One of the main themes of this blog, and probably a core theme of my daily work as a holistic, integrative doctor, is the place of narrative in our lives.
I recently mentioned in another post that working with patients’ narratives was a part of what I and my colleagues do every day at the Centre for Integrative Care in Glasgow. A couple of readers have asked me to say more about that and I thought I’d pull together some thoughts into this post.
One of the first books I read which impressed me about the importance of stories in medical work, was Arthur Frank’s “The Wounded Storyteller”. In this book, which is the product of years of research, Frank claims that there are two very common types of story patients present to clinicians – “restitution” stories, and “chaos” stories. He proposed that we can think of these as two primary “genres” of story. The former is probably the commonest in biomedicine healthcare. It can be captured with the phrase “I’m broke, please fix me”. It’s an approach to illness and health which considers that disease is a dysfunction or lesion somewhere and that if the bit that’s wonky could just be fixed then all would be well. The latter is also very common, especially when there are a multitude of symptoms and the person has become lost in the illness.
Frank proposes that a clinician’s job is to help patients turn these stories into “quest stories” – based on the principles of Joseph Campbell’s hero narrative.
The integrative journey from stuckness or chaos to flow and coherence emerges out of this creation of a new narrative.
Another reason to work with narratives is the human need for myth creation. We are meaning seeking creatures, and the myths, or universal stories, as Karen Campbell calls them, shape our lives. So it makes sense to understand which myths we’ve incorporated into our stories.
Shifting from the materialistic, reductionist myth to a soulful, heart-focused, holistic one, allows the creation of a much more positive story, one which brings hope, and which opens up the possibilities of a different future path.
A key component of the creation of a future with a more clear set of potentials is choice. William Glasser’s Choice Theory, turns our narratives on their heads, and focuses us on the verbs we use to describe our experience. What emerges is a much more autonomous, more powerful story – a shift from passivity to activity, from victim to autonomous individual, from zombie to hero.
But it’s not just the verbs in our stories which are important. It’s the metaphors too. The amazing work of Lakoff and Johnson demonstrates the embodied nature of metaphor, and in so doing gives us the opportunity to pick up on the metaphors we are using, including the bodily locations of our diseases or disorders, and gain a profound understanding of the meaning of our illness experiences.
I hope for stories of improvement as I work with patients, but the stories which excite me the most, are the ones of transformation. Yet again, this week, I’ve heard several such stories. That makes it a complete thrill and delight to be able to practice Medicine this way.
Heroes Not Zombies 
“Another reason to work with narratives is the human need for myth creation. We are meaning seeking creatures, and the myths, or universal stories, as Karen Campbell calls them, shape our lives. So it makes sense to understand which myths we’ve incorporated into our stories….”
Hi Bob, thanks for this post which really spoke to me, since my own 2001-8 journey to and from the Underworld of total collapse ( triggered by a long family crisis ) was supported and made bearable and ultimately, creative, at least partly through the support of myth. I am beginning a research study of “creative responses to Dark Night of the Soul experiences” and using a particular 3000 year old myth of descent and return as an overall context for the piece of work.
I have, in fact, written a short piece on the theme of how the knowledge that we are participating in universal human experience can support us in our individual suffering. Your readers might be interested in it:
Regards
Anne
Fascinating Anne. I’d love to hear more about your research study. Find me on twitter? @bobleckridge
Thank you for exploring this further, and including so many rich resources for us to follow up.
I found myself thinking this morning about illness, and how sometimes it cannot be healed or cured or fought or resisted, for death must come to us all some time, but that what is always possible, in every day and every moment, what is possible in every story, however terrible, is grace, and transformation.
So it was kind of strange – in a good way – to find you writing about that very thing.
I really enjoyed reading about some of the ways this can play out in practice. I hope maybe some day I’ll get the chance to explore some of this with you in person – it’s a subject so dear to my heart.
Joanna, I’d love to do that too. Want to tweet me and we’ll set something up? @bobleckridge
Very interesting post. I wish we had a center for integrative medicine that is supported by the medical community here in Israel. Still there are a lot of people doing body mind work here, myself included. I find that incorporating narrative, or script, metaphors , dreams all help to further healing.Thank you
Hi Yael, thank you for this kind feedback. I’d be interested to find out more about your work. I’ll “follow” you on twitter…..see you there!
Thank you for your posts. I really enjoy your thoughts and find it close to my perception and world view. Sometime I just do not have time to read it carefully. So, I save it and read while waiting at the airport or elsewhere due to my often travelings. My name is Maxim Goncharov. I am MD, PhD, psychiatrist, psychotherapist, European and World Certificates of Psychotherapy holder, member of directors board of the World Association of Positive Psychotherapy, international master trainer of Wiesbaden Academy for Psychotherapy (WIAP) and International Academy for Positive and Transcultural Psychotherapy (IAPP). I am a head of private clinic “Center for positive Psychotherapy” in Khabarovsk, Russia (Russia).
In one of your posts “Healing narratives” you mentioned the importance of stories and wisdoms. My teacher prof. Nossrat Peseschkian the founder of Positive Psychotherapy has a book called “Merchant and the parrot” – oriental stories. I am sure you will like it very much and I think the concept of Positive Psychotherapy (after Nossrat Peseschkian you will find very interesting, simple and applicable.
While searching for this book you may find another names connected with the term of Positive Psychotherapy. For instance Martin Seligman. Just for your information Mr. Seligman is the founder of Positive Psychology which he develops from ’90s. As a psychological movement it is quite popular in USA. Martin Seligman has started to use the name of “positive psychotherapy” recently in 2006. It has nothing to do with Positive Psychotherapy after Nossrat Peseschkian who gas established method in 1968. You can read an article about the differences between PPT and Positive Psychology: http://t.co/PtjfQgsl When Seligman first time mentions the term PPT without any reference to Positive Psychotherapy, which already existed almost 40 years, the International Academy of Positive Psychotherapy had trained more then 38000 professionals.
Fabulous Maxim – thank you so much for taking the time to write this wonderfully positive comment. I know the work of Martin Seligman, but I’m ashamed to say I’ve never even heard of Positive Psychotherapy. I’ve immediately popped across to Amazon and ordered a couple of his books.
🙂 Thats Ok. Thanks. PPT well know in Europe but not yet in US. I also think it is more than just strange that Seligman made no reference to Peseschkian who is the founder of Positive Psychotherapy and the term of transcultural psychotherapy. In 2009 he was nominated for Nobel Prize in physiology and medicine. Unfortunately did not get it. But it’s OK. Karl Rogers also was nominated and did not get it 🙂
[…] What I love is the story. Every person I meet tells me a new story. It’s in the narrative that I can make sense of their suffering. It’s in the narrative that I can see the connections between the mind, the body and the spirit. […]