Narrative Practices: Therapeutic Letters

by Tiffany | Jul 30, 2018 | Narrative therapy practices, Writing

(This is an expansion of a post that was shared with my Patreon patrons earlier this month.)

I am learning how to do narrative therapy, how to be a narrative therapist, how to engage with my clients in ways that are narratively-informed. But what does that mean? What is narrative therapy? What does a narrative therapist do? What benefit does narrative therapy offer?

In this series of posts, I’m inviting readers to join me in the learning process. The first of these posts was shared in April, and was about using narrative practices of collective documentation as it was used in a group exercise of Connecting To Our Skills. This post is also about documentation! (I really love generating documents, in case you couldn’t tell!)

This post is about therapeutic narrative letters.

Narrative letters are an important part of narrative practice, and have been part of the field for years (and therapeutic letter writing is also present in other disciplines). I had written some letters to community members who consulted with me, but my recent trip to Sacramento to learn from the therapists at the Gender Health Center really encouraged me to explore this practice further. The therapists there, particularly David Nylund, use narrative letters regularly – both with community members and also between therapists and supervisors. I was able to hear some of those letters, and it was a moving experience.

Shortly after I returned from Sacramento, I ran a two-hour narrative group therapy session at Camp Fyrefly, and I wrote narrative letters to the participants. Each of the participants gave me permission to share these letters.

I learned a lot through this process of writing, and one thing I learned is that it takes a long time to write a narrative letter! I knew this from my earlier efforts, but writing to a group like this really brought home for me how challenging this practice is. And yet, despite that challenge, it is a practice I will be incorporating more regularly into my narrative work. This is not only because I value opportunities to create documents, but also because I think a letter can be a powerful thing and I want to offer something back to the community members who consult me. Something that, hopefully, offers them a tangible reminder of the ways in which they are responding to the problems in their lives, and that connects them with the stories of their lives.

This isn’t just my own gut feeling, though. Other narrative therapists have written about the power of therapeutic letter writing.

In a 2010 paper, published in the International Journal of Narrative Therapy and Community Work, Susan Stevens wrote:

Letter writing has been a wonderful way to assist my growing understanding of narrative practices, particularly in learning the various maps. Crafting a letter has required me to carefully reflect on conversations in a similar way to reviewing recorded sessions. I have found it has given me some space to really examine my practice and facilitate further learning. I have discovered opportunities that I have missed that I can then pursue in the letter, as well as positive moments that can be developed further.

Letter writing following counselling sessions has created many more possibilities for working together than I initially envisaged. It has been a great privilege to work alongside people as they revise their relationships with significant problems in their lives. Hearing how the letters have supported people to construct preferred storylines of identity and celebrating their achievements toward this has been incredibly exciting.

In 2016, also in the International Journal of Narrative Therapy and Community Work, Renee Butler wrote:

Letter writing in a counselling context has a long history (Watts, 2000) and in particular, the use of narrative documents has been heavily influenced by the field of anthropology (Myerhoff, 1992). Myerhoff talks about how we can be ‘nourished by our stories being fed back to ourselves’ (Myerhoff, 2007, p. 25), and one of the ways in which this can be done richly in practice is through offering documents that honour and acknowledge the stories we hear from the people who consult with us. In a narrative context, these types of therapeutic documents have been used with the purpose of creating double-story development, where the listener provides an acknowledgement of the problem as well as a rich description of an alternative story that was hidden within the dominant ‘problem’ story (White & Epston, 1990). White and Epston were interested in the value of therapeutic documents and because of this they undertook some informal research into the usefulness of this practice. They established that a good therapeutic document (or letter) was worth 4.5 sessions of good therapy (White, 1995) and concluded that engaging in this process was worth the time and energy needed by the therapist.

David Nylund (at the Gender Health Center, which I visited last month) has participated in research into the therapeutic efficacy of narrative letters. From a 2015 paper:

At the present time, there is not much evidence for the effectiveness of therapeutic letters in narrative therapy. However, both David Epston and Michael White (Freeman, Epston and Lobovits, 1997) have conducted informal clinical research, asking clients questions such as these:

1. In your opinion, how many sessions do you consider a letter such as the ones that you have received is worth?

2. If you assigned 100 per cent to whatever positive outcomes resulted from our conversations together, what percentage of that would you contribute to the letters you have received?

The average response to Question 1 was that the letter had the equivalent value of 4.5 sessions. In response to Question 2, letters were rated in the range of 40% to 90% for total positive outcome of therapy.

Such findings were replicated in a small-scale study performed at a large medical facility in California. Nylund and Thomas (1994) reported that their respondents rated the average worth of a letter to be 3.2 face-to-face interviews (the range was 2.5–10) and 52.8% of positive outcome of therapy was attributed to the letters alone. As supported by this research, the amount of time it takes to write letters seems worth the effort.

So a narrative letter can be the therapeutic equivalent of 3.2-4.5 narrative therapy sessions. And it can assist in my own development as a narrative therapist, and enrich the experience of the community members who consult me. That seems like a really important practice to develop, especially since a lot of the folks consulting me do not have the finances to sustain frequent or extended therapeutic work.

But it’s hard work! And it takes a long time. For me, as a newbie to the practice, these four letters took me almost 12 hours, and many drafts.

I’m not sure exactly how this practice will develop in my work, since I won’t be able to write a narrative letter for every session. But it’s certainly something that I am considering, and if you are interested in working with me and are particularly keen on letters being part of our therapeutic relationship, let me know!

I’m sharing these four letters for two reasons.

First, because I think that the insider knowledge shared during our group conversation was valuable and might help other folks. Sharing these letters means that you have an opportunity to read and respond, and if anything particularly resonates for you, you can send me your response and I can share it back with the community members.

And second, because I’m “showing my work” and inviting you to see what happens behind the scenes as I learn.

Anyway! Here they are!

The letter to the group:

Dear A., E., and J.,

It has taken me a while to get these letters written.

Every time I sat down to write, I got lost in the wealth of information and insight that was shared during our conversation. I could write you each a whole novel! But that wouldn’t be a very good narrative letter.

Each draft of the letter that I wrote just didn’t seem to work. I couldn’t figure out how to make it coherent, how to shape it into something meaningful. I wanted to answer some critical questions:

What stands out the most to me when I think about our conversation?

What moved me in our conversation?

What do I want to note, and hopefully in a way that offers something meaningful back to you?

You were each so generous with your time, your energy, and your stories.

After many attempts, I realized that the problem was in trying to write a single letter to the group, rather than specific letters to each of you. Although there was so much resonance between your stories, you each brought something unique to the conversation. In trying to compress my response into a single letter, I kept losing the richness of the diversity in your contributions and your shared stories. And, since camp is so much about honouring and holding space for diversity, I finally realized what I needed to do! So, four letters. This one, and one to each of you.

As I mentioned during our conversation, this practice of writing narrative letters is new to me – I have done a lot more work in collective documentation. In collective documentation, I take a group conversation, and then generate a document or resource that shares the insights and stories with a broader audience. In those documents, I am sharing outward from the group, and a single document makes sense!

What I found as I tried to write this letter (now ‘these letters’) was that it is a bit of a different thing when I am writing inward, to the group, rather than outward, from the group.

One of the things that everyone in the conversation shared was the commitment to holding space for complexity, and for valuing the well-being of the people around us.

This was true for each of you, and it belongs here, in the group letter.

There was an ethic of care that extended in multiple directions – from the counsellors to the campers, from the campers to each other, from the campers to the counsellors, and from the counsellors to each other. This multi-directional, complex, compassionate care was beautiful to see.

My favourite quote from our conversation, and the one that has stuck with me, was this – “Giving up hope on a solution by generating hope for a process.”

I think that throughout our conversation, we found very few solutions. We talked about problems that are ongoing, that are supported and strengthened by the oppressive and marginalizing systems around us. Problems with deep roots and wide-ranging impacts. We did not solve these problems in our conversation – Imposter Syndrome (supported as it is by capitalism, by individualist culture, by hierarchies of knowledge, by a culture that values “expertise” and “productivity” in very specific ways); Guilt (supported internally and externally, by our desire to take care of each other, and also by social contexts that leave very little room for imperfection, failure, and growth); Comparison; and others.

So, no solutions.

But so many steps towards process, and so much hope for process.

These processes include harm reduction, disconnecting from value-judgements, holding and curating space for ourselves and each other, imagining ourselves and each other with complexity and compassion, naming our memories, seeking external validation and choosing to receive it, recognizing the potential for growth in failure, and so much more.

These processes, informed by your insider knowledge into navigating the problems in your lives, are full of hope.

I feel fortunate to have been able to particulate in such a rich and hope-filled conversation.

And I appreciate your patience with how long it has taken me to work my way through this process. I am incredibly thankful for this learning opportunity.

Warmly,

Tiffany

The letter to A.

Dear A.,

Thank you for being part of the narrative therapy conversation. I know that you said there are not many places where you’re able to talk about your feelings openly, because you’re worried about how that might impact the people around you.

As I worked on this letter, I kept thinking about what it means that you have maintained a connection to your desire to share, which you said is healthy for you, despite the fact that you have fewer spaces for that sharing.

What has allowed you to stay aligned with that desire to seek out safe spaces to share your feelings, while also looking out for the people around you?

I also wonder if you were able to find more of those spaces for sharing while you were at camp, and how you navigated those opportunities and conversations.

One of the stories that you shared, that has really stuck with me, had to do with how you’ve responded to and resisted one of the problems in your life. This problem is related to Comparison. There are moments when you witness friends laughing together and you might get thinking, “I should have been the one to make them laugh.”

A., you mentioned that sometimes you really get in your head about it, and even when it starts as a small thought, this feeling of Comparison can get pretty big and loud. In navigating these hard situations, you’ve developed a skill of Naming Memories, to quiet the mean voice that tries to convince you your friends might not care about you if you aren’t the one who always makes them laugh, or if you aren’t always their first choice for an activity.

This skill of Naming Memories lets you stay connected to your knowledge that you’re still important even when someone else is busy.

I wonder if there are any people in your life, either now or in the past, and either real or fictional heroes and inspirations, who might support you in this skill of Naming Memories? Do you have cherished memories that you return to more often when you are resisting Comparison and Fear?

In all of your stories there were so many references to caring for the people around you, even when expressing that care meant making hard choices; giving space to a friend even when it’s the hardest thing, and reaching out to other friends even when you might want to keep just one person close.

Your hard work is paying off, and I wonder what else might become possible as you continue to do the hard thing in order to care for yourself and the people around you.

I also wonder, do you think there might be a time when the “hard thing” becomes less hard? What might that look like?

It was really inspiring to hear about how you have taken action to respond to the problems that show up in your life.

You shared the story of going to an event, and chatting with a totally new person, despite the fact that you have a hard time talking with new folks! Your friends were enthusiastic and proud of you. J. also shared a story of receiving validation from her community, and how helpful that was. E. pointed out what an active process it is to receive validation, and to choose to believe that what someone says is true. When you shared this story of attending the conference and reaching out to a new person, it touched on a shared experience in the group of reaching for and finding validation in the people around us.

One other thing jumps out at me when I remember our conversation – you mentioned a few times that you are learning to “stop thinking in black and white”, and we talked a bit about what that means, and how there is now more range of colour in your life, and more possibilities.

What does it look like, when you can see your life in this expanded range of colours?

It was an honour to share narrative space with you, and I hope that camp offered you a rich range of experiences and possibilities.

Warmly,

Tiffany

The letter to J.

Dear J.,

First, it was such a pleasure to meet you, and a gift to have you endorse my work to A. and E. When you mentioned that my work has been helpful for you, it meant so much to me. Thank you.

I so appreciated your willingness to open up our conversation by sharing about how Imposter Syndrome has sometimes got you thinking that you aren’t worthy of taking up space, that you don’t belong, and that you aren’t qualified.

This Imposter Syndrome has shown up for you at various times in your life, and this resonated for all of us in the conversation.

You had really noticed it showing up for you at camp.

You’d seen other counsellors making connections and demonstrating how attuned they are to their campers, and you’d felt that as a gap in your own experience so far. You hadn’t had that chance for a one-on-one sit-down with a camper, and that had been hard. It was discouraging.

I wonder if you did get that chance to have a one-on-one sit down with a camper before camp ended?

I also wonder what it might mean to the campers, if they knew that you were paying such close attention to their needs, and so committed to making sure that campers who needed a one-on-one chat were able to access it?

I saw this awareness and commitment to community care put into action when you witnessed E.’s story and immediately responded by sharing that you had heard from campers that E. offered “the queer space to feel safe in.”

When you were talking about the effects of this Imposter Syndrome and the dreams you had of showing up for your campers and connecting on a personal level, I heard a strong commitment to community care, and an awareness of the people around you and what they might need. I heard you wanting to be part of creating safer spaces, and offering campers the opportunity to have their experiences even when those experiences might be uncomfortable or challenging. Rather than simply looking for solutions, you were, as E. framed it, “generating hope for the process.”

I also want to honour that you had experienced some disappointment, and even some guilt, about not having had those opportunities for one-on-one connection yet. In those moments when Guilt shows up, sometimes it has you wanting to disappear in order to make things better, because you are valuing other people’s experiences and their well-being.

This really seemed to resonate with what A. said about sometimes feeling like a downer, and Guilt showing up in those moments. E. also seemed to connect with this idea.

I was really interested in the story that you shared about receiving validation from your coworkers, and how this was a bit of an antidote to the Imposter Syndrome.

You actually went into social work (amazing!) because of the feedback that you got from your coworkers – they saw something in you, and encouraged you in this direction. You actively sought out that feedback, and chose to accept it. As E. pointed out, receiving validation is an active process of choosing to believe that what someone says is true.

I wonder what it means to your coworkers that you valued their opinion so much?

And I wonder if it makes it possible for them to feel connected to your work in the world, knowing that they were part of that process?

What might you say to Imposter Syndrome if it shows up for you again?

Do you have any ideas for how you can resist Guilt when it makes you want to disappear?

Are there ways that you can strengthen your relationship with Trusting Validation?

I would love to hear how things go for you as you continue to resist and respond to these problems, and cultivate your values of community care, connection with others, and doing justice in the world.

I hope that the rest of your camp experience was rich and rewarding.

Warmly,

Tiffany

The letter to E. 

Dear E.,

Thank you for being part of the narrative conversation at Camp fYrefly.

I really appreciated your contributions to the conversation, and some of what you said about holding complexity has really stuck with me and informed some of the narrative sessions I’ve facilitated in the last week.

I’m new to the process of narrative letters, and still trying to figure out where my voice is. I’ve left your letter to last, because I want to respond with my Big Feelings, and I’ve been worried about whether that’s how I’m “supposed” to do narrative letters. But I’m taking some advice from you, and removing my value judgement from these Big Feelings.

E., when you spoke about feeling like you were not able to be fully present because some of your own big stories had been brought up at camp, that really hit me. I struggle with this myself, and with the guilt over it. I want to make a difference in the world, and I want to create spaces and facilitate conversations that open up a wider range of possible responses for people who are responding to the problems in their lives. Michael White, who was a founder of narrative therapy, said that “deficit-focused stories present a narrow range of potential responses” and I really agree with this. But it can be so difficult to move away from a deficit-centered story when painful history intrudes into the present.

It was so encouraging and inspiring for me to see you show up, be present, despite the stories that had come forward for you. Even though you said that you were struggling with being present, your contributions were still so compassionate, insightful, and resonant.

This made me think about whether we make a difference even when we feel ourselves to be at a distance. It got me thinking about the value of my own work, even in the moments when I feel so far away from the self and the work that I most want to be and do. Thank you.

During the conversation, you shared your insider knowledge into what an active process it is to receive validation, and to choose to believe that what someone says is true.

This is a valuable insight, and I became curious about how you came to this knowledge. Have there been people in your life who made this work, which is often so overlooked, visible? How have you learned to see and validate this work in your own life, and in others’ lives?

You also shared that you have worked hard to value your big feelings, which happen in lots of directions. You’ve had some help in this work from skills like Introspection and Challenging Ideas, but you’ve also worked on holding space for feelings even when they are “bad” ones. You talked about how much growth and opportunity exists in failure, and how failure makes things possible but it still sucks.

I really appreciated how each of your comments demonstrated your close relationship with complexity and space-holding.

I also appreciated what you said about how you’ve worked with reimagining yourself as the villain. I’m really interested in this idea.

What villains have inspired you? Which villains have offered you insights into holding space for your own complex story?

It was a pleasure to meet you, and I hope that camp offered you a rich, and deliciously complex, set of experiences.

Warmly,

Tiffany