While life is, indeed, full of events we do not expect and cannot control, we play an active role in determining how our life stories unfold, by the moments we choose to focus on and remember, and how we remember them.
When it comes to health, we can’t always control what happens to us, but we can control how we choose to respond to what happens to us. Sometimes this is all we have.
Dr. Annie Brewster and Jonathan Adler, PhD, of the Boston-based, nonprofit Health Story Collaborative, believe that storytelling represents an important layer in moving toward healing—regardless of prognosis.
This belief is grounded in the psychological research on narrative, and specifically in the concept of narrative identity—the notion that our identities develop through crafting and sharing stories about ourselves.
Dr. Adler’s primary research focus has been on the relationship between narrative and mental health, and he, along with his colleagues, have documented the potent role of certain narrative themes in promoting psychological health.
Following is an overview of themes that makes for a therapeutic narrative:
- Agency: What do people have control over in a health journey?
- Coherence: How do all of a person’s different stories fit together and make sense?
- Redemption: What have been the “silver linings” of a health experience, even one that has resulted in trauma, suffering and loss?
- Communion: Who has been there, riding shotgun through a health journey with the patient and family caregivers?
While a great deal of research has supported the association between these themes and positive mental health, a 2012 prospective study by Dr. Adler demonstrated that increases in agency clearly preceded improvements in mental health among a group of psychotherapy patients, suggesting a causative role. There is power in this. How we tell our stories, the meaning we make out of our experiences, matters and can actively promote health.
A 2015 paper by Dr. Adler and eight co-authors presented the first data to suggest that the positive mental health changes associated with these narrative themes persist over time and can be especially adaptive in the face of physical health challenges.
Dr. Brewster points out that therapeutic storytelling need not be uniformly positive. For true healing, she said, stories need to be authentic.
This can mean messy, as confirmed by every person with whom we visited to capture what healing looks like. Dr. Brewster knows messy, too, as a doctor, and a patient.
She was diagnosed at age 32 with multiple sclerosis, in the midst of her medical training. “It disrupted my sense of self,” she said.
But with the passage of time, and life experience, currently as an internist at Massachusetts General Hospital in Boston, Dr. Brewster said she has pieced herself back together, reframed and revised her self-story, and rebuilt her identity.
“I made a choice to heal from a disease for which there is no cure,” she said. “It took me a long time and a lot of processing to get to a place of readiness to make such a choice, but I am so glad I did. What’s the alternative?