Training Program in Narrative and Indigenous Studies

Post-Graduate Training Program in Narrative Studies.

In the spirit of post-graduate training programs, we plan to offer a training program for human service practitioners.  Check with us regularly to learn how far we have gone in implementing this program.  Here is what we hope to accomplish and to offer:

 

 The program begins with an introduction to the burgeoning field of narrative studies, grounding students in the history of this ideological movement, its philosophical underpinnings, and its relationship to other fields of inquiry – anthropology, sociology, linguistics, ethnic and indigenous studies, women’s studies, social justice, the arts, literature itself, and the sciences.  Next is an examination of this movement in depth within the fields of both medicine and psychology.  Following this, in the second course the narrative itself as a means of reporting illness is examined, as a template for experiencing illness, as a means of conceptualizing illness, as a means of making meaning and purpose out of illness, and as a means of changing illness. Next participants develop the competencies to work within a narrative framework – how to elicit the stories of illness, how to tell these stories back to patients in meaningful ways, how to teach patients and family members how to tell better stories to each other, and how to develop counter- and alternative stories that involve change and transformation.  Then we further the journey into changing clinical outcomes through changing stories and telling stories.

 

We further aim to integrate indigenous wisdom and practice with modern science and humanities.  We aim to enrich your life and professional practice with the wisdom, medicine, culture, and spirituality of the indigenous world and provide a means to bridge indigenous culture with the post-modern world through a narrative approach, thereby teaching and honoring the wisdom of the ages and of diverse cultures, and incorporating it into our modern practice of the healing arts."

 

The Logistics

 

We anticipate a four year course of study consisting of one program each quarter and participation in our supervision/mentorship group, our special topics seminar, and once yearly attendance at one of our “healing camps”, where we practice these techniques together.  Our programs are offered both face-to-face and on-line and may be offered in sponsorship by other organizations.  Coyote Institute has a commitment to turning no one away regardless of ability to pay, but not all other sponsoring organizations share that philosophy, so fees/donations for programs may vary.  There are eight core programs and then a variety of other elective/supplementary programs to provide 16 programs over the course of four or more years.  Course materials and lectures that we produce are placed in the public domain to the extent possible (depending on our relationships with others).  We aim to be a coordinating/collaborating resource for narrative and indigenous studies.

 

Narrative and Indigenous Studies

Program Descriptions

Ongoing Seminars

Supervision/Mentorship.  This is a live, on-line seminar to assist participants to move their current work in a more narrative direction.  It is anticipated to meet over a lunch hour (Eastern time) to allow the maximum ease of participation.

Special Topics Seminar.  The Special Topics Seminar addresses recent developments in the field and allows students and faculty to present their work along with outside guests and experts. 

 

Core Programs:

 

1. Narrative Medicine and Psychology: History, Principles, and Philosophy.

We explore the theoretical foundation for the practice of narrative medicine and psychology and examine how we understand healing and curing within our unique cultural contexts. We explore the works of Kleinman and Frank to help us understand illness narratives.  We explore culture as collections of shared narratives and methods of telling those narratives, all of which are embedded in language, geography, history, and networks of relationships. As narrative theory involves telling and listening, dialogue becomes crucial and the study of its practices essential.  This leads us to the work of Kenneth and Mary Gergen and Hubert Hermans. If we reach backwards even further into the past, we find Vico and trace an intellectual thread through Volosinov to Vygotsky, Bakhtin, Bruner, Sarbin, Strong, Harré, Landau, and others. However, ideas of narrative pre-existed European academic thought.  Narrative is a core idea for indigenous thought in which “all that exists is story”.  Story is the social neurotransmitter of a collective brain.  The notion of narrative is essential to most indigenous cultures. At the center of this project are medical encounters in which one person gives an account of himself or herself and another person is expected to receive it. The laboratory component of the course takes place in local medical offices where students function as witness, observing and representing what occurs as a way to help both patient and doctor to take full measure of what they do together.  We conclude with a discussion of the recent work in medicine through the writings of Rita Charon, David Morris, Lewis Mehl-Madrona, Bradley Lewis, John Launer, and others.

2. The Narrative Clinical Encounter.

Illness and disability autobiographies highlight the importance of subjectivity and embodiment, while simultaneously reflecting larger social, political, and cultural realities. The clinical interview seeks to uncover the story that is embodied in the illness and the story that it would tell. These stories are imbedded in families, communities, and larger political processes. We will focus on building skills.  We will practice listening without judgment or interpretation.  We will consider how to interview to elicit stories, both of illnesses and of lives affected by illnesses.  We explore how to find the root metaphors appropriate to the story of the illness.  Within this, the neurophysiology of telling and listening become important, supported by recent fMRI studies showing that the teller creates coherence in the same brain areas of the listener as are being activated in the teller.  We explore what it means to have narrative competence, including theory of mind, folk psychology, and the ability to tell an inspiring and compelling narrative.  Narrative competency alters the practitioner-patient relationship and affects outcome, patient satisfaction, and other measures. 

 

 3. Changing Stories/Changing Outcomes.

Psychiatrist Milton Erickson wrote that psychotherapy was the substitution of good stories for bad stories.  Indigenous elders have spoken similarly.  How do we accomplish this?  Does it affect both mind and body, and what type of inter-subjective relationship is necessary to make this happen?  We will explore the clinical encounter from a variety of perspectives with a view toward better understanding the ways that we can foster inter-subjective, empathetic relationships between clinicians and patients that form a scaffolding for change. In this class, we will explore how to facilitate the changing of stories.  We will explore how to narrativize a variety of psychotherapeutic settings, including behavioral medicine, psychoanalysis (short and long), cognitive-behavior therapy, and humanistic and existential therapy.  We will explore techniques long used by the world’s indigenous cultures to change stories.   We finish by considering how narrative work can be done with individuals, couples, families, and small and larger groups (communities).  We will practice in our own unique clinical settings how to facilitate the change of stories.

4.  Narrative Medicine: Transforming Illness Narratives in the Medical Setting.

This course details and models the skills required for the practice of narrative medicine in the medical setting.  This course transfers our narrative competency and therapy skills into medical settings.  The course considers how to help people discover their illness narrative and potentially transform that story.  The course considers how we find the root metaphors that guide the story and how we work with these metaphors.  The course relies upon the work of Brian Broom, Rita Charon, David Morris, Bradley Lewis, Lewis Mehl-Madrona, and John Launer. for changing illness narratives in medical contexts.  We will focus primarily on developing therapeutic skills for use in the medical encounter.  We will review the literature on the doctor(practitioner)-patient relationship regarding the effect of increased narrative competency on quality and the effect of quality on medical outcomes. At the same time that this course demonstrates the theories and methods in seminar, students will be putting these skills into practice in teaching practicums arranged in tandem with the seminar learning.

5.   Narrative Inquiry and Research

Innovative practices enter the mainstream through the production of supportive evidence. Quantitative studies have been conducted on the effect of hearing other people’s stories on blood pressure and on writing one’s own story on rheumatoid arthritis and asthma. Narrative inquiry has emerged as a qualitative method in its own right.  In this course, we will explore participant observation, interviews and focus groups, participatory action research, and research ethics. We will engage in small projects to practice the methods of data collection and analysis. We will explore how to measure narrative competence, including the use of software programs including SALT.  We will explore research on diaries, stories, the use of mixed methods to assess stories on particular dimensions of interest, the use of self-reflexive methodology, case study methods, and autoethnography.  We will examine the use of the arts, including poetry and novels, in autoethnography.

6.  Medical Writing and Medical Writers

This course explores medical writers and medical writing.  We will examine and practice writing about patients in the style of Oliver Sachs.  We will look at medical novels that explore the lives of people with particular disorders.  We will look at key medical writers of prose and poetry, including Anton Chekov, Oliver Wendell Holmes, Michael Crichton, William Carlos Williams.  We will review contemporary medical poets and how poetry helps us to make meaning of our experience of doctoring. We will explore the practice of writing poetry and stories with patients as therapy. We will look at how writing transforms the writer as well as Rita Charon’s concept of the three part chart.  We will look at storied communication through emails between meetings with patients, and of the use of zines and cartoon writing. We will consider the act of writing itself, its neurobiology, its physiological effects, and how it facilitates change.

7. Narrative and the Body: The Physical Story

This course explores narrative techniques for practitioners who work with the body – physicians, physical therapists, massage therapists, nurses, chiropractors, and others.  Every culture provides hands-on therapies.  On Zuni pueblo, in New Mexico, for example, high velocity adjustment practices developed parallel to and preceding the development of chiropractic medicine in Iowa.  Native studies scholars have argued that American osteopathy and chiropractic arose from the study of existing Native American methods.  Hawai’ians have lomilomi, Cherokee have a well-developed style of bodywork, as did Apaches.  Physicians have their own forms of touch – both in the physical examination and in osteopathic manipulation, which includes techniques also used by physical therapists.  The course explores how those practitioners who touch the body can include narrative in their work.  The course explores how practitioners can elicit a story from the body and the affected body parts even as they examine or attempt to assist these body parts to function better?  The course explores how we combine dialogue with touch.

8. Creating Genuine Cross-Cultural Dialogue

Medicine presents a global technology that is proposed to be universally true because of its basis in “science.”  It has been unfriendly to the keen observations and analysis of indigenous knowledge keepers regarding health, illness, and well-being and in its bias against treatments that are individualized and relational.  Traditional indigenous elders consistently point to the need for community involvement in healing and well-being. They say they are embedded in families and that disease exists in relationships and not within people.  If we address disturbed relationships, the people will sort themselves out.  We will explore how to actively listen to the stories of people from other cultures, eliciting a narrative within which that person’s pain and suffering makes sense to them, including appreciating the audience for which the story is enacted.  We will explore our hidden biases and assumptions about others.  We will explore the hidden stories and assumptions of contemporary biomedicine and how those relate to indigenous people.  We will learn methods of appreciative inquiry and talking circles/healing circles/reconciliation circles. 

 

Sampling of Elective Programs

1. Therapeutic uses of imagery and visualization in narrative practice          

This course explores the use of storytelling, imagery, and visualization as part of the healing and curing process for both indigenous and contemporary cultures.  It explores how stories inspire people to believe they can be healed or cured and how therapeutic and positive stories revise people’s sense of what healing and curing means and how it comes to pass.  Within the modern world, Alcoholics Anonymous provides an example of the healing power of stories.  Through testimonials, other alcoholics learn to believe that they can stay sober also.  The Native American Church and other cultural practices also use stories to inspire transformation.  Storytelling requires the use of language as rhetoric, including the power of verbal persuasion. Evocative visual images make the story more powerful. 

2. Therapeutic uses of hypnotherapy/hypnosis in narrative practice.    

Words have served healers, doctors, priests and politicians from time immemorial.  This course considers the art of speaking the language of healing.  It explores how words affect attitudes, change beliefs, and nurture faith.  Hypnosis is the art of speaking persuasively.  In hypnotherapy we aim to facilitate a movement toward greater health and the reduction of suffering and pain.  We persuade people to relinquish old self- deleterious stories in order to embrace those that are more life affirming.   With voice, tonality, phrasing, and words we can change our body reality, transforming sickness to health; despair to hope; and misery to happiness. The course considers what makes a good story, a healing story, and a powerful story, asking how we tell these stories as part of our therapeutic work.  It looks at storytelling as the original hypnosis from time immemorial and reflects upon how a story maintains audience attention and how stories elicit trance states. There can be deeply encoded messages for change in story that consist of universally shared myths, or fables, both ancient and modern; or of client specific stories, constructed with that particular client’s situation in mind. They may be anecdotal stories, meant to convey an underlying (hidden) message to the client’s mind. The course will consider how the elements of hypnotic technique are also the elements of good storytelling and will explore how indigenous elders, healers, and storytellers have used these techniques long before there were hypnosis training courses, as these techniques naturally arise from the intuitive understanding of language and its effect on the body.  The course includes practice telling stories both as a stand-alone event and within a larger hypnosis session.

3. Narrative as Performance: drama, ceremony and ritual within community and for an audience.                  

This course considers the importance of ceremonies and rituals.  Narrative therapy can include drama therapy and theatre techniques, particularly in the use of dialogical self-theory and practice of Hermans and Hermans-Knopka.  Ceremony is the performance of stories.  Illnesses are performed.  Stories from the familial and historical past can be reconstructed for therapeutic reasons. The course considers the common elements of rituals and ceremonies from multiple cultures and considers the usefulness in health practice of ceremonies.  These can include welcoming the dawn, greeting the twilight, removing adverse energy or entities, purification ceremonies, vision quests, and other specific practices of local tribes or groups.  The course explores the concept of spiritual entities and various concepts of how they interact with humans, especially in reference to health and disease.                       

4.  Working with Psyche and Substance: narratives of biology and pharmacology.

This course explores the many stories our multiple cultures have about changing self through ingestion of substances.  These include “magic potion” stories, the stories that are linked to addictions and mind-altering drugs. It looks at the stories indigenous cultures have about plants and the natural world and ask how these are different from the views of more modernist cultures.  It explores these alternative points of view regarding herbs and plants and animals and their use in healing and curing, including ideas of communicating with the spirit of plants to learn what the plants want to heal.  It explores the stories that lead to drug use, misuse, and abuse, and the stories that are created to heal from abuse.  These include 12-step approaches and Wellbriety.     

5.  Narrative approaches to family, community, and large group work

Within a narrative stance and a post-modern framework is the idea that groups best solve their own problems.  Groups decide what constitute problems and what comprise acceptable methods for solving these problems.  This course considers group narrative practices, including healing circles, large group meetings, therapy with social networks, and therapy with communities.  The course explores the healing power of large group therapy for healing communities and ideas of appreciative inquiry and other narrative-based techniques for social change.

6.  Narrative and Energy Medicine

Energy healing is a common aspect of the indigenous world, largely dropped by modern biomedicine.  Multiple types of energy healing practices exist.  Cherokee culture, for example, uses hands on the body, hands over the body, the shaking of rattles, burning of herbs, use of crystals, and the use of feathers and feather fans to move energy.  Cherokee also practices an acupuncture-like process of inserting needles (thorns, porcupine quills) into specific points along meridians to remove energy blockages.  In this module, we will consider the concept of energy – what is it, how does it work, how do we work with it, what happens when we work with energy.  We recognize that these are constructions to guide us and not necessarily absolutely true, but rather models to guide our practices.  Energy healing is used to clear energy from ourselves, our sacred objects, and our dwelling places.

7.  Stories about mind, mental health, health, and healing from Indigenous perspectives.

History shapes contemporary health problems, and cultural stories and practices both change and persist in response to colonization and social injustice.  We will explore the interactive, inter-relationships among culture and human pain and suffering.  We will define culture and explore readings from other cultures on the relation of culture to pain and suffering.  This will help us explore the various ways in which different cultures conceptualize and categorize suffering.  We will use the activity to create a framework or template for students to use in their exploration of concepts of mind, illness, health, and wellness in their communities of interest.  Narrative concepts for cross-cultural understanding will be introduced along with the systems theory concept of emergent properties and the non-linear nature of change.  We will explore how people instantiate internalized story to guide interpretive thought.  We will collect and read the stories that emerge to shape views of self and other during periods of culture change and disruption. 

We will explore concepts of institutional violence, including readings from South Africa, Canada, and Australia.  We will read and discuss excerpts from Goffman and more contemporary writings on authoritarianism, degradation ceremonies, the induction and perpetuation of powerlessness, unnecessary dependency, labeling, and the primacy of institutional needs over those of the persons it is ostensibly serving. We will explore how politics and policy affect health and illness and pain and suffering.  We will explore aboriginal concepts of mind and mental health, and, more broadly, what constitutes a good life.  We will review historical changes in these concepts as culture evolved through contact with other groups.  In continuing to develop a narrative methodology, we will see how cultures can be conceptualized as a dynamic narrative of affiliation and belonging, ever changing, and consisting of smaller units (communities, kinships, families, individuals), all of whom can be defined as syncretic totalizations of all the stories they have ever heard and especially the portions they have internalized and instantiated as performance.

8.  Narrative and Indigenous Approaches to reducing pain and suffering..

We will explore the stories people tell about their pain and suffering and how the enactment of these stories within a communities of witnesses (the audience) affect their pain and suffering.  We will relate this to the neurobiology of pain and how brain constrains and supports the stories we make about our experiences.  We will practice working with people who suffer from chronic pain and learn how to transform their stories toward less pain.  We will explore how to make cognitive behavior therapy and dialectical behavior therapy more narrative.

 

Programs under Development

Narrative Philosophers and Philosophy: Bakhtin, Vygotsky, Volosinov, Harre, Shotter, Gergen, and more.

One week in-residence together:  Integrated Practice:  Putting it all Together.

Besides having time to revisit how our theories and ideas have changed over the course of the training, we will visit some modern practices that seem to build upon indigenous understanding of the world.  These include practices like hypnosis, biofeedback, neurofeedback, magnetic therapies, and electrical stimulation.  We will take time to explore some of these tools to wonder how they might be integrated with indigenous practices.  We will visit the world of applied quantum theory to talk about the theoretical basis for our being connected with each other and being influenced by each other, sometimes in unexpected ways.

 We are doing this in Denmark in 2013, August 14 - 19.   

Our programs are often co-sponsored with other organizations.  Costs of Programs may vary depending upon that.  No one is ever turned away from a Coyote Institute sponsored event regardless of ability to pay.