Presentation Abstracts Invited Symposium Αθηνά Ανδρουτσοπούλου, Κία Θανοπούλου και Τσαμπίκα Μπαφίτη
"Voicing Mrs Maisel: Emergence and reinforcement of weak and silenced voices in three theory-building case studies
Three theory-building cases studies are presented in this symposium. They aim to specify, and explicate a theoretical model, specifically the unfolding of narrative/dialogical-informed systemic psychotherapy in four stages (4-stage process model): (i) Recognising restricting life themes and dominant inner voices, (ii) Challenging restricting themes and dominant inner voices. (iii) Revising restricting themes - strengthening silenced or weak inner voices, (iv) Supporting more liberating themes - maintaining a revising/ reflexive stance or ‘authorial’ voice. The researchers use narrative and dialogical methods to analyse therapy transcripts and/or therapist notes from different types of sessions (individual, family and group). The findings highlight ways to recognise, revise and challenge dominant voices and support more liberating voices, and identify steps. The findings emphasize the dialogical and co-operative nature of therapy, highlighting the contribution of the therapist in this shared endeavour. A number of interventions are suggested.
Key words: narrative/dialogical, systemic psychotherapy, case studies
1. Challenging unhelpful voices: A narrative-dialogical sequence analysis of initial sessions with an individual client.
Athena Androutsopoulou, Erasmia Grypari, & Theano Makarouna,
‘Logo Psychis’- Training and Research Institute for Systemic Psychotherapy.
The purpose of this case study is to specify and explicate the four-stage process model of narrative/dialogical informed systemic psychotherapy as described in the symposium abstract. A further theoretical starting point of this study is that therapy is a co-operative task where each party (therapist-client) takes certain positions in the dialogical exchange. The transcripts of the first 5 sessions with a young, female client with work anxiety were analysed with a narrative and dialogical sequence analysis method. Various steps in the process of working with a restricting theme were identified, specifying the movement from the first stage of the therapy to the third. Our analysis indicates that the various positions taken in the dialogical exchange allow therapist and client to eventually “meet”, agree on a revised theme, and thus construct a shared meaning based on client experiences. Even though the four-stage process model of therapy has been developed based on long-term clinical experience and research, this study highlights its usefulness in a micro-level, putting forward the idea of progress in a spiralling mode until core restricting themes are tackled and dominant voices are challenged. Examples of therapy questioning are suggested based on the findings.
Keywords: work anxiety, dominant voices, initial individual sessions
2. Uncovering secret voices: Narrative analysis of therapy notes on working with a single family.
Kia Thanopoulou, Family Therapy Unit, Psychiatric Hospital of Attica
This theory-building case study explicates the first stage of the four-stage process model of narrative/dialogical-informed systemic psychotherapy as described in the symposium abstract. Further, the study also captures the complication of recognising restricting themes and identifying weak/unsaid voices in the context of a family session. The narrative analysis is based on therapy notes taken for a period of 15 sessions. Following the attempted suicide of their daughter (presenting problem/symptom), the family in therapy uncovers the long-buried secret of a baby abandoned at birth. Initially, one restricting theme was drawn from the presenting problem or symptom treated as a metaphor. This theme was supported by the unsaid voices of the parents which occupied the internal space of the daughter. An interconnected restricting theme was further recognised supported by parental dominant voices and traced back to past generations. The study verifies the usefulness of drawing themes from symptoms as metaphors and explicates the first stage of the therapy model by specifying the nature of restricting themes and the types of voices that support them. Further clinical implications are suggested.
Key words: metaphors, dominant voices, family sessions,
3. Hearing the polyphonic self: Narrative analysis of a session with a single client in long-term group therapy.
‘Logo Psychis’-Training and Research Institute for Systemic Psychotherapy
This theory-building case study focuses on a client in the final stage of the four-stage process model of narrative/dialogical-informed systemic psychotherapy as described in the symposium abstract. The client requested therapy five years ago due to severe symptoms of major depression, de-realization and depersonalization episodes, self-harm behavior, addictions and suicidal ideation. She participated in long-term group psychotherapy. By applying a narrative and dialogical analysis method to a transcript of a recent group session, a polyphonic multi-dimensional self is heard, as a number of relieving processes unfold: understanding of and reconciliation with the past, being sad without fear of depression, being tolerant of ambivalent feelings for others, discovering new ways of negotiating with others, identifying new options in her professional and romantic relationships, forming realistic expectations of herself as well as others. The case confirms the general processes described in the last, fourth stage of the model: the client recognized and challenged dominant voices of harsh criticism and unrealistic expectations, while she strengthened compassionate, empowering and liberating inner voices.
Keywords: psychopathology, long-term therapy, liberating voices