In my therapeutic work, there is a distinct pattern that I often see in couples who have been together for a while. After years of engaging in a pursue/withdraw pattern, also known as the “anxious/avoidant attachment dance,” the withdrawer tires of feeling steamrolled or like they are always the problem. They start to bite back. This is how the attack-attack pattern happens in relationships.
From Turning Away to Turning Toward
This attack-attack pattern features a pursuer (someone who tends to present as angry in conflict and a defensive partner who first withdraws but then counterattacks. While the pursuer is often the one to confront with demands or criticisms, the defensive partner responds with the same put-downs. It’s important to note that each is motivated by slightly different feelings and aims. I’ll present an amalgamation of couples with whom I’ve worked rather than an actual couple I’ve had in therapy.
Sue is a pursuer. She often worries about abandonment in their relationship and is preoccupied with questions of, “Do I matter to my partner? Does he really want to be with me? Does he care about me?”
These fears are triggered in her relationship with John when he stays late at work. She is consumed with fears of being unloved and less important to John than his work. When she’s triggered, Sue gets loud, puts John down, and demands that he stop working so late, or else!
John is a former withdrawer turned defensive attacker. He has a demanding job, and feels a sense of competence from conquering his challenges at work. What he hears when Sue protests his work hours is, “You aren’t good enough. You can’t meet my needs. You are failing, and you just might lose me because of it.”
What John used to do when he heard these messages was to withdraw. He would shut down and hide, and sometimes what this would look like was him retreating into work, where he felt good about himself and that he was not failing. But John has become sick and tired of always feeling like the problem, so he started to bite back. Instead of turning away and hiding, now John turns to Sue and says, “You know what, you aren’t such an angel yourself. What about how you came home an hour late after hanging out with your girlfriends last night? I’m not the only one who comes home late!”
Such patterns are often confusing to both partners. John is confused by his new way of responding—his self-image is rocked. While he used to see himself as a gentle man who valued harmony and would never criticize his wife, he is confused by the new feelings of frustration that have replaced his shame. Sue is shocked—she’s never seen her husband this angry before. The status quo of the relationship has shifted. When I see this pattern in relationships, it’s a clear sign that partners need to turn towards each other in more vulnerable and authentic ways. What is happening in the attack-attack pattern, is that both are turning against each other, while one used to turn away.
As an Emotionally Focused Therapy (EFT) therapist, when I notice this shift toward attack-attack, I try to hold it with both care and curiosity. It’s a sign that something long suppressed is finally breaking through, and it’s often a hidden plea for balance and recognition. Rather than pathologizing the escalation, I frame it as a moment of protest that reveals the depth of both partners’ unmet longings to be seen, understood, and cared for. My first move is to slow the process down so both John and Sue can see the tender emotions driving the harsh words. I might say, “This anger feels big. But can we look at what it’s protecting?” That reframing helps them recognize the humanity in each other’s defenses.
As the work progresses, I guide them toward moments of emotional risk, where the fight gives way to reach. The withdrawer engages and begins to express shame and longing instead of counterattack; the pursuer softens, starting to share fear and sadness instead of blame. These moments are sacred, though rarely neat. They are points where partners start to find each other again. What began as mutual attack becomes the first glimpse of mutual engagement, and from there, the groundwork for secure connection begins to take shape. Through repetition, John and Sue will learn how to communicate in the language of vulnerability, and it will start to feel less scary to take emotional risks. They will no longer feel the need to protect themselves from each other, and no longer see the other as a threat. They will feel safe.
I try to help clients like John and Sue learn to share their feelings and needs in more authentic and vulnerable ways, so that they can break out of patterns of criticism and defensiveness. Sue will learn how to share her needs to feel close and loved, motivating John to meet them rather than reinforcing his feeling that he must defend himself. John will learn to speak from his own experience about not feeling good enough, so that Sue can comfort him rather than feel triggered by his responses, and that’s how attack/attack turns into mutual turning toward.
Much has been written about women who have been trafficked, coerced or otherwise unwillingly arrived at sex work (1). And while the challenges for counselling and psychotherapy with sex workers have been described, little has been published about narrative therapy with sex workers. This paper offers a perspective that has been missing from the literature. It privileges the voices and insider knowledge of women who choose sex work of their own volition, and conveys how narrative practices such as re-membering, externalising, deconstructing dominant discourses, the use of therapeutic collective documents and the Tree of Life can highlight agency and elicit preferred identities when working individually and collectively with people engaged in sex work.
I (pronouns: she/her) have intimate knowledge of sex work, and this paper is shaped by my insider status as someone with lived experience in the industry. I hope this paper will encourage people whose lives connect with sex workers—professionally or otherwise—to depart from the dangers and limitations of single-storied understandings that can bring additional hardship to people in the industry. I share stories of sustenance from people fighting marginalisation, stigma and isolation, and hope to illuminate sex workers’ resistances in ways that restore dignity (2). The stories and perspectives in this paper are from the experiences of cisgender women who do sex work. I hope in future projects to honour the experiences of trans and nonbinary folks and cisgender men who engage in sex work.
This paper describes narrative therapy conversations I shared with seven women who described themselves as “high-end” sex workers. They had a high degree of freedom and autonomy in their work, setting their own terms in relation to location, services and renumeration, rather than having terms imposed by clients or managers. Each of the seven women participated in three sessions. The first two were one-to-one conversations with me, and the last was a group session that involved the women working together to write a collective document (3) and create an adapted collective version of a Tree of Life (4). The group was culturally diverse in that it consisted of four women from the dominant Anglo cultural background and three women from Black, Asian and minority cultures.
I hope this paper assists readers to question dominant discourses and makes visible insider knowledge that is distanced from the prejudiced, moralistic frameworks that commonly exist about sex work. I hope the stories included here bring out aspects of women’s lives that are not usually revealed: their leading role in their own life stories and the avenues they pursue in expressing personal agency, making decisions about what is important to them.
The Context
Dominant social discourses position women in the sex industry as victims: oppressed, there by force, unable to exit the industry, in competition with one another, emotionally distant, unqualified for other work, and/or addicted to substances. These discourses are often accompanied by reports about trafficked migrants, underage girls and dominating pimps. The sex industry can indeed be a site of abuse, coercion and exploitation. I acknowledge the diversity and variety of forms of sex work, the diversity of experiences people have in the industry, and the different conditions of work that exist, some of which are conducive to abuse, trafficking and violence.
Harcourt and Donovan (5) reviewed 681 publications to produce a global typography of commercial sex work. They identified at least 25 types of “direct” and “indirect” sex work, including street prostitution, escort work and brothel-based work, as well as lap dancing, telephone work, and massage with sexual services. I am well aware that there are many whose experience in this industry is negative and who experience harm. The participants in this project each described taking actions in solidarity with people who work in less privileged ways (for example, donating to relevant local charities that support women to leave the industry, such as ONE25, a Bristol-based charity supporting women who do street sex work; and SWARM which, stands for Sex Worker Advocacy and Resistance Movement, a collective of sex workers that campaigns for the rights and safety of people engaged in sex work).
This paper, however, elevates the voices of female sex workers whose experience in the industry has been generally positive, and who have privilege within the hierarchy of sex work: a high degree of control over their working hours, location, pay and conditions. This includes sex workers employed by escort agencies who are able to refuse bookings. Because the pay rate is high, the longer they are in the industry, the more selective they can be, as they are able to free themselves from financial constraints (such as debt or unpredicted expenses), which are often the impetus for entering the industry. This paper is about women who have a sense of agency in relation to their sex work, whose presence in the industry is of their own volition, and who don’t want to be pitied or labelled “victims”.
The participants used the term “companion” when talking about their role. This involved daytime, evening or overnight bookings offering “the girlfriend experience”: time spent enjoying dinner or other activities as creative and varied as clients are willing to spend, from visiting exhibitions or the theatre to attending a spa, in addition to sexual services carried out at a hotel or home. The activities were chosen by or negotiated by the companions and were used to create conversation or a sense of familiarity. Some bookings would have a minimum duration of two hours, while some participants only accepted dates of a minimum of 24 hours and only worked during weekends.
Four of the seven women had other jobs and considered sex work to be “moonlighting”, despite it providing a much larger income than their “civilian” job. Three worked exclusively in the sex industry. Five participants worked for an agency and two worked independently.
I’ll now describe the narrative practices that I used in the one-to-one conversations with the women and some of what emerged in these conversations.
Re-membering Conversations
The participants were interested in re-membering conversations (6) in relation to their “dates” – the men and couples to whom they offered their services. I will include here some of the questions I asked in the individual meetings and the directions these conversations took.
What did this person appreciate about you?
Betty highlighted that her listening skills were appreciated the most. “I don’t think people realise how much listening we do. Clients like to be heard, and sometimes they come to us because at home, they’re not listened to or asked about their day. They don’t feel seen.”
“Affection”, “warmth”, and “validation” were named by most participants. Others described being appreciated for offering “respect”, having the “discretion of a confidante”, “reliability”, “zest for life” and “joviality”.
What skills and initiatives did this person value in you or your time together?
Penelope emphasised being valued for her excellent conversational skills and that a large part of a date involved talking over dinner, sharing a bottle of wine. Tracing the history of this skill, Penelope attributed it to her work and her studies, and also to observing how her grandparents spoke in a calm and kind way to other members of the community.
Other skills that were valued included an ability for intimacy, ability to “connect in meaningful ways”, empathy and “adopting a nonjudgemental position”.
What might this person say about how you have contributed their life? How do you think this contribution might have made a difference to how this person saw their life?
This question elicited stories and knowledge that were out of phase with dominant views about sex work. The participants highlighted often-neglected aspects of their clients’ lives, known by very few. By sharing their stories, they illuminated a different narrative. I heard stories of clients being given the opportunity to become a better version of themselves, becoming happier, more alive, triggering a chain of life-affirming, courageous decisions such as taking up paragliding, becoming bolder in business, inviting more generosity.
Anna read a card from a client: “I appreciate your independent mind, your enthusiastic, nonjudgemental joy for life and all its pleasures, your willingness to develop a beautiful blend of intimacy, hope, desire, laughter and love.”
Freya brought in a book with a hand-written dedication from a client: “You have enabled me to fulfil dreams that in my civilian life I would have never been able to. Meeting you has been life changing.”
Penelope read a message from a client: “You offered me the opportunity for escapism and the realisation of certain dreams and fantasies, and with you I found a desire to explore my sexuality. With the ever-increasing pressures of the modern world, time spent with you really gives me something incredible to look forward to, and it is worth saving for.”
These acknowledgments of the effects that the women’s work had on their dates contradict the dominant discourse that all forms of sex working are objectifying and demoralising. Sophia said, “I had to unlearn many things I was taught when I was younger, when I too was under the weight of terrible misconceptions about sex workers. I now see value in what my connection with the clients brings to both them and me”. According to Morgan (7), “thin description leads to thin conclusions about people’s identities, and thin conclusions often lead to more thin conclusions as people’s skills, knowledges, abilities and competencies become hidden by the problem story”. Thin descriptions about sex work were challenged in this exercise.
Externalising secrecy
Externalising creates distance between a person and a problem and opens space to find preferred ways of relating to the problem (8). Externalising secrecy and shame supported the creation of alternative stories. It also made it possible to richly acknowledge the real effects of the hardships experienced by sex workers. These included economic hardships that precipitated taking up sex work and hardships exacerbated by shame and secrecy. The externalising questions I asked included:
What kind of step was it when you stood against poverty?
What was this debt separating you from that you wanted to hold on to?
What has secrecy taken away from you that you valued?
If shame tries to make a comeback, how will you handle this?
Externalising conversations about secrecy revealed that secrecy offered protection to important values held by the participants, such as relationships and dignity. Anna said:
My father would think I’m better than that, that’s why I am trying to protect his ingrained notions about how a daughter should behave, how a woman should behave. I don’t want to shatter his view of me. He would feel I am denigrating myself; he wouldn’t understand it’s something I embrace and want. He would hate that his daughter is a sexual being who ventures into things like sex working. Coming from a religious East African background, he wants to know his daughter is loved and cherished by one person, in a marriage, because that feels safe and better for him. I keep everything a secret from him to preserve this relationship.
Other participants said that secrecy protected their other jobs, which they loved and valued and would lose if their sex work were exposed. Secrecy gave the participants control over their lives because they gained a sense of agency over who was allowed to step into knowledge about their sex work. How about Zoom Today, At Fox 2:30 PM, your time Safety was another important factor that secrecy protected, particularly for participants who lived alone. Penelope explained that while secrecy protected her preferred way of being seen in society, she felt she had grown apart from people who wouldn’t understand:
It took a long time before I told my best friend. The reason why I felt I had to let her in was my fear of dying, and I wanted someone to tell my family, to be able to speak to them and dismiss that stigma. I wondered who would represent me? Who would explain? Who would know the reasons why I’ve done this?
In describing what secrecy took from the lives of participants, a common phrase was “sharing stories”: communicating and sharing anecdotes was hindered by secrecy. In Freya’s words:
I am a communicator, and secrecy has taken away my chance to communicate with my friends and family freely about these experiences. It’s quite lonely for me. Experiences are better for being shared. My clients are the only ones who know me in this capacity. That’s why I write them letters.
When asked about the influence of societal views on sex work in maintaining secrecy’s position, the participants confessed that they entered the industry with prejudices that matched dominant discourses. They harboured misconceptions about those in the industry, but agreed to join with the intention of remaining only until alternative solutions could be found for the financial issues that prompted them to join the industry. With time, they departed from stigmatising ideas and opted to remain in the industry for multiple reasons, including having control over their time, meeting new people, becoming activists for sex workers’ rights, feeling stimulated by their relationships with clients and other women in the industry, and for some, the ability to explore bisexual fantasies that couldn’t be explored in their civilian life.
Betty said,
I know there’s stigma and shame. But there’s so much more, too. My relationships with clients have allowed me to fight for and access things that made it possible for me to enjoy life, not just survive. I joined [the sex industry] because I wanted more money. I am really proud that I can say that I am part of this, part of this movement. I understand I have privileges, but I have earned my place here. I have learnt so much as a person. I have developed more kindness and compassion because of the people I have met – little moments with different people. Some people want intimacy, some want to be cared for, some want the centre stage. But it gave me the chance to put on a pair of glasses and I saw what people can do and be in their vulnerability. Many other sex workers I have collaborated with have shown great empathy and connection with their clients. You look at the clients’ lives and somehow examine yours and how you live it. Stigma and misconceptions almost robbed me of these lessons.
Betty had departed from known and familiar discourses to new journeys that opened space for a fuller participation and a stronger voice in the story of her life.
Acknowledging struggle through the absent but implicit
There were moments in our conversations when the concept of the “absent but implicit” (9) was significant. When the women were speaking of the struggle and pain they had been experiencing prior to starting sex work, I used the following questions to illuminate neglected aspects of their stories:
When you said life before sex work was a struggle and a fight, what kind of life were you struggling and fighting for?
You described the pain of your son being put on an eight-month-long waiting list for health care. What is this pain testimony to? What is it you hold precious that has been violated?
What do you give value to, that you’re refusing to abandon, that sustains you in this work? What matters to you?
Responding to risks with collective action
The risks for workers in the sex industry vary, depending on the form of work undertaken, with street sex work, for example, exposing workers to greater risks than high-end escort work. The participants in this project spoke of three types of risk: health risks linked with lack of condom use, physical violence and emotional risks. Participants wanted to talk more about emotional risks, as they stated that these were the most significant risks encountered by sex workers, irrespective of what form of sex work they are taking part in. The marginalised position of sex workers means that while not all workers in the industry encounter aggression and sexual health issues, all of them encounter discrimination, stigma and exclusion, and many experience the stress of leading a double life.
The women’s initiatives in response to emotional risks involved connecting and engaging with other sex workers, including organising get-togethers, spa retreats and days out. This was easier, however, when working for an agency, and social connections were not readily available to the independent workers. To reduce the risk of exclusion, an “indie collective” had been created as a space for independent workers to meet and support each other through advice, mentoring and protection. This generated connection and a sense of affiliation with others working in settings that can be isolating. These initiatives unfolded through time, becoming more than just “wellbeing rituals”. The get-togethers became regular, and with the help of social media they were usually funded by donations from clients.
These events played an important role in privileging the insider knowledge and voices of workers. They offered a chance to share information about sexually transmitted infection screening, sex education and sexual health, as well as blacklists of clients with a negative reputation and security tips such as identity screening. Some independent workers had initiated small female-run partnerships that involved renting an outcall location and sharing costs with others.
This discreet endeavour offered a solution to those who refused to work in hotels. It created a safe place to negotiate their work and see clients and allowed them to access safety and protection when required. These responses provided a platform that helped address the workers’ predicaments and dilemmas, reduced loneliness and elevated hard-earned knowledge and experience. All the participants had a strong appreciation of these initiatives, which can be seen as unique outcomes. They were clearly filled with meaning and symbolised what was important to these women. I asked Penelope a number of questions about these initiatives.
Serendipity: Can you explain to me what is it that you want for your life, and how that fits with your initiative to organise this?
Penelope: Well, I want to make it easier for others. I hope “passing the baton” [the name Penelope gave to this initiative] can help us not only feel safer but continue to enjoy this work, and have our heads screwed on. That’s when we’re at the highest risk when we’re not sticking together. I just hope to make this field better than when I started, for the other girls. One of the new indies now has at least three mentors that will know her bookings and can check in with her after her bookings are completed to see if she is safe. In an agency you have the manager who checks on you. If you’re an indie and nobody knows you’re doing this, who’s going to check you’ve left the client safely?’
Serendipity: Would you say “passing the baton” and getting the women connected has improved life for you and others?
Penelope: It will improve their experiences in this work. It was vital for so many of the young and unexperienced ones. They had a space to ask questions in a relaxed location. I remember how hard it was for me when I started, with no-one to ask questions, no-one to take me under their wing.
I went on to ask about what Penelope’s initiatives said about what she held precious in the world and in her life, and about the history of these values. Penelope said she found this exploration a novel experience: “I never took the time to think about why I did that and why it mattered to me. It’s good to know my values can have consequences on women’s lives”.
Some of the other questions I asked the participants about their collective initiatives included:
What ideas or forces supported these ways of connecting with other sex workers?
What are your intentions in using these knowledges and skills to help other sex workers?
What do these intentions reflect about what is important to you, or about precious beliefs about life and the world?
Do you do other things that reflect this principle?
Are there any proverbs or sayings from your culture that are linked to these values? Or are there any songs, stories or images from your community that are linked with this knowledge or skill?
Where else in life have you come across initiatives like the ones you have described?
Has this become important to you recently or has it been important for a long time?
What might someone have seen you doing back then that would be an expression of these values?
How did you learn this? Who did you learn this from?
Did the women in the collective become allies in this act of resistance? What differences did it make to have an ally?
What would you call this initiative?
Exposing patriarchal discourses
The women spoke about the toxic competition in the sex industry, and how it is conducive to envy, jealousy and hostility among sex workers. Patriarchy manifests as a divisive force of competition and comparison. It creates the illusion that there is only one appropriate appearance for sex workers, leading workers to fear that they don’t measure up. Discourses around appearance, age and attractiveness lead women to compete with each other for clients, supporting a narrative that only a few can succeed, and only at the detriment of others. This, in turn, separates workers from each other as sources of support.
The initiatives taken by the women to promote safety and to support each other without discrimination sought to limit the power of this discourse. Their actions created a community that offered degrees of immunity to the isolating power tactics sponsored by patriarchy.
The questions I posed to expose dominant discourses included:
Do you think other people ever have a similar experience [of whatever issue is being discussed]? Which people in particular are most likely to have this sort of experience?
How might other people experience this?
Why do you think women of different ages, sizes and shapes might end up feeling this way?
What does this suggest about what sex workers should be doing in such situations?
Are there any other things that this set of ideas says you should be doing?
Where do these ideas come from? Who benefits from you seeing things this way?
What are you promised as a reward if you do all the things these ideas say you should be doing?
Do you think this promise is always delivered? Were there other reasons why you had bookings, despite not being of a certain age, shape or size?
How much of this fits with how you prefer to think about yourself?
Is this an example of you keeping going with what is important to you in contrast to what these ideas tell you that you should be doing?
These questions elicited accounts of other aspects of the women’s work that were appreciated, such as conversation, listening, humour and conveying nonjudgemental attitudes, and shed light on the limits of appearance-based discourses.
A Collective Tree of Life
In our session together, we used the “Tree of Life” exercise (10, 3, 4) to thicken and document the women’s preferred life stories and to elevate their sense of self. The stories shared by these women in our conversations together contradicted the normalised cultural truths that often structure sex workers’ narratives. We also looked at the skills and values that afforded the participants the ability to navigate the challenges involved in sex work. Our conversations allowed us to share with each other the gifts we had brought from the various cultural groups we belong to, and to reflect on the differences and the similarities in our values, skills, hopes and dreams.
A collective tree
The women were invited to share stories about their backgrounds and countries of origin, the communities they came from and what is important to them. I adapted the prompts for each part of the metaphoric tree.
Roots and soil
The roots were used to represent significant people, areas and origins that had contributed to the women’s identities. The soil represented the day jobs and other roles the women had, the places they got their energy from, their sanctuaries, and the songs that they played while they got ready for dates.
Prompts for the roots included:
Where do you come from?
What aspects of your country or community are you proud of?
If I could interview your country or your community, what would it say about you being an expression of it? What values would it see in you that it would link with itself?
What are you affiliated with, in being part of this city?
Can you tell me a story that shows something special about your relationship with this place?
What is it that you appreciate in what East Africa (or other place) gave to you?
Prompts for the soil included:
What influences you on a daily basis?
Have you always enjoyed this?
Can you tell me a story about how this became important in your life?
How would you describe living on a narrow boat?
What does this say about you and what you stand for in life?
The trunk
The trunk was used to represent the skills and abilities that enable the women to do this job, or that this job had given them. One participant indicated she had become a chameleon, assessing each booking before opting for the colour/attitude/mood/persona she would put on. “Energy management”, “fast learning” and “experiencing pleasure” were other important aspects.
Prompts for the trunk (skills):
Can you tell me a story about something you’ve learnt about yourself since entering this industry?
What would other people tell me about your skills?
What’s it like hearing the other participants say this about you?
How does your ability to turn into a chameleon contribute to your wellbeing?
What’s the history of this skill in your life?
Can you share the first time you remember using energy management?
What ancestors share this skill with you?
Who gave you this skill?
How have you demonstrated it in the past?
The leaves
The leaves were used to represent the hopes and dreams that motivated the women to work in this field, for example owning a home, investing, security and independence.
Prompts for the leaves (hopes and dreams):
What is the history of this hope of owning your own home?
What is privacy trying to protect that is meaningful to you?
Is dreaming of security linked with somebody significant in your life?
Can you tell me a little about your relationship with this person?
How come you haven’t given up on this dream of having independence?
How long has independence been important to you?
Can you share a story of the first time you realised this was important to you?
Who else would agree that this is important to you?
What has sustained your hope for a better world for your son?
Flower petals
On the flower petals, the participants added significant people who had supported them in balancing the work and other commitments, or whose views the participants valued. These included other sex workers, children, sisters and partners.
Prompts for the petals (significant people):
What was special to you about your nan?
What do your parents know about you that you sometimes don’t know about yourself?
If I could look at you through your child’s eyes, what would I see?
Did you have good times with your partner?
What would your sister say are your moments of greatness in life?
The fruit
The fruits were used to represent gifts from clients, other sex workers, and significant people outside the industry. Gifts from clients included experiences, new abilities such as acquiring sommelier skills, travel, advice and mentorship. Gifts shared among sex workers included collaboration, friendship and a sense of community.
Prompts for the fruits included:
How did your clients contribute to your life?
What did that make possible for you?
What did you discover about yourself as a result of that contribution?
How might have you contributed to your parents’ lives?
How did other sex workers contribute to your wellbeing?
Why do you think they gave you this?
What made her act in this way towards you?
What did she see in you that you can now see in yourself?
What did your grandmother appreciate about you that would have led her to give you the skill of knowing how to wait?
From what ancestors can you trace the gift of generosity?
Still standing – enduring ‘the Inevitables’
I also used the Tree of Life metaphor to help us speak about the ways participants had endured hardships. Through exploring what enables a tree to remain standing even after being shaken by storms and harsh conditions, the participants named the more challenging aspects of sex work and how they weathered these.
They named the difficult times the “inevitables”. They shared how, if they had a negative experience with a client, they would circulate a warning to others in a social media group to prevent further bookings with that person. As we discussed dealing with the inevitables, I shared a story about coastal redwood trees, which despite their great height, have only shallow roots. The secret of their survival in strong winds, floods and other challenges is connection – their roots spread outwards and connect with other coastal redwood roots. Their roots intertwine and this togetherness adds to their stability. The participants loved this analogy, and acknowledged that their connectedness with each other provided them with a similar strength in responding to the stress of leading a double life, providing shelter from isolation and enabling them to stand together against exclusion and discrimination.
A Collective Letter
Newman (11) emphasised how narrative practitioners can use documentation to enable people’s stories to continue to live in the lives of others. The following letter was written collectively during the session the group of women had together. Its purpose was to highlight stories about how the women had addressed the effects of isolation and other challenges in their work. I sought to make links between the women’s personal experiences and the broader social issues they represented, to move from an individual to a collective approach, and to enable the women to contribute to other groups and communities through documenting their knowledge and making it available to others experiencing similar hardships (3). Through this process of drafting the letter, further stories of resistance against hardship emerged. As Denborough (3) described, collective narrative documents “convey a range of hard-won skills and knowledges, in parallel with a rich acknowledgment of the circumstances in which these have been hard won” (3).
What keeps us going: A collective letter from the words of sex workers
Living in the shadow of stigma, discrimination, secrecy, pain, judgement, misconceptions, labels and exclusion is challenging. With this document travels a hope that it will support people who are joining the industry, people who are curious about us, and people whose work and worlds intertwine with sex workers in different ways: therapists, support workers, lawyers, police, activists.
We are seven women working as high-end sex workers. Here are some stories of what keeps us going during challenging times.
People think we are our work, but really, we are human beings like you: women trying to make a living in a patriarchal society. We juggle many roles and wear various hats. You see, people who sell sex are everywhere. We are your neighbour, your colleague at work, the person in the queue at the post office or in the waiting room of the health clinic. Our kids probably play in the same parks or go to the same schools as yours. We probably go to the same place of worship.
Supporting each other
Being there for each other is a form of sustenance: a way to remove isolation, a way out of despair. Sometimes, being able to talk to someone who understands and doesn’t judge – and can listen without gasping – makes a difference in how we walk this journey. Connecting with people in the industry provides protection, mentoring, sharing of knowledge and ideas, and it ultimately reduces loneliness.
The skill of supporting each other stems from a desire to be safe in our work – protected, understood. Here are some examples of the expression of this skill:
offering to pay for a sexual health screening test for a sex worker who can’t afford it
offering to call each other after a booking is over to check we’re safe after the client has left
organising get-togethers and extending the invitation to people who work in different forms of the industry.
One sex worker created a platform for “naming and shaming” clients whose behaviour is risky, so women in the industry are able to warn and safeguard each other. The sex worker who started this traced the history of this initiative to her childhood, when, as the eldest of her siblings, she was in charge of keeping the younger ones safe when their parents weren’t around. Initiatives like this make a real difference to our lives because they remove some of the effects that secrecy has on some of us.
Supporting families – our own and each other’s
The sex workers involved in this project prioritised providing for their families with food, better opportunities and a better education. This was a way of responding to many difficulties linked with the nature of our work and a strong motivation to keep choosing what works instead of folding under the pressure of the hardship. One of the participants said: “Being a sex worker means that I can spend more time with my son, who is disabled. It also means I can pay for private health care for him. I have waited for so long for funding to be made available for his care, and I was done with waiting. I now can offer him the best treatments and I am available for him in more ways than I could be if I had to work all day to be paid just enough to be able to put food on the table.”
Another participant supports her family who live in a war-torn country. “I can resist the challenges brought by this work when I know that the money really makes a difference to my family back home. When I know that my father can have the dentures he needs, when I know that my brother can access education because of my work, I feel the grip of shame loosen. Where I come from, we are proud that we don’t treat other people’s material needs as trivial. I am so glad I actively do something to contribute. It isn’t just material though. Some of my clients have improved the quality of my life by advising me, counselling me, guiding me, mentoring me and offering perspectives I would have never been exposed to if our worlds had not met.”
Freya mentioned the solidarity among women in the industry who have difficulties finding childcare that is discreet and reliable. Some sex workers who have children develop friendships and babysit for one another. This is an expression of solidarity and a recognition of the challenges that secrecy creates for some sex workers. In tracing the history of “looking after each other”, Freya remembered how when she was a child, the community was the family. All the doors were open, and dinner was rarely at home. Most of the children came home already fed by other mothers and spent hours playing together in the neighbourhood. She remembered how her mother cooked large quantities, expecting to have at least five of the neighbours’ children attending dinner, and how welcoming every family was.
Investing in ourselves, in our health and wellbeing
We understand the importance of looking after ourselves. We invest part of our earnings in our health, paying for treatments and memberships in health and wellness centres. We make better choices when it comes to nutrition and self-care now, and this affects how we feel, sleep and live. The way some of us resist discourses about the “dirty” bodies of sex workers is by really looking after our bodies, eating healthily, ensuring balance between rest and work, and keeping up with all the testing. These are all acts of rebellion against people who use graphic and misogynist language in debates about sex workers and their bodies. This skill is rooted in the knowledge that there is hate towards us as a group, that stems from misogynist and old ideas about sex. We are on the receiving end of responses of disgust. There are discourses of bodily degradation, discourses of us being disease-spreaders. To stand against all of that, we are vigilant in how we treat our bodies.
Empowering our children
Some of us are motivated by wanting to empower our children by ensuring they have better opportunities than we did. “My children are in debate clubs. They take martial arts classes. They learn a different language. We didn’t have these chances and privileges growing up. At least they do, and it gives them a head start. They will not be as advanced as other children, but my work is moving them forward.”
Making something meaningful for the future by funding skills and education
We know that some of the people involved in sex work are at the bottom of the social pile in terms of qualifications for well-paid jobs. We are not bankers, scientists or politicians. Some of us have been able to fund our own education from our earnings, an action that supported us in seeing ourselves in preferred ways, rather than in ways stigma tries to convince us to see ourselves. This is an expression of wanting to be financially independent, beyond the sex working years of our lives. One of the participants shared how she had always wanted to be a qualified hairdresser, but for economic reasons her parents weren’t able to support her to pursue that path. Knowing that, with time, she would be able to save and pay for the course with her own finances enabled her to forge her own relationship with her work, based on what it made possible for her, and not based on how others might think of it.
Anna, who is of African origin and very close to her roots, shared how she had been donating and campaigning for girls’ education in her home country. She encourages her clients to donate too, and influences them by subtly reminding them that “the cost of a bottle of perfume could make more of an impact – here, let me show you how to donate to CAMFED (Campaign for Female Education, a grassroots pan-African organisation promoting education for girls).
Refusing to take on patriarchal values
It takes care not to take on patriarchal values. We have to learn and notice the signs that indicate that we’re susceptible to these values, and choose to work in collaboration instead of in competition with each other. This involves the skill of working in solidarity with each other first and foremost: refusing comparison with each other in negative ways, refusing invitations to see ourselves as being in competition with one another, and instead, recognising the uniqueness of what each of us can offer to the industry. This is really sustaining of us as sisters. We are aware of the ways in which patriarchy sets women to compete with one another. Some of us are watchful for the times when patriarchy wraps its tentacles around us, putting us down, diminishing us, making us feel inferior when we don’t have the “right body shape”, the “right height” or the “right skin colour” to be able to generate income in the industry. There are some rules that are known to most of us: we never badmouth other sex workers in front of clients. We don’t gossip about other workers (although some clients, believe it or not, sometimes pry). We resist invitations to join in when clients throw mud at other sex workers, and we very quickly make it clear we’re not interested in participating in gossip.
People think we are our work, but really we are human beings just like you, trying to make a living in a patriarchal society.
We hope this letter is helpful to you.
Acknowledgments
I would like to acknowledge with heartfelt gratitude the participation of the women in this group. Their generosity with their time and stories taught me so much. So too did my companions on social media who supported this project by answering my questions, clarifying terminology, and assisting me with directions and ideas. I would also like to extend my gratitude to David Denborough, Marnie Sather and Manja Visschedijk.
References
(1) Agustin, L. (2002). The (crying) need for different kinds of research. Research for Sex Work, 5, 30–32.
(2) Reynolds, V. (2019). Justice-doing at the intersections of power: Community work, therapy and supervision. Dulwich Centre Publications.
(3) Denborough, D. (2008). Collective narrative practice: Responding to individuals, groups, and communities who have experienced trauma. Dulwich Centre Publications.
(4) Ncube, N. (2006). The tree of life project: Using narrative ideas in work with vulnerable children in southern Africa. International Journal of Narrative Therapy and Community Work, (1), 3–16.
(6) White, M. (2007). Maps of narrative practice. Norton.
(7) Morgan, A. (2000). What is narrative therapy? An easy-to-read introduction. Dulwich Centre Publications.
(8) White, M., & Epston, D. (1990). Narrative means to therapeutic ends. Norton.
(9) White, M. (2000). Re-engaging with history: The absent but implicit. In M. White (Ed.), Reflections on narrative practice: Essays and interviews (pp. 35–58). Dulwich Centre Publications
(11) Newman, D. (2008). “Rescuing the said from the saying of it”: Living documentation in narrative therapy. International Journal of Narrative Therapy and Community Work, (3), 24–34.
Descriptions of sex workers’ lives that honour their own agency, skills and knowledge are rarely found in published literature, but there are some exceptions. I’d recommend:
Curtis, M. G., Jr. (2017). Sex worker and proud: A phenomenological study of consensual sex workers’ lives. (Publication No. 3123) [Master’s thesis, University of Nevada]. UNLV Theses, Dissertations, Professional Papers, and Capstones. http://dx.doi.org/10.34917/11889682
Ding, Y. (2020). Beyond sex work: Understanding work and identity of female sex workers in South China. Social Inclusion, 8(2), 95–103. https://doi.org/10.17645/si.v8i2.2644
Toone, K. (2018). Come back for us: A critical reflection on the shared history of queers and sex workers and our need for solidarity. Hecate, 44(1), 110–121.
This paper, originally published as: Serendipity, K. (2024). Departing from stigma and secrecy and elevating stories of agency: Narrative practice in the voices of sex workers. International Journal of Narrative Therapy and Community Work, (1), 2–14. https://doi.org/10.4320/WTZN9783, is re-published here with explicit permission of both the author and Editor of IJNTCW.
Shame often comes to me as a revelation that shakes me to my core. It has the power to suddenly evaporate every illusion I have about myself, which often leaves me feeling exposed and unworthy. Because of this, shame can also open the door to my deepest vulnerabilities, including childhood attachment fears, as it carries me into heavy emotions that sometimes feel impossible to hold. Shame is the most demanding internal experience for me, followed closely by grief.
I don’t like to feel exposed and unworthy, so I typically and automatically try to avoid connecting with my shame. The possibility of experiencing shame is such an unwelcome experience for me at times that it can polarize my avoidance tendencies into two opposite and extreme positions: “the ideal” and “the victim”. These two positions are a safeguard in the short term because my shame does not immediately take hold of me. However, these polarized positions become problematic in the long term. They often initiate a destructive cycle of shame that can pull me deeper into my extreme positions by paradoxically producing more shame within me over time.
The more common extreme position that I fall into is thinking that I am greater than I am. This polarized focus is something I like to term “the ideal.” Instead of acknowledging myself as I truly am, I attempt to act out an idealized version of who I want to be. This allows me to avoid my shame in the short term since I can remain focused on being an idealized version of myself. However, the shameful reality of who I truly am finds me in the long term when I inevitably fall short of that ideal.
Unfortunately, the experience of me falling short of that unattainable ideal makes me experience even more shame, which intensifies my desire to avoid my shame once again by pretending that I am in fact closer to an ideal version of myself than I actually am. The only way for me to break free from this cycle is to acknowledge and bear the shameful reality of what I truly am in any given moment rather than trying to avoid that reality by thinking that I am already “the ideal.”
Evoking the Ideal: The Case of David
One of my clients, whom I will call David, serves as good example of how shame evokes the extreme position of “the ideal.” David initially sought counseling with me at the request of his partner. David’s partner thought he was struggling with undiagnosed ADHD due to his difficulty in attending to her and his responsibilities at home. She wanted him to get additional support. After working with David for a few sessions, the underlying pattern became quite clear. David had been placing an impossible pressure on himself to attend to all things in his desire to please his partner, and he did this by seeming like he was more capable than he was truly able to be.
Instead of acknowledging his true capabilities and limits, he would begin to feel overwhelmed by all the responsibilities he would take on, which would then make him miss things that he would normally not forget. These actions would reinforce the shame of him being someone that is forgetful and/or not attentive, which would motivate him to try even harder to not be seen in that way. As this cycle became reinforced in his partnership, David’s shame amplified, and his depression got worse. When I first talked to him, he was nearing a psychological breaking point. He felt that he had somehow become the incapable person that he had been so desperately attempting to avoid.
At the start of treatment, I encouraged David to be curious about his identity of being the incapable one. We explored the origins of this identity and uncovered his underlying overwhelm and deep sense of shame. As we explored David’s shame with love and acceptance, I also encouraged him to learn how to bear a little of his shame with me. David was able to realize that he was not the incapable person that he and his partner had come to know him as. He also came to slowly accept that he was not the highly capable person that he hoped he could be. He humbled himself and started to give realistic expectations towards himself and others in reference to his capabilities.
His shame and depression faded, and his true capabilities began to grow as he gave himself space to start over with an honest understanding of who he was. Other people took notice of this shift in David. Instead of taking the bait and falling back into the belief that he was fully capable due to other people admiring his newfound capacity, he continued to humble himself and find slow, but persistent growth in his true capabilities. Through the course of our time together, David cultivated the qualities of the capable person that he always hoped he could become, not be forcing “the ideal” onto himself, but by paradoxically accepting that he was not yet that person.
Overcoming the Victim Role: The Case of Avery
The other opposing extreme position that I fall into is thinking that I am much less than I am. This polarized focus is something I like to term “the victim.” Instead of acknowledging myself as I truly am, I exaggerate my inadequacies to avoid facing the real imperfections that I do contain. This allows me to avoid experiencing my actual shame in the short term since I can remain a victim by focusing on all the negativity that I place on myself. However, the hopeful reality of who I truly am finds me in the long term as other people continue to remind me that I am more than I am pretending to be.
Unfortunately, the uncovering of my victimhood makes me experience even more shame which intensifies my desire to avoid my shame once again by trying to convince myself that I am completely irredeemable. The only way for me to break this cycle is to acknowledge and bear the hopeful reality of what I truly am in any given moment rather than trying to avoid that reality by allowing myself to play “the victim.”
One of my clients, whom I will call Avery, can serve as a useful example of how shame brings about the extreme position of “the victim.” Avery initially sought out counseling with me due to her worsening depressive symptoms. She had solidified a deep-seated belief through the course of her life that she was fundamentally unlovable and that her future was hopeless. She struggled with suicidal thoughts and felt as if most of her life was simply a constant battle for survival. After working with Avery for a few sessions, the underlying pattern began to emerge. Avery had become so terrified of accepting the possibility that she might truly be worth something that she trained herself to believe that she was in fact completely worthless to save herself from the shame of falling short of the real potential she did contain.
Instead of acknowledging that she might have some level of significance as a human being, negative thoughts would quickly flood into her mind telling her that she couldn’t be more mistaken. These negative perceptions of herself would then make her feel worse about herself, which would only solidify her self-created identity as someone that is fundamentally irredeemable. As this cycle became reinforced in her own identity, Avery’s shame intensified, and her depression got worse. Her skewed sense of self had become so ingrained that the affirming comments that trusted others gave to her only made her feel more unworthy and alone. When I first talked to her, she was nearing a suicidal breaking point. She was seriously considering an act that would forever symbolize her fundamental sense of unworthiness in this world—taking her own life.
At the start of treatment, I encouraged Avery to be curious about her identity of being the unworthy one. We explored the origins of this identity and uncovered her underlying fears of having to bear the real shame of her faults. As we explored Avery’s shame with love and acceptance, I also encouraged her to practice bearing a little of her shame with me. Avery was able to realize that her shame was not as scary as she initially feared. The negative perceptions of herself that she previously entertained were slowly replaced by images of her innate goodness as she learned how to embrace her shame in a real and healthy way. Avery’s newfound ability to be present to her shame also opened to her new avenues of growth as she welcomed higher aspects of her own goodness despite her fears of falling short of her potential.
Her shame and depression faded, and her former hopelessness was replaced by a solid sense of self-worth as she cultivated the courage to start over with an honest understanding of who she was. Other people took notice of this shift in Avery. Instead of resisting their positive feedback and falling into her former belief of being unlovable, she allowed their love to enter her as she cultivated a healthier balance between her goodness and the ways in which she fell short of that goodness. Through the course of our time together, Avery cultivated qualities of the worthy person she secretly hoped she could become, not by pretending to be “the victim” of a cruel world, but by paradoxically accepting that she truly might be worthy of love.
The middle path of shame amid both extremes is humility. It is the integrating virtue that allows us to cultivate freedom from these extreme positions by acknowledging that we are simultaneously a mix of good and not good enough. I always encourage my clients, along with myself, to work on bearing just a little shame. I don’t need to pretend that I am shameless, and I also don’t need to allow myself to be crushed by the weight of my shame. Bearing just a little shame opens the door of humility, which allows me to resist extremes and move through my shame in a redemptive and life-generating way.
I must take a stance towards my shame. There will always be a risk that I orient toward my shame in a polarizing way, but attempting to avoid it altogether leaves me in an even worse place. The shame that I never acknowledge accumulates within me and only leads to more shame and isolation in the long term. Shame is not something I can resist; it is something I must move through to find integration, healing, and wholeness.
As a final note, I have always found it to be a deep irony that I tend to respond to my own experience of shame with avoidance and fear, but that I feel a deep sense of empathy, connection, and attention when I am in the presence of my clients experiencing their shame. I often consider how that experience as a therapist serves as a signpost for how I should be orienting towards my own shame. Though the process of shame can feel paradoxical and shrouded in mystery at times, the outcomes are always perfectly clear. The clients I have known that have truly become integrated, alive, and whole have been the clients that were courageously willing to face their shame and bear it in the presence of trusted others.
I’ve spent years sitting on the floor with autistic kids who believe, long before they ever meet me, that they are the problem. Not because someone told them directly, but because they’re perceptive. They’ve absorbed the tension at home, the tightness in a parent’s voice, the helplessness after another school call, and the weight of adults who are out of options.
A surprising number of the autistic children I meet can recite their diagnoses the way other kids list their favorite characters: ADHD, ASD, OCD, ODD, generalized anxiety, social anxiety, sensory processing disorder, mood dysregulation…on and on.
They say these words with the matter-of-fact tone of someone who’s decided the only way to survive being treated like a problem is to name it first. When they sit across from me, small legs pulled up to their chest or folded tightly underneath them, their first question is something like, “Are you going to fix me? My dad says you’re here to fix me.” Kids don’t lie about this stuff.
They report what they hear, and somewhere along the way, the professionals in their life—in an attempt to help, simplify, or categorize—stacked labels so high the child couldn’t see themselves anymore. That’s what autistic kids have taught me about therapy—the room becomes safer the moment we stop trying to fix them.
When a Child Arrives Already Carrying Blame
I’ve had children walk in and immediately seek the farthest corner of the room. I’ve seen kids tuck themselves inside the tent and whisper, “I know I’m the problem.” I’ve had children refuse to take off their backpack because they weren’t sure if they’d be allowed to stay. I don’t coax them out. I don’t insist they talk. I don’t ask for eye contact. I sit. I lower my voice. I match their posture. I wait.
If all I do in that first session is show the child that I’m safe, that I won’t force vulnerability, and that I see them as a person—not a project—then the session has done its job. Many autistic kids communicate through energy before words; through pacing, breath, doll placement, construction patterns, retreat, play sequencing, and the way they use space.
When I pay attention, the child is already talking.
They show you:
what feels overwhelming
what feels grounding
what feels predictable
what feels too close
what feels sensory-safe
and where their nervous system sits on the ladder that day
If I’m willing to enter their pacing—not impose mine—I get invited into their world. And that invitation is sacred. One child taught me this by accident. She was drawing spirals on the carpet with her finger—not talking, not looking at me. I followed her spiral with my breath, slowing as she slowed. I didn’t realize she was watching until she said quietly, “You breathe like me.” That was the moment I realized that I don’t need eye contact to build connection; I need attunement, as do they.
Parents Don’t Come to Me Because They’re Cruel—They Come Because They’re Terrified
I’ve worked with so many families who start with resignation, “We’ve tried everything.” “He’s going to get himself killed someday.” “She ruins every family outing.” “I can’t deal with her anymore.” “I don’t even like being around my own kid.” Years ago, those sentences pierced my chest. Now I listen for what they’re trying to say beneath the frustration.
Parents aren’t villains in these stories. They’re exhausted humans who’ve been in survival mode for years. They’ve taken time off work for school meetings, fought insurance companies, been given contradictory advice, been judged by strangers, and weathered crises other parents can hardly imagine—elopement, medical trauma, meltdowns in public spaces, property destruction, suicidal ideation from a child too young to tie their own shoes––and the harshest words often hide the most fear. The more hopeless a parent sounds, the more likely they’re experiencing complete desperation.
Once, after weeks of angry refrains, a father finally said, “I’m terrified. I don’t know how to help her. I don’t want to lose her.” I didn’t confront him. I didn’t correct him. I didn’t lecture him on parenting styles. I just let the truth settle, because that moment—when fear becomes visible—is where the real therapy began.
Parents need a place to collapse too. They need someone who sees through the panic. They need someone who can interpret the emotional signal behind their words. If I look long enough, “She’s awful” usually means “I’m afraid I can’t protect her.”
Why Control Matters So Much
Some autistic kids arrive in therapy having had their choices stripped from them over and over; what they eat, what they wear, how they sit, what they focus on, how they talk, what stims they’re allowed to do, how they should “behave,” and what parts of their personality are acceptable. By the time they get to me, they assume adults will tell them who to be. So, I reverse the power dynamic. “You’re in charge here,” I tell them. Not metaphorically. Literally.
They choose the:
activity
pace
distance
sensory input
theme
transition
silence
disclosure
exit
Some kids don’t test the boundary at all. Some test it immediately. Some test me for months. Autistic children who’ve been controlled harshly will often push against me to see if I’m just another adult who’s going to tighten the lid. But when they realize I’m not—when they learn I won’t force engagement, shame them for retreating, or push a conversation they didn’t choose—their nervous system relaxes. The rigidity softens. The play becomes exploratory. Autistic kids respond to empowerment the same way plants respond to sunlight: slowly, and then all at once.
The One Rule: No More Self-Insults
Kids (and adults) absorb the words they repeat about themselves. So, in my playroom, we say feelings, not identities. “I felt stupid” instead of “I am stupid.” “I felt annoying to others” instead of “I am annoying.” “I felt overwhelmed” instead of “I am too much.”
Parents often mirror this pattern without noticing. “He’s impossible.” “She’s manipulative.” “He’s just dramatic.” “She doesn’t care.” I gently redirect both because identity words shape how kids understand their place in the world. Autistic kids, who often face a lifetime of criticism for simply existing, need a place where their sense of self can remain intact. Correcting identity language is one of the simplest and most transformative interventions I practice.
The “Safety Parent”
Every autistic family I’ve worked with has a parent who feels like the “problem parent”—the one who yells, withdraws, threatens consequences, avoids conflict, or gets labeled as harsh. What I learned is that the parent who struggles most is usually the one who needs the deepest invitation into the child’s world. I bring that parent into sessions—not to supervise, but to observe attunement in action. I let them see how:
slowly I talk
I match the child’s breath
I phrase questions with permission
I wait in silence
I interpret behavior as communication
I anchor the room with predictability
This is my favorite part of my work because the safety parent becomes powerful, gentle, and connected once they see their child accurately. Not through shame but through understanding. Over time, the parent becomes a co-regulator instead of a correction officer, and the child, seeing this consistently, begins to reach for them again. I’ve watched relationships that seemed broken transform into genuine companionship, not because I fixed the child, but because the parent finally had a map.
When We Stop Treating Autism Like Defiance
In my work with these children and their families, I’ve come to understand that therapists must know autism—not pop-psych autism, not social-media autism, not outdated autism—actual autism, and actual autism is:
sensory processing differences
a different communication rhythm
a unique relational style
a distinct way of understanding fairness and truth
a predictable stress/recovery cycle
and often, a trauma history from being misunderstood
Autism is not a behavioral issue, manipulation, noncompliance, or defiance. Too many autistic kids have been placed in settings that only worsened their dysregulation. Too many have been punished for sensory overload. Too many have been misdiagnosed as oppositional, disrespectful, or personality-disordered because clinicians didn’t understand autistic communication.
In my work with autistic clients, I’ve learned, or I should say, they’ve taught me that competence isn’t optional and that I needed to understand that stimming, masking, shutdown, overload, monotropism, sensory profiles, are the way autistic nervous systems respond to relational pressure. I’ve needed to be comfortable with silence, scripting, indirect play, rejection, honesty, rigidity, and shifting connection. And, of course, it’s been crucial for me to step away from the gravitational pull of diagnoses, because each child is unique. Kids aren’t broken. Our lens is.
Why Parents’ Growth Heals the Child
People think therapy “works” when the child changes. In my experience, therapy works when the parent:
softens
sees accurately
shifts interpretation
stops fearing their child
recognizes their child is trying
When the parent experiences a moment of clarity, they come to realize that maybe my child isn’t trying to hurt me. Maybe she’s trying to survive, and the entire trajectory of treatment changes. I once watched a parent who was initially rigid and overwhelmed grow into the most attuned, steady presence in the child’s life. He told me, “I didn’t realize how hard she was trying until I watched you watch her.” That’s the beauty of working with autistic families––when understanding enters the room, hope returns.
What Autistic Kids Have Taught Me
Autistic kids have taught me that therapy isn’t about perfect technique—it’s about presence. They’ve taught me to:
move slowly
assume goodness
stop pathologizing difference
treat autonomy as essential
let the child be in charge
listen beneath behavior
respect sensory truth
see parents as co-survivors, not antagonists
hold space for relationships that need repairing, not replacing
Most of all, autistic kids have taught me that I’m not there to fix them. I’m there to see them. I’m here to understand their internal logic. I’m here to become someone they don’t have to defend themselves against. That alone can change everything.
I’ve seen families reconnect in ways they didn’t believe were possible. I’ve seen kids reclaim freedom inside their own bodies. I’ve seen parents rediscover the softness they thought they lost, not because anyone was broken, but because the adults finally learned to hear the story beneath the struggle.
If I could offer one reflection to therapists who work with autistic families, it would be this: When you hear a parent say, “I can’t stand my kid,” don’t judge them. Translate it. What they usually mean is, “I’m afraid for my kid.” If we can hear the fear beneath the frustration, then therapy stops being about correcting behavior—and becomes about connection, compassion, and the possibility of healing.
Squirrel, my current therapist is wise, patient, authentic, and non-judgmental at least most of the time. She doesn’t impulsively rush to conclusions. She affords me time to process my own experience which I appreciate. Unfortunately, and without exaggeration, she also seems to be totally devoid of empathy. She never gives me the reassurance that she can imagine what it must be like to be me. Nevertheless, she will likely be my last therapist. I’m 76 years old, and despite Squirrel’s feline lack of empathy, I am making progress. I am able to see her whenever she chooses to leap off the bookshelf and make herself available.
I’m curious about her detached approach. I thought I’d seen them all. Prior to retiring, I was a clinical psychologist in private practice. My graduate program required all students to have 45 hours of individual therapy. I loved it and engaged in more, a whole lot more, than what was required. At various times I was in Gestalt Therapy, couples group therapy, dream analysis, encounter groups, and other therapies. I’ve engaged therapy dogs as co-therapists. I know the psychotherapy territory and am an avid supporter of people seeking to grow and evolve into their better selves. Still, after retirement and at the end of my traditional therapies, I sensed room for continuing psychological growth. Then along came Squirrel.
I don’t know if Maine Coons have ever been licensed as therapists, but I wouldn’t be surprised. Squirrel is a natural at encouraging me to evolve. She embodies all the qualities of a Rogerian therapist allowing for, and even encouraging, transference in the service of increasing self-awareness. I ask her if she likes being petted, and she simply fixes her gaze at me, allowing me to answer my own question. The reason that I ask her if she likes being petted is that Squirrel makes a habit of coming close to visit just out of arm’s length. If I reach out to pet her, she moves a bit further away. Very occasionally, she will allow me to pick her up and pet her for a minute or two. When I do get to hold her, she purrs and shows me her belly. She can be so very inviting, but only occasionally. I want to tell her everything. After a couple of years of this routine, I thought to rename her “Princess Ambivalence,” an appellation befitting her decidedly approach/avoidance posturing.
It occurred to me recently that my self-esteem was suffering because of my inability to “win over” Squirrel. Despite offering nothing but kindness, soothing words, the occasional pets, and cat treats, she tends to keep her distance. Her ambivalence has tested my patience, my control issues, and ultimately, my ability to forgive. I can visualize her now and imagine she’s thinking that she doesn’t like to be called Princess Ambivalence. As she stares silently at me, encouraging me to process my experience, I become aware that I had been dealing with my hurt feelings by passive-aggressively renaming her Princess Ambivalence.
Squirrel provided me with the time to process my judgmental reaction to her simply by acting like a cat, and eventually I realized that both Princess and Ambivalence were pejorative terms, reflecting my frustration and hurt feelings. Thankfully, Squirrel is too seasoned a therapist to engage in countertransference. She simply fixed her gaze at me again until I understood my own behavior.
I’ve known for some time that insight is not enough to facilitate change, and apologies are an insufficient indication of genuine transformation. If I were to have truly internalized my experience, I would have to demonstrate evidence of real change in my interspecies relationship with Squirrel. I decided, therefore, to rename her again with a less judgmental and mean-spirited name. Her new name is much more descriptive and emotionally neutral. She is now, “Proximity Cat.”
She stares at me, and we both understand that her new name reflects my progress but is also an insufficient marker of my change.
Happily, my therapy continues, however; I know I’m not done. As Proximity Cat continues her deep gaze, she helps me understand that I have a sense of entitlement that enables me to believe that I have the right to change her name. I’m not yet ready to call her Squirrel, although I hope to get to that place in time. I am, as Proximity Cat reminds me on a daily basis, still a work in progress.
Lawrence Rubin (LR): I’m here today with Kay Ingamells, a therapist, educator, and author who lives in New Zealand. We’ll be chatting today about the Wonderfulness Inquiry, a fascinating and foundational intervention embedded in narrative practice. Hi Kay.
The Wonderfulness Inquiry
Kay Ingamells (KI): Well, that’s actually a very big question, so I’d like to begin by saying where it comes from. As most people reading this may realize, David Epston, one of the founders of Narrative Therapy, originated the Wonderfulness Interview. It came about through necessity as he found himself in live interviews with children and families where he knew that what he had to bring was not going to be sufficient, and he needed to invent something pretty much on the spot. That evolved over time into a very clearly formulated, distinct practice, which, to my mind, is as important as a Narrative Therapy practice as externalizing is.
It’s absolutely foundational to my practice, and I say inquiry, not interview, because it is an inquiry into what is remarkable about somebody. It’s an inquiry into what David Epston would call their moral character, or what Sasha Pilkington would call their virtues. So traditionally, for the last however many decades, the way that people have come to know people through therapy has been through a particular lens, which David has called the crisis of representation. Here, people are represented, to you, by you, to themselves in therapy interviews, through a lens of pathology or stigma or a diagnosis.
A wonderfulness inquiry turns that tradition of focusing on the crisis or symptoms on its head. And so what I’m doing at the beginning of an interview, whether it’s with a child or young person or a family or an adult, starts from the other direction. I might begin with a question like, “before we talk about the problem today, and I know that the problem is something that you’ve come here to talk about, would it be okay if I was to get to know you in another way all together? (I’ll relate this to working with a child with a family present) Could I ask you what’s wonderful about Billy? What is it that I would come to know is wonderful about him if I was to get to know him as well as you do? The reason I’m asking this is because people don’t come to therapy without having had life experience. As parents, you will have worked through all sorts of things in your life, in your lives, individually and as a family, and you will have wisdom and qualities and abilities to bring to what we’re dealing with today. And if I know what those are, we can put our heads together and think about how we might use Billy’s wonderful abilities and your family’s wonderful abilities together to deal with this problem.” That’s one of the ways I might begin it. And hopefully that gives you a sense of what it is.
LR: It does indeed. A little bit earlier on, you drew a distinction between an inquiry and an interview, and while some may use those terms interchangeably, my sense is that they are very different processes for you.
KI: In several ways. The first is that this is something I’m doing with somebody. I’m not interviewing somebody. I’m inquiring with people. We’re inquiring together. I’m not bringing in the expectations of where I think we will end up specifically. I don’t have a list of questions in front of me. It’s an inquiry. It’s an inventive, imaginative inquiry that really stems from narrative values about being decentered as a practitioner, valuing people’s knowledges, and wisdoms. It’s about connecting to and bringing out their insider knowledge. When I say inquiry, it occurs inside of a larger narrative inquiry, which is about the development of a counterstory. And the counterstory is an attempt to co-create a narrative with the client, with the parents of the client, that counters one of pathology and problems.
Wonderfulness inquiries or virtue inquiries are so helpful in interviewing people because the conversation is directed at what’s wonderful about them, what you appreciate and respect about them. With older people, you’re discovering who that person is as a character, a moral character. You are characterizing them as a protagonist in their own story; champions in their lives, who they are as a resource, who they are––someone they can be proud of in their lives. Then you’re taking that character and using it as part of the larger counter storying endeavor or process.
LR: When I think of moral, and I may mistakenly be conflating it with morality, my sense is that when you say moral character, it’s far deeper than right vs. wrong.
KI: Yes, that’s a really interesting point. I don’t mean moral in that moral sense of right and wrong. Instead, it draws on Aristotle’s ideas of virtue. When I say moral, what I really mean is how people wish to be known. It’s about the values and virtues we take pride in; those that we’re living our lives by, and that might be something like courage, honesty, integrity, kindness. Most people live their lives or attempt to live their lives in these ways.
Preferred Identities and Counterstorying
LR: Is this what the narrative clinician would refer to as a preferred identity.
KI: Yes, I think those two could probably be conflated. Someone’s moral character or preferred identity is based on how people have enacted it. It’s not just how somebody would wish to be, it’s how they have actually evidenced virtues in their lives. Part of a narrative wonderfulness inquiry is to actually bring forth how people practice those things. It’s about looking for stories which really bring to life how somebody is enacting those virtues in their lives.
LR: Some of our readers may be familiar with the notion of re-membering conversations, so I’m wondering how these may be related to wonderfulness inquiries.
KI: I think that’s a very interesting question.Whilst distinct practices, you can absolutely bring re-membering inquiries or conversations into a wonderfulness inquiry, you can also use internalized-other questioning. Quite often, clients do not bring people with them to interviews, and you need an audience to have these conversations. So, it’s helpful to interview people about what other people would admire or respect about them, or believe what is wonderful about them. You can use a re-membering conversation for that. I don’t do that exactly in a wonderfulness interview, but I am asking the young person to look back at how other people have seen her.
LR: Although our client might not bring physical people into the therapy space with them, they do bring internalized others with them. So you might inquire into who first recognized some of the client’s virtues in elementary school? Or who wouldn’t be surprised that you have accomplished what you have at work? Who would not be surprised that you’ve become the young person that you are?
KI: Absolutely! It’s a key thing to do at the beginning of the session with a child or young person or family as part of the counter storying endeavor. For instance, you could just ask somebody what their strengths or virtues are. That would become a very flat interview. You could say a bit more about it. Again, that could be quite flat, and you could end up with a thin interview, as narrative therapists call it.
You have to bring narrative counterstorying skills to it and be really persistent in the questions you ask people, because these are not things people ordinarily talk about. People’s virtues sometimes are only ever talked about at their funeral. So you have to give people lots of prompts and lots of follow-up questions; be really persistent and ask imaginative questions.
LR: I would imagine that the more a client is entrenched in what the narrative therapist calls the thin, problem saturated story, the harder you have to work to draw them into these conversations. If I was the client and you were asking me to identify the qualities of my moral character or my virtues, and I was in a particularly depressed space, I might say to you, okay, I’m just not in a place where I can even think about something positive about myself. How persistent must you be?
KI: It’s very important if you’re going to set this up for success, to give a really strong preference. I will start by ideally phoning somebody before the first conversation and asking them what they think about that; then when it comes to how; there’s a time and place for everything. I would err on the side of persistence because, as I said, people aren’t used to these inquiries and don’t know how remarkable they can be. It does take something to really get people engaged in this kind of conversation.
With the example you gave, and I’ll call you Frank, “Frank, you know, I realize that you’re feeling so depressed. I appreciate that. We’ll have plenty of time to talk about that shortly. Would it be okay for you if we just took a little bit of time for me to begin to understand what it is that you’ve brought to bear against this depression? For, however long you’ve been experiencing it, I know that you will have knowledge and practices, and you will have wisdom that we can really use together to help in the rest of this conversation and in our other conversations.”
I’m always seeking consent and judging whether or not somebody is willing and ready to engage in this different kind of conversation. I take my cues carefully.
The Legacy of Wonderfulness Inquiries
LR: What is it about Kay that has attracted you to this particular intervention?
KI: That’s a question I wasn’t expecting. There are so many ways I could answer that question, but what I would say in short, and it is part of a bigger question about what attracted me to Narrative Therapy, is that I’ve always disliked the way people are always talked about because I’ve always believed in the beauty of people. One of the things I’ve discovered since really ingraining wonderfulness inquiries into my practice is that I’m meeting people who are so much more wonderful than I was meeting before. I meet people who are so much more remarkable than I was meeting before, and that brings me great joy.
I would also say that I really value connection. There was an article that David and I wrote many years ago about bringing together strength-based practice with narrative practice and talking about how we might story peoples’ strengths. That has a bearing on this interview because David asked me similar questions, and I found myself reflecting back to my grandfather, who I never met. He was a residential Canon in the Church of England, and he set up the first youth work programs in the UK and youth camps after the Second World War. My sense of him from stories I’ve heard is what he loved was connecting people and connecting people to spirituality and to God. That’s not for me since I’m not religious, but I’d like to think that I follow in his footsteps in some sense.
LR:Well, I wish we could spend some time talking about your grandfather, but my guess is that many of the qualities that helped him to be effective in what he did are the ones that you’ve inherited.
KI: Well, thank you, I’d like to think so. I only have my mother’s memories to go on, but this actually brings us to something else that’s really important about wonderfulness inquiries. When I’ve heard really evocative stories about someone’s wonderfulness in action, I’ll ask about the legacy of those wonderfulnesses. I might ask, “has someone passed this down to you or taught you how to be brave, for example, or how to be kind, or how to keep going in the face of fear?” And then all sorts of stories emerge, and it can be very moving with the family present, because, again, these are things people have very rarely talked about, not in this way. They might have been mentioned in passing or you might have been told that your grandmother was X and did X, but not in relationship to the rest of the family or the young person. I could give you a couple of examples if you like.
LR: Absolutely!
KI: I remember many years ago—and this will appeal to American audiences—working with, a young woman and her mother. TI was conducting a wonderfulness inquiry during the first session, our first conversation, with an American family—the young woman had been born in New Zealand, was about 15, and had a commitment to social justice and social causes. I asked the mum if she had any idea where her daughter’s commitment to social justice comes from?
She started telling me about herself and her own history as she’d done lots of volunteering work and particularly around the area of domestic violence. Then I said, “who handed it down to you?” She paused and thought, because it didn’t come readily to mind and said, “of course, my father was a factory owner during the McCarthy era in the United States, and he was told in no uncertain terms that he needed to sack his workers who were presumed to be communists. He refused to do that.”
This young woman was hearing for the first time in a storied way how her commitment to social justice had been nested in her grandfather’s experiences, his whole legacy. As a young person, especially in the individualistic culture we live in, you can imagine the difference it makes to have that sense of connection and belonging to a group and to a tradition.
LR: As you talk about tapping into the legacy that contributed to this client’s sense of self, I think we can also consider how a client, maybe not a child or a teenager, can influence other people in their lives. In other words, asking an adult how they would like their children or grandchildren to experience their own qualities? It’s almost like embedding a time machine into the wonderfulness inquiry.
KI: A time machine is a beautiful way to talk about it! And that’s exactly right––a reverse legacy. You can then say to a parent, “has Alex inspired bravery in you?”
There’s also times when I’ve gotten young people to take on a problem by demonstrating their wonderfulness to their parents. For example, I asked the five-year-old, who’d been really brave at the dentist, and whose father was not feeling brave about going to the dentist, to take his father and hold his hand and give thanks.
Playing Into the Wonderfulness Inquiry
LR: How has your style of wonderfulness inquiry evolved as you’ve grown as a therapist?
KI: Oh, that is a very interesting question. I think in the beginning, I was experimenting with the basic question. “If I were to get to know X as well as you do, what would I come to appreciate and respect about them, what’s wonderful about them?” There’re so many creative ways to weave wonderfulness inquiries into narrative interviews, and it’s not like they are separated and divided into discrete little boxes. They are overlapping practices that get woven together in improvisational and imaginative ways.
I’ve become more fluid and fluent in bringing forth wonderfulness in many different ways depending on what the situation best calls for. For instance, I remember doing an internalized other interview with a woman in her early 40s who had experienced horrendous abuse––sexual abuse and neglect–– in her family. This one character, her grandmother, was a person who really saved her and saved her sense of who she was. I interviewed her as if she was her grandmother, and it was in that internalized other interview that her own abilities, her own wonderfulness, really became alive for her. From there the therapy was a downhill journey. She had her grandmother alongside her.
You need to learn specific practices like externalizing, wonderfulness inquiries, internalized other interviews, how to search for sparkling moments or unique outcomes, how to counterstory, and of course, how to formulate really good imaginative narrative questions. Those are all practices. It’s like learning a musical instrument; if you want to get to the stage where you’re an artist, you have to learn and then practice the basics and become comfortable improvising. You learn your scales, you learn your set pieces, but at some point, to really be performing it, you have to be able to integrate that in an improvisational fluid way.
For me, there’s no limit to how you could use wonderfulness inquiries, and if you think about it, it’s about believing that people are not their problems. The problem is the problem. It’s a whole way of thinking about people, of operating inside of that stance, which is quite different. It’s like a doorway into another country than traditional psychotherapy interviews. I’m not meaning at all to give traditional psychotherapy a bad name at all––it’s just that it’s a very different orientation.
I don’t have a playroom at present, but I can see so many options for kids for that––what’s important to remember is the audience. What’s important is that the child is hearing this, or young person’s hearing this from others; the importance is that it’s brought to life. I’d be doing that with parents or other people in the room co-creating that story with a sandtray or puppets. I’m very, very playful in my practice which is the key to narrative therapy with children. The foundational book in narrative therapy for working with children is called Playful Approaches to Serious Problems.
I was talking on the phone this morning with the mother and her five-year-old little boy, who I will call Eli. I met with them about six months ago, and he was dealing with enormous fear about being on his own in the house and at school, and it came upon him from seemingly nowhere. What we did was to bring a lot of playfulness into how we engaged with the problem, because the important thing to remember about wonderfulness inquiries is that they’re just the beginning. You’re bringing forth stories of someone’s wonderfulnesses so you can then engage those in standing up to the problem. Otherwise, to quote Tom Carlson, you just end up with a cute interview.
But where does it go in terms of engaging with the problem? With this little boy we came up with all sorts of imaginative ways of engaging with the problem, and one of them was that he and his father were going to make tiger masks and go out in the garden to scare the fears away because he had identified that the fears came from the garden, and he actually told me in the first interview that an alien had come down and taken one of the worries out of the tree in the garden.
I was using what he said, the environment of the garden,his bravery, and turning him into a tiger with his father as his supporter and bravery-giver as well. They would go out every night after his dad came home from work and put on the tiger masks which they made together, which was very important. They tore around the garden, screaming and grumbling and chasing away the worries. Mum told me this morning that he had found these masks in a drawer the other week, and he pulled them out and hung them on his bedroom door. This was six months later which is quite a long time in a five-year-old’s life.
LR: In the case of this brave little boy who, what were his moral qualities; his virtues that you were able to tap into?
KI: I had interviewed them extensively about his wonderfulnesses, and there were so many. When I have a child in the room, I will sit on the floor with them and I will draw pictures of what the parents are talking about to bring it to life. This child was a great listener and of course, very brave, which was the key thing. They gave me some wonderful examples, like he was very good at trying new things and had no limitations in what he was willing to give a go to. It was the bravery that I zoned in on and knowing that he would probably give this a go because he always gave things a go. Especially his love of tearing around and being outside in the garden.
LR: From what you’re saying, the more you know about a person, the more useful the wonderfulness interview becomes because it’s a reservoir of resources that you can help the client tap into to stand up against the problem.
KI: Absolutely. I take very detailed notes in my sessions, so I have that clearly written down to refer back to at any point in time. You can always dip back into the first interview for both of these if we need them.
LR: I always go back to something that David Nylund said in this regard which is something like, “who gets to decide what the evidence of effective treatment is?” In this instance with Eli, the evidence of the outcome was hanging the masks on the door of his room. I wonder if this would have been as effective had the clinician not been grounded in narrative practice.
KI: That’s a very kind and interesting question. And I say this boldly, but if the clinician is not practicing inside of a narrative stance, they’re not doing a wonderfulness interview. It’s something else, and I’m not saying that’s bad. I’m not saying it’s not helpful, it’s just not a narrative inquiry. There’s a fantastic article by Victoria Dickerson called Positioning Oneself Within an Epistemology: Refining our Thinking about Integrative Approaches. It’s an argument against eclecticism.
To be practicing on a particular side, a particular framework, you have to be sitting inside of the values, principles and philosophies of that way of practicing. That’s not saying you cannot take other practices from other modalities and kind of graft them into your practice, but if I’m a CBT therapist doing the wonderfulness inquiry, then I’m not doing Narrative Therapy. Using a wonderfulness inquiry without any anchoring in narrative therapy might yield an interesting conversation. But where would the conversation go?
A History of Standing Against Oppression
LR: Can you share the last time you used the wonderfulness inquiry with an entire family present where it was clear that the client wasn’t the only one in the family who was struggling?
KI: Yes, I could give an example, but I won’t give too much detail. It was a typical teenage problem of a young person vanishing out the bedroom window in the middle of the night and hanging out with people that the parents would rather they didn’t. And of course, when you come to wonderfulness inquiries it would be silly not to draw on the wonderfulnesses that the whole family has to bring against a problem that the whole family is concerned about or involved in.
What was really lovely about this family was when we looked at the genealogy of this young person’s wonderfulness, she was so appreciative of what her parents had contributed to her—the wonderfulness of the entire family. The family had really worked together as a team which had come from doing amateur dramatics together and playing a lot together. Her father used this wonderful term—“we’re really good at walking problems down.” So, I took that term as a headline to the counterstory that this family had what it took to walk problems down. We then talked about other problems that they had walked down. I then interviewed the children about stories from their lives, about where they had used this ability that their parents had handed down to them.
In this case, you’ve got the children really speaking to their appreciation of their parents and how they’ve taken these abilities and use them in their life. My sense was that this young person felt so privileged in the interview that I really think it enhanced what we call in New Zealand in Māori her mana, her sense of being respected by others. Then I wrote them a narrative letter following the interview, which really brought forth all of this. And then that was it. Problem over!
LR: A traditional, or modernly-trained clinician might look at the genetic precursors to a family problem, but you’re talking about the genetic predisposition to wonderfulness which is entirely different and far more hopeful.
KI: There are wonderful things, what I call counterstory threads and counterstory headlines, that you can pull out which the whole of the work can then hinge on. I remember interviewing a young woman, I think she was about 17, about anxiety, and her mother was present. We brought her grandmother in for the next session.
What emerged was that there was this history of women in the family having strong backbones. So, I interviewed them all about this history and then how they’d use their strong backbones, because it turned out that anxiety was something they all encountered and had used their backbones to stand up against. Now you’re really working with how a family history of engaging with the problem can be used to support a young person engaging with a similar problem. It never ceases to amaze me that these stories, and this history, are rarely ever known prior to these interviews. They might have had glimmers or snatches, but not in a way that is a resource like this.
LR: I can see this being so helpful in working with families whose ancestors suffered from and stood against systems of oppression.
KI: Absolutely, because as a narrative therapist, I do see problems inside of a social, political, cultural context, but not inside the individual. A problem has its beginnings, as you say, sometimes generations back, and it’s located in history. To be able to locate it there can be so liberating for people and then, as you say, engage the whole history of how a community, a family may have engaged with a problem over time.
That is particularly true for Māori families where there is such a strong connection to ancestors and the people who walk with you and ancestral warriors and people who’ve engaged with colonization and practices of colonization. People can often trace back their ancestry to a particular ancestor who perhaps was involved in signing the founding document of New Zealand, the Treaty of Waitangi.
I’m thinking again of that young woman, Fatu, who came from a very poor Māori community. Many of the young people around her were in dire straits. One of them had recently killed himself. We located the problem at one stage inside of racism. She told me the story in a subsequent session about how she went to a party, where it was mostly White kids there, and she was feeling really comfortable. She was with her friends., and then somebody said something really racist. We were able to talk about what happened at that party in terms of racism, not in terms of anxiety or how she could be more confident in situations like that. I think that meant the world for her to talk in terms of race like that, and allowed her then to engage her voice of opposition, of outrage, of agency against that problem and to talk about it because how many young people would have the confidence to talk about a problem like racism, unless a therapist brings that up and locates it there?
LR: As you’re talking, I had the image of a tree and how a wonderfulness inquiry can help a person sprout branches of hope while remaining anchored at the roots, their ancestors.
KI: That’s just lovely. And, you know, you think about the liberal, individualistic world that we live in, and this has never been more needed. Think about how young peoples’ measurement for what it is to be successful in the world mostly comes from social media. Today, it’s all about perfection and success for measuring up to these standards, which are never unique. They are packaged versions of who people are. One of the things about wonderfulness inquiries is if you really story in depth, what comes forth is a picture of that young person which is unique to them. They can aspire to be themselves or be inspired to be like their family or their ancestors, not like the influencers on social media.
Standing Up Against Suicidality
LR: Are there any clinical situations where you would NOT use a wonderfulness inquiry?
KI: In an emergency such as a young person who is actively suicidal. That’s not to say I wouldn’t do a wonderfulness inquiry, but I almost certainly wouldn’t begin there. As I said, a wonderfulness inquiry is part of a whole way of seeing the person, so I would be weaving those questions all the way through the interview to bring forth their wisdom, strengths, and abilities. Where else is it more important to do that than when somebody feels that life is not worth living? But it would be a different inquiry, and that would go into no doubt, reasons for living. So, it would simply have a very different flavor to it.
If there were other people in the room, I would be only using them in that emergency as much as possible to bring forward a young person’s resources, abilities and strength in the face of what they’ve been dealing with in life that’s led them to feel that they might wish to take their own lives.
LR: In such a situation, how would you respond to a critic who might say, “it sounds like you’re just trying to talk someone out of their symptoms—their wish to die?”
KI: Symptom isn’t a word I would use. However, it’s absolutely not about ignoring the problem. It’s how you come up on the problem through a different lens, one about what somebody has to bring to put against it. You’re just more resourced against the problem, and understand that they may have resources to use against it, and then you fiercely engage with and on behalf of the person with the problem. It’s not as direct. I’d like to think it’s a more secure, or more cleve way to go about it, and I don’t mean that in an arrogant way––maybe it’s a more nuanced way.
Paying Forward
LR: As we wind down, Kay, what advice would you give to new therapists who may not fashion themselves as creative or spontaneous, and who would see something like a wonderfulness interview or narrative practice, for that matter, as too different or too uncomfortable?
KI: Just like most things, it requires application and practice. If you want to do something in a way that is really interesting, like play an instrument or play tennis to a high standard, therapy is no different. And why should it be? I think what I’d say is there’s a distinction in therapy between a paint by numbers kind of therapy where you have a method and a craft where you’ve developed skill to a reasonably high level, and then there’s art or artistry.
When I first met David 23 years ago, I asked him what his secret was because I was just so mesmerized by his practice. He sagely said to me, and I remember his tone even now, “practice, practice, practice.”
LR: On that wonderful note, Kay, I will say thanks so much for sharing yourself with our readers.
KI: It’s been an absolute pleasure to talk with you today. I have so enjoyed your questions and the conversation. Thank you for inviting me.
References
Delano, L. (2025). Unshrunk: A story of psychiatric treatment resistance. Penguin Audio.
Epston, D. (2025 release). Notes on moral character and wonderfulness. Journal of Contemporary Narrative Therapy, October, 56-62.
Epston, D. (2025 release). Wonderfulness interviews: An origin story. Journal of Contemporary Narrative Therapy, 18-55.
Epston, D., Markham, L., & Marsten, D. (2024). Narrative therapy in wonderland: Connecting with children’s imaginative know-how. W. W. Norton & Company.
Claire was working on her licensure, and she asked that I supervise her throughout the process. I’ve been lucky to have strong clinical mentors across my career, and so it felt like an honor to be asked for help. I was surprised to receive a text message from her first thing on Monday morning, “Can we touch base soon? I think I really messed up.”
My stomach tightened. I wondered how badly things could have really gone. Claire was a new therapist, but she had strong clinical skills. I hadn’t expected the urgency of this request. Soon after, she came into my office holding back tears. “I’m too close to one of my clients,” she spoke in low volume. “I don’t know how it happened. It’s not romantic, but I’ve told him about my family and my own problems. Now when we talk… it feels like a friendship. He’s been giving me advice. I screwed up and I don’t know what to do.”
I took a breath, “You made the right choice.”
“I know,” she said. She mistook my response for sarcasm. “I don’t know how I let this happen.”
“No. That’s not what I meant. You had a choice between embarrassment or secrecy. To share this with me or keep it to yourself. It’s a hard choice, but you made the right one.”
We explored the reasons why the relationship with her client had changed and what to do next. Her willingness to feel embarrassed, and to admit her mistake, was the first step towards repair. It was the first of many such conversations I’ve had since, both with new therapists and advanced ones, too. It’s also a conversation I’ve had with myself.
Unskillful self-disclosure is common; probably more common than we think when considering how many clinicians choose the path of secrecy over embarrassment. Choosing embarrassment by admitting our mistakes means walking against the wind, and so many therapists choose to have the wind at their back.
But how does this happen? Despite our good intentions, why do we leave our therapeutic post? There are probably many reasons, but the first is that the rules of healthy relationships are broken in good therapy. These are the rules of give-and-take, or reciprocity. When reciprocity is absent in our personal relationships, we tend to conclude these relationships aren’t desirable. Whether giving without receiving, or receiving without giving, these are usually signs that something has gone terribly wrong. If someone talks about themselves but never asks a question in return, we notice it. Somewhere in the back of our mind there’s an accountant who keeps tabs. And if this accountant doesn’t count every penny, they help us determine if our relationships are in general balance.
In therapy, our job is to fire the accountant. While reciprocity is beneficial in personal relationships, in therapy it undermines our ability to maintain focus on a client’s problem. So, we learn new conversational habits. We temporarily adopt a non-reciprocal style of relating to help our clients. It’s strange to acknowledge, but dysfunctional behavior outside of therapy is useful behavior within it.
Of course, some therapeutic approaches do emphasize mutuality and appropriate therapist disclosure. But even within these frameworks, disclosure serves therapeutic goals, not the therapist’s emotional needs. This distinction matters. If good therapy requires temporarily implementing this imbalanced dynamic, it shouldn’t be surprising that we struggle to make this adjustment. We’re asked to do something that, at its core, just feels wrong. Our inner accountant balks.
A second reason unskillful self-disclosure occurs is connected to the first, and it can relate to the problem of therapist loneliness. We are not like other professionals and therapy is not like other jobs. While our individual temperaments vary, most of us become therapists because we’re drawn to people for one reason or another. This draw towards others might seem like a good fit for a career in therapy, and sometimes it is, but other times, therapy can be a lonely place. Back-to-back appointments in empty office buildings or remote work from available bedrooms can bring with it a great silence.
And this silence isn’t only environmental. In our conversations with clients, we’re required to strategically deprioritize many of our reactions. This doesn’t mean these relationships are insincere, but that large parts of ourselves don’t participate in our discussions. When personal reactions aren’t in service to a client’s goals, we do our best to restrain them. We ask them to hide.
While we all have a strong interest in human connection, we’re met with more environmental and relational silence than expected. Loneliness is what happens when longing meets absence, and in therapy, there can be a great amount of both.
Returning to Our Post: The Art of Repairing Unskillful Self Disclosure
Understanding how unskillful self-disclosure happens is only half the task. The harder part is knowing how to return to the therapeutic framework without damaging the relationship. Once we’ve come to the realization that a clinical relationship has lost its professional shape, what can be done? This problem is difficult because while solving it, we simultaneously introduce three new risks into the therapy.
The first is that many clients enjoy having insider knowledge about their therapist. They may feel this is the basis of their rapport. To have insider knowledge is to feel special, and to lose access means losing this feeling of specialness. With open doors now closed, the sound of turning locks can create feelings of rejection. Feeling pushed away can damage the therapy, even while we’re trying to repair it.
Another risk is introduced when clients are more comfortable with the reciprocal dynamic. They may prefer to share the spotlight rather than feel its bright circle pointed at them alone. Reducing self-disclosure will increase the number of empty spaces in the conversation. There will be more silence, and with more silence, more discomfort. When we start walking back to our clinical post, new intensity emerges.
The last risk is that a client might decide that they’re to blame. They might conclude there’s something uniquely wrong with them if their therapist behaves differently with them than with other clients. Sensing that they lie at the center of their therapist’s dilemma, they might experience shame. It’s a shame that tells them that somehow, they’ve hurt their helper.
Whatever steps allow us to walk back to our clinical post, it’s important to think about managing the risks of rejection, new intensity, and shame. There’s no perfect script for this conversation, each therapeutic relationship requires its own approach, but one framework I’ve found useful centers around four steps:
Step 1: “I haven’t done a great job protecting your therapy…”
Expressing this step demonstrates that our aim is to protect their therapy, and to implicate ourselves at the heart of the problem. To name that we’ve failed to guard their therapy lessens the chances the client will blame themselves.
Step 2: “and so I’m going to pull back on how much I talk about myself…”
This signals the incoming adjustment. This statement is directive in nature as we’re not asking the client for permission with this new course of action. We’re telling them it’s happening. This is the first act of stepping away from the reciprocal dynamic, and instead, returning to the clinically imbalanced one.
Step 3: “but I want to let you know how to interpret this change.”
This step is particularly important because it helps reduce, though not eliminate, the new intensity that can emerge in the therapy. The client is being prepared to understand what new interactions mean, but also what they don’t.
Step 4: “The truth is that my enjoyment of our work hasn’t decreased, but my investment needs to increase.”
This final phrase reiterates that our adjustment reflects a stronger commitment to the client, not a weakened one. We’re disengaging in the wrong areas and reengaging in the right ones. We’re subtracting non-clinical interactions to deepen the clinical purpose. By expressing that our enjoyment hasn’t lessened, we maintain the appropriate degree of specialness that exists in every meaningful relationship.
Conclusion: The Ongoing Practice of Returning
Addressing unskillful self-disclosure isn’t a single moment but an ongoing practice. After we’ve initiated the repair, it’s important to continue monitoring our own pulls toward reciprocity. The loneliness that may have contributed to the initial drift doesn’t disappear simply because we’ve named the problem.
This is where consultation, supervision, and our own personal relationships become essential. We need spaces where we can acknowledge our humanity: our loneliness, our need for connection, our own vulnerability to unskillful self-disclosure. When Claire came into my office, she made the right choice because bringing it forward made the repair possible.
I’ve learned that therapeutic work isn’t about being perfect. It’s about being honest enough to recognize when we’ve drifted and courageous enough to find our way back. Every time we effectively manage our need for reciprocity and our loneliness, we strengthen our capacity to help our clients. Even when we don’t prevent unskillful self-disclosure, if we practice repair, we remind ourselves that while we may fail at our post, we’re still worthy of returning to it.
I hope I’ve succeeded in conveying the message that psychiatric drug withdrawal is often more than pharmacology, dose reductions, and withdrawal symptoms. For many, stopping medication also represents a departure from seeing themselves as ill and lacking agency. This important process can be challenging if those around them continue to embrace the medical model and view them through the lens of illness as a “patient”.
Even if this doesn’t apply to you personally, I encourage you to keep reading. It will provide you with an understanding of the daily challenges faced by those who do.
I recall a former client, Ulrik, who arrived at my office one cold and grey Scandinavian February morning, wearing the broadest smile. He had just been to the student counselor the Friday before and was thrilled to be re-enrolled at university, having recently tapered off the antipsychotic that for so long had numbed his emotions and the cognitive abilities he needed to study. Yet it wasn’t just his return to university that was the source of his smile – it was his encounter with the student counsellor. She was the first person he’d met in years who didn’t know he had once been a psychiatric patient diagnosed with – and now fully recovered from – what psychiatry labels paranoid schizophrenia. This made all the difference in how she saw him.
Like many people with psychiatric labels, Ulrik’s diagnosis had levied such stigma upon him that his completely normal emotional fluctuations and reactions were often misinterpreted as symptoms of illness.
Those around him had grown accustomed to seeing him through the lens of illness, constantly scrutinizing and judging him, and his freedom to act naturally was heavily limited as a consequence. But for once, this way of being classified in advance as a sick person was gone. For Ulrik, it was a relief not to be defined and judged by his diagnosis. “She saw me as a regular person with aspirations, dreams, and a future full of possibilities. I haven’t felt this way in years. She had expectations of me, and that made me want to try,” Ulrik said, clearly emotional upon realizing the contrast with how many of his friends and relatives still sometimes viewed him as fundamentally sick and defective.
That Monday morning, our entire hour together centered on the profound impact of others’ perceptions and how they shape a person’s path to recovery. “I also need to be part of something where I am need-ed and people count on me, where my contributions are valued and expected. People with jobs and families can easily take that feeling for granted – but for me, it’s what I long for most,” Ulrik added thoughtfully.
Breaking free from over-identification with a diagnosis can be challenging, especially if the important people in your life continue to view you through that diagnostic lens. One common obstacle is when loved ones undergo so-called psychoeducation, where they are “educated about the illness” and where a person’s supposed “lack of insight” is interpreted as part of the illness itself.
The question of disease identity – becoming so intertwined with a diagnostic label that it becomes an identity – is too big to fully cover here, and frankly, I believe it’s not appropriate for professionals to intrude into such deeply personal territory. Instead, we should leave the subject to those who have lived through it firsthand. Fortunately, one such book has just been written by American author and director of the Inner Compass Initiative, Laura Delano, titled Unshrunk.
Research also indicates that family dynamics can significantly impact the recovery process. A meta-analysis dating back to 1998 showed that a family’s degree of what’s known as “expressed emotion” could predict the likelihood of relapse of psychosis, depression, and eating disorders. Expressed emotion is defined as “emotional over-involvement and critical communication from family members and closeones.” In such cases, addressing the issue with individual psycho- therapy can inadvertently problematize the individual who may merely be the bearer of symptoms within a broader family dynamic. Family therapy and Open Dialogue may be necessary.
A Strategic Choice
Many people have to be strategic about who they involve in their efforts to taper off psychiatric drugs, knowing that the decision may not be well received or supported by everyone around them. It’s understandable yet unfortunate that this is sometimes the case, as support from loved ones is crucial to both coming and staying off psychiatric drugs.
From loved ones, I often hear that the powerlessness and fear of revisiting past struggles from before the medication can be a difficult combination. For both parties, I hope this chapter has eased the feeling of powerlessness and that together you can see concrete, practical steps to take if withdrawal and emotional re-emergence becomes challenging. The situation is likely new and unfamiliar to both of you, and there is often an element of having to chart a path through it together.
And to loved ones: Remember that simply being present as a human companion offers a powerful antidote to low mood, racing thoughts, and anxiety. In the end, the same principle applies to any form of sup- port during difficult times: The more atypical and to you incomprehensible your loved one’s reactions and behaviors, the more crucial it becomes to remain open and curious about what they are experiencing. Strive to look beyond the surface – to the emotions, experiences, and unmet needs they are grappling with.
This excerpt is published with permission from the author, Anders Sørensen.
Ever wonder if therapy is really helping? I’ve sat on both sides of the couch—first as a client, now as a clinician—and I’ve often heard the line, “Therapy isn’t working for you.” Usually, that says more about the person saying it than about the reality of what’s happening on the couch.
Izzy’s Story: Healing on Your Own Timeline
This question came into sharp focus after a session with a 36-year-old client I’ll call Izzy. Not long ago, he shared that his mother had remarked, “You’ve been in therapy for two years and it’s not working.” Her words landed heavily. Izzy had come to me less than 24 hours after an unthinkable loss—his girlfriend had been killed in the middle of the night under tragic and complicated circumstances. The fact that he had the courage to seek help so quickly was impressive.
Over the past two years, Izzy has navigated the raw terrain of grief. We’ve been bearing the unbearable together; slowly piecing together a life that no longer looks like the one he imagined while learning to grow around grief. His mother’s remark felt dismissive and were deeply wounding, as though the depth of his love and sorrow could be timed. Instead of compassion, she offered judgment, measuring his healing against her own expectations.
I’ve discovered that what often looks like judgment is really a projection of someone else’s discomfort. Izzy’s story reminds me that progress isn’t always visible to others—and that’s okay. Healing doesn’t follow a stopwatch.
Shayna’s Story: When Progress Can Be Quantified
Some gains in therapy are concrete and measurable. Shayna came to therapy with severe anxiety and somatic symptoms, many mornings she got physically ill from the stress. Driving felt impossible without taking alternate routes to avoid feeling unsafe on the highway, and seeing a doctor was terrifying. She was afraid that they would find something seriously wrong.
As we unpacked her fears, validated and normalized her emotions, things began to shift. Shayna gradually stopped getting sick in the mornings. With courage, she went to her mammogram and colonoscopy. She even found a doctor she could trust despite feeling shaky and afraid. The hardest hurdle, driving, is still a work in progress, but she continues to show up and face the challenge.
In Shayna’s case, progress is not abstract. She stopped getting sick. She faced the screening tests and doctors she once avoided. These steps were visible proof that healing can sometimes be measured in clear, undeniable ways.
Concrete Wins You Can See
Other clients show measurable progress in different ways. One client, terrified of flying, eventually took a cross-country flight without panic. Another, who hadn’t cried after losing a loved one, began to access and release his grief. A 25-year-old moved out of his home after planning and executing steps used in therapy.
These milestones are tangible, and important. They show that therapy can create results we can point to, celebrate, and even track.
Subtle Shifts That Make a Difference
So much of therapeutic growth is quieter and harder to tally. Change happens beneath the surface—in noticing patterns, sitting with discomfort, and making different choices. Clients start recognizing which relationships drain them and which restore them, and which old beliefs no longer serve them. Many learn to nurture themselves with curiosity and compassion rather than judgment. Some become choosier about what they allow in their lives.
These subtle shifts often manifest in daily life: responding more calmly in conflict, steadier self-talk, asking for help when needed, and seeing people—including oneself—with nuance. I see transformation in clients: behaviors that once triggered intense stress now pass with more ease, and moments of self-compassion come more naturally.
For clients recovering from trauma, progress involves layers of insight, emotional processing, and coping skills. Progress may not appear on a chart, but it shows up in life: a disagreement that doesn’t escalate, a decision made from clarity rather than panic, a boundary held firmly, a quiet sense of relief in being kinder to yourself.
What Progress Really Looks Like
So how do you know therapy is working? It isn’t about speed, neatness, or whether others notice. It’s about internal shifts that allow you to live more peacefully, confidently, and authentically. Some gains are visible: overcoming a fear, reducing symptoms, or achieving a milestone.
Others are felt in small but profound ways: calmer reactions, steadier self-talk, greater ease asking for help, and the ability to hold complexity—recognizing that a parent could have loved you in one way and harmed you in another, less black-and-white thinking, and understanding that many things can be true at the same time. Every type of progress matters.
If you’re wondering whether therapy is working for you or for someone you love, look for the small changes that ripple into everyday life: the subtle ease in reactions, moments of kindness toward ones self, or the ability to stay present with someone difficult. Even something as simple as using the word ‘no’ as a full sentence can be a quiet victory—one that often becomes the foundation for lasting change.
