Do we help our patients change their narrative or detach from their narrative?

We all have seen folks who have an unhelpful narrative in their mind, and have “bought into”, “hooked into”, or fused with that story like being fully immersed into a drama show or book. 

This is normal of course, but if the narrative is bad and the fusion is intense and prolonged, then we will have a mood problem. 

When counseling, I am always curious to understand the narrative, where it came from, and the intensity of the fusion with that story. 

If it’s more of a story problem, and not so much about fusion, then try to reframe, challenge, and change the story. This is more CBTish (Cognitive Behavioural Therapy).

If it’s more of a fusion problem, then work on defusion, unhooking, or detachment of that story.  This is more ACTish (Acceptance Commitment Therapy).

Often it’s both, so we need to work on both but probably defusion first perhaps before the story can be effectively changed or reframed.