By Christina Mathieson, LMFT #115093, founder of My Mental Climb.
Narrative therapy is one of those modalities that sounds vague when you read about it online, and concrete the moment you experience it in a session. Most descriptions land somewhere between "exploring your story" and "rewriting the narrative" without telling you what either of those phrases actually mean clinically.
This post is a plain-language explanation of what narrative therapy is, what it actually does in practice, and when it tends to be the right fit. On our team, Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093) is the clinician who works most extensively in this modality.
What Narrative Therapy Actually Is
The premise of narrative therapy is that the way you tell your story shapes how you experience your life, often more than the events themselves. Two people can go through structurally similar experiences and come out with very different relationships to those experiences, and a substantial part of that difference comes from the story each person has built around what happened.
Narrative therapy works on the story directly. The clinician helps you notice what story you've been carrying about yourself, where it came from, what it does to you in the present, and whether there are other true stories that could be told about the same set of facts.
This is not the same as positive thinking. The work is about accuracy, not optimism. Many of the stories people carry are distortions in one direction or another, often ones absorbed from family, culture, religion, or specific painful events. The narrative work is to see them clearly enough to choose differently.
The Core Moves of Narrative Therapy
A few specific techniques that show up in narrative therapy:
Externalizing the problem. Instead of "I am anxious," the work reframes to "anxiety is something I carry, and here's how it operates." This sounds like a small shift but tends to be substantial. It separates the person from the problem, which makes the problem something to engage with rather than be defined by.
Identifying the dominant narrative. Most clients arrive with a story they've been telling about themselves for years, often without realizing it. "I'm the responsible one." "I'm always the one who messes things up." "Nobody ever stays." The narrative work is to name the dominant story and trace where it came from.
Looking for unique outcomes. Once the dominant narrative is named, the next step is finding moments that don't fit it. The client who carries "nobody ever stays" can be helped to remember the friendships that did stay, the relationships that ended for ordinary reasons, the people who chose them. These exceptions become the foundation for an alternative story.
Re-authoring. The slow work of building a new dominant narrative that holds up under examination, integrates the difficult material, and allows for more agency in the present.
Naming the influence of culture. Narrative therapy takes seriously that many of our stories aren't really ours. They're absorbed from family-of-origin, from religion, from gender norms, from cultural expectations. Naming the source of a story is often the first step in deciding whether to keep it.
When Narrative Therapy Fits Well
Some specific situations where narrative therapy tends to be especially useful:
Clients who have done insight-oriented therapy and gotten stuck. They understand their patterns but the patterns haven't shifted. Narrative work can move things by changing how the pattern is held in language.
People in major life transitions. Divorce, career change, identity shifts, becoming a parent, losing a parent. These are moments when the old story doesn't work anymore and a new one is being formed.
Clients carrying inherited stories that don't fit. Family-of-origin patterns that have been operating for decades, religious frameworks that no longer match current values, gender expectations that have been quietly shaping someone's choices.
Couples and families where shared narratives have hardened. The story of what's wrong with the relationship, who started what, what the other person is really like. Narrative therapy can help loosen these so other stories become possible.
Trauma where the meaning of the event is what's stuck. Sometimes what's holding a trauma in place isn't the memory itself but the story the person has had to construct about what it means about them. Narrative work, often paired with EMDR or other trauma approaches, can shift this.
Common Misconceptions About Narrative Therapy
A few things narrative therapy is not.
It's not denial. Re-authoring a narrative does not mean pretending difficult things didn't happen. The hardest material is often the most important to look at directly. The work is finding a more accurate, more complete story, not a softer one.
It's not positive thinking. Narrative therapy is not about replacing negative thoughts with positive ones. Sometimes the new story is harder than the old one. The point is accuracy, not comfort.
It's not just talking about your past. While narrative therapy looks at where stories came from, the work happens in the present. The goal is changing how the story operates in your current life, not lingering in childhood.
Who on Our Team Does Narrative Work
Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093) is our team's primary narrative therapy clinician. Her experience with attachment-based work and narrative therapy makes her well-suited to clients working through inherited family patterns, identity shifts, and the long-term stories that have been quietly shaping their lives.
Michelle works with individuals and couples, and frequently combines narrative therapy with other modalities including EFT for couples and trauma-informed approaches for individuals.
Common Questions About Narrative Therapy
How is narrative therapy different from CBT?
CBT focuses on identifying and changing specific thought patterns that maintain distress. Narrative therapy works at a higher level on the larger story you've built about yourself, your relationships, and your life. The two are complementary; many clients benefit from both, sometimes in sequence and sometimes together.
Is narrative therapy evidence-based?
Yes, with caveats. The research base for narrative therapy is smaller than for CBT or EMDR, but there's solid evidence for its effectiveness with adults working through identity issues, family-of-origin material, and meaning-making after major life events. It's a recognized, well-established approach used widely in clinical practice.
How long does narrative therapy take?
It varies. Focused work on a specific story can move within 8 to 12 sessions. Broader re-authoring of long-standing narratives often takes longer, particularly when the dominant narrative has been operating for many years.
Can narrative therapy help with depression or anxiety?
Often yes, particularly when the depression or anxiety is being maintained by a self-defeating narrative ("I'm broken," "nothing ever works for me," "I'm too much"). The narrative work doesn't replace medication or other treatments where those are indicated, but it can substantially loosen the cognitive layer that holds the symptoms in place.
Does narrative therapy work for couples?
Yes. For couples, narrative work focuses on the shared story of the relationship, including how each partner has been characterized within that story and whether other true stories could be told. This pairs especially well with Emotionally Focused Therapy (EFT), which Michelle Cortez also practices.
If narrative therapy sounds like something that might fit what you're working on, book a free 15-minute consult and we'll talk about whether Michelle is the right match.
Related from My Mental Climb: Individual therapy · Meet Michelle Cortez, AMFT · Free 15-minute consult
Tagged
Last clinically reviewed: by Christina Mathieson, LMFT #115093.
