Journal of Systemic Therapies, Vol. 34, No. 1, 2015, pp.

1632

NARRATIVES OF PSYCHOSIS, STORIES

OF MAGICAL REALISM
SONJA BAR-AM
Narrative Practices Adelaide, South Australia, Australia
Uniting Communities, South Australia, Australia

This article extends an invitation to therapists and counseling practitioners to

explore the qualities of the literary technique and genre of Magical Realism
as a conceptual and therapeutic space to listen to clients detailed stories
of acute psychotic episodes and other expressions of mental illness. The
author will briefly situate some current therapeutic practices that respond
to clients psychosis and support self-agency in psychiatric treatments, while
at the same time recognizing that conversations about psychotic content are
not often attended to by practitioners. The author, a counseling practitioner
oriented to post-structural therapies, mainly Narrative Therapy, introduces
and develops the idea of a Magical Realist listening space for clients to safely
explore psychotic content for non-pathologizing therapeutic meaning making.
Woven into the primary thread of this article is a further invitation to find
philosophical resonance for therapeutic practice by extending thinking and
reflection about practice into and beyond post-structural philosophies. This
conversation specifically engages with the post-structuralism philosophy of
Gilles Deleuze and Felix Guattari (1987) and their ideas of the rhizome and
nomadic conceptions of identity in A Thousand Plateaus: Capitalism and
Schizophrenia (and other of their works). Client conversations are introduced
as examples of where reality and the magical merge in narratives of psychosis.
A good description is a magician that can turn an ear into an eye, and an eye into an ear.
Anonymous

This article explores the potential of the literary technique (device) and genre of
Magical Realism in listening to clients accounts of acute psychotic episodes.1
Address correspondence to Sonja Bar-Am, Intensive Support Services, Uniting Communities, Level 1,
10 Pitt St., Adelaide, 5000, South Australia, Australia. E-mail: [email protected]
1I

would like to acknowledge early on in this article that any conversation about and with clients
experiencing psychosis must consider safety, particularly of the client, while attending to therapeutic
help. This article does not directly address safety issues, although safety first and always for vulnerable
clients is in the forefront of this authors mind. It is a valuable and necessary conversation to continue
in the background of a conversation about therapy. And the author feels it necessary that conversations
about risk consider what is safest and most helpful to the client first.

16

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Narratives of Psychosis, Stories of Magical Realism

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The invitation is presented as a largely theoretical and philosophical exploration

with case examples. As a counseling practitioner, my interest in developing Magical Realism as a listening space came about while searching for a frame to listen
to my client, here named Eva, recounting an acute first-episode psychosis that she
had experienced during the Australian summer of February 2012. Clients regularly
present to the Family and Relationship Counselling service2 for life or relationship issues, which involve experiences of psychological distress that disconnect
them from their sense of self and safety in the world; experiences that psychiatric
professionals capture within psychiatric diagnosis of mental illness, such as bipolar disorder. This article also reflects recent practitioner interest in Magical
Realism literature blended with Narrative Therapy (Polanco, 2010) and the poetically evocative post-structural philosophy of nomadic identity and experience
(Deleuze & Guattari, 1987; Hoffman, 2008; Sandru, 2004). It is hoped that through
such rambling engagements with diverse areas of thinking and writing, new ideas
might unfold to conceptualize the process and content of clients experience of
their psychiatric presentations. New expansive therapeutic imagination may help
us, as practitioners, unstick seemingly definitive medical diagnoses from clients
contextual lived experience. Alongside the process of unsticking, an imaginative
conversation may create multiple reflective surfaces for the client to move to helpful understanding of his or her identity (of self) in experiences of relational life.
CURRENT MOVEMENT TOWARD THERAPY FOR PSYCHOSIS
There is much international movement toward a contemporary post-structural
therapy in both psychiatric treatment and other therapy contexts that critique the
power and hierarchy implicit in standard psychiatric systems, the Diagnostic and
Statistical Manual of Mental Disorders, fifth edition (DSM-5), the relationship of
academics to drug companies, the heavy use of psychotropic drugs, and involuntary
admission to psychiatric wards. This movement (more recently termed the postpsychiatry movement) has observed and articulated (indeed protested) that psychiatry has narrowed to internalized-deficit ideas of disorders, technical metaphors, and
psychopharmacology (Bracken & Thomas, 2006; Szasz, 2008; Thingmand, 2012).
The post-psychiatry movement has been given particular momentum and creative
energy from the user movement (such as the Hearing Voices Network)people living with mental illness coming together in mutually supportive ways. Practitioners
and thinkers in post-psychiatric and post-structural therapy movements are rigorous
in explicitly questioning the power and effects of the medical-psychiatric model,
and endeavor to create alternative psychologies for supporting clients (Bracken &
Thomas, 2006; Foucault, 1994).
2The

service, is part of one of Adelaides largest not-for-profit community service agencies, Uniting
Communities.

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18 Bar-Am

Conversations with Narrative Therapy practitioners working in mental health

settings in Adelaide, Australia, reveal that therapeutic practices are useful in the
examination of the problematic effects of the psychiatric system that defines and
positions a person within a psychopharmacological diagnosis (C. Dolman, personal
conversations, February 2013).3 A counseling practitioner looking through a poststructuralist lens may duly notice the stigma and the power of a mental health system
that is structured hierarchically, vertically bearing down upon the clients experience
and understanding of themselves (Foucault, 1994). These systems construct and
sustain objectified psychotic or schizophrenic personas upon which to endorse
system coercion and control. In the counseling room, narrative practitioners will
likely notice and inquire into the effects and power of the diagnosis and the system
on their client.4 Narrative Therapy practices make visible the concerns a person may
have about the ways systemic power commits him or her to psychiatric wards, the
effects of medication, feelings of being herded, and so forth (Hamkins, 2014; Russell
& Verco, 2009). Conversations with clients that focus upon mapping the effects of
the psychiatric system on the client will assist the client to take a position on these
effects and to find agency within whatever system (psychiatric, family, relationship) is
containing the clients experience and in his or her own sense of identity (White, 2007).
I would like to suggest another layer to therapeutic conversation: that there could
be much value in asking about or listening for the specific details and narratives of
the content of psychosisvoices, delusions, visions, nightmares, beliefs, and other
content of a psychotic episode. For narrative and other systemic counselors, we
have what seems to be only thin understandings of what questions, indeed maps,
to engage with when inquiring into a psychosis and its aftermath and the lives it
joins with. We could be asking about effects of the diagnosis and the psychiatric
system, but are we also asking about the specific experience of psychosis? Where
might we begin? What might we ask about context and what might privilege the
clients personal agency within his or her context? What might psychosis teach us
about being, identity, and relationships? What language does it speak?5
What is often not listened to nor inquired into are the stories of the persons narra3Following

an externalization map as set out in the Narrative Therapy literature by Michael White and
others may allow the therapist to offer a conversation that externalizes the effects of psychiatric diagnosis on the identity, relationships, and life, such that the person frees up space within the conversation
for stories of resistance to the problem and self-sustaining efforts to come forward.
4Narrative Therapy practices of externalizing and re-authoring are useful here to allow the person to
generate agency of the self within these systems (White, 2007).
5In this article, I use italics for questions that as the counseling practitioner I am asking myself, aloud
and in self-conversation and particularly in relation to the client Eva, whom I will introduce later, as
the practitioner reflecting on how to proceed in the practice of Narrative Therapy with a client who is
talking about her experience of psychosis. These questions are my own visible thoughts and dilemmas
in working with psychosis. By articulating these questions here in italics, my hope is to make more
transparent this practitioners conceptual flow, dilemmas, and ponderings about how to proceed and
how best to create reflective surfaces for the client. It is also this authors attempts at creative ways to
write about counseling practice and thought processes.

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tive details (in their minutiae) and the content of the psychotic events. The psychotic
identity is perhaps an identity fragmented into multiplicities in overload, destabilized
by a buildup of cognitive noise (Deleuze & Guattari, 1987). In psychiatric meetings,
what might be given small attention, indeed minimized or dismissed, is an exploration
of context, meanings, values, and hopes in peoples lives in relation to their experience
of psychosis or manic episodes.6 The possibility of fruitful exploration of psychotic
content has been called upon by various writers such as Pat Bracken (Bracken &
Thomas, 2006; Thingmand, 2012), Thomas Szasz (2008), and Oliver Sacks (2011).
In February 2014, I had the privilege of holding one brief Open Dialogue session
as a volunteer co-therapist with Markku Sutela, psychologist with the Finnish Open
Dialogue Project, with a family of both parents and four of six adult children present in Adelaide. This was held in Adelaide at the Mental Illness Fellowship of South
Australia, as part of a demonstration Open Dialogue family therapy session during
Sutelas training delivery of the project to counselors, peer workers, mental health
workers, and a psychiatrist. I observed that in discussing the material of the psychotic
event, Sutela neither confronts to contradict the content of the material nor dismisses the narration (M. Sutela, training session communications, February, 1718,
2014). This provides immense possibilities for a different space to counter these two
positionsfor meaning making the context and importantly the content of psychosis.
A person presenting to a psychiatric facility will appear confused, perhaps frightened, speaking nonsensical phrases, lethargic, speaking and thinking very fast or
very slow, or having visual and auditory hallucinations. The person gives him- or
herself over to attending medical teams and may not be lucid or aware of the admission process or medical goals in this process. There is little or no opportunity for
talking therapies here. As such, the person interfaces with treatment teams, from
the psychiatrist, medical doctor, mental health nurses, and social workers to peer
support workers on the bottom. The system represents only one structure, yet arguably the wholly dominant structure that a person finds him- or herself in without
question and without opportunity to voice his or her preferences for treatment.
Preferences cannot be explored where choices for care are not articulated.7 It has
6I

believe that the therapeutic attitude within which psychotic content is explored has been particularly
useful (in my understanding) to the outcomes published by the Finnish mental health teams of the
Finnish Open Dialogue Project (Holma & Altonnen, 1997; Mackler, 2011; Seikkula & Olsen, 2003).
7It must be strongly acknowledged here that community mental health systems provide care and support, particularly to clients who lack other family and social supports. Many psychiatrists offer generous and pragmatic
nondiagnostic connection and care while monitoring pharmaceutical uptake (Carrey, 2007). Family, friends,
or trusted colleagues can stay with the person on a daily or weekly basis, and these regular connections can
provide safe companions for the person experiencing manic psychosis that is followed by weeks of anxiety
and despair. These regular, non-pathologizing, everyday connections provide a therapeutic, safe, and trusted
holding space for the experience to run its course. This is not unlike the Open Dialogue Project, where both
mental health treatment teams and loved ones provide in-home support to the person. In the project, the Open
Dialogue mental health treatment teams are in constant, open, and curious dialogue with the person and his
or her supports (Mackler, 2011). It is valuable to read about the Open Dialogue approach to psychosis if the
reader is interested in scaled-up holistic team and psychotherapeutic approaches to first-episode psychosis.

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stood out to me in conversations with clients, mental health workers, psychiatrists,

and counselors that no one is asking specifically about the details or story of the
psychotic experience for the benefit of the client to make meaning of it.
INTRODUCING MAGICAL REALISM
If what is transformative in therapy is the dialogue between the therapist and the
client (and the reflexivity generated in those moments), then I believe we need to
take extra care not to colonize the client with questions generated by the sane,
with expectations of sanity for the purpose of therapy. So, cautiously, I introduce Magical Realism as a listening space and position for counseling practitioners hoping to engage uniquely with psychosis. Magical Realism is a phrase that
characterizes a particular literary genre of diverse writers (mostly) of colonized
cultures, notably Alejo Carpentier, Jorge Luis Borges, Gabriel Garca Mrquez,
Carlos Fuentes, Isabel Allende, and many more.8 Magical Realism has been defined
by the Oxford Dictionary of Literary Terms (Baldick, 2008, p. 194) as a fiction
where fabulous and fantastical events are interwoven in the narrative, but which
otherwise maintains the reliable tone of objective realistic report. The narrative
in a Magical Realist novel reaches beyond the confines of realism and draws upon
the energies of fable, folk tale, and myth.9 In a Magical Realist approach to relating and listening to psychotic episodes, we may listen to a narrative that involves
fantastical elements, sublime tellings, spirituality, culture, illusions and delusions,
magic, and mythology inside everyday life, moreover, stories of an everyday life
that are aware of politics of power, privilege, and sociopolitical and cultural forces
that keep us in our contextual place. Could this be an acceptance of stories where
a manic euphoria is described as a real life experience?
Why Magical Realism? (And not some other form of literature?) Magical Realism in contemporary fiction describes the context and landscape of a story that are
otherwise realistic, even hyper-realistic, within which fabulous and fantastical events
are included. Yet, distinct from fantasy, the narrative maintains a reliable, realistic
tone of an objective report (reminding this therapist of the way that clients report or relate their story in session, the content being both fantastical and strongly
emotive). The story reaches beyond the boundaries of realism to draw upon the
energies of fable, folk tale, and myth. What may appeal to the narrative and politically minded therapist are settings and struggles of often phantasmagorical political
realitiesconflict, war, abuse, racism, and privilege. Beyond its postmodern position, Magical Realist literature develops and maintains a strong contemporary social
8I

may be suggesting here that those who have traveled through or with psychosis are in a minority
colonized by the culture of psychiatric power.
9It does this while maintaining strong contemporary social relevance by making visible the experiences
of women, slaves, minority cultures, children, and others, and making post-structural sociopolitical
commentary.

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relevance and actively decenters privilege by giving voice to those who speak
from the margins.10 Characters in popular Magical Realist novels such as Gabriel
Garca Mrquezs One Hundred Years of Solitude (1978) are given or experience
fantastical attributeslevitation, flight, telepathy, telekinesis, but also delusions
and illusions, nightmaresas blending matter-of-fact with everyday reality.
What is interesting to counseling practitioners, then, is listening from a position that is open and curious to descriptions of psychosis that might be Magically Real, and how these descriptions can become helpful for clients in making
meaning of their experience. What can be explored is a new space that can link
therapist and client in a non-pathologizing exploration of context and meaning of
a psychosis. This new space may involve stories with nonlinear streams. While
plot lines and themes may be retained in the narrative construction, a rhizome
metaphor invites practitioners into the philosophy of Gilles Deleuze and Felix
Guattari (1987).11 Here, the therapy, as family therapist Lynn Hoffman suggests,
may become alive, and alive in a way that the context of a therapy becomes a
part of peoples lives that connects to a life-giving community (Kinman, 2012a).12
This therapy, like a rhizome, can conceive of metaphors that evoke messy strata
of endless relations (Kinman, 2012a).13 What kind of conversations might be
possible if we extend our frame of therapy through the rhizome metaphor and
Magical Realist listening position?
Currently, family and narrative practitioners are stretching the philosophy of
their practice toward exploring the metaphor of the rhizome (Carey, personal communication, 2012; Deleuze & Guattari, 1987; Hoffman, 2008).14 The decentered
sprawl of the rhizome metaphor allows practitioners to shift our post-structural
thinking toward metaphors of the interconnecting living threads of stories, conversations, and networks that decentralize activity and reflect our new world of webs,
10Theo

L. DHaen (1995) explores this beautifully in reflection of the Magical Realist writer Carlos
Fuentes on Octavio Paz, There were no privileged centers of culture, race, politics (p. 194)which
also allows Magical Realist literature itself to be decentered from accepted and dominant hierarchies
of literature. This tendency toward social and political activism resonates deeply with the philosophy
and intentional practices of Narrative Therapy (Polanco, 2010; White, 2007).
11Specifically into their experiment in schizophrenic, or nomadic, thought (Massumi, 1992, pp. 14).
12This may resonate with narrative therapists, counseling practitioners, and strengths-based systemic
therapists who explore the use of life-giving and life-sustaining conversations that connect people
with a peaceful resistance to abuse, and letting therapy bear witness to peaceful and personal resistance
and strengths.
13Hoffman (2008) writes: stamped out in one yard, they just sprout up next door. They continually
create new plateaus or assemblages. The Tree, on the other hand, symbolizes a bureaucratic structure
that is a characteristic of modern life (para. 3).
14Gilles DeleuzeandFlix Guattari(1987) use the terms rhizome and rhizomatic to describe lines
of thinking, theory, and research that allow for multiple, nonhierarchical entry and exit points. This can
challenge other metaphors that can be seen as notably hierarchical, such as the arbor (tree) metaphor
for complex ultra-metaphors. Metaphors become important as a philosophical and therapeutic tool
for counseling practitioners, both as generated by the client and as descriptive and generative of a
philosophical position from which to conceptualize therapy.

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networks, and neurobiological understandings (Deleuze & Guattari, 1987; Kinman,

2012a).15 Through the rhizome metaphor, we may traverse an ever-growing network
of intertwining connections of peoples meaning making and identity performing.16
As a narrative practitioner, keeping with storying, meaning making, and identity, I
have been led by this traversing to possible maps of inquiry that describe a living
landscape of identity with ever-growing, ever-changing plots, plot lines, themes,
webs, neural pathways, relationships, and ways to language and describe peoples
experience (Gergen, 1996), thus making more visible Deleuze and Guattaris philosophical efforts in fashioning the concept of schizophrenia, not as a pathological
condition of deficit, but as a quelled attempt to engage in the world in unimagined
ways (Massumi, 1992, p. 1). The unimaginable magical reality of psychosis allows
us to acknowledge that episodes of it do not happen spontaneously of their own
accord.17 A psychosis is a significant life event, and as such it resists being reduced
to descriptions of chemical imbalances in the brain. A post-structural view would
hold that the psychotic event occurs as a reflexive response by the person to his
or her contexts, experience, history, and relationships, and as such, there could be
much value and helpfulness for the person to retell its content as stories. Meaning
making generated through narrative practice could engage the client in relation to
his or her life and the hopes for his or her life in the aftermath of the psychotic
eventit could be meaning making in ways that a therapist who has never had such
an experience may never begin to imagine. By suspending fixed ideas of reality,
by storying the narratives available in the counseling session, the therapist him- or
herself may experience (if only in the listening to it) a reality that is contextual,
subjective, in flux, and magical.
Reading Magical Realism introduces identity, reality, and narrative that stands
not only in opposition to the pragmatic modernist view of the realist norm, but also
takes this and extends realism into a broader vision that includes marvelous and
conflicting realities (Young & Hollaman, 1984; Zamora, 2002; Zamora & Faris,
1995). It is indeed in listening to clients stories that we often find contradicting and
varied realities that are supernatural but also grounded in conventional descriptions
of experience and experience from within our social and cultural weave. We can
describe embodied experiences of gender, race, language, family, and physicality as
they are inscribed in narratives of particularities, peculiarities, time, dreams, visions,
magical happenings, magical places, ghosts, thoughts, wishes, hopes, powers, and
relationships. These may not contradict our ideas of what generalized discourses of
adulthood, childhood, motherhood, heterosexuality, maleness, femaleness, and so
on should look like; After all, what is a normal narrative conversation? A listening
15And away from explaining human thought and behavior through an individualistic, mechanical,
medical, and hierarchical language.
16We may even dispense with the term structural (in post-structural), opting for an organic rhizomic,
growing, sprawling network representation of our contexts.
17Could we push further through to Kenneth Gergen (1996): If we succeed [in?] losing the self we
may be prepared for a conjoint reality of far more promising potential (p. 11)?

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position that listens to not just the dominant story line and the preferred story line,
but all the other story lines and threads of ideas of stories of the real, the magically
real, and the surreal, which all stand in deliberate and powerful opposition, collide and sometimes merge with each other and emerge as conversational narrative
crafting, storytelling. And if we stay with our organic rhizome, these stories are
entwined and may be presented as constructing a magical reality. What matters
is that the domination of any one way of looking at things is, at least temporaily,
placed in jeopardy. Normal notions about time, place, identity, matter and the like
are challenged, suspended, lured away from certitude (Young & Hollaman, 1984,
p. 2). As listeners and counseling practitioners, we must be ready to doubt our
realist assumptions and to hesitate as we listen to a psychosis on its own terms
(Bowers, 2004, p. 21).
To further articulate the thought, a Magical Realist listening position can draw
us away from the storytelling dichotomy of dominant and subordinate story lines
and, through hybridity, take us into multiple, multilayered (rhizomic) story lines,
which at the same time resists a pathological colonizing of diagnosis and therapists
narratives (Polanco, 2010). The Narrative Therapy theory of developing preferred
story lines as resistant to dominant story lines is a critical and profoundly effective part of narrative therapeutic maps and narrative practice. A Magical Realist
listening position, however, may account not just for the dominant and preferred
dual narratives, but also for multiple story lines, magical story lines, and the thick
and thin threads of stories we hear.18 Adopting the point of view that stories are
multiplehave multiple strands and meanings and are changeable with the contexts
of peoples livesfits rather creatively within our post-structural attitude. It might
also fit, more or less, nicely within an acceptance of paradox in our minds and
livesthat we do not draw towards either end of black-white, either-or practicebased dichotomies or story lines of a normal self in relation to a psychotic/crazy
self, to either a wholly spiritual, magical, supernatural self or a real self, but we
can still articulate which story or narrative, which hopes, identity, and behaviors
we prefer for ourselves, for each other, and for our ethical intentions of how we
wish to be in the world.
THE FANTASTICAL AND THE DELUSIONAL
What this exploration may provide practitioners with is a frequency that holds
notions of fixed reality in question through which to listen to the psychotic experience and its content, such as hearing voices, thoughts, fears, and beliefs that
18Sometimes stories, such as resistance to diagnosis, may be helpful to articulate with a client; sometimes,

with the same client, this narrative of resistance to a diagnosis may not be helpful. Story lines are
relative to the context within which they are told; they also have many different possible meanings at
different times.

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emerge during the psychosis.19 Perhaps importantly, this thinking about psychotic
elements as a Magically Real experience to the client can give us a unique conceptual reflective surface for questioning assumed ideas of reality itself: that
a conversation can neither dismiss magical elements, nor treat them as some
competition to an actual reality. As conversations, they flow in and out of the
personal history and include personal mythology, folk tales, and fables as inherent
in the creation of narratives.20 Individuals experiencing manic hallucinatory states
can have conversations of psychosis that are not a diagnosis of defect. Psychosis
is not a journey away from reality, but a journey through a personal reality in
fluxa story of excess rather than of deficit. Psychiatrist John Watkins (2010)
in Unshrinking Psychosis writes:
Thus, rather than seeing psychosis as a rare and strange anomaly totally alien to normal people, we may begin to see that, while a person undergoing it truly has entered
another world, it is one which in many ways resembles the mysterious realm all
human beings visit every time they dream. (Chapter 5, para. 87)

So what might this way of listening look like? Lets flesh out some examples.
In 2012, a client, whom I will name Eva, began accessing counseling services
at the Family and Relationship Counselling of Uniting Communities, Adelaide, as
she was feeling that the psychosis was both generated by and had effects on her
relationship with her partner and children. Other counseling and mental health
services she was accessing, including psychiatrists, had not given her sufficient
feelings of trust and understanding that she felt she could speak about these effects
on her relationships.21 In the initial counseling session, Eva described:
The first hallucination in my episode happened in a cubicle of the ladies toilet at a city
restaurant and truly seeing the broken flush as a waterfall gushing down for some
15 minutes. I believed this as being the citys historic/mythic water wells welling up
through the toilet. A divine sign of being forgiven.
19The notion of a frequency for listening is the authors attempt at re-languaging metaphors and
analogies for counseling away from visual metaphors (while not at all dismissing the usefulness of
visual metaphors) and toward metaphors evoking the frequencies of sound and the ether through which
we communicate. The notion of holding fixed reality in question may resonate with some more purist
post-structuralists (like the author) who consider reality as a constant negotiation and relation among
its participants, their constructs, their contexts, their imaginings, and becoming.
20Not limiting our listening of Magical Realism to individuals of cultures where collective myth and
fable bind communities.
21It is not unusual in Adelaide that clients facing a number of concerns in their lives need to access
different services and may also get passed between services. For example, clients accessing drug and
alcohol recovery services who also present with mental health concerns may be asked to go to a mental
health service before they can look at their drug addiction issues or vice versa. Under the broader umbrella
of Family and Relationship Counselling services, we may be consulting with a client with any number
of other concernsdrug addiction, violence, stress, mental health diagnosis, disability, and so onas
they all affect and are affected by peoples relationships.

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Elements in a manic psychosis such as hearing voices (auditory hallucinations)

or visual hallucinations can be described as occurring outside the person.22 In
actuality, this is how a psychotic episode may be experiencedhallucinations as
outside the person and, similarly, voices heard by the ears as occurring outside the
person (rather than inside his or her mind). Eva said:
While being detained in a white-walled room at the treating hospital, I heard the
helpful, constructive critical voices of my friends, commenting on my dialogue with
the nursing staff as if I had headphones on, and so I was looking around for visual
recording devices in the room.

Listening to Eva speak about her experiences is giving relevance to her experience without pathologizing, such that Eva can, with the help of the therapist,
explore what about this story points to value and meaning. You mentioned that
your friends are very kind and supportive, how were they guiding you? Were they
talking about something helpful to your situation while you were sitting with the
mental health nurse?
Sarah Hughes, a therapist in the U.S., talks about her work with a Miss M (on
the online study group NCIP managed by Peggy Sax, 2011):
She was a bit of a mess when I saw her at first this afternoon. She has shaved her head,
lost more weight; she was shaking and upset....She said she has wanted to call on spirits
to help her but has felt too ashamed. She said the doctors increased her shame and now
it was really big. I wondered if we moved the shame over to the other chair for just a
minute and pretended it wasnt therethen what might she use to call on her spirits. She
then had lots of ideas incense, lotus flowers, salt water from the Atlantic...This made
her talk about her dad (who died when she was a child); she said he had a big Buddha
in his studio. She knew he would want her to call on Buddha....At this point she was
very into the exercise and was standing beside me at the board. I asked what we should
call this...She thought for a while and said magic carpet. I [drew] a carpet. I got her
to use all her senses to feel this carpetit is purple and smells of lavender, it is soft like
velvet, it has handles and she can hold on and float with the birds and the clouds. Her
dad is on it with her. He is holding on to her tightly. We were both laughing and smiling
at this point. I asked her what would help her hang on to this image. She said she wanted
to go home and paint it....She was no longer shaking....She felt excited, almost
hopeful and she felt her dad with her. I know this was a not a miracle but my goodness
it felt magical. (S. Hughes, post on closed web forum, 2011)

Tangled in this conversation are threads that prove useful and meaning making
for the client: evoking the memory of Miss Ms father in support of Miss Ms per22Indeed,

our post-structural and relational sensibilities lead us to question what inside and outside
mean. To what extent are such ideas reliant on what Michael White described as the encapsulated self,
dear to the modern West? What would it mean if we accepted a much more porous interconnected sense
of the person, or the self as continuous and fluid rather than boundaried and discrete? (T. Callahan,
personal communication, April 8, 2014).

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sonal mythology and membership of her life. Populating her story are animals in
the service of strengths and powers for Miss M to draw upon. We might further an
inquiry with Miss M by asking what is amazing (magical, fantastic) to her about
the magic carpet. What does it allow her now to do in terms of what is precious
to her? A magic carpet is indeed a mode of transport in the realist sense, but also
an evocation of a journey that moves both Miss M and Sarah (White, 2007): Where
are you moved to, Sarah, by co-weaving this Magic Carpet with Miss M?
MYTHICAL LANGUAGE AND HYBRIDITY
Marcela Polanco is a Colombian narrative therapist, practicing in her adopted
home of the United States. Her explorations in bilingualism, Magical Realism,
and Narrative Therapy constitute a careful project in translation of both language
and culture. Polanco translates Michael Whites (2007) Maps of Narrative Practice into her own native language and then translates back into English through
a Magical Realist cultural expression that she claims is embedded in her native
Colombia. Polanco differentiates between Poetic Memory, entering into which can
unveil and unearth potential stories, and Colonized Memory, which is the dominant
subjugating story (single-mindedness). Her discussion of clients who are bi- and
multilingual, and their subjugated voices and stories against dominant colonizing
discourses is, I think, a mythic one (with references to Gabriel Garca Mrquezs
novels). What is appealing to this author and counseling practitioner is Polancos
ideas about transforming poetic memories into stories as an antidote to colonizing
dominant discourses (Polanco, 2010). Uniquely, Polanco describes a use of poetics and hybridity of stories and their counter stories, notably in descriptions of
bilingual and multilingual clients against the language of the dominant culture, to
create new multi-subjectivities through which magical reality can be novel-ized
(Polanco, 2010, p. 2).
Magical Realism is a convergence of contradictory realities (the mythic and the
real) to create perhaps another reality. I would suggest that this other mythical and
magical experience of reality could be akin to psychotic reality in its aliveness and
convergences. For therapy, Polanco (2010) suggests that this Magical Realist reality
is a hybrid of multiple stories (particularly the problematic account with alternative
accounts, interrupting each other in order to exist). In this example, she evokes
the work of David Epston; here David works with Sasha and her mother Marie:
Maries chest seemed to swell as she summoned up what I surmised was her courage
and through whatever means started in running down her arm to her hand and then on
to Sashas waiting right hand. Turning to Sasha I enquired: Can you feel it yet? After
only a few seconds, she reported she had. I asked: Is it warm and cosy? Or cold and
chilling? She found it the former. We then tracked it around her body and it travelled
up her arm, down into her heart, and finally with the pull of gravity it reached the end
of her toes. (Polanco, 2010, p. 8)

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27

We can become attuned to listening for and expanding poetic memories through
our questions, memories that are beyond the intellectual, memories that transport,
that are emotive, embodied, moving, and visual.23 As part of a Magical Realism
listening position, a counseling practitioner may invite a client to activate inner
visual capacity and recount the poetic memories of his or her psychosis. This could
intentionally make space for the clients story to exist as both magical and real in
a simultaneous hybrid.
IMAGERY: TURNING AN EYE INTO AN EAR
AND AN EAR INTO AN EYE
What unique possibilities are generated by linking up the active elements of imagery usage (and metaphor) in Magical Realist texts to listen therapeutically to accounts of psychosis? In Magical Realist literature, the device becomes a literal embodied performance
of metaphor and imagery. Bowers (2004) describes that the character Saladin Chamcha in Salman Rushdies The Satanic Verses (1988) is demonized as an illegal immigrant and therefore evolves into a devil-like goat when he is arrested by the British
police (p. 51). To the police, though, his monstrous appearance is quite ordinary:
What puzzled Chamcha was that a circumstance which struck him as utterly bewildering and unprecedentedthat is, his metamorphosis into this supernatural impwas
being treated by the others as if it were the most banal and familiar matter they could
imagine. (Rushdie, as quoted in Bowers, 2004, p. 51)

Eamon Graham (2003) reflects on Rushdies use of literal metaphor and imagery:
they become magic words, the abracadabras by which changes are made in the
world (para 3).
This use of metaphor in narrative therapy has been applied by narrative practitioner Maggie Carey.24 Carey is of the view that the use of imagery can support
23I resonate with Polancos thinking in relation to her description of the hybrid of Realism with the
Magical. I have framed this hybrid as a listening position for counseling practitioners. Magical Realism
allows us to support a client in articulating multiple subjectivities. For myself, I find it valuable and
philosophically helpful (as a thought experiment) to express this hybridity in the metaphor of a rhizome,
not in terms of interrupting each other to exist but in terms of a merging or stories where both may exist
together and differently given contextual variables. A point of departure from Polancos therapeutic use
of Magical Realism seems to be in my specific application of Magical Realism to listening to distinct
expressions of psychosis. Here this listening practice might find a tangible therapeutic application.
24A personal endearing term is nomadic, describing Maggie Carey in both her practice and teaching.
Carey teaches Narrative Therapy in wonderful and exotic places in the world. The term nomadic
therapist also describes ways in which we can think about a philosophy of Narrative Therapy practice;
that we can take our practice into new territories of thought and maps, rather than just duplicating the
original maps first set out by Michael White and David Epstonthat we can use therapeutic questions
to develop (scaffold) new maps of practice, covering territory newly thought about and newly articulated
(Braidotti, 2011; M. Carey, personal communtication, August 6, 2012).

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all practices in the narrative approach and can contribute to rich and embodied
experiences of stories. We may listen for a magic realization of metaphor, which
is embodied by the person in psychosis, such that the therapist can accept the clients metamorphosis through/into something supernatural, magical, or bizarre (M.
Carey, personal communication, August 6, 2012).
How might questions exploring metaphor and imagery feed into conversations
for psychosis?:25
If a person says that he is a fish, it could mean different things....This does not mean
that one is being dishonest by electing to communicate using his choice of metaphor.
It does not mean that others have to agree that they perceive him to be a fish. It only
means that they are trying to understand why he perceives himself that way. Asking
questions such as What kind of fish? will reveal more about his train of thought and
thus serve to perpetuate communication along with healing. (Whigham, 2008, para. 18)

Metaphor and imagery are more than language. Inside the metaphor or image
offered in the content of the story of a psychotic episode there seems an embodied
sense that makes it transformative, indeed magically real, with poetic memory and
resonance. Imagery may help establish pathways from experience to abstract conception and also to meaning making through narratives of the clients personal mythologies. as well as those mythologies that are available to us from our culture and may
be drawn upon during the psychotic episode. Clients may often describe ideas about
Jesus or aliens or other pervasive icons that are available from the imagination of
popular culture as well as their own significant, meaningful icons such as parents,
partners, friends, and teachers (S. Mann, personal communication, July 8, 2014).
Lynn Hoffmans (2002) extraordinary book Family Therapy: An Intimate History
has accompanied me on this journey to connectedness through Magical Realist
metaphor-meaning making. I am inspired to try to converse with what is unnamed,
what is unsaid in the undercurrents of relational conversation and identity (Hoffman, 2002). Hoffman (2002) extends a particular use of metaphor and imagery
in therapeutic conversation that was introduced by Michael White (2007) as the
outsider witness practice; a practice that evolved from Whites study and evolution of therapeutic reflecting teams through the narrative metaphor (White, 2007).
When, to Hoffman (Kinman, 2012b) a mental picture appears along with associated emotions and story, she activates the image as embodied metaphor and
gifts this to the client for resonance and meaning making (Hoffman, 2002). By
way of example: in a video interview (Kinman, 2012b), Italian therapist Pietro
Barbetta discusses a joint counseling session he and Hoffman held with a client
contemplating suicide. Barbetta describes himself as both co-therapist and translator
for Hoffman in the co-work session. He tells how Hoffman generated a metaphor
for a client damned to hell (Kinman, 2012b). Hoffman evokes Michael Whites
25In terms of therapeutic narrative practice, I was thinking specifically about how re-authoring
conversations might proceed.

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29

club of life imagery for the client, to help make his tomorrow possible, and
through her body language, embodiment of the imagery, she makes an emergency
intervention (Kinman, 2012b). She offers this:
Take the [good] spirit of your dead father, your mother and your sister. You can bring
them with you in hell in spirit, those who inhabit you. Take the spirit of your father
and put him on your hand; then your sister and your mother on your arm and shoulder.
And other friends. The client said: And the therapist (Barbetta) and you (Hoffman)
here and here (demonstrating how he places them on his arms). Hoffman says: And
you can go and face hell. (Kinman, 2012b)

Such evocative client counseling sessions hold the magically real space, where
both client and practitioner can utilize imagined analogies and metaphor, suspend
fixed ideas of reality, and join in a magical reality to make self-agency possible.
READINESS, TIMING, AND THERAPeuTIC RESPONSIBILITY
Critics of these ideas might caution that acknowledging or reminding a person in
psychosis about an image or metaphor he or she had spoken about may trigger
further psychosis. Watkins (2010) suggests that sufficient time should be allowed
for the initial impact of the crisis to subside since episodes which eventually prove
spiritually enriching or transformative are sometimes marked with agitation, preoccupation and inflation during the early phases. Only when there has been adequate
opportunity for stabilization...will the enduring effects, positive or negative, of
a psychotic crisis become evident (Chapter 10, para. 10).
In Finland, however, Jaakko Seikkula (interviewed by Mackler, 2011), of the 20year Open Dialogue Project that provides immediate therapeutic response to clients
experiencing a first-episode psychosis, suggests that it is particularly in those first
days of the clients psychotic experience that the most valuable content for meaning making through therapeutic dialogue is offered up. Additionally, that dialogue
may become an agent in reducing psychotic symptoms. Seikkula (Mackler, 2011)
suggests that attending to the client 2 days after the onset of the full expression
of the manic experience is too late and that the window for therapeutic meaning
making gets smaller. Seikkula (Mackler, 2011) asserts that as time passes, the
content of the hallucinations, hearing voices, thinking, etc., becomes less available to be articulated and dialogued, less able to be described richly by the client.
A person in psychosis is living inside metaphor and imageryan all too real
dreamingan overload of cognitive noise, uncensored and uncontrollable. In this
endeavor, we must be aware that it is also the stigma experienced in the persons
contact with the world that leads to the most distress. Gentle therapeutic containment for the client may involve a practitioner understanding the clients readiness
for dialogue; providing safety for the client both in the dialogue and in the clients
broader context; giving warm and attentive therapeutic engagement; working with

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what content and narratives are brought from the client and his or her supports;
and adopting a decentered but influential and intentional listening position (White,
2007). Such therapeutic containment may be the most significant and influential
part of a clients overall psychiatric care.
I believe that in meeting with psychosis in the counseling room, it is critical for
us to learn what our clients have to teach us about their highs and lows, about their
experiences, identities, and their wishes to remain in and of the world through psychosis. In my experience in meeting with clients who attend counseling and have
been diagnosed from the list of DSM-5 conditions, they remain cautious toward
helping professionals and about their own sense of safety in the world, and yet
these clients (like all of us) wish for support that is loving and nonpathologizing
and doesnt burden them with constructs of sanity.
The invitation here takes Magical Realism as a literary device developed by
writers from many countries, cultures, and languages to enhance our positioning
with clients experiencing psychosis in particular. There is potential for elements of
the magical and the real to be listened to in a clients story as part of a fuller, richer
narrative, hopefully encouraging opportunities for unique meaning making and
self-agency for the client. For counseling practitioners, a Magical Realist listening
position may creatively extend our living metaphors and imagery of reality, being,
and identity in a postmodern understanding of what therapeutic help could be most
helpful to clients. We can explore the use of a Magical Realist listening position such
that the therapeutic conversation can be particular to our own cultures, times, and
places to guide and make sense of psychotic experiences, to be explored uniquely
and with caution to reduce pathology toward clients, and indeed to create safety
and understanding for them in their darkest times.

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