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.
