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Divorcing the voice of fear:

A collaborative, narrative approach to anxiety

by Evalie Horner and Patrick Davey Tully

Evalie Horner lives in Boulder, Colorado, with her wife Heidi and their young twin girls. She
runs a successful private practice in Boulder, and teaches LGBTQ Psychology. Evalie is
also a poet and prose writer, with great appreciation for the ways in which narrative therapy
synthesises her multiple loves of language, story, and service. Her therapy practice specialises
in LGBTQ clients, with a particular focus on working with the Transgender Community. Evalie
can be reached at +(1-323) 557 7193, or email: evaliehornertherapy@gmail.com

Patrick Davey Tully is currently pursuing his master’s degree in Clinical Psychology from
Antioch University Los Angeles and will pursue licensure as a marriage and family therapist
in California. Patrick graduated from the American Academy of Dramatic Arts Los Angeles
and has been an actor for many years. Acting allowed Patrick the fascinating experience of
understanding those around him as well as himself. Through his own therapy experience, he
was inspired to start training as a psychotherapist and is thrilled to have the chance to publish
part of his own experience with a therapist in a narrative journal. Patrick can be reached by
email: pdavmail@gmail.com

Co-created by a therapist, Evalie Horner, and her client, Patrick Davey Tully, this paper
introduces and explores narrative therapy as an approach for addressing issues of anxiety.
The paper alternates voices between Horner and Tully as they embark upon and develop their
therapeutic relationship. After reviewing a variety of other treatment approaches, they bring
the reader into their joint process of narrative therapy, from inception through to the present
day. Horner and Tully illustrate the tools they use to deconstruct various discourses and social
constructions of truth, including externalisation via the creation of distinct, representative
character voices. They discuss how narrative therapy connects past experiences to the
present. And they show how narrative therapy engages the client in a pro-active, co-creative

Key words: externalisation, anxiety, LGBTQ, hearing loss, narrative therapy,

collaborative therapy

our perceptions of ourselves. And unlike most therapeutic
Introduction: Evalie modalities, narrative therapy doesn’t focus on diagnosing
As a graduate student in psychology, I was specifically drawn every issue as a problem.
to narrative therapy. As a writer and former student of theatre
and literature, I saw it as an opportunity to incorporate my Having experienced cognitive behavioural therapy, somatic
previous training into my new field. I was also drawn to experiencing, and psycho pharmacotherapy, I was looking
narrative therapy’s collaborative emphasis between therapist for a therapeutic approach that focused on the past as
and client, as well as to the lack of pathologising that naturally well as the present, while also allowing a collaborative talk
accompanies this different sort of therapeutic arrangement. therapy atmosphere. I experienced cognitive behavioural
What I discovered during my traineeship under David Marsten therapy to be effective, but limited. It left me feeling flawed,
at Miracle Mile Community Practice, thanks in large part to as it only examined and reframed my present thoughts. Also,
my fortuitous collaboration with Patrick Davey Tully, is that it focused on diagnoses such as my ‘generalised anxiety
narrative therapy is even more empowering to clients than disorder’ as well as ‘ADHD’ (which in retrospect, I disagree
I had previously imagined. with). Somatic experiencing gave me a glimpse into past
experiences, viewing them as feelings trapped in my body,
Patrick was my very first client, and I was fortunate that he but for me, the collaborative element was missing. My psycho
was an excellent fit for narrative therapy. Patrick and I both pharmacotherapy experience allowed me to try different
come from a creative arts backgrounds, which uniquely medications and combinations in an effort to discover the
positioned us to take full advantage of narrative’s playful, best drug combination, but nothing more. This particular
creative, and unconventionally challenging approach to psychiatrist did talk to me. However, responses were not
mental health. Additionally, as a lesbian from Oklahoma and encouraged. His technique offered two things only: drugs
a young gay man with hearing loss, we are positioned as and his opinions. A friend of mine suggested I look into
social outsiders with self-proclaimed, unique sensitivities. Miracle Mile Community Practice, which offered ‘narrative
The collaboration between us was a joyful, intense, and often therapy’. Narrative therapy aims to look at the timeline of
humour-filled exploration of the landscapes of both identity one’s life and identify past experiences that may not have
and of action. been fully explored, as well as piecing together life stories
in a streamlined way. This therapeutic approach strives to
Patrick and I conceived of and wrote this paper together, understand past experiences and their relationship to the
each contributing our own voice and perspective to each of present. I started seeing Evalie Horner, who to this day
the components. I could not think of a better way to illustrate remains my therapist. Having been through narrative therapy
the collaborative nature of narrative therapy and the mutual with Evalie, my understanding developed immensely as to
sense of empowerment that consequently inspires both client how much of an impact society was having on my thoughts,
and therapist. and how my past experiences frame my present ones. It also
gave me valuable tools to work on present issues.
The body of the paper is organised into two distinct sections.
The first section focuses on the theme of collaboration, as
well as the story of Patrick’s and my specific work together,
complete with colourful narrative characters and hijinks.
Collaboration: Evalie
The second section even more directly tackles the role of Simultaneous with meeting Patrick, I was introduced to what
larger social and political forces on psychotherapy, as well we soon began to call the ‘voice of fear’. The attractive,
as narrative’s particular place in this broader landscape. charming young man I met in the waiting room was tyrannised
by an as-yet undefined force that presented Patrick a very
different picture of himself than the one I saw. I was new
Introduction: Patrick to narrative therapy, and yet Patrick, eager for relief, good-
naturedly jumped in with both feet, into what narrative
Being hard of hearing has led me to experience anxiety and therapists call the process of externalisation. This process
to receive a clinical diagnosis of generalised anxiety disorder. allowed us to separate the harshly self-judging thoughts
In an effort to work through my anxiety, I have explored a Patrick carried with him, from Patrick himself. Patrick was
myriad of therapy techniques. To date, I have found narrative invited to see himself as a person with a relationship to
therapy to be the most fulfilling of these techniques. The anxiety, rather than as someone suffering from an anxiety
method explores both past and present experiences. It disorder diagnosis. Additionally, he was invited to identify
allows creativity by encouraging a combination of therapy the social conditions that perpetuated and enlivened the
techniques, and it examines the impact society has on judgemental voices, rather than be defined by them.

Although I was new as a narrative therapist and, for that Patrick to interview this silly, costumed man. After quite
matter, to the process of being a therapist, I quickly learned a few interviews, Patrick took on a strikingly more
that each meeting is fresh and best served by ideas and compassionate tone in the interviews. Over the months,
associations that are unique to the client’s current situation, as we worked, he began to have glimpses of this voice not
or ‘experience-near’ as we like to call them in narrative just as a cruel oppressor, but also as a misguided bully
therapy. I found that my lack of past knowledge created a who meant well but had limited and ineffective tools at his
blank slate on which Patrick and I began to create characters disposal. These interviews left Patrick feeling less fearful
from the various voices that were alive with meaning and and much more empowered.
resonance, rather than engaging our process in a way that
was limited by stale, fossilised intellectual ideas I might have In Playful approaches to serious problems, narrative
forced upon the situation. therapists Freeman, Epston & Lobovits (1997) write that
what happens ‘when we engage our imagination, humor,
I asked Patrick to both draw and visually describe the ‘voice and resourcefulness in opposition to the deadly seriousness
of fear’. We were both highly pleased and amused by the of problems’, is ‘the rise of inspired problem solving and the
results. The voice of fear looked like a man in a red devil downfall of serious problems’ (p. 3). This philosophy led me
costume with a toy pitchfork. This ‘devil’ was not the religious to create several certificates for Patrick, including one which
sort, but rather a clearly secular metaphor. Using what I had ‘legalised’ Patrick’s ‘divorce’ from the voice of fear, and later
recently learned about narrative externalisation, I asked a restraining order against the voice of fear.

The light-hearted, playful approach Patrick and I embraced much useful to him than the words of the voice of fear. These
robbed the voice of fear of its once tyrannical hold over interviews helped us to thicken the once unique outcome of
Patrick’s life. Though the authors of Playful approaches calm by reviving memories of Patrick’s relationship with his
to serious problems were specifically describing narrative mother, a definitive influence of the voice of calm. This ‘calm
therapy with children, it is my experience that this philosophy blue goo’ had a previously ignored history of its own, which
holds true with a willing adult. Patrick and I learned together Patrick and I continue to thicken together.
that problems carry more and more weight when taken
seriously, codified, and diagnosed by the ‘powers that be’. The creative narrative approaches Patrick and I innovated
Patrick still lives in relationship to the voice of fear, but it no would not have been possible were it not for the fertile ground
longer has the upper hand. of egalitarian collaboration provided by narrative therapy.
Had I presented myself as the ‘expert’, offering previously
The safe, creative space invited by Patrick’s and my intellectualised answers from on high, nothing new would
collaboration also led to interviews with what Patrick called have been born. This can be an intimidating, scary space
‘the voice of calm’. He revealed this voice as looking like to work in as a new therapist, but it is also a space, in
a ‘protective blue goo’ which enveloped him with words of my experience, in which creative healing, rather than the
assurance and calm. Patrick found these words to be more recycling of previously established ideas, can take place.

because narrative therapy is intrinsically interactive. Because
Collaboration: Patrick these creative ideas come from the therapist and the client
Ever since I was a child, I have been deeply attuned to working together, it fosters a non-judgemental environment.
how hearing loss and sensitivity made me weak. This led to This leads the way for ongoing support and collaboration.
anxiety. A mental chatter of thoughts that felt never-ending With narrative therapy, I am a contributor, not a passive
fuelled this anxiety. The never-ending chatter was so fast- recipient. I hope there are a variety of therapists who are
paced that it convinced me my issues would always lead to able to cater to different segments of the population so
endless suffering. Through narrative therapy, I learned to that everyone can have access to therapy in a non-
separate the chatter into metaphorical voices: ‘the voice of stigmatised way.
fear’ and ‘the voice of calm’. By separating the two, I started
to be able to see what messages were founded in reality, and
which messages were distorted by anxiety. Messages based
on reality were part of the voice of calm, and those based on
Social context: Evalie
anxiousness were part of the voice of fear. Patrick was an ideal first narrative therapy client, not only
in terms of his immense creativity and playfulness, but also
My relationship with the ‘voice of fear’ started when in the way he had been negatively impacted by a variety of
I was young and were based on how I understood certain social discourses masquerading as ‘the Truth’. Some of the
experiences. For example, because of my hearing loss, first discourses we started to unpack centred on medical
I was placed in a hard-of-hearing school for a couple of years. and psychological ideas around being fatigued. When I met
The school utilised over-structure and fear to keep students Patrick, he had internalised this as a sort of diagnosis, but it
in line. Permission had to be granted for every single task wasn’t doing him much good. In fact, we discovered, it was
and right and wrong were constructed dichotomously in very much feeding the voices of fear and judgement, voices
black and white. There was no grey area there with regard to that were in turn feeding fatigue!
proper behaviour. All of my life, I have felt disconnected from
a society that operates in shades of grey, because of my fear Patrick reported that his early schooling involved
that society would not understand the right/wrong principles indoctrination into a very rigid, black and white way of
that for me had been so deeply ingrained. understanding the world. As a result, Patrick initially reported
frustration with a postmodern/narrative approach to problems;
Through narrative therapy, I learned that we all have a path he saw me as an authority that could give him ‘correct’
within society, and there’s no one right way for every single answers. However, in doing narrative work, Patrick quickly
person. If each of us followed one path, we would not be able became willing and able to deconstruct various discourses
to share unique experiences with one other. and social constructions of truth. He also soon embraced
the narrative philosophy that, while there might not be one
Narrative therapy promotes creativity. I was encouraged to ultimate truth, he could pick and choose interpretations of his
visualise the metaphorical ‘voices’ of fear and calm in my own story that empowered rather than disabled him. Patrick
mind as separate tangible beings. Our brain powers us with was able to embrace some labels and reject others based on
the amazing tool of visualisation. Evalie asked me what his own individual values and preferences. All the while, he
I thought these ‘voices’ looked like. The voice of fear was continued to understand that any label, preferred or not, could
a red devil sitting next to me, and I was able to talk back to be deconstructed. But this time around it was Patrick, rather
it, eventually getting a ‘divorce’. The divorce was officiated than dominant ideology, who was choosing the bricks with
by Evalie. The voice of calm was a ‘blue goo shield’ that which he would construct his own narrative.
surrounded me with protection.
A good example of a different sort of discourse that Patrick
I also became familiar with other voices. As an actor, for me, personally found empowering is The highly sensitive
the judgemental voice of Hollywood is ever-present. Evalie person, by Elaine N. Aron (2003). Aron argues that a certain
arranged for another therapist to come in dressed as the minority percentage of the population innately falls into the
voice of Hollywood and, as a result, I was eventually able to category of highly sensitive people. Highly sensitive people,
interact and respond to the Hollywood voice in a safe way. In she continues, process stimuli more slowly, but also more
this way, with the guidance of my therapist, narrative therapy deeply, than other people. Being a highly sensitive person
proved to be an incredibly interactive and creative process. means needing different self-care than the average person
(for example, more recovery time/resting in response to
Throughout the therapeutic process, a dialogue between highly stimulating events and people). Yet it also comes with
myself and Evalie was always encouraged and organic, different abilities. According to Aron, highly sensitive people

have historically played unique cultural roles as artists, sages, Unravelling this complicated web of what Michel Foucault
healers, and counsellors. (1984) calls power/knowledge continues to be an extremely
important part of our work together.
Patrick immediately resonated with Aron’s concept of the
highly sensitive person. Unlike a generalised fatigue issue,
this was a label to which Patrick could assign pride rather
than shame. He followed suggestions in the book and found
Social context: Patrick
himself more and more able to cope with life and to approach Society tells us we’re wrong if we don’t fit into the tiny box that
himself with acceptance and tolerance. The term ‘highly makes us perfect. However, that same voice of society also
sensitive person’ aided Patrick in constructing a life and daily tells us this perfection is impossible. In fact, there’s no such
routine that worked for him and diminished the influence thing as being perfect and thus perfection is unattainable.
of the ‘devilish voice of fear’. The alternative narrative that Nevertheless, it remains the goal. For me, as society
Patrick and I continue to write of his life as a highly sensitive discovered my ‘faults’ – never being fit enough, being hard of
person, rather than as a sufferer of fatigue, proved to be hearing, being too anxious, as well as struggling with fatigue,
similarly supportive. Aron’s highly sensitive person concept society’s ‘voice’ took over, leading me to feel miserable, too
helped Patrick to reclaim authorship of his own story from the much of the time. Being a highly sensitive person, I sense
voice of fear. stimuli more strongly than most people. This causes my
energy to become depleted faster than societal expectations
Unpacking discourses utilised by the voice of fear led us to would like. However, I am now able to approach situations
develop what I call ‘narrative genograms’. with a deeper understanding of how my body works with
stimuli in order to prevent burnout. I am also able to accept
when I feel tired and not view this as a rejection of society’s
ideal of endless energy.

I have battled this voice of society my entire life. Still, to this

day, I have a self-judging, negative connotation attached to
fatigue. Every time I feel fatigued, I feel there is something
inferior about me. I am not a muscular man. Therefore I’m
a failure according to the voice of society. This voice kept
telling me that I was a failure because I wasn’t buff enough.
It also convinced me that, since my hearing wasn’t perfect,
I was a failure. Every time I became tired, this voice would
torture me about fatigue. After all, as society tells us, we
cannot be fatigued. We must be energised and ready to go
at every moment.

These society-fed thoughts turned to feelings, and since

I had no clue what to make of the feelings, they were quite
complicated. Complicated feelings, according to the voice of
society, make us defective. We shouldn’t have to explain how
we feel, it tells me. It should just be obvious to us how we
feel! The voice of society also tells me, particularly as a man,
An adapted ‘narrative genogram’ outlining the relationships to sweep any such feelings under the rug, to be ‘strong’. You
between various externalised ‘problems’ don’t need to embrace your feelings, the voice continues. An
uninhibited spiral of social messages pushing us to abandon
our personal welfare is the result of such folly.
For instance, the ‘voice of fear’ often seems to be in cahoots
with the ‘voice of society’, and Patrick and I therefore deem What I ultimately came to realise is that this voice of society
them brothers, at times. Other times they seem more like a only leads to misery and isolation. Narrative therapy
married couple that has given birth to children, children such deconstructs each social message and, in therapy with Evalie,
as the voice of homophobia. This disgruntled family of voices I was able to examine each message as it arose. This helped
would leave Patrick feeling very uncomfortable with his own me learn to accept myself as I am and let go of the societal
body, his hearing loss, and his other unique experiences. image I wanted so desperately to project. Patience is key, as

it takes time to accept that we are valuable, in spite of strong
and prevalent societal discourses. Narrative therapy allowed
Conclusion: Patrick
me that time. There was no rush to find a conclusion. I was Narrative therapy set the foundation for Evalie’s and my work
able to work at my own pace. together. To this day, we continue to practice narrative therapy
together. With narrative therapy, I learned to externalise fears
and recognise calming thoughts. I can honestly say today
that I am happy with myself, and I recognise the unique
Conclusion: Evalie contributions I make to the world. In a recent check-in with my
Just the other day, Patrick told me that he still sees himself relationship with anxiety, I realised that I now have the upper
as having a relationship with anxiety, but that he is no longer hand in the relationship. I continue my life knowing this upper
troubled by the relationship. This is an outcome that we now hand is present with the voice of fear overall. I am content with
playfully refer to as ‘dancing with the Rubbery Red Devil’. The my value system, and I am much less affected by external
change I see in how Patrick positions himself, the relief that expectations. I am thankful for narrative therapy, and I look
narrative therapy has given him, deeply moves me. forward to the continued work that Evalie and I will do together.

During my conversations with Patrick, I learned to perform

therapy for the first time, while simultaneously learning to
deconstruct it. The space we inhabit is, of course, infused with
power, but I believe our work together, like so much narrative Aron, E. N. (2003). The highly sensitive person: How to thrive
work, is full of unique outcomes. when the world overwhelms you. London, UK: Element.
Foucault, M. (1984). The Foucault reader (P. Rabinow, Ed.).
New York, NY: Pantheon.
Freeman, J., Epston, D., & Lobovits, D. (1997). Playful
approaches to serious problems: Narrative therapy with
children and their families. New York, NY: W. W. Norton.

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