Narrative Therapy: What is It?

If you’ve been diagnosed with a mental health disorder such as depression or anxiety, or if you need help dealing with grief, stress or other difficult aspects of life, your mental health provider may suggest a form of treatment called narrative therapy.

Narrative therapy involves seeing your problems as separate from yourself. It involves viewing your life events from a different perspective and deconstructing them, allowing you to see them in a more constructive way.

Like other forms of therapy, narrative therapy can help you to gain more control over the ways you think, feel and behave.

Below, we’ve explained what narrative therapy is, as well as how it can help you to grow as an individual and overcome challenging aspects of your life.

We’ve also discussed the efficacy of narrative therapy techniques, as well as other options you may want to consider if you’re feeling stressed, depressed or anxious. 

Narrative therapy is a form of psychotherapy that involves working with a mental health provider to understand the dominant stories of your life, then “re-authoring” these life stories into truthful, life-enhancing narratives that help you to approach life in a more helpful way.

The idea behind narrative therapy is that humans have a need to find meaning in life’s moments and events, including problematic stories. By deconstructing these events, it’s possible to learn more about yourself, identify patterns and rediscover the purpose behind your life.

Narrative therapy was established by Michael White and David Epston in the early 1990s as an alternative to other forms of psychotherapy, with a greater focus on the concept that a person’s life is a work in progress that has a large range of potential outcomes.

The “narrative” in narrative therapy refers to a person’s role as the narrator of their own life story — a role that can allow you to, for example, find positive interpretations and messages in parts of your life that may otherwise contribute to stress, anxiety and other negative emotions.

Narrative therapy involves collaborating with a psychologist, narrative therapist or social worker to tell your own story, then identify opportunities for you to rewrite your story to change the way you think and behave.

As part of the narrative therapy process, you and your mental health provider may use some of the following narrative therapy techniques: 

• Creating your narrative. One of the first steps in narrative therapy is working with your mental health provider to share your stories and create your narrative. You’ll discuss the issues that are troubling you, as well as more positive life stories.
  From time to time, your mental health provider may check in on certain topics to discuss them and identify if they still have an impact on your wellbeing.
  

• Externalizing your problems. A key aspect of narrative therapy is externalization — the process of creating a certain amount of psychological distance between yourself and the problems you face in life.
  A variety of techniques are used to externalize problems and help people view their lives from new perspectives, includingjournaling and art.
  

• Deconstructing stories. Another major aspect of narrative therapy is deconstruction, or breaking down a person’s life story into approachable, changeable parts. This can help people to overcome and change negative stories that become a part of their identity.
  

• Producing new outcomes. Finally, narrative therapy involves developing alternative stories that result in new thinking, behavioral changes and improvements in quality of life.
  For example, narrative therapy may involve developing a positive story from a difficult, stressful experience, then using it as a source of inspiration for personal change. 

Throughout this process, your mental health provider will work with you as a collaborator and partner, not solely as a source of advice. You’ll work together to challenge negative stories in your life and identify opportunities to create alternative stories that improve your wellbeing. 

Research generally suggests that narrative therapy is an effective, versatile form of therapy for both mental health conditions and everyday life difficulties. 

For example, a small study published in the journal Psychotherapy Research in 2011 found that adults with major depressive disorder showed improvements in most symptoms after taking part in a series of eight narrative therapy sessions.

A different study published in 2015, which also involved eight sessions of narrative therapy with an emotional approach (NTEA), also found that narrative therapy produced differences in hope, positive emotions and depression symptoms.

Other research shows that narrative therapy can help women experiencing marital issues, such as low marital satisfaction.

Compared to many other forms of psychotherapy, narrative therapy is relatively new. As a result of this, we still don’t have a complete understanding of its potential efficacy for different types of mental health disorders. 

In addition to narrative therapy, several other forms of psychotherapy are used to treat anxiety disorders, depression and other mental health conditions. These include:

• Cognitive behavioral therapy. This form of therapy involves helping you to identify and become aware of thoughts, feelings and behaviors that are inaccurate or harmful to your mental wellbeing, then make changes to replace them with positive alternatives.

• Problem-solving therapy. This form of therapy involves identifying solutions to specific, concrete problems. It’s often used to address issues that are related to stress and other problems in life. 

• Exposure therapy. This form of therapy involves deliberately exposing yourself to items or situations that cause you to experience distress for short periods in a safe, supportive and controlled environment. It’s often used to treat anxiety disorders. 

• Mindfulness-based cognitive therapy. This type of therapy involves using techniques such as meditation to promote relaxation, calmness and awareness of the present. It’s linked to improvements in depression, stress and certain forms of anxiety. 

Our full guide to the types of therapy provides more information about the forms of therapy your mental healthcare provider may employ if you have depression, anxiety, chronic stress or other difficulties that affect your mental wellbeing. 

In some cases, your mental health professional may prescribe medication to help you gain more control over your depression, anxiety or other symptoms. 

Common medications for mental health issues include:

• Antidepressants. These medications work by increasing the levels of certain natural chemicals in your brain and body. They’re used to treat depression, as well as certain anxiety and pain disorders.
  Our guide to depression medications explains how common antidepressants work, as well as why you might be prescribed this type of medication.
  

• Anti-anxiety medications. Medications such as benzodiazepines and beta-blockers can reduce the severity of some anxiety symptoms. Our guide to anxiety medications explains how these medications work, their potential side effects and more. 

Narrative therapy is one of several forms of psychotherapy that can help you if you’re affected by stress, depression, anxiety or other mental health issues. 

If you’re concerned about your mental health, you can get expert help by asking your primary care provider for a mental health referral or scheduling an appointment with a licensed mental health specialist in your area. 

You can also use our online mental health services to get help from home, including therapy online with a professional counselor. 

Not sure how therapy works? Our full guide to what you should expect from a therapy session discusses how psychotherapy works as a form of mental health treatment, as well as the most common reasons people take part in therapy.