Demystifying postmodernism’s stance

I have found many students and practicing clinicians who are learning postmodernism therapeutic approaches to struggle with one of the core assumptions that there is no absolute truth and that reality is socially constructed, which informs the clinician's role (therapeutic style/process). Their reservations and concerns in adapting a postmodern approach seems to stem from their assumptions about therapy, the therapist's role, and what is considered "good" therapy. After all, typically, most students in the MFT program received a BS in Psychology, which embraces a modern epistemology (concrete, cause and effect, linear, uni-versal truth, etc.).  Therefore, the absence of what they have learned to be true would raise concerns. The question isn't necessarily what is true or truer, as this perspective can be limiting. Postmodernism is strength based and challenges the assumptions of repressive ideologies (not accepting others' realities, not acknowledging the implications of power, social justice, culture, and diversities).

In my experience, some students struggle initially with not being the expert and accepting all truths as valid. I believe they get hung up on these ideas and take it to be literal (black and white thinking - absolutes). Some have questioned the validity of the approach and even some ethical considerations because they seem to visualize themselves as not being helpful if they "simply" follow the client's lead, accepting their reality and working towards the narratives they want, which may or may not be realistic or healthy. As noted, it seems to me some students visualize themselves as not active or effective clinicians if they don't direct their clients (an expert); to those clinicians, I would say, accepting a client's reality/truth does not mean you follow their lead blindly. As a postmodernist, clinicians can accept a client's reality/truth, exploring how those were constructed (social (culture and experience) and biological), providing some insight on the role those may play in the client's interactional cycles (feedback loops and homeostasis), and yet still be an expert of therapy (evidence-based models, assessments, systemic implications, etc.).

I don't see postmodernism as being on the complete opposite end of a spectrum where modernism is on the other end; first of all, there are several models within both of these theoretical approaches which are not the same. Both modernism and postmodernism have a lot to offer clients, as both have evidence-based models accordingly. In the end, the clinicians will have a preference of which theory and model fits them and their client population; hopefully, based predominately on research.

With this said, the postmodernist clinician considers their assumptions and biases (truths/realties) and their implications on their therapeutic work. Just like one cannot not communicate, I would say one cannot not have an opinion. Though postmodernist clinicians hold a stance of not being an expert, this is about the client's life/story. Also, being nondirective does not equate to passive, inactive, or a nonexpert. On the contrary, a postmodernist clinician is highly actively involved in the therapeutic process of achieving change. Given the assumptions and concepts held by a postmodernist, they would ask lots of process questions, circular questions, nonjudgmental questions, and be mindful of culture and diversity implications, acknowledging the clients are the authors of their life, instilling strengths and resources. According to Doan (2017), "there is a large difference between saying no singular account is sufficient to stand solely on its own and saying all accounts are equally valid." Doan (2017) further notes, essentially there is a danger of not considering alternative accounts.