story healing: part 1

 

I spent last week at a memoir writing retreat in Massachusetts with Nancy Aronie, author of "Memoir as Medicine."

I've taken this workshop with her several times over the years. I went back this time because I was looking forward to presenting my own twist on the healing power of storytelling this week at the annual Pennwriters Conference in Lancaster, so I wanted to soak up some of her inspiration, humor, and wisdom to tide me over. And I did. Unfortunately...I also picked up Covid while I was there. Meaning I had to cancel my debut presentation this week...

...after all that work.

So, instead, I decided to put it here for any one who is interested. The title is "Story Healing"…the idea that putting our personal stories into words and sharing them with others can play a role in healing…not just emotional and psychological healing…processing the pain, feeling better about ourselves, easing the symptoms of anxiety and depression…but real physical healing that we can observe and measure.

Seriously. This is good medicine.

It interests me because, for those of you who don’t know me, I’m a physician. I practiced family medicine for over thirty years…until I retired, because my other passion in life is writing…and I had a story in me that I really wanted to tell.

So…I want to talk about what we mean by Story Healing…the power of getting our stories down and sharing them with others. Is there really anything to it? How does it work? What happens between us when we share our personal stories, and why it’s so important that we do.

I'll also be talking a tiny bit about the science behind the process. I'm going to share my family's story because I think it illustrates some of the painful consequences of keeping our stories under lockdown. And, finally, I'm going to provide you with a prompt to encourage you to begin sharing your story.

By way of introduction, I live near Harrisburg. I have three grown children and three grandchildren. I’m an avid walker and meditator, and now that I’m retired, a wannabe writer. I post this blog which is loosely based on the practice of narrative medicine, almost weekly. But…enough about me.

I’m more interested in who you are and what drew you to this space. Are you a healthcare provider? A nurse? Doctor? Therapist? First Responder?

Are you a caretaker?

Do you have a personal story about an illness or injury? About abuse? Trauma? Fear? Shame?

Do you keep your story under lock and key even though you’ve been over it a million times in your mind…and it just won’t go away?

Of course you do. We all do.

The point is that we ALL have a story to tell. The problem is that 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 our story into words. We tell ourselves that what we have to say isn’t important. That no one will be interested in it. Sometimes shame silences us. We blame ourselves for what happened to us. We have been conditioned to keep secrets.

Or…perhaps it’s simply too painful, or sad, or maddening to revisit. We’d like to pretend it never happened. We’d like to forget it…but we can’t.

So…our stories go untold…and as such, I’m telling you…they wreak havoc on our bodies.

The anger we keep bottled up, the grief we can’t bear, the shame we keep under lock and key all take a toll on us. We know that they raise levels of stress hormones and inflammatory chemicals in our bodies, like cortisol and adrenaline because we can actually measure them. And we know that these substances 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.

Unless we acknowledge and explore the source of the problem, nothing we do or say will touch the cause of our pain. The rape. The abuse. The loss. All the medication in the world will not solve the problem. Traditional therapy will barely scratch the surface.

Honestly, it might be wiser to try storytelling.

*

There is, in fact, some science to support the idea that telling our stories can help us heal, not only emotionally and psychologically, but physically, as well. We know that storytelling can lower levels of inflammatory hormones in the body, because we can measure them…and we can observe their effects on the body. In studies where subjects were asked to write about a painful episode they had experienced vs 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.

In another study, participants underwent a small skin biopsy that left a tiny open wound. They were then assigned to write about a painful experience or a neutral topic. The open wounds healed sooner in the cohort that wrote about their pain.

In other studies, functional MRI scans of the brain demonstrated synchronization in electrical activity between the storyteller and listener. Their brain waves actually changed.

The point is that telling our stories affects us in ways we can actually measure and observe.

When you give your story a title, describe how it unfolded, and name the characters in it, you may begin to understand why it still disturbs your peace after all these years. If someone you trust is listening, you may come away with an entirely different perspective on it.

Let’s say, for example, that you’ve been struggling with guilt after a friend committed suicide. You pick up a book like “The Ticking Is the Bomb” by Nick Flynn whose mother took her own life. His story looks at suicide differently. He explores the fact that it was inevitable given the course of his mother’s life. It wasn’t his fault. After reading it, you might see things a little differently, too. It wasn’t your fault your friend found life unbearable. Perhaps you didn’t miss the clues because there were none. A layer of guilt falls away. The aching in your chest subsides. This is healing.

Or maybe your friend has been diagnosed with cancer, and it doesn’t look good for her. You have no idea what to say or to do for her…no clue how to support her. No clue how to just be present for her. Then you pick up a novel like “Talk Before Sleep” by Elizabeth Berg, and you learn all the ways you can comfort and encourage her, and even bring a touch of humor to the situation. This is healing.

When you tell your own story, 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. And still aren't. Inflammatory hormone levels come down. Your BP and blood sugar levels normalize. Anxiety and depression improve.

This is definitely healing.

When I was in practice, I listened to patients’ stories all day long. Of course, we didn’t call them stories. We took the HPI, better known as the history of the present illness…better described as the story of the present illness. We explored the PMH, or past medical history...or story. The patient’s FH or family history...or story.

Nowadays…those stories have been replaced by a series of bulleted lists in the electronic medical record. (Don't get me started...) Details go missing. You overlook the fact that your patient’s headaches started the day she discovered the cigarette burn on the sleeve of the sweater her ten-year old wore to school that day. Or that she can’t sleep because of the pile of unpaid bills collecting dust on the kitchen counter. Or that your patient has heartburn because he’s headed for divorce...

…unless, of course, you invite him to tell you about it.

Rita Charon, MD, PhD, at Columbia University College of Medicine, pioneered the practice of "narrative medicine" over twenty years ago as a tool to help medical students uncover the missing piece in their patients' histories.

This is how she begins with each new patient: "Tell me what you think I should know about your situation." Then she listens to the patient without interrupting, clarifying, correcting, or taking notes. Instead, she focuses her attention on what is revealed and how it is communicated, noting the patient's posture and gestures, images and metaphors, facial expressions, and the characters who play a role in the story.

When we reach into our patients' cholesterol laden hearts to understand why they are poisoning themselves with food, we need to know more than what they are putting into their mouths. When we encourage a friend to talk, we may discover that the real reason for this one's fatigue, or that one's intractable headache is end-stage disappointment, or anger, or shame that has festered out of sight for years.

Only then can we help them heal.

Stories form the basis of every relationship. They are the foundation of all friendship. They are an integral part of healthcare. They reveal 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.

I know this because it took me fifty years to get mine down.

The good news is, it’s never too late to get started. This is your chance. 

Remember:

"The work of your heart is your gift to the world."

Next week I'll share the story that my brother kept under lock and key as a child, how our family's life unfolded around it, and why it took fifty years to reveal itself. Story Healing: Part 2.

 jan