The actor–spectator paradox and narrative analysis
The narrative analysis typically takes on the perspective of the teller or the actor in a specific social situation. Applied in research about substance use-related dependency, narrative methods can offer an in-depth description of the drug users’ experiences, cognitions, and emotions, which can be important when trying to understand long-term use of alcohol and drugs (see Diamond, 2002; Heyman, 2009). The actor—spectator paradox is a methodological challenge in narrative research since it describes a tendency of actors to attribute causality for their actions to situational factors, whereas observers are inclined to attribute causality of these same actions to personality characteristics possessed by the actor.
The tendency of actors and observers to have diverging perspectives may, however, be a result of using different background data to evaluate the meaning of the action. A critical comment may be that the actor—spectator paradox and the considering of divergent perspectives are related to power or power inequality between, for example, a social worker and a client. It has been pointed out that it is important to consider different aspects of power in analyzing relationships (Dreyfus and Rabinow, 1983; Foucault, 1983). But, it can be important to adopt an observer perspective in order to capture different narrative dimensions of which the teller, or the actor, may be more or less unaware. The actor—spectator paradox points to the importance of paying attention to both teller (actor) and spectator narratives since both parties can be unaware of certain aspects due to their different role-positions (von Braun, 2013; von Braun et al., 2013a, 2013b; von Braun, in press). From a critical social work perspective it can be a fruitful narrative research strategy to construct research teams consisting of clients, social workers, and researchers in order to reach narrative descriptions based on different role-positions and experiences of psychosocial problems, moving towards more user-influenced or user-empowered research.
Narrative case analysis
The narrative case below illustrates the need to analyze personal and social aspects of a life narrative in order to understand the multidimensional complexity of the case. One client who participated in a narrative research interview described his substance use-related dependency in the following way:
Client case 1 - Social trauma and multiple identities: 1 (the client) have been taking benzodiazepines since 1 was five years old when a 17-year old boy tried to sexually assault me. I got tranquillizers then from the general practitioner. I remember being there with my mother. Nobody in my family talked about the assault afterwards. I remember we went out to (visit) some friends just as if nothing had happened.
When I’m on pills I have another identity compared to the one I have when 1 am not on pills. When I am on pills I am more independent. 1 have more self-esteem and can do things I didn’t dare before, e.g., tell my boss that 1 don’t agree with his pedagogical views. 1 feel I am capable of doing things and I feel less anxious and less uneasy. And then 1 can talk to other people and I am more open. When I am without the pills 1 am much more dependent. 1 feel helpless, powerless, and unable to influence the outcome of events in a positive way. I feel insecure and have low self-esteem. I think I am not worth much and I feel I am good for nothing. 1 feel uneasy, anxious, and depressed. 1 don’t dare get in touch with other people and feel inhibited ... 1 am thinking of the tranquillizers as sort of my chemical identity.
(Skinhoj et al., 2001: 1174-1175)
Comment on the case: An interpretation of the narrative account described above is that the psychoactive drug seems to transform the individual’s self-consciousness and identity state, i.e., the drug creates one sense of self or sub-identity with the drug in relation to “the sober self-sub-identity” when not using the psychoactive drug. Similar descriptions have been presented in the research literature (Etherington, 2010; Hamlin, 1993; Larsson et al., 2001a, 2001b). One needs to contextualize these kinds of identity states with and without the drug. The person in Case 1 had experienced a traumatic sexual assault when he was a child. The family system could not deal with the social situation by talking about the event, but instead tried to solve the psychosocial problem on a medical level. This way of “solving the problem” later on became a new psychosocial problem, i.e., dependency on psychoactive drugs. A critical social work perspective on these kinds of client narratives requires a psychological and a social or systemic analysis of the person’s social network and what has happened there, including how it affects the subjective world of experience. Otherwise there is a risk of psychologizing social problems. Other social work researchers have highlighted the importance of social dimensions in order to understand mental distress (Tew, 2005; Tew et al., 2012).
A compelling case can be made for a narrative analysis in critical social work. Telling a story is a means of telling someone else about identity constructions and the self (Lieblich et al., 1998). Telling a story to someone else also means telling that storyline to oneself and, thereby, the teller can gain some metacognitive insights into the internal narrative dialog of different sub-identities or voices within the mind (Ornstein, 1986; Rowan and Cooper, 1999). Stories convey meanings about the teller’s identity as well as about the social context of which the teller is a part (Crossley, 2000; Wetherell and Maybin, 1996). Narrative methods and listening to stories from addicted people can contribute to the understanding of the subjective mind processes, including the alternate state of consciousness experienced when using alcohol and drugs and the relationships between different sub-identities within the mind of the drug user, with and without the drugs (Etherington, 2010; Larsson, 1992; Larsson et al., 2001a, 2001b). Narrative methods are of importance when studying identities, life stories and stories told by minority and excluded groups in society (Halberstam, 2005; Riessman, 2002). Narrative accounts can provide us with access to identity constructions of minority and/or discriminated groups whose narratives can express their, often unheard, voices (Elliott, 2005; Halberstam, 2005). Narrative methods can be relevant to acquiring more knowledge about how the individual’s subjective experience and their self-structure is affected by different circumstances in society such as poverty, discrimination, and stigma including health problems related to misuse of alcohol and drugs (Amodeo and Lopez, 2011; Barber, 1995; Hennessey, 2011; Miller 2006; Parrish, 2010).
One limitation of using narrative strategies is that it is time-consuming and requires relational skills from the researcher, such as empathy and skills in eliciting stories in interviews. There are ethical implications in using narrative in research that need to be considered (Elliott, 2005;
Larsson and Sjoblom, 2010; Larsson et al., 2008). The validity of narrative research is established by considering factors such as the quality of the interview, rich in-depth descriptions of the tellers’ accounts, and the accuracy of the interpretations, including how narrative data correspond to theories and previous research.
Alvesson, M. & Skoldberg, K. (2010). Reflexive methodology. London: Sage.
Amodeo, M. & Lopez, L. M. (2011). Social work interventions with alcohol and other drug problems. In J. Brandell (ed.), Theory and practice in clinical social work (pp. 525—560), (2nd edn). London: Sage.
Antaki, C. & Lewis, A. (eds). (1986). Mental mirrors. London: Sage.
Atkinson, P. & Delamont, S. (eds). (2006). Narrative methods (Vol. 1—4). London: Sage.
Barber, J. G. (1995). Social work with addictions. London: Macmillan.
Berzonsky, M. D. (1988). Self-theorists, identity status, and social cognition. In D. K. Lapsley & F. Clark Power (eds), Self, ego and identity, (pp. 243—262). New York: Springer.
Brandell, J. (ed.). (2011). Theory and practice in clinical social work. London: Sage.
von Braun, T. (2013). Therapists’ narratives of therapeutic relationships in the treatment of drug dependent patients. In S. Larsson, J. Lilja and Y. Sjoblom (eds), Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 1416—1433.
von Braun, T., Larsson, S. & Sjoblom, Y. (2013a). Perspectives on treatment, alliance and narratives concerning substance use-related dependency. In S. Larsson, J. Lilja and Y. Sjoblom (eds), Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 1386-1403.
von Braun, T., Larsson, S. & Sjoblom, Y. (2013b). Narratives of clients’ experiences of drug use and treatment of substance use-related dependency. In S. Larsson, J. Lilja and Y. Sjoblom (eds). Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 1404-1415.
von Braun, T. (in press). Theorizing the therapeutic process in substance use-related dependency treatment. Doctoral thesis, Stockholm: Stockholm University.
Chase, S. (1995). Taking narrative seriously: Consequences for method and theory in interview studies. In R. Josselson and A. Lieblich (eds), Interpreting experience — The narrative study of lives (pp. 1—26), Vol. 3. London: Sage.
Coppock, V. & Dunn, B. (2010). Understanding social work practice in mental health. London: Sage.
Crossley, M. (2000). Introducing narrative psychology. Buckingham: Open University Press.
Denzin, N. (1987). The alcoholic self. London: Sage.
Diamond, J. (2002). Narrative means to sober ends. New York: Guilford.
Dreyfus, H. L. & Rabinow, P. (1983). Michael Foucault: Beyond structuralism and hermeneutics (2nd ed.). Chicago, IL: The University of Chicago Press.
Elliott, J. (2005). Using narrative in social research. London: Sage.
Ethenngton, K. (2010). Trauma, drug misuse and transforming identities. London: Jessica Kingsley.
Evans, C. & Fisher, M. (1999). Collaborative evaluation with service users. In I. Shaw and J. Lishman (eds). Evaluation and social work practice (pp. 101—117). London: Sage.
Foucault, M. (1983). Afterword: The subject of power. In H. L. Dreyfus and P. Rabinow (eds), Michael Foucault: Beyond structuralism and hermeneutics (2nd ed.) pp. 208—228). Chicago, IL: The University of Chicago Press.
Goldstein, E. G. (2001). Object relations theory and self-psychology in social work practice. New York: The Free Press.
Grinnell, R. M. & Unrau, Y. A. (eds). (2011). Social work research and evaluation. Foundations of evidence-based practice (9th ed.). Oxford: Oxford University Press.
Halberstam, J. (2005). In a queer time and space. New York: New York University Press.
Hamlin, M. (1993). Why people take benzodiazepines. In C. Hallstrom (ed.), Benzodiazepine dependence (pp. 1—12). Oxford: Oxford University Press.
Harre, R. (1980). Making social psychology scientific. In R. Gilmour & S. Duck (eds), The development of social psychology (pp. 27—52). London: Academic Press.
Hennessey, R. (2011). Relationship skills in social work. London: Sage.
Heyman, G. M. (2009). Addiction — A disorder of choice. Cambridge, MA: Harvard University Press.
Hollway, W. (2007). Self. In W. Hollway et al., (eds), Social psychology matters (pp. 119—144). Maidenhead: Open University Press.
Hutchison, E. (2008). Dimensions of human behaviour. Person and environment. London: Sage.
Jung, J. (2010). Alcohol, other drugs and behavior. London: Sage.
Larsson, S. (1992). Identitet och beroende. (“Identity and Addiction”). Stockholm: Sober.
Larsson, S., Lilja, J. & Hamilton, D. (2001a). Identity, cognitive structure and long-term tranquilliser use: A multi-dimensional approach. Substance Use and Misuse, 36(9—10): 1139—1164.
Larsson, S., Lilja, J., Borg, S, Buscema, M. & Hamilton, D. (2001b). Toward an integrative approach in the analysis of dependency problems. Substance Use and Misuse, 36(9—10): 1323—1356.
Larsson, S., Lilja, J. and Sjoblom, Y. (eds). (2013a). Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 5—16, doi: 10.3109/10826084.2013.815025.
Larsson, S., von Braun, T. & Lilja, J. (2013b). A multidimensional model for narrative analysis of substance use-related dependency. In S. Larsson, J. Lilja and Y. Sjoblom (eds), Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 1306—1316.
Larsson, S., von Braun, T., Lilja, J., Sjoblom, Y. & Hamilton, D. (2013c). A self-theoretical perspective on the use-misuse of alcohol and drugs based on qualitative and narrative data. In S. Larsson, J. Lilja and Y. Sjoblom (eds), Narrative methods in understanding the use and misuse of alcohol and drugs. Substance Use & Misuse, 48(13): 1317-1335.
Larsson, S. & Sjoblom, Y. (2010). Perspectives on narrative methods in social work research. International Journal o f Social Welfare, 19: 272-280.
Larsson, S., Sjoblom, Y. & Lilja, J. (eds). (2008). Narrativa metoder i socialt arbete. (“Narrative methods in social work”). Lund: Studentlitteratur.
Lieblich, A., Tuval-Mashiach, R. & Zilber, T. (1998). Narrative research. London: Sage.
Liese, B. S. & Franz, IL. A. (1996). Treating substance use disorders with cognitive therapy. In P. M. Salkovskis (ed.) Frontiers of cognitive therapy (pp. 470—508). New York: Guilford.
Lilja, J. & Larsson, S. (2003). Ungdomsliv, identitet, alcohol och droger (“Life of adolescents, identity, alcohol and drugs”). Stockholm: Statens Folkhalsoinstitut.
Lilja, J., Larsson, S. & Hamilton, D. (1996). Drug communication. Kuopio: Kuopio University Press.
Lilja, J., Larsson, S. & Hamilton, D. (1997). Toward a theory of social pharmacology: The actor-spectator paradox applied to the psychotropic prescribing process. Substance Use and Misuse, 32(9): 1175—1215.
Lundh, L-G. (1983). Mind and meaning. Uppsala: Acta Umversitatis Upsahensis, Studia Psychologica Upsahensia 10. Doctoral dissertation, Uppsala: Uppsala University.
Magnusson, D. & Allen, V. L. (1983). An interactional perspective for human development. In D. Magnusson & V. L. Allen (eds). Human development: An interactional perspective (pp. 3—31). New York: Academic Press.
Marsh. P., Rosser, E. & Harre, R. (1978). The rules of disorder. London: Routledge and Kegan Paul.
Martin, R. (1999). Histories in social work. In I. Shaw and J. Lishman (eds), Evaluation and social work practice (pp. 133—147). London: Sage.
McAdams, D. P., Josselson, R. & Lieblich, A. (eds). (2007). Identity and Story. Creating Self in Narrative. Washington, DC: American Psychological Association.
Miller, L. (2006). Counselling skills for social work. London: Sage.
Nisbett, R. E. & Wilson, T. D. (1977). Telling more than we can know: Verbal reports on mental processes. Psychological Review, 84: 231—259.
Ornstein, R. (1986). Multimind. London: Macmillan.
Parnsh, M. (2010). Social work perspectives on human behaviour. London: Open University Press.
Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.), London: Sage.
Payne, M. (2006). Narrative therapy. London: Sage.
Perlman, F. T. & Brandell, J. R. (2011). Psychoanalytic theory’. In J. Brandell (ed.), Theory & practice in clinical social work (pp. 41—80) (2nd ed.), London: Sage.
Rames, J. C. (2011). Evaluating qualitative research studies. In R. M. Grinnell & Y. A. Unrau (eds), Social work research and evaluation (pp. 488—503). (9th ed.). Oxford: Oxford University Press.
Riessman, С. K. (2002). Analysis of personal narratives. In J. F. Gubnum & J. Holstein (eds), Handbook of interview research (pp. 695—710). London: Sage.
Riessman, С. K. (2003). Performing identities in illness narrative: Masculinity and multiple sclerosis. Qualitative Research, 3(1): 5—33.
Riessman, С. K. (2008). Introduction. In S. Larsson, Y. Sjoblom & J. Lilja (eds), Narrative methods in social work. Lund: Studentlitteratur.
Riess man, C. K. & Quinney, L. (2005). Narrative in social work: A cntical review. Qualitative Social Work, 4(4): 383-404.
Rowan, J. (1991). Subpersonalities: The people inside us. London: Routledge.
Rowan, J. (1993). The transpersonal: Psychotherapy and counselling. London: Routledge.
Rowan, J. & Cooper, M. (1999). The plural self. London: Sage.
Safran, J. D. & Greenberg, L. S. (1987). Affect and the unconscious: A cognitive perspective. In R. Stern (ed.), Theories of the unconscious and theories of the self (pp. 191—212). Hillsdale, NJ: The Analytic Press/ Erlbaum.
Shaw, I. & Lishman,J. (eds). (1999). Evaluation and social work practice. London: Sage.
Singer, J. A. (1997). Message in a bottle: Stories of men and addiction. New York: Free Press.
Singer, J. L. (1993). Experimental studies of ongoing conscious experience. In G. R. Bock & J. Marsh (eds), Experimental and theoretical studies of consciousness — Ciba Foundation Symposium 174. Chichester: John Wiley.
Skinhoj, K., Larsson, S., Helweg-Jorgensen, S. & Holme-Hansen, E. (2001). Experiences of long-term tranquilliser use: A psychodynamic perspective. Substance Use & Misuse, 36(9—10): 1165—1187.
Smith, R. (2009). Doing social work research. Maidenhead: Open University’ Press.
Sussman, S. & Ames, S. L. (2001). The social psychology of drug abuse. Buckingham: Open University Press.
Tart, C. (1986). Waking up — Overcoming the obstacles to human potential. Boston, MA: Shambhala.
Tew, J. (2005). Social perspectives in mental health. Developing social models to understand and work with mental distress. London: Jessica Kingsley Publishers.
Tew, J., Ramon, S., Slade, M., Bird, V., Melton, J. & Le Boutillier, C. (2012). Social factors and recovery from mental health difficulties: A review of the evidence. British Journal of Social IToR, 42: 443—460.
Thomas, K. (1996). The defensive self: A psychodynamic perspective. In R. Stevens (ed.), Understanding the self (pp. 281—339). London: Sage.
West, R. & Brown, J. (2013). Theory of addiction. (2nd ed.), Oxford: Addiction Press, Wiley, Blackwell.
Wetherell, M. & Maybin, J. (1996). The distributed self: A social constructionist perspective. In R. Stevens (ed.), Understanding the self (pp. 219—279). London: Sage.
Wilkinson, S. (1981). Personal constructs and private explanations. In C. Antaki (ed.). The psychology of ordinary explanations of social behavior (pp. 205—220). London: Academic Press.