A multi-dimensional model

Lilja et al. (1996: 29—37) and von Braun (in press) propose a multidimensional reasoning based on narrative analysis for the understanding of alcohol and drug use. The model focuses on personal and social dimensions of an individual and can be viewed as closely related to a critical social work perspective in understanding human behavior (see Figure 20.1).

Figure 20.1 The multidimensional interaction model for the narrative analysis of health issues such as alcohol and drug use/misuse - inspired by Magnusson and Allen (1983)

Figure 20.1 describes how narratives can refer to both intrapersonal and interpersonal dimensions. Narrative methods can bring authenticity to accounts of people’s lives and circumstances that are difficult to reach by other approaches. Narrative accounts are a rich source of evidence that can provide detailed descriptions or detailed validity of personal and social life-worlds and the use of alcohol and drugs.

The personal side of the interaction - the intrapersonal: The mediating system in the figure describes the person’s cognitive and emotional systems. These are important for the understanding of a person’s awareness, perceptions, emotions, and memory structures that are involved in the decision-making processes. The cognitive-emotional systems are constructed by dynamic multidimensional learning through assimilation and accommodation (see Brandell, 2011). The mediating system involves systems for motivation, goal-setting and coping strategies as well as the personality, the self- or identity structure (Larsson et al., 2001a, 2001b). The mediating mind-system can operate consciously or unconsciously. The biological system includes genetic and biological structures and processes and is an important individual factor. The observable behavior consists of the behavioral repertoires of an individual when performing certain actions (Lilja et al., 1996).

The social side of the interaction - the interpersonal: The actual situation refers to the part of the environment that is accessible to sensory perception on certain occasions while the perceived situation is the person’s interpretation of the actual situation, and it includes the meaning given to the situation by the individual (see Lilja et al., 1996). The perceived situation is important, which is demonstrated in the actor—spectator paradox where actors and observers often perceive a situation differently (von Braun et al., 2013a, 2013b). The micro-level of the environment includes the part of the environment that the individual is in contact with and interacts with in everyday life. The macro-level of the environment includes the general environmental factors determining the individual’s microenvironment such as social rules and the cultural beliefs, political, religious-spiritual and economic structures in society (Lilja et al., 1996: 30—32). The metacognitive structures refer to a person’s ability to think about the thought processes occurring in his/her mind (intrapersonal metacognition) as well as the ability to think about other actors’ cognitive processes in a specific social situation (social metacognition — see Antaki and Lewis, 1986). The spiritual and existential dimensions refer to “the person’s search for a sense of meaning and morally fulfilling relationships” (Hutchison, 2008: 189).

The multi-dimensional model applied to addiction

The multidimensional model considering the person by situation interaction is in line with the multidimensional reasoning that has been proposed by other researchers in the field of social work (see Hennessey, 2011; Hutchison, 2008; Parrish, 2010) and interactional psychologists. A multidimensional narrative analysis of alcohol and drug misuse needs to incorporate psychological and social theories in order to reach a holistic understanding. On the personal side, the narrative analysis of the mediating system can use cognitive perspectives to analyze the alcohol and drug user’s cognitive mind processes and self-schema with and without the use of the drug (see Parrish, 2010: 5; Jung, 2010). A psychodynamic perspective can be relevant for analyzing narratives on traumatic experiences in childhood that may affect drug use (see Etherington, 2010). Humanist and existentialist perspectives can be relevant for analyzing the drug users’ motivation processes for stopping use of drugs (see Heyman, 2009; West and Brown, 2013). On the situational side, social constructivism can highlight how social processes continually shape and reshape the self by interactions with other people and by involvement in socio-cultural events including the use/misuse of alcohol and drugs (Hutchison, 2008). System perspectives are relevant for the analysis of individuals’ social context and the sub-systems they experience, such as life in the family, at work and among. Metacognition can enhance self-awareness and help the individual to cope with addiction (Jung, 2010: 48). Gains in spirituality can be related to an absence of heavy drinking (Jung, 2010: 368).

Methodological challenges

All people are storytellers, and at the same time we are the stories we tell. We all struggle with questions about who we are and how we fit into the social world. Narrative identity refers to the stories people tell about themselves in order to define who they are both intra-personally to themselves and inter-personally in relation to others in the social world (McAdams et al., 2007). When listening to stories it is important to notice that each person deals with the world including other people by using her own interpretative framework. Individuals are capable of describing their own realities and therefore we should ask them to do so. When studying people who interpret reality in their own terms then their qualitative narrative accounts are the main source of data because the individual acts on each situation as she sees it (Wilkinson, 1981: 216).

The use of narrative accounts also needs to be critically discussed and problematized. Cognitive science has emphasized that the use of introspective reports can be problematic since people do not always have the ability of true introspection. Instead peoples’ reports are often based on implicit causal theories. On the other hand it should be noticed that what Nisbett and Wilson (1977) are referring to in principle are people’s reports about why they acted in a specific way. However, introspective reports are often reports about what a person thinks and feels (Lundh, 1983: 167). What they are are focusing on are people’s reactions to why-questions. To ask why-questions is therefore not actually to ask for introspective reports but instead to ask for theoretical self-knowledge. If one applies this way of reasoning to the analysis of the use of narrative strategies it can be important to focus mainly on what- or how-questions rather than on why-questions, since the individual may not be aware of why they experienced certain thoughts, emotions, or behavior during different social situations. However, as narrative interviewers, we can try to discover hidden or submerged stories, which includes listening for gaps, contradictions and silences in order to encourage a fuller narration (Chase, 1995). Narrative research has tried to deal with hidden or implicit stories. Hollway (2007) describes The Free Association Narrative Interview (FANI) that considers conscious and more or less unconscious stories, realizing that people are not fully aware of everything that makes up their identities, cognitions, emotions, or what motivates their actions (Hollway, 2007: 136—139). But looking for deeper meanings hidden from the actor has in its turn been problematized (Harre, 1980: 44—45).

A critical reflexive methodology

Narrative analysis needs to consider first order and second order narratives. The first order narratives refer to what people say about themselves and their own subjective experiences. Second order narratives are the accounts that researchers develop in order to make sense of other individuals’ experiences and their narratives of the social world, for example, based on theoretical analysis. The second order narrative is not focused on a single individual but mainly on patterns relating to many individuals or “the collective story” (see Elliott, 2005: 12—13). The first and second order narratives relate to the actor—spectator paradox and the necessity to capture both actors’ and spectators’ narrative accounts. There is a need for critical reflection in social work research. According to Smith (2009), when doing social work research it is important to open up a dialog between different methodological conventions and try to combine a critical perspective or “the view from the outside” with a strategy of trying to “learn from the inside.” The importance of narrative methods lies in their ability to highlight “the inside view” or the accounts of people’s lives. Narrative methods can offer detailed descriptions of subjective life experiences and can give voice to marginalized groups that often may be overlooked or dismissed. But at the same time there is a need to develop a critical social work perspective that problematizes and offers alternative interpretations on the social reality (see Smith, 2009: 55—90, 135—143).

One needs to take a further step in developing a critical narrative social work methodology'. Alvesson and Skoldberg’s (2010) “reflexive methodology” can inspire critical social work research. They highlight four dimensions characterizing a reflexive research strategy: (1) interaction with the empirical data focusing on narrative accounts in interviews, (2) researchers’ interpretations of meanings (“double hermeneutics”), (3) critical interpretation (“triple hermeneutics”) of power, or ideology positions, and (4) a critical interpretation of text production and language used by the researcher which represents a kind of meta-reflection on the research process as a whole, including its theoretical paradigm (“quadruple hermeneutics”).

Alvesson and Skoldberg’s (2010) multidimensional reflexivity is in line with leading social work researchers who propose a critical research methodology' for social work (see Grinnell and Unrau, 2011; Smith, 2009). Raines (2011) emphasizes similar critical arguments or highlighting “credibility checkpoints” in the social work research process, relevant for the narrative study of lives. He proposes: (1) triangulation of data sources or asking people with different rolepositions to give their narratives on the same situation, (2) performing a negative narrative case analysis or including contradictory data, (3) testing for rival hypotheses, (4) member checks, asking the participants to give narrative feedback on the accuracy of the conclusions drawn by the researcher, (5) using thick descriptions of narratives or verbatim statements, and (6) triangulation of theories (see Raines, 2011: 497). Narrative research often adopts an intensive design and undertakes an in-depth study of relatively few cases. This can lead to a detailed validity of the analysis of the cases but we can only hypothesize about the typicality of the case analysis (Marsh et al., 1978: 20).