Storytelling as Healing A project that produced one ofthe fist hooks on the relationship between it rate and medicine Trautmana 1982) was refered to as “Healing Ans in Dialogue” The inclision of iterature among the healing ars has legitimacy ‘when one understands the vious ways in which soytling can self be & Story a Mecne 5 Suffering is produced ad alleviated by the meaning that one ataches to ‘one's experince. The primary human mechanism for attaching mening to particular experiaces sto ell stories about them. Stories serve to latin ‘vidual experiences tothe explanatory contuct othe society and cutie snd also to place the experiences within the content ofan icv’ ie history ‘The fist function of storytelling allows one to label an experience ae repre- senting say. an act of cowardice ofan act of religious devotion The second function allows one to label an experince 3, sy, completely in chars ter with the early upbringing of tht inva o totally atypical out of ‘character. The meaing of an experience far a individual person, inthe sense that wil use the tem, partakes of both thes indvidusland sociocultural ieasions."| ‘One way of understanding the importance of storie in healing i 0 ap proach the subject by way ofthe placebo response. The plicebo response i ‘ies actual bodily change and isnot restricted tthe patient's subjective im pression, a has ben well documented inthe medial erature on placebos We may define i riety for our purposes asthe change inthe patent's bodily ste that results fom the symbolic or emotional impact ofthe healing en counter Seiemsts are Leaming 4 good del about the psychological abd bio ‘chemical mechanisms by which the placebo response wodks, ba one Way to summarize much of the available data is that 4 postive placebo response Soems most likely 1 occur when the meaning ofthe illness experience sal tered in a postive dreton (Brody 1980; Brody and Waters 1980)" A posi tivechangein the meaning the patient attaches othe illnes experience can in tur be broken down int tee distinguishable bt closely related compo- ‘ens. Fist, the illness experience mot be given an explanation ofthe sort that the patient finds acceptable given he patients existing bli system and ‘waldvew. Second, the patient must perceive that se i suroundd by and ay rely upon a grep of earing individuals. hid the patient mst achieve sense of mastery of coal over the ines experience, either by feeling esonlly powerful enough to affect the couse of events for the beter by feeling that her individual powerlessness can be compensted for bythe power of some member or members ofthe ating group (such a the shyscan)." ‘Consider the very commonplace office visit fran upper respiratory nf tin, The easurng story tld by the physician to aceon for the illness ex iene (I Took like you've picked up that virus that is ruaning sound {oyn—you're te sith person I've seen today with exactly the stme symp ‘oms"), coupled with the caring and slicitous atte of physician and ofhee | muse and the reassuring rituals tht promise conto of events ("Take two acetaminophen four times day, garle with warm saltwater every hou, a ‘ay in bed til the fever goes away”), may well effect a speedier recovery than“ STORIES OF SICKNESS, onl sso fo cher by he wl potas reinsion rte ofthe nes bythe pry parmacologialecacy ofthe reeds sii ‘se, Physics who anu ostve mesg oath iano aed ‘once tat rment wl wok may hae rc th ce ate compare © tonconitalcolkages Tomas 987) Reseach sows that physica who teat he patent in nant ht cn be desi “oni pa tetipe wil ve a mere pose eft om heh etcomes Ls0pld a 1988). Uofominaty, tse sume “meaning” spect of» meen can work agit the patents eal ne cages the lence. aon ‘nny inert wit orient impenosl meal em est cmt fring hat even se unexpnd, a thywe cae sd eat contol af heir pron is impossible. We can pedi such ces hat heath couldeasy dtr The este caer are calle nebo ety ‘ome (Ha 985) Sometimes agave arava igen a noceo ef. fcc scully rote. ichord Mica «pssst, worked with fmt sss ne cs sore Sahat a es ‘Many women nth group were tj eal lence a frm of tare while their later psychiatric symptoms were referable to these experi ccs in important ay, tas extealy cl og he women od Cts (or event ami tne epndes forthepetc proses: One worn Cxplane bth he shane she fet and er onion that eld never be {the or are by obcrsng. “Man is gol woman soto 100 doy eld inti mo you can pk tape of and iti be god 9 Ifyou do cton ino he diy eee Phys arehary th oly scl ges empleyed in he i of fusing. Stones sed by many ors in order reas and ono by tring meaning 10 evusy nepal and hrf ening expe Ene Relius ois and mth sh tton of csston tps ns gression coupled wi roms fate redemption ae obs xa nthe inpornce of folk Hesture apd epic tas in sustaining he pre an spn of enc! group i well accepted However, sane Indice deve to changing things othe beer win» crn oa ‘etn al he eamens of meanings deserted ove st be res for the medial encom fo be scsi, even fm ther comes mfeng imy be ahuaged merely byte it ofthe thre men proing a sti toy employ sein). Ths the exe od within te mein Counter mos ofr explanatons for illness, Bama ination, 4 3 n Soch oy facie ing responses fom oer and coming on Histcal. thse feo fe abl foretl h ft wll fo Be {Blt cont he past were egal Yala tontleea ooo progmoricadon ts it wo bea nll posessed by the physician, the medical Serving in Modine 5 Story takes on special ftportance. When one has ciently based ere to oe for an ilies, the aura of mastery td contol can easily be sustaine, Yet even it no care i available (sin Hippocrates’ tine), the ability to pros nosticate accurately, ol th sory ofthe future ofthe ines. main 9 ‘sense of contol and thus may symbolically, even if not pharmacological. lead to enhanced healing. ‘The sociocultural dimension that plays role in meaning as described shove suggests tha the cole ofthe physician somehow goes beyond the tling of sores to individual patients. Berger aempte to analyze the roe that Particular English county doctor played in the ite of his community (Bersct ‘nd Mohr 1967) He argued that oe feature fa person's psychological reac ton tills isthe conviction that he illness unig; great confor sus when the physician abet give a name to the compli: it has a name, t _musthave an existence apart fom me; s then Ica strugele against Berger snd Mohr 1967: 68). The unhappy person like hel person, fs the unique nes of his complaint bu fels even more that be is fundamentally unten nizable by ee persons and so destined to remain unhappy “The unhappy Patint comes toa doctor to offer him an illes inthe hope that this pat of him (ie illness) may be recognizable. His prope self he believes tobe un- knowable” (Berger and Mobr 1967: 69). The physician, to heal the unhapy) Patient, must somehow funtion as an Everyman in which the patient can see reflections of his essential sel, before the patent ca seriously entertain the oon tat the physician ean recognize his personhood. The county doctor in ‘question sometimes succeeded in this task and sometimes fale, notes Berge, but he was fundamentally a good doctor because “ier is about him "he constant wil of an tying to recognize” (Berger and Mohr 1967-71, ‘These features of illness and sutering le to the unique fle the county doctor filled fo the village asa privlge the villagers accord o hime ‘was “the requested cee of their econ” (Berger an Mohr 1967-103). The villagers percived a need o know that they eld if they wished, consul the Sori of theres thei pas illtses and sufering included, secur inthe Knowledge thatthe records they consliod were objectively validated ac ‘counts and not merely reflections of thee own subjetve impressions." They Wished. daly to have a record keeper wo was thorovgh and who could e late their stores othe outside word, erin draving upon lev! of atic lateness that they lacked. This was not the funtion ofthe parish priest the piysicianelimed to represent no all-powerful of omiscient being and of fered ther records to no higher judge than themselves. The fonction vss per formed atthe vilges’ request and oaly upon their inition hence the humble tle of clerk. The villagers inded seldom consciously thought of their doctor a a witness or record keeper, yt “the most rent opening to = ‘conversation with him, if it was not a professional coretinnigy nena,Soryellng a Madcine " ling ory sory out what as een hpi hiss what Ect by is the eng ory atory ening unstated mean- people Iedicne several tines a day; they ma have to give up hard6 STORIES OF SICKNESS, Storytelling in Maisie © Stories of Surgery owed to attend their ils schoo, ignoring sent reassuranes ofthe a sence of29 STORIES OF SICKNESS, Storyelting in Matcine sea arene a ei~ STORIES OF SICKNESS.3 = Dimensions of Sickness ‘What Does It Mean to Be Sick? rmotite or primary experience? Ho ‘medical activity? How is sickness construed as atogether these disparate dimen offerte following summary conclu- ments epesents a pilosopical generalization of ‘Each, therefore, could be misused aba way of ino Soctation anong otherwise disparate narative accountsSickness and Disruption of Self commonly emphasize the idea ofa disrupcon of sef—anunplesartly me ened break or split in. sens of personhood tht ough insted, obey whole or complet, ‘A basic tenet underlying this phenomenology of sickness artesian duis and an in[STORIES OF SICKNESS, Dimensions f Sickness roi ‘world, urs ot the “object body rel (Gadow 1980) ness ish trly an ie meang that calls into question the continued, inter personal self. Relief of suffering comes most often by changing© STORIES OF SICKNESS. Dimensions of Sickness 5 fering whe seeking to relive it Sickness, Treatment, and Medical Activity sth fale ofthese earlier ef formative ndertaning mene wane Towing tributes concep of disease that i genera «an be distinguished from science with eprd + Bel ns both certain natural aptitude andeo [STORIES OF SICKNESS D fons of Sick ‘out, epardss of whether tat wath id any othe rata human endeavor outside of scence itself siternal regulatory principles also have a moral mpl, constitutes one ofthe mast hase existing conceps suffering. Like doorstep and demand that py is promised within medicine as thas evolved to date as a nd coherent practice. Sickness, Social Roles, and Cultural Betis ‘ms shocked to fear that Ted had die nbs sleep, he looked like he was perfect health yesterday.” Fartermote, a cases of Tustrate, i members ofa society regard an individus and treat him as be» [STORIES OF SICKNESS, sia and acquired immunodeficiency syndrome cannot be understood in termsSTORIES OF SICKNESS,ee 8 ‘STORIES OF SICKNESS Dimensions of Sickness ~ of sickness. Sickness and the Nature of Human Systems ‘and, perhaps ater, by the seientiie explanations ofthe pofes- “onal healer” This further reinforces our determination to seek an under-STORIES OF SICKNESS, iensions af Sickness o{ STORIES OF SICKNESS . Dimorsios of Sihress ‘trouph ose in ely ements ste ses, Posies of seta ge" Becker iy ha es ot acknotede he dee sympa naceon STORIES OF SICKNESS,What Is Life Story? flowsB STORIES OF SICKNESS Sickness, Life Stories, and Self-Respest ate personal though he had ab these evens, personal motives for doing anything he had dons, and Linde states Life Stories and Self-Respect ‘When we come to grapple with specific stores of sickness, we will some7 STORIES OF SICKNESS, it he basic den of if plan. L want to keep in mind the elitist concerns we have already discussed and make sure thatthe notion of a life plan is kept donot wish life plan to suggest hain der 0 be specting person, one should have developed a detailed timetable for and thea stick to ic What I ave i ing and bocome an organi farmer in Vermont, then the unfolding ie toy ‘would be cferent, but if the same person were to havea great deal of body piercing done and then join a motoreyele gang, the resoing ie sory would ss, Life Stories, widely and maximize his novel expsine and mary Soon or extend = Should he ty to make precise ow thom, or should be Ait and se what opportunites tr up oftheir own accord?STORIES OF SICKNESS , Life Stories, and Self-Respoct self-respect and the ongoing const ement, "You're not going ‘to make a career ofthis, are you?” was mae, Taio suspect thit she was able to accep the message hecase of how fr se had ee Had her mother made such remark prematiely,STORIES OF SICKNESS, ‘Sickness, Lie Stories, and Self-Respect the message, she Found hat she had a selEespect —) 4 numberof options, She ‘tom hee peer s rele j ke") What appeared to be the best op te patient ole as having steady served its purpose | ot by ret© [STORIES OF SICKNESS, =5 = ~ Conclusion: The Patient— Health Professional Relationship as a Narrative ecisional and Relational Fics and neglecting the more commonplace sitions ‘we focus on unusul cases in bospitale of another Patients ns, we might imagine tat the ethics of hospital and su take ona somewhat diferent wheter the patient takes ull advantage of th ithe patient patient's autonomy ‘of autonomous cho ‘spable of with regard to thi immediately pressing ‘moral principle of respect for autonomy renomy will do thei best to accommodate the fac that ‘along wide spectrum. Some may demand both det Conetsion 265 1, We canbe helped both by those who know vs recognize our cre values and projects and also by thse who choices and options help oreore ches and options oh ae wo as cn tbe by sikness. one focises on piysician paternal thea in partnership. mong patient-pyscian208 STORIES OF SICKNESS, were gathered together in a retet st prt of the ongoing research efor. The psychologist found an opporrity t between his father’s death and his wn continuing froth nd he paced positive conottion upon the conection so that the Slory wat ad sory isa beter story, and that ‘ected is not imply that death mast be accepted and that he boy wa tint over te as prt ofthe relational rom one magic word dropped a psycholo How Much Narrative? tient per day. Just what physic i s the task thats contemplated? An extended metaphor may helo le the apparent task down toa reasonable size ‘Imagine that you are walking along a long. straight street in a city. On one.308 STORIES OF SICKNESS ent Second the ese knows of the se rately humble about v what Dysician and oder health-care provides, ‘Toward a More Storied Medical Practice270 STORIES OF SICKNESS Conclusion on st ey oe eo the metas, we would reveal