What is “Narrative Medicine” ?
I spent last week at Kripalu at the inaugural Narrative Medicine conference put together by Lisa Weinert. It was a great opportunity to meet like-minded people, and to connect with a larger movement of folks interested in bringing literature and well-being together.
When I tell people about the conference, most people react positively, then pause a moment and ask me, “So what exactly is narrative medicine?”
What’s exciting about this field is that it’s still being defined—there is no “exactly” about it. There are institutional definitions: Columbia University has a program by that name--“Narrative Medicine”--which supports the use of narrative throughout medical training and practices. The simple premise is that when doctors have the tools to really listen to patients’ stories, they become better doctors. In a time when doctors are allotted less and less time with patients, this practice seems absolutely essential.
But as the Kripalu conference showed us, simply listening to patients is not all there is to Narrative Medicine. Narrative Medicine encompasses both regular medical practices and more alternative practices. Lewis Mehl-Madrona, one of my heroes, brings together his Stanford medical education with his Lakota and Cherokee heritage, and for the past twenty years he has written about the power of story in healing. One of his books is titled “Narrative Medicine,” and his presentation at the Kripalu conference asked us to think not only about the role of story, but also the role of community in story telling. Mehl-Madrona shows us how the imaginative and mythic help us connect us not only to ourselves, but also to others.
There was still more: Jillian Pransky, a therapeutic yoga teacher, brought in the physical practice of yoga, deep relaxation, and listening to the conversation around narrative medicine. The yoga and meditation that she led us in were designed to open space within each of us. She used a wonderful metaphor: if you have a spoonful of salt and put it in a shotglass of water, you’ll have very salty water. If you put the same amount of salt in a bowl, you’ll have less salty water, and if you put it in a lake, you’ll have less salty water still. The more we make space for ourselves, for our emotions, for our physical bodies, the more we will be able to process and counteract the toxins that make us unhealthy emotionally and physically.
There were researchers, a Rabbi, and numerous memoir and fiction writers who spoke of the ways writing saved their lives; in the act of making meaning and sense and order and beauty from chaotic life stories, these writers came to healing.
And finally, there was the experiential piece: writing our own stories, putting experience on paper, at once claiming it and letting it go; and the equally, if not more powerful experience of being a loving and supportive ear for everyone else’s stories of loss, love, confusion, healing—in short, of life.
So how does this all fit together in the field of Narrative Medicine?
While there is no neat formulation, at the heart of narrative medicine is the recognition that every single person’s life is full, rich, complicated and full of meaning. And that to tell and to listen to stories is to make sense of that meaning. As we give shape, order, respect, and openness to our stories, healing and transformation occurs.
This is not just a kind of soft, feel-good healing that occurs, but can be scientifically documented: James Pennebaker has repeatedly demonstrated, in scientific studies, the direct link between writing one’s stories and decreased medical symptoms in test subjects. We know more and more about the relationship between stress and illness, and between mental and physical health. If writing just for twenty minutes, as Pennebaker had his subjects do, has such a noticeable effect, think of the radical effects we might have if we all took more regular time for story telling and listening.
What’s particularly exciting to me about the field of narrative medicine is that when we do this kind of story telling and listening, healing occurs not only on the individual level, but also on the communal and social level. As Lewis Mehl-Madrona reminds us, we live in communal stories, our stories are never only our own.
In an age increasingly dominated by media and by the frenzied mixed attention that our media demands of us, in an age dominated by violent movies and bad news in the newspaper, think of how empowering and healing it can be if we tell and listen to the kinds of stories that we want to hear, stories of meaning-making, connection, deep attention, love and compassion.
To tell and listen to these kinds of stories is not to be in denial, but instead to make our own meanings. It is to live the stories we believe in, individual and collectively, in our minds, bodies and spirits.