cognitive-narrative

theory, research and techniques

december 2007
 narrative workshop
an approach to exploring meaning

J. Rocha1,2, R. MacLeod3 and L. Kerzin-Storrar3

1IBMC, Univ. Porto , I2 ISCS-Norte, Paredes, 3Academic Unit of Medical Genetics and Regional Genetics Service, Manchester
second cognitive revolution
Wittgenstein
Vygotski
Frankl
Kelly
Watzlawik
Bruner
Pennebaker
Neimeyer
Gonçalves
 Wittgenstein (1919)
* The world consists of independent atomic facts out of which larger facts
are built.

* Language consists of atomic, and then larger-scale propositions, that

correspond to these facts by sharing the same "logical form".

* Thought, expressed in language, "pictures" these facts.

* We can analyse our thoughts and sentences to express ("express" as in

show, not say) their true logical form.
 Vygotski (1931)

language has a central role

(p.e.) on development and thinking
 Viktor Frankl, 1959

holocaust and searching for meaning

 George Kelly, 1955

personal constructs theory

antecipation based on past experience
evolutive nature of constructs
anxiety when constructs fail
 Watzlawick

logic and analogic communication

(Watzlawick, Beavin and Jackson, 1967)
 Bruner (1)

To perceive is to categorize, to conceptualize is to

categorize, to learn is to form categories, to make
decisions is to categorize.
The individual is a metaphor of its culture
Narratives mediate reality-individual negotiation
 Bruner (2): narrative
1. Narrative diachronicity: take place over some sense of time.
2. Particularity: deal with particular events.
3. Intentional state entailment: characters have "beliefs, desires, theories, values, and so on".
4. Hermeneutic composability: narratives can be interpreted in terms of their role as a
selected series of events that constitute a "story."
5. Canonicity and breach: about unusual happening that "breaches" the canonical (i.e.
normal) state.
6. Referentiality: references reality not in a direct way; narrative truth can offer
verisimilitude but not verifiability.
7. Genericness: the story can be classified as a genre.
8. Normativeness: a claim about how one ought to act.
9. Context sensitivity and negotiability: requires a negotiated role between author or text
and reader, including the assigning of a context to the narrative, and ideas like suspension of
disbelief.
10. Narrative accrual: stories are cumulative, new stories follow from older ones.
Pennebaker and Niemeyer
narrative coherence, narrative complexity
and narrative multiplicity

individual as an active constructor of their

experiences (Neimeyer, 1999)
 cognitive-narrative
an intentional scheme of five stages (Gonçalves, 1997):
recalling
objectifying
subjectifying
metaphorizing
projecting
subjectifying session

aim:
narration with sense of authorship, coherency and diversity
of cognitive and emotional content

method:
to give structure to the sequence of scenes
evoke and activate emotions triggered
to find adjectives for these emotions
explore physical sensations felt when emotion where activated
exploration of cognitive components
metaphorization session

aim:
to generate a metaphor that encapsulates their experience

method:
summarization of the course woman have been through
emphasize emotional and cognitive components
generate metaphors
encourage generating metaphors in others perspective
ask for a title or unifying theme
meaning for metaphor and for the episode were discussed
projection session

aim:
to experiment other possible organizations of the episode

method:
recall similar episodes with an alternative function
generate metaphor for the new episode
suggest imagining the termination episode with that new metaphor
consider the different emotions and thoughts
discuss the way this narrative may represent a more adaptative
functioning
intervention effectiveness
 top research
TOP
Results
15 days 6 months

First Evaluation Second Evaluation

Anxiety (Zung SAS) Anxiety (SAS)
Depression (BDI) Depression (BDI)
Coping (CRI-A) Perinatal Grief (PGS)
Decisional Conflict Structured Interview:
Structured Interview: -Social support
-Socio-demographical -Subjective evaluation
-Decision perception -Metaphor
-Others perception
-Specific coping
-Metaphor
 top program
Session 1 Session 2 Session 3 Session 4
- Decision - Subjectifying - Metaphorizing - Projecting

Results TOP

15 days 21 days 28 days 6 months

First Evaluation Second

Evaluation
 evaluation methodology
randomized groups with repeated measures of depression and anxiety.
• control group with conventional approaches and intervention group.
• intervention consistency rating scale, intervention manual for
therapist/counselor and client satisfaction instrument.
 Subjects
•From 11 pnd Portuguese institutions
*
** *
**
* •Control Group:
* •n=67; age x=33,3 years (sd=6,7);
gestational age: x=18,5 weeks (sd=3,4)
•Intervention Group
•n=24, age x=32,3 years (sd=6,0);
**
* gestational age x=20,17 weeks (sd=2,3)

Institutions network in this

research distributed over
Portuguese territory
 anxiety comparative results
A. prevalence (zung>40)
15 days n.s. 6 months*
intervention 30,4% 4,3%
control 40,6% 20,6%
* Pearson Chi-square=4,77; p<0,05

B. average
15 days n.s. 6 months*
intervention 36,57 31,26
control 38,83 34,82
* t test; p<0,05

C. negative evolution
increased anxiety n.s.
intervention 9,1%
control 22,9%
depression comparative results
A. prevalence (BDI>12)
15 days n.s 6 months*
intervention 39,1% 4,3%
control 41,3% 26,0%
* Pearson Chi-square= 4,77; p<0,05

B. average BDI
15 days n.s 6 months *
intervention 9,87 4,57
control 12,13 7,74
* t test; p<0,05

C. negative evolution
increased depression*
intervention 0%
control 18,8%
* Pearson Chi-Square= 4,73; p<0,05
 Client opinions
“Participate in this program was important for you?” 100% yes
“Does program helped you living in a better way this episode?” 100% yes

x sd
“How important was it?” (between 0 and 10) 8,95 1,14
It helped to decide? 5,21 3,56
Help understanding moral values? 5,56 3,35
Cleared out what I felt? 8,33 2,09
Supported emotionally? 8,73 1,56
Organized my emotions? 8,47 1,37
Organized my thoughts? 8,23 1,52
Help partner communication? 6,83 2,85
Less afraid of new pregnancy? 4,65 3,31
working in pairs
recalling exercise

aim:
to recall a episode this master degree

method:
support participant to focus on a specific episode
invite participant to explore that episode
describe as much detail as possible the episode
explore what were the main emotions associated
metaphorizing exercise

aim:
to generate a metaphor that encapsulates master degree episode

method:
summarization of the chosen episode
emphasize emotional component
facilitate to generate a metaphor, e.g., ask for a title