The inter-subjective and dialogical nature of narrative therapy, as commonly practiced, remains unarticulated. Further, there currently exists no rigorous empirical research investigating the process or outcome of narrative therapy. The research aim, to investigate the process and outcome of narrative therapy, comprised theoretical and empirical objectives. The first objective was to articulate a theoretical synthesis of narrative theory, research and practice. The process of narrative reflexivity was identified as a theoretical construct linking narrative theory with narrative research and practice. The second objective was to substantiate this synthesis empirically by examining narrative therapy processes, specifically narrative reflexivity and the therapeutic alliance, and their relation to therapy outcomes. The third objective was to support the proposed synthesis of theory, research and practice and provide quantitative evidence for the utility of narrative therapy, by evaluating depressive symptom and inter-personal relatedness outcomes through analyses of statistical significance, clinical significance and benchmarking. Founded in theories of self, language and narrative (James, 1890; Bruner, 1986; Gergen, 1991; Hollway, 2006; Vygotsky, 1934/ 1987), narrative therapy was conceptualized as involving dialogical and intra-personal processes. Narrative therapists generally apply a story metaphor and commonly focus on the inter-personal field (White, 2007). This thesis recognised the storied and inter-personal nature of narrative therapy, but proposed this does not represent narrative therapy in its entirety. The notion of story connotes monological processes, inconsistent with the conversations of narrative practice, and neglect of intra-personal dimensions is inconsistent with narrative notions of inter-subjectivity. This thesis proposed an integration of dialogical narrative theory (Cooper, 2003; Hermans & Kempen, 1993; Lysaker & Lysaker, 2006) and narrative research (Angus, Levitt, & Hardtke, 1999) provides a model for understanding narrative therapy (White, 2007) as involving the inter-subjective and dialogical process of narrative reflexivity. During the process of narrative reflexivity, a person engages in dialogue with his or her own self and others as extensions of self, interpreting experience from diverse perspectives in the context of personal aspects, such as beliefs, values and intentions that give meaning to experience, to achieve a rich narrative and a sense of well-being. To support this theoretical synthesis, a process-outcome trial evaluated eight-sessions of narrative therapy for 47 adults with major depressive disorder. Dependent process variables were narrative reflexivity (assessed at Sessions 1 and 8) and therapeutic alliance (assessed at Sessions 1, 3 and 8). Primary dependent outcome variables were depressive symptoms and inter-personal relatedness. Primary analyses assessed therapy outcome at pre-therapy, post-therapy and three-month follow-up and utilized a benchmarking strategy to the evaluate pre-therapy to post-therapy and post-therapy to follow-up gains, effect size and pre-therapy to post-therapy clinical significance. Results indicated that when a sub-sample of clients were categorised into five least-improved and five most-improved groups (according to depressive symptom change), there was a differential change in the percentage of reflexive sequences in the discourse of clients at the end of therapy depending on outcome. Improvement in the quality of the working alliance was associated with improvements in depressive symptoms and inter-personal relatedness, with working alliance improvement from Session 1 to 8 sharing 19% of the variance in depressive symptom improvement and 17% of the variance in inter-personal relatedness improvement from pre-therapy to post-therapy. The clinical trial provided empirical support for the utility of narrative therapy in improving depressive symptoms and inter-personal relatedness from pre-therapy to post-therapy: the magnitude of change indicating large effect sizes (d = 1.10 to 1.36) for depressive symptoms and medium effect sizes (d = .52 to .62) for inter-personal relatedness. Therapy was effective in reducing depressive symptoms in clients with moderate and severe pre-therapy depressive symptom severity. Improvements in depressive symptoms, but not inter-personal relatedness, were maintained three-months following therapy. The reduction in depressive symptoms and the proportion of clients who achieved clinically significant improvement (53%) in depressive symptoms at post-therapy were comparable to improvements from standard psychotherapies, reported in benchmark research. This research has implications for assisting our understanding of narrative approaches, refining strategies that will facilitate recovery from psychological disorder and providing clinicians with a broader evidence base for narrative practice. Despite limitations of a repeated-measures research design, use of a standardised intervention protocol, coupled with outcome evaluation of clinical significance enhanced internal validity. Future research could examine narrative therapy in a larger sample, with different disorders, and with an alternative therapy or control group. Coding a greater number of therapy transcripts for evaluating associations of narrative reflexivity with working alliance and outcomes could enhance understanding of narrative reflexivity. Thesis strengths included a strong theoretical foundation underpinning the research design and arguments, examination of therapy process in the context of outcome, and a parsimonious evaluation of narrative therapy outcomes.

Comment se fait le processus de conversion de certains acteurs sociaux occidentaux au bouddhisme dzogchen ? Afin de répondre à ce questionnement, cette étude, qui repose sur une méthodologie qualitative, a été menée auprès des groupes français et italiens de deux réseaux associatifs : la communauté dzogchen Internationale et Rigpa. Elle s’inscrit dans le courant de la sociologie compréhensive et cherche à rompre avec l’idée selon laquelle la conversion est une affaire exclusivement individuelle ou une expérience soudaine. En effet, cette recherche met en lumière les dynamiques relationnelles et processuelles qui permettent d’appréhender ce fait de conversion. Dans un contexte marqué par l’occidentalisation du bouddhisme et par les transformations du paysage religieux contemporain, la conversion au dzogchen s’opère, tout d’abord, par l’action « missionnaire » de certains agents, représentants d’une institution née de la routinisation du charisme du « maître ». Mais la conversion de l’acteur résulte également d’une adéquation aux propositions institutionnelles, qui entraîne l’acquisition d’un nouveau récit, d’une nouvelle manière de gérer ses émotions et prévoit la mobilisation de certains dispositifs rituels. Ce processus d’apprentissage a notamment lieu lors d’interactions intersubjectives entre les pratiquants dzogchen eux-mêmes et, entre les pratiquants dzogchen et les représentants de l’institution tibétaine. Ainsi, l’exemple des groupements dzogchen nous permet de mettre en valeur la dimension relationnelle de cette forme de religiosité, qui offre à l’individu qui se convertit des espaces de socialisation propres à une communitas / How does the conversion processes of certain western social actors to Dzogchen Buddhism work ? In order to answer such question, this study, carried out using qualitative research method, was conducted among French and Italian groups of two association networks: the International Dzogchen Community and Rigpa. This research is in line with the field of comprehensive sociology and tries to break away from the idea according to which conversion is solely an individual matter or a sudden experience. In fact, this research highlights the relational and procedural dynamics that allow the understanding of this type of conversion. In a context characterized by the westernization of Buddhism and by the transformations of the contemporary religious landscape, Dzogchen conversion results from two factors. First of all, conversion is an outcome of the “missionary” action of certain agents, representatives of an institution born from the routinization of the “master’s” charisma. The second less observed factor is how the conversion of a social actor results also from the adoption of institutional proposals, which leads to the acquisition of a new narrative, a new way of managing emotions and takes into account the involvement of certain rituals. This process of learning happens especially during intersubjective interactions between Dzogchen practitioners amongst themselves as well as between Dzogchen practitioners and representatives of the Tibetan institution. Therefore, through the example of such Dzogchen group we are able to highlight the relational dimension of this kind of religion, which provides the individual who converts with some socialization spaces proper to a communitas

Leon Dash and Ted Conover have modeled an ethnographic approach to literary journalism. This approach combines literary journalism's compelling narrative techniques with ethnographic “naturalist-like” (Brewer, 2000) thoroughness and trustworthiness. Rosa Lee: A Mother in Urban America, by Leon Dash, and Newjack: Guarding Sing Sing, by Ted Conover, exemplify this painstaking method that skillfully uses the narrative craft, generates trustworthy data, and contributes to an academic body of knowledge as well as exposing findings to the general public. Dash, Conover, and others have demonstrated the synergy and problem-solving potential of merging anthropology with literary journalism, yet there is no typology, no common name and no set of ground rules describing this work. Identifying Dash's and Conover's methods may advance cross-pollination between anthropology and literary journalism, fields that share the role of reporting on contemporary culture. This cross-pollination serves both disciplines. Ethnography stands to increase its numbers of readers by enlisting the writing techniques of literary journalists and by publishing “more public-spirited” (Fillmore, 1987, p. 1) findings in more public venues. Literary journalism stands to be seen and applied as a credible form of qualitative science by enlisting trustworthy naturalistic methods and aiming to contribute to an academic body of knowledge. This thesis explores the promise of ethnographic naturalism in narrative form, as “scholarship for real readers” (S. Olsen, March 2, 2009, personal communication) by examining how practitioners meet rigorous naturalistic criteria for trustworthiness (Lincoln & Guba, 1985) and how they present findings in narrative forms and public venues. This exploration draws on personal interviews with Dash and Conover and analyses of their long-form narrative research texts in the context of other scholars' outlooks. Key findings include the discovery that although Dash and Conover were not consciously using naturalistic criteria for trustworthiness, their work meets these criteria. Another key finding is that while both writers consider themselves primarily journalists, they both have read anthropology extensively. A notable finding is the fact that Dash and Conover rely on time-invested “unfettered inquiry,” (Dash, 1996) the mind-set of insatiable curiosity, caring and the liberty to apply practices of other disciplines to conduct research, free from external controls.

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Ce projet de recherche a pour objectif de mieux cerner le champ de la pratique clinique en psychothérapie utilisant des médiations artistiques. En outre, il vise à interroger la position du psychothérapeute dans un contexte de soin avec une médiation artistique (peinture, dessin, modelage). La situation clinique en art-thérapie possède deux caractéristiques qui la distingue d’une thérapie verbale : (1) le passage du face-à-face impliquant le contact visuel à une présence du clinicien hors du champ visuel du patient lorsqu’il est face au chevalet, (2) il y a la création d’un objet plastique sous le regard du clinicien. Cette recherche s’appuiera sur un travail d’analyse des concepts fondamentaux de la psychanalyse appliqués à la psychothérapie médiatisée et sur le développement de la notion « d’image critique ». Désigner l’image comme un lieu critique, c’est la considérer comme un lieu de mise en tension et de mise en crise du symptôme selon différentes logiques de symbolisation. L’hypothèse métapsychologique qui guide cette recherche est que les processus de symbolisation dans la construction de l’image plastique en séance s’appuient sur une situation intersubjective de partage de différents niveaux de symbolisation entre le thérapeute et le patient. Une étude de cas du suivi d’un patient constitue la méthode de cette recherche. / The goal of this research project is to define the scope of clinical practice in psychotherapy that uses artistic mediations. It also intends to examine the position of the psychotherapist in the context of care through an artistic mediation (painting, drawing, clay).The clinical situation in Art Therapy has two distinctive characteristics from verbal therapy: 1. the passage from a face to face interaction that implies a visual contact to the presence of the clinician outside the patient’s visual field once s/he is working at an easel, 2. the creation of a plastic object under the sight of a clinician.This research is based on a work of analysis of fundamental psychoanalytic concepts applied to mediated psychotherapy and on the development of the concept of “critical image.” To denote an image as critical is to consider it as a place of exerted tension and exerted crisis of a symptom according to different logics of symbolization. The meta-psychological hypothesis that guides my research relies on symbolization processes based on the inter-subjectivity of sharing different levels of symbolization between the therapist and the patient. A case study of a patient undergoing art therapy constitutes the methodology of this research.