In Remapping Your Mind (Bear & Company, 2015), Lewis Mehl-Madrona and Barbara Mainguy explain how the brain is specialized in the art of story-making and storytelling. The following excerpt from Chapter 1 discusses how personal and cultural narratives can contribute to poor health, and offers narrative therapy as a solution for reducing or eliminating symptoms of chronic illness.
Discovering the Stories We Live
The sufferer is a poet in search of metaphors adequate to express his predicament. —Laurence Kirmayer
These are all matters we need to know. It’s easy to become sick, because there are always things happening to confuse our minds. We need ways of thinking to keep things stable, healthy, beautiful. We try for a long life, but lots of things happen to us. So we keep our thinking in order by these figures and we keep our lives in order with the stories. —Dene Elder on the purpose of Dene String Designs
We are born into stories, stories about our conception, our history, about who we are supposed to become, about our parents and our families, about our world. We are born into the world as story listeners and storytellers. We learn language through story, by hearing and telling story. We make meaning of the world by telling ourselves stories about it. The skill of storytelling begins with the first moment we try to navigate our safe passage through turbulent life. At any given moment in time, whether we are aware of it or not, we bring these stories to mind to explain ourselves, to make decisions, to create change. All the time, though we may not be aware of it, we draw upon elements of all these tales to create a master story, a meta-story, a current explanation for our lives.
We all carry a “master identity narrative,” our version of the story we tell to explain ourselves. We tell short versions of this story to encourage others to see us as we wish to be seen. This master narrative or identity narrative is a synthesis of many stories we have accepted and repeated about ourselves. Sometimes we are only vaguely aware of the source of some of these stories. We can remember the point and forget where we got the story.
By the time we are young adults, we no longer are aware of the depth and complexity of the woven field of stories we inhabit, and we think our stories are simply “the truth.” This sense that they carry some kind of absolute weight leads us to think that they also are a condition for “the way we really feel.” This can lead to suffering that we may not understand. Illnesses unfold in us in the context of these stories.
An important aspect of narrative practice involves identification of the stories that shaped us and our master narrative. The Lakota speak of these stories as our nagi. They believe we are surrounded by a swarm of stories that influenced us and made us who we are today. Nagi includes both the stories and the tellers of those stories. It is our legacy. To understand our suffering, we must tap into our nagi. Some of the stories we heard taught us to suffer, perhaps needlessly or unnecessarily. Other stories perhaps tell versions of events that may be outdated. As we grow and change, we bring new understanding to our lives and some stories may have become dead weight. To minimize suffering and pain, we need to become aware of the contents of our nagi. Through our human capacity to direct our attention, we choose through an act of volition the stories that will guide us most.
The stories that underlie our ideas are mutable. We have created them by pulling together pieces of the different stories that are part of the woven fabric of tales all around us. Once we accept that they are raw material from which we draw, it takes away the constricting parts of our personal relationship to the story, the sense of its “truth,” and allows us to consider if we might not need more raw material from which to create our lives, more examples of how things are and can be created.
The Language of Story
The way we conceive the world, the ways in which we think, and the ways in which we act in the world, fall into the template of story and its accompanying use of metaphor, the language of story. Metaphor is powerful and activates more of the brain than anything we know. Like the conveyer belts in the baggage area at the Athens Airport, called metaphorae, metaphors allow us to more easily carry concepts (luggage) from one place to another. They allow us to understand and experience one thing in terms of something else. Metaphors structure how we perceive the world. They determine what we experience, regulate how we relate to each other, and shape the choices we make.
You can conduct a small experiment—write down the metaphors people use and their illnesses, and you will see how people’s illnesses are grounded in their stories that contain the meanings and values that they live. You can do this for yourself as well, or ask a friend or family member you trust to note what metaphors you often use.
Here’s an example from our general practice. Terry was a forty-four-year-old woman with a twenty-four-year history of severe, relatively intractable, irritable bowel syndrome (IBS). Upon sitting down in my office, she remarked that she had tried every conventional and unconventional approach to IBS and none had worked. This is a wonderfully daunting way to be approached by a client. She had been to gastroenterologists, the Mayo Clinic, the Cleveland Clinic, other local general practitioners, naturopaths, homeopaths, acupuncturists, herbalists, kinesiologists, psychic healers, shamans, energy healers, Reiki masters, chiropractors, osteopaths, and more. The central character of her story was IBS, perhaps even more central than she in her initial narrative.
I began with the faith that appreciating and then helping her to change her identity story could be associated with improvement in her IBS symptoms. Perhaps the many physicians and healers to whom she had gone had paid less attention to her story and more attention to their stories about what should work. If so, I would be lucky and appear to be more helpful than they.
Our performance of stories is always embodied. We enact our stories in a physical world. The body reacts to the stories we tell ourselves and to the interpersonal performances required by those stories. Our autonomic nervous systems, our hormonal systems, our immune systems respond to the simulations we run in our minds, to the “what ifs . . .” that we ponder. The lives and stories of people suffering from illness are inseparable from the illnesses. They are one and the same. We physically experience our relationships and interactions with others. Illness is dynamic because we are dynamic. Some changes improve illness; others worsen it.
During the course of our first six meetings, Terry’s story emerged. She remembered being a seventh grader in a Catholic School and being very angry with God. She had learned to view God as a white-haired old man on a throne in charge of everything. She was angry with God for not making her life and her family’s life better. She thought if she were only more perfect and better behaved, God would smile upon them and make things better. This idea seemed to pervade her life—that God would reward you and take care of all the problems in your life, if you are only good enough. We found a five-year-old Terry suffering under these beliefs as well as a three-year-old Terry, barely aware of the concepts yet comprehending the injunctions.
We went looking for other important characters in her internal mental world—characters telling stories that affected her life. One, whom she labeled the Saboteur, did everything possible to keep her from being happy because: “You don’t deserve it. You haven’t earned it. You aren’t good enough to be happy.” She began to reflect on the voices of all her relatives as she grew up, the meaning behind the stories they told her, their notions of life, their misery and pain. These characters resolved into those relatives and their stories that supported the ideas that she had internalized. The message she learned was “Be like us. Be unhappy. Day after day life is the same old thing. Life is drudgery. You live for retirement; then you retire; and then you die.” “How depressing,” she thought.
Another theme underlying Terry’s childhood stories was security. Her parents were children during the Great Depression and therefore insisted that security was the ultimate value and goal. Terry was admonished against taking risks, however small. In telling her story, she realized that she didn’t develop IBS until she began working as an IT (computer) consultant, a profession she hadn’t wanted and only took because her parents insisted that it was secure. She remembered her mother scaring her into being dependent, living at home, and not venturing into the world. She dreamed of escaping. She recalled everyone in her family throughout her childhood saying, “No, you can’t (won’t, don’t, etc.). You can’t do anything unless you’re perfect first.” These voices included her mother, maternal grandmother, maternal grandfather, father, and seventh- and eighth-grade teachers.
Terry thus grew up with stories about the frightening world and the need for security that influenced her gut years later. We can’t escape the stories of our childhood. The best we can do is to identify them and to evaluate whether or not we want to keep them. They have been our best friends for years. Some are not so kind to us, however.
Terry’s illness narrative had included the possibility that her life and her stories might be contributing to her illness. Since she had tried every treatment narrative imaginable, she accepted my idea that we could begin by becoming aware of her stories, the stories that lived through her and that she enacted in the world. Becoming aware of those stories, I said, and learning where they originated, would lead us to further ideas about her IBS. This is what we did for six weeks.
We emerged with a new illness narrative: that IBS was somehow related to Terry’s doing what she didn’t want to do in order to be secure, to take no risks. The plot that emerged was about a woman who didn’t feel that she deserved more and settled for what she didn’t want because that was safe. We could hypothesize that healing IBS might involve changing this plot. This led to the next phase of our work together, which was co-creating a new story.
Terry wanted a story about her being able to follow her passion, to take risks, and to not need God (or a godlike external expert) to fix her. As she explored and provisionally enacted new stories with this plot over the next ten weeks, the IBS began to change. Her symptoms improved as she began to actively oppose the internalized voices of her family. She reevaluated her job and found a different position in which she had less pressure and responsibility and could be more creative. She reevaluated her relationship and broke with a boyfriend who was barely working and was living off her. She began to explore traveling and reached out to a new set of friends who were more spiritually inclined.
At sixteen weeks her IBS was substantially better and she was actively exploring these new possibilities. We could have stopped there and our work would have been a success. However, we chose to continue four more months, by the end of which her IBS symptoms were gone. This was not magic, just attestation to how our lives, stories, and illnesses are inseparably interwoven. Our guts respond to every thought. That’s why we (as did Terry) speak about “gut feelings.” We have many metaphors for this, including “gut wrenching,” “all twisted up in knots,” “sick to my stomach,” “that makes me sick,” and more.
Terry’s changes were qualitatively greater than some. She changed more than just one or two stories; she changed her identity narrative. She took on a new identity, and that new identity did not have IBS.