story healing

 

In a couple of months I'll be presenting my first ever workshop on the healing power of sharing our stories. 

"One of the most valuable things

we can do to heal one another 

is to listen to each other's stories."

~Rebecca Falls~

Here is some of what I'll be covering:

Today we’re going to talk about what I like to refer to as the healing power of storytelling, and what that means. Is there anything to it? How does it work? What happens between us when we share our personal stories, and why it’s important that we do.

This fascinates me because, for those of you who don’t know me, I’m a family physician. I practiced medicine for over thirty years…until I retired because my other passion in life is writing…and, you know, sometimes you have to make tough choices.

Plus…I had a story in me that I really wanted to tell.

Anybody else??

"Write about what disturbs you, 

what you fear, 

what you have not been willing to speak about.

Be willing to be split open."

~Natalie Goldberg~

The point is that we ALL have a story to tell, but most of us never get around to sharing it. Instead, we make up excuses. We tell ourselves we don’t have time to write. We don’t know where to begin, or how to put it into words. We tell ourselves that what we have to say isn’t important. That no one else will care about it. Sometimes shame silences us. We blame ourselves for what happened to us. We have been conditioned to keep secrets. Perhaps it's just too painful, or sad, or maddening to revisit.

So…our stories go untold…and as such, I’m telling you…they wreak havoc on our bodies. The anger we bottle up, the sorrow that never fades, the shame we keep under lock and key all take a toll on us. They raise levels of stress hormones and inflammatory chemicals in our bodies that raise the heart rate, elevate BP, and raise blood sugar levels. This can lead to all kinds of problems in adulthood--hypertension, heart disease, diabetes, and autoimmune problems like lupus and RA. Not to mention anxiety and depression.

Think of it. If someone produced a pill that could lower your blood pressure, control your blood sugar levels, and elevate your mood, we would all buy stock in it, wouldn't we? So…why not invest some time and effort into storytelling? Unless we explore the anger, or despair, or confusion that is at the root of our pain, nothing anyone says or does will touch the cause of our suffering. All the medication in the world will not solve the problem.

"Your body's ability to heal

is greater than anyone

had permitted you to believe."

~multiple attributions~

There is, in fact, science to support the idea that telling our stories can help us heal. We know that storytelling can lower levels of inflammatory hormones in the body, because we can measure them. In studies where half the subjects were asked to write about a traumatic episode they had experienced and half wrote about a neutral topic like the weather or a favorite food…heart rate, BP, and sugar levels fell in the first group as compared to the neutral group. Their brain waves actually changed. Functional MRI scans of their brains demonstrated synchronization in electrical activity between the storyteller and listener. We don’t have time today to go into the science behind storytelling as a healing practice, but I’ll be around all weekend, so stop me if you’re interested.

The point is that telling our stories affects us in ways we can measure and observe. When you give your story a title, describe how it unfolded, and name the characters that populate it, you may begin to understand why it still disturbs your peace so many years later. If someone you trust is listening, you may come away with an entirely fresh perspective on it. You may finally be able to forgive yourself or the person who hurt you. You may be able to cast aside some of the things you’ve always imagined were wrong with you, but never were. Your BP and sugar levels may come down. Anxiety and depression may improve.

"The healing that can grow out of

the simple act of telling our stories

is often quite remarkable."

~Susan Wittig Albert~

As a physician, I listened to patients’ stories all day long. The history, or story, of the present illness. The past medical history, or story. The patient’s family history, or story.

That, of course, was back in the days when I could scan my schedule for the day and envision every patient, I knew them that well. With a quick glance at the schedule, I knew who was getting ready to start chemo, who had just welcomed their first grandchild into the world, whose mother was recently transferred to the dementia unit. I knew because I had asked about it, the patient told me the story, and I made a note of it in the chart.

Nowadays, rather than dictating a note about the clinical encounter (a.k.a. narrating the patient’s story), you open an electronic medical record (EMR) that presents you with a confusing array of bulleted items, complicated charts, and abbreviated details. You can easily pick out a list of symptoms that were problematic at the patient’s last visit, when they started, how often they occurred, and how long they lasted. You know what tests you ordered and how you treated him, but you might not remember anything else about the patient because nothing else is recorded there. He looks like any other older patient with diabetes, or heart failure, or COPD…because you missed the fact that he’s a decorated Vietnam veteran. You can’t understand why your pregnant patient is so anxious because you failed to ask about her sister who had three miscarriages in a row. You don’t know because you didn’t get that part of the story. 

 "The most important part of the story

is the piece of it you don't know."

~Barbara Kingsolver~

If you’re a healthcare provider, it's easy to understand how missing details can make it hard to come up with the correct diagnosis. You miss the fact that your patient’s headaches started the day she discovered a pack of condoms in the back of her daughter’s dresser drawer. You have no way of knowing that the patient’s heartburn and indigestion have been a problem because of the pile of unpaid bills that are collecting on the kitchen counter. Or that your patient has insomnia because he is headed for a divorce.

Sharing our stories helps us heal. It is built into healthcare. It can’t be ignored.

The stories we share in the back of an ambulance, or in the examination room, or at the bedside are the same stories we share with our families and our best friends. They make us who we are. They help us process what happens to us. They embody our unspoken fears, our deepest sorrows, our greatest regrets…which is why we don’t tell them. It’s hard to put them into words.

It took me fifty years to get mine down on paper.

How long will it take you?

"Can you tell me about a moment

that was big for you...

a moment when

you saw things differently from then on...

Not a sensational moment--

you won ten-thousand dollars in the lottery,

you were lost in the woods alone with no food--

but a quiet moment when your whole awareness shifted?"

~Natalie Goldberg~

That's the one.

Tell us about that.

jan

tell me your story, show me your wounds

When we refer to the healing power of storytelling, we're not talking about some kind of magical cure. It won't restore the strength to your arm or leg after a stroke. It won't shorten the course of chemotherapy if you have cancer. It can't speed up wound closure or prevent infection. So how does it work?

Illness can leave us feeling fearful, angry, ashamed, or depressed...not a healthy emotion among them. Telling our story forces us to reflect on an experience we'd rather forget, or deny, or pretend never happened. Which is what makes it so difficult. We tell ourselves no one would be interested in hearing about it. We avoid talking about it because it still brings us to tears, or makes our hearts race, or embarrasses us. We don't want people to see us like that, so we order our memories, our feelings, our pain into lockdown. Then we wonder why we're getting headaches. Why we feel anxious all the time for no good reason. Why we can't relax without a couple of good stiff drinks at the end of the day. The aftermath of illness and trauma takes a toll on us in ways we don't always recognize.

The thing to remember is that writing is a safe haven for difficult problems.

"A day will come when

the story inside you will want

to breathe on its own.

That's when you'll start writing."

~Sarah Noffke~

 

If all you do is jot your thoughts down in a private journal, it will help. There, you can take your time searching for the right words to describe your experience and your feelings about it. There is no wrong way to begin. No one needs to see it. Even if you decide to take a torch to it later on, you will have learned something about your SELF. Where you're stuck and why. What helps and what doesn't. What you need to do in order to heal, and what you need to avoid.

"It's important that we share

our experiences with other people.

Your story will heal you and

your story will heal somebody else."

~Ilyana Vanzant~

The day will come when you're ready to share what you've learned. When you realize you need help and you're ready to reach out for it, you'll be able to share your story with the rest of us. Some of us have been through the same thing. We'll be there for you...to comfort and encourage you, to hold you up, to hear you out.

Some of us may not be as far along in the process as you are. We need to know how you survived. Where you turned for strength and comfort. How you ever managed to smile again. Tell us so we can heal, too.

"Tell me your story,

show me your wounds

and I'll how you what loves sees

when love looks at you.

Hand me the pieces,

broken and bruised,

and I'll show you what love sees

 when loves sees you."

~lyrics from The Story~

jan



how to beat the winter blues

A lot of people I know are experiencing the winter blues right now, given our recent cold spell and its accompanying snowfall, the threat of impending war, our country's political shenanigans, etc. Has winter got you down? Are you tired of dealing with drifting snow and sooty slush? Then you might want to try this:

• Peruse this spring's seed catalogs. They should be arriving in the mail any time now. If you start early, you'll have plenty of time to plan out the lush, perfectly groomed flower beds and foundation plantings that will have your neighbors wide-eyed with envy. This way, when it's 90 degrees outside, and you're weeding and edging and trimming away, you'll be reminded how lovely it was in the winter when all you had to do was spread a little Ice Melt every couple of days.

www.summercottage.co.uk

• Start your search for the perfect beach house to rent for your vacation. Think about all the money you'll save if you go in the off-season this year, say in March rather than July--during peak hurricane season, which is an altogether different kind of adventure.

www.thehouseplanshop.com

• Check out the fashions that will be all the rage this summer. If the thought of appearing in public in a swimsuit is more than you can bear, instead of a house on the beach this summer, consider renting a cabin in the woods where denim and hiking boots are always in style. 

www.debbiesellsredding.com

• Take a walk. If the thermometer inches up over 30 degrees, and you dress for it, you should be able to embrace the outdoors without risk of frostbite or hypothermia. Feel some compassion for the birds and squirrels and the deer who are stuck out in the cold day and night without recourse to a warm meal or a soft warm bed. And don't forget to enjoy the beauty.

www.iamcamjr.blogspot.com

If that doesn't appeal to you, you can always brew a cup of good strong coffee, add a splash of Baileys or three, wrap yourself in a nice warm blanket, and settle yourself next to the fireplace where you can read a good book... 

~www.depositphotos.com~

...or write one.

*

To paraphrase my favorite poet:

www.fineartamerica.com

"The woods are lovely, dark, and deep,

but I have promises to keep,

and pages to write before I sleep. 

And pages to write before I sleep."

jan

can you hear me now?

If you are interested in, or for that matter, even if you're a bit skeptical about the concept of narrative as an instrument of healing, you should run right out and pick up a copy of “What Patients Say, What Doctors Hear” by Danielle Ofri, M.D. If you harbor any cynicism about the relevance of narrative medicine as a healing practice, you should read this book. Then, lend it to a friend, or two, or three.

Among the topics she tackles are:

• Obstacles to effective communication including time constraints, over-booked schedules, and individual productivity quotients that have nothing to do with improving patient care.
• The importance of listening patiently when obtaining the patient’s medical history, and how our body language and facial expression can intimidate or discourage the patient from sharing important parts of his story.
• The role our own back story plays, and how it affects our expectations and interactions with patients.
• How the use of jargon reflects our attitudes towards patients, for example, referring to the disease rather than the person who has the disease (the diabetic, the epileptic, the asthmatic) or labelling the patient who fails to respond to treatment as a “difficult” or “noncompliant”.
• The influence of gender identity, race, culture, socioeconomics, and religion on communication.
• How to break bad news to the patient and his family.
• The correlation between poor communication skills and malpractice claims, and the pros and cons of disclosing medical errors.
• How effective communication influences the perception of pain, and how this affects healing. 

I often hear from people about the fragmented and impersonal relationship they have with their healthcare provider. They feel as though they aren’t being heard or understood. Issues that are important to them are dismissed or left untouched by physicians who appear hurried, distracted, or disinterested in their problem.

“Listen. People start to heal

the moment they feel heard.”

~Cheryl Richardson~ 

The physician can hardly help himself. He is forced to practice in a health care system whose number one priority is corporate profit. His schedule is overbooked. He struggles with an electronic medical record that doesn’t work for him. He has to navigate a baffling coding and reimbursement system, and he is tethered to his very own productivity quotient, a.k.a. how much income he is expected to generate.

These stresses drive a wedge between the patient and his provider, disrupting the fundamental patient-doctor relationship. The patient is disappointed in his care, and the physician is disappointed in himself.

On the other hand, physicians who are trained to practice narrative medicine learn skills that help them elicit and interpret the patient’s history, to seek missing details, and to understand the patient’s illness in the context of his life and his community. As a result, patients under their care feel as if someone is finally listening to them. That someone cares. When they feel heard, they do better. They cope better. They are more receptive to therapeutic intervention.

Do they heal because of it?

That, of course, depends upon how you define healing.

“You are so brave and quiet

I forget you are suffering.”

~Ernest Hemingway~

It might take a stretch of the imagination to say that a narrative approach to patient care speeds wound closure (although some studies have demonstrated this phenomenon), or that it prevents the spread of cancer. Antibiotics would be a better choice for pneumonia. You need surgery if you have appendicitis. Nevertheless, the empathetic resonance that develops between the physician and the patient when the patient is heard in a caring, receptive, and nonjudgmental manner can improve his prognosis.

No illness is free of emotional fallout. Fear. Anger. Shame. Heartache. None of which the patient may want to admit or be able to express. These feelings may, however, be the most amenable to the healing power of storytelling in the clinical setting. Only if the patient is encouraged to express his frustration, fear, and sense of loss can we know what kind of support he needs. Perhaps he just needs facts to help him understand and embrace his treatment plan. Maybe he needs constant reassurance and encouragement. A glimmer of hope. Maybe she needs assistance arranging for help at home. Some patients may welcome prayer at the bedside. All of which can help the patient heal.

For those of us involved in patient care, the operative word is “care”. This involves more than tending to the tasks required to treat our patients. It implies caring about them. Caring enough to explore the impact of their illness on their emotional and psychological well-being, and its impact on their family and friends. On their future. On their souls. All the hidden places pain lingers.

"The healing that can grow

out of the simple act of telling our stories

is often quite remarkable."

~Susan Wittig Albert~

Training in narrative medicine empowers the physician to elicit, interpret, and respond to the stories that patients tell us about their illnesses. In addition to exploring the occurrence and progression of their symptoms, it encourages the physician to consider the nature and course of suffering, attitudes about healing and recovery, and the ways family members, community, and circumstances influence these attitudes, all of which affect patient outcomes.

The overwhelmed health care provider may suggest that this is what we have nurses, social workers, pastors, and family and friends for. But by disengaging himself from the patient’s psychological, emotional, and spiritual life, the physician sacrifices his connection with his patient, and with it, his sense of empathy. With loss of empathy, morale suffers, and when morale suffers, physicians tend to burn out.

Storytelling is one of the many art forms that enables people to explore and to process the full scope of illness and recovery. It is built into the clinical encounter under labels like “the history (or story) of the present illness”, “the past medical history (or story)”, “the social history (or story)”, and “the family history (or story)”, as though an epic novel is about to unfold.

Storytelling is a useful tool for the patient himself as a means of exploring the cause, effect, and meaning of his own illness. He needs more than a diagnosis, a referral, or a prescription. For healing to proceed, he needs to know that his provider cares about what he has to say, understands him, and addresses all the ways he is suffering.

“The most precious gift

we can offer anyone

is our attention.”

~Thich Nhat Hanh~

jan

 

three questions you should ask yourself

 

I have a handful of friends whose stories I know inside out. I may have heard them over cup of coffee or a glass of good red wine, on a hike in the woods, or during a stroll on the beach. Getting them to write their stories down is a different task. I nag them to do it because there are people everywhere who need to hear from them. Someone who has recently been diagnosed with cancer needs to hear from someone who has been through it. It helps to know that they share the same feelings, that the diagnosis was devastating, the treatment grueling, and the recovery painstaking. They need to hear from someone who has been through it that there is hope. That a cure is possible. That victory is glorious no matter what it takes.

Among my friends is a woman who held her brother in her arms as his life slipped away after someone broadsided the car she was driving at an intersection. She was just sixteen years old. He was twelve.

Another woman lost three of her six children. A train took one down when he was eleven years old. That tragedy drove her second son to suicide. As if that weren’t enough, another one succumbed to an oppositional form of childhood leukemia.

Another friend of mine hasn’t seen her daughter, her only child, in over ten years…not since the day her ex absconded with the child to a war-torn country in the Middle East following a bitter divorce.

I could go on.

The point is, it took a long time for these stories to emerge. They were shared with me little by little, at odd moments, over a period of years. There are still some details my friends can’t bear to reveal, some for which there are no words. No way to describe the horrifying moment. To process its meaning. To live on in spite of it.

Which is why I continue to plead with them. Please…write it down for us. Tell us everything.

Why?

Because when we know someone’s story, we have a better shot at understanding who they are and what they’ve been through. We’re able to provide them with meaningful and appropriate support, encouragement, and care. We know when they need space. We get a glimpse into the dark side of their lives, and it doesn’t scare us.

Likewise, when someone tells their story, it helps allay their fear, dispel the anger they feel, and overcome the shame that has silenced them. The process of sharing your story with someone you trust leads you out of isolation.

"Tell us the story of the mountain you climbed.

Your words could become a page

in someone else's survival guide."

~Morgan Harper Nichols~

This why I encourage my friends to tell the rest of us what happened to them. To tell us how they got through it and how they go on today. How they get up in the morning and go to work. How they ever manage a smile. What gives them strength, or hope, or solace. What they still need from us.

The stories they could tell would be full of wisdom and insight. Even humor. They have something to teach all of us. To encourage us. To help us heal. If only they would begin.

I encourage them even though I know how hard it can be to get words on the page. To stay focused on the work at hand while sitting alone, in silence for long periods of time. To return to it again and again even though you sometimes feel like giving up. Perhaps the story is too painful to revisit. Too achingly sad to put into words. So confusing it doesn’t make sense.

If this resonates with you, please begin writing. Do it for the rest of us. Open a new document, or run out and get yourself a journal that strikes you as welcoming and forgiving. Go ahead. Put your name on it.

Still not convinced you should share your story? If you are keeping an untold narrative under lock and key, or a chapter tucked away somewhere in your heart, or a tender memory smoldering out of sight, ask yourself these three questions:

     1. What do I know?

Perhaps you lost a child. Maybe it happened because of a miscarriage no one saw coming. Perhaps someone convinced you to have an abortion when you were too young to understand what was happening…and now you can’t forgive yourself. Or maybe you spent an inestimable number of sleepless nights at your child’s bedside while he fought for his life, to no avail. You know everything there is to know about suffering. Everything the rest of us wish we knew.

"Write hard and clear

about what hurts."

~Ernest Hemingway~

     2. Who else needs to know it?

If you survived, someone else needs to know how you managed to pull it off. Someone, somewhere needs to know that healing is possible. It might be the father who suffers a disabling injury, or the parent of a child with special needs, or the woman who is hearing the word “cancer” for the first time. When you express your anguish, it gives them permission to admit theirs. The story of your journey may be a wellspring of hope for others. Your strength may be the only thing that keeps them standing under the weight of the burden they are carrying

     3. How will I tell them?

One painful word at a time. One affirmation after another. Honestly, openly, and courageously.

If you still can’t get started, try writing something else first. Maybe a poem or a letter.  Perhaps you should run out for some new paints and a fresh white canvas. Or raise your voice in song. Or put on some music and dance. There is more than one way to tell a story.

How will you tell yours?

When will you begin?

"When you stand and share your story...

your story will heal you and

your story will heal somebody else."

~Iyanla Vanzant~

jan