Stories That Heal: On Narrative Therapy

By Shlomo   Maital  

Rita Charon 

   Stories, we know, inform, entertain and convey the lessons of an entire culture from one generation to another.  Stories have evolved from stories told around a campfire, or a village square, by a journeyman storyteller, to printed books and magazines and now, more commonly, to film and video.

   But stories can not only entertain, they can heal.  The brilliant British neurologist Oliver Sacks has been writing fascinating books about single illnesses (starting with Migraine, in 1970), books that tell stories about illness and overcoming it.  Sacks’ latest book is called Hallucinations.   Sacks, according to Siri Hustvedt (writing in today’s International Herald Tribune), is “part of a long tradition of descriptive, narrative, case-oriented medical writing Sacks calls ‘romantic’ “.

    But it is also leading to a new approach to healing, known as narrative medicine. Take for instance the narrative medicine department at Columbia University, headed by Rita Charon.  In this approach, “doctors draw insights from and explore forms of literature, for their work with patients.”   Charon is very unusual.  In addition to her MD degree,  she also has a Ph.D. in English literature. 

    Here is how one reviewer summarizes her 2006 book *:

  Charon defines narrative medicine as “medicine practiced with these skills of recognizing, absorbing, interpreting, and being moved by the stories of illness”   She calls this a “new frame” for medicine, believing that it can improve many of the defects of our current means of providing (or not) medical care. Caregivers who possess “narrative competence” are able to bridge the “divides” of their relation to mortality, the contexts of illness, beliefs about disease causality, and emotions of shame, blame, and fear.   Charon finds that medical care and literature share five narrative features; she argues that careful reading of narratives builds skills that improve medical care, including intersubjectivity between caregiver and patient, and ethicality. Beyond the theory, there are powerful and persuasive examples of interactions between caregiver and patient, many from Charon’s own practice. A mother of a sick daughter experiences stress that makes her ill; when she sees a narrative connection, she begins to heal.

 As I see it, we understand our ill health by telling a story that explains and interprets it, to ourselves.  Doctors like Charon (who are rare) can help.  Then, we heal ourselves, by telling ourselves another story, in which our ill health diminishes or disappears.  This healing story is powerful, because we know there is a strong physiological connection between the brain, neural pathways and the body’s functioning organs.  Narrative therapy counteracts the growing, and distressing, trend toward mechanical medicine, which analyzes illness solely through tests, data, symptoms and research.   Illness is about people.  Narratives and stories return the individual person to the scene.  By honoring their stories, we can heal the sick.    

* Rita Charon. Narrative Medicine: Honoring the Stories of Illness  Oxford Univ. Press, New York:  2006