Imagine a teenager who gets introduced, again and again, as “the anxious one.” At family gatherings, in school corridors, even in his own head: that’s just who I am, I’m an anxious person. Over time the label stops describing him and starts defining him. Anxiety isn’t something that happens to him anymore — it’s become him.
This is the starting point of narrative therapy, an approach developed in the 1980s by family therapists Michael White and David Epston, and it rests on one deceptively simple reversal: the person is not the problem. The problem is the problem.
Separating the stone from the path
Picture a boulder sitting beside a footpath. It isn’t blocking the way — it’s just there, a separate thing you can walk around, examine, even decide what to do about. Now picture that same boulder somehow fused into the path itself, so that every step forward means stepping on it. That’s roughly the difference between having a problem and being one.
Narrative therapy works by gently, deliberately moving the problem from “fused into the path” to “boulder beside it.” In practice this often starts with language — giving the problem its own name and its own habits, as something with a personality of its own rather than a trait stamped into someone’s character. Not “I am anxious,” but “Worry has a habit of showing up before exams and talking me out of things.” Not “I’m an angry person,” but “Anger tends to grab the wheel when I feel disrespected.”
This is called externalising, and it isn’t a word game or a trick of positive thinking. It’s a genuine shift in where a person stands in relation to their own difficulty — from inside the problem, where there’s no room to do anything but be it, to alongside it, where there’s suddenly room to notice it, question it, and decide how much ground to give it.
Why this matters more than it sounds
Language shapes identity more than we usually notice. A person repeatedly told, or repeatedly telling themselves, that they are depressed, are difficult, are an addict, can end up living inside that sentence — making decisions, explaining setbacks, even choosing friends, as if the label were the whole truth of who they are. Externalising doesn’t deny that the difficulty is real or serious. It simply refuses to let the difficulty swallow the entire person.
There’s something quietly freeing in asking, instead of “why am I like this?”, a different kind of question: When does worry manage to boss you around, and when does it not? What does anger talk you into that you don’t actually agree with? What tricks does the problem use to convince you it’s unbeatable? These questions treat the person as someone with a relationship to their difficulty — a relationship that, like any other, has better days and worse ones, and can change.
A clarification worth making
None of this means narrative therapy treats serious mental illness as something you can simply talk your way out of, or that it stands in for medication, crisis support, or other established treatment when those are genuinely needed. Externalising is a way of relating to a difficulty, not a replacement for treating it. It tends to work alongside standard care, not instead of it — much the way understanding why someone feels the way they do, which we explored in this blog’s last series, doesn’t replace good clinical support but deepens it.
What externalising does offer, often from the very first conversation, is a small but real loosening: the sense that whatever you’re carrying, you are still the one carrying it — not the thing itself.
Next in this series: “When Did the Problem Not Get Its Way? Understanding Unique Outcomes.”
This post draws on Stephen Hamkins’ The Art of Narrative Psychiatry (Oxford University Press, 2014), Martin Payne’s Narrative Therapy: An Introduction for Counsellors (2nd ed., Sage, 2006), and the foundational work of Michael White and David Epston. If you’re currently taking psychiatric medication, please don’t stop or change it without talking to your own doctor first.
