempt to interrupt effective practice. Finally, isomorphic to clinical practice, supervision is perceived as a place for the exploration of identity and a recognition of the multi storied nature of people's lives.

REFERENCES Foucault, M. (1979). Discipline and punish: The birth of the prison. New York, NY: Vintage. Gallant, J. P. (2008). In memoriam: Michael White-Therapist, teacher, innovator. Journal

ofMarital and Family Therapy, 34(4),427-428. Payne, M. (2006). Narrative therapy: An introductionfor counselors. London, England: Sage. Polkinghorne, D. (2004). Narrative therapy and postmodernism. In L. Angus & 1. McLeod

(Eds.), The handbook ofnarrative andpsychotherapy: Practice, theory, and research (pp. 53-68). Thousand Oaks, CA: Sage.

Russell, S. (2010). Exploring narrative approaches to supervision. Workshop presentation at the Catching the Winds of Change 3 Conference, Halifax, Nova Scotia.

Vodde, R., & Gallant, P. (2002). Bridging the gap between micro and macro-practice: Large scale change and a unified model of narrative-de constructive practice. Journal ofSocial Work Education, 38(3), 439-460.

White, M. (1989). Selected papers. Adelaide, Australia: Dulwich Centre. White, M. (1993, March). Three approaches to couples therapy. Workshop presented at

the Annual Conference of the International Association for Marriage and Family Counseling. IAMFC Distinguished Presenters Series, Atlanta, GA.

White, M. (1997). Narratives of therapists , lives. Adelaide, Australia: Dulwich Centre. White, M. (1999). Extending narrative therapy: A collection of practice-based papers.

Adelaide, Australia: Dulwich Centre. White, M. (2000). Reflections on narrative practice: Essays and interviews. Adelaide,

Australia: Dulwich Centre. White, M. (2004). Narrative practice and exotic lives: Resurrecting diversity in everyday

life. Adelaide, Australia: Dulwich Centre. White, M. (2007a). Maps ofnarrative practice. New York, NY: W. W. Norton. White, M. (2007b). Narrative therapy workshop presentation, sponsored by The Narrative

Therapy Institute, Maitland, Florida.

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White, M. (2007c). Michael White workshop notes. Retrieved September 27, 2000, from www.dulwichcentre.com.au

White, M., & Bpston, D. (1990). Narrative means to therapeutic ends. Adelaide, Australia: Dulwich Centre.

Winslade, J. (2008, October). Workshop Notes from John Winslade Workshop on Narrative Mediation. Nova Southeastern University. Fort Lauderdale, FL.

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