The Importance of “Once Upon a Time …”

“If life were a book, and you were the author, how would you want your story to go?”  ~ Amy Purdy

Our stories are important. They act as magnificent containers and sacred vessels. The stories that we tell about our life, determine what our life looks like, feels like and ultimately becomes. We all hold and carry different stories. Some have amplified stories of sadness and tragedy, others have magnificent stories of joy and triumph. Sometimes we can feel that the stories we live happen to us, rather than us writing them into being.  But what if we decided to take a different view and instead designed the stories we told about our life? When we do this, when we intentionally design the stories of our life to be filled with meaning, triumph and inspiration, they start to move from the pages in our mind out into the world we inhabit. Then it’s not just the essence of our stories that are filled with vibrant inspiration, but also the essence of our life.

When we remember that it’s the stories we choose to tell about who we are and what our purpose is that become the vessel of how our life unfolds, we can start to consider more carefully what stories we choose to write. But where do we even begin?  If we haven’t studied the art of masterful storytelling, how can we start to design our own?  It’s much simpler than you might think. No matter the genre, time it was written or spoken, depth or simplicity, a compelling story essentially does two things: it captures your imagination and it makes you feel. So, when you think about the stories you tell, be thoughtful in what you convey. Begin to design stories that capture your imagination and make you feel the inspiration you want to live. With this approach, you are already on your way to intentionally creating your next chapter.

However, designing stories of meaning and magnificence doesn’t mean you eliminate problems or conflicts, but it does mean you can work with and through them more quickly. This is because the emotion-laden stories of inspiration and meaning we tell go beyond the how and the what of our life all the way to the why. When we start to connect with our why, it gives a new context by seeing past the mechanics of our actions, all the way to the meaning of our life. In turn, this helps draw out more effort, more energy and more focus. We think Steven Denning had it right when he said that analysis might excite the mind, but it hardly offers a route to the heart … and that’s where we must go to design stories with more purpose and motivation.

The story of your life is in your own hands. Only you determine what is written, what is remembered. YOU are the author of a very important book and you have the power to design how the next chapters will be written. So, all that’s left to ask is, what story will you write?

1 Comment

  1. Gregory W. Petersburg, D.O.
    Reply

    I appreciated the Asterisk “The Importance of Once Upon a Time…”
    I am a physician specialized in lifestyle and proactive aging medicine. Additionally, I teach, mentor and consult with physicians across the country on a variety of topics, including narrative medicine, experiential medicine, etc. I am attaching a short article I have written which you may find of related interest.
    Thank you.

    “The Story Behind Every Story”
    by Gregory W. Petersburg, D.O.

    There are 1,045,910 physicians in the U.S., yet every one of them could share, in common, one story in particular: the story of the ‘problem patient’ – noncompliant, lazy, resistant, self-defeating, stubborn.

    The question is what that frequently-told story has to do with anything. More to the point, why is it a story told by every physician and does it reveal anything about the state of health in the U.S.? For starters, the Institutes of Medicine reports that more than 75% of all medical problems that now cause people to consult health care professionals are largely preventable or remedial through health behavior change. On top of that, 85 cents of every dollar spent in the U.S. goes toward treating chronic medical conditions that never had to happen, according to the Centers for Medicare & Medicaid Services. Yet, the World Health Organization says that patient adherence to preventive recommendations and therapies suffers at less than 28%. A clue to these dismal statistics can be found in a white paper from the American Hospital Association’s Physician Leadership Forum, which concludes that the biggest gaps in physician core competencies are in communication skills. It is likely that the ‘problem patient’ and the sad state of health in the U.S. are not only intertwined, but share the same story.

    Here’s why. Human beings are hard-wired to hear and tell stories, and to use stories to communicate complex ideas, emotions, and experiences. Stories teach us values, they emphasize connections and connectedness. If being listened to is one our most fundamental human needs, it is exponentially so during times of illness, distress, crisis, trauma, and trauma. Although telling stories is a normal part of our culture, medical practitioners are trained to think predominately with the biomedical disease-oriented story. Doctors seem to have lost the ability to listen to illness stories. The language of evidence-based medicine is too often complex and opaque. In short, it lacks the narrative elements that tell a story.

    One irony of this story is that every physician is trained to use the ‘problem-oriented’ approach to diagnosis and treatment. The trouble begins when the ‘problem’ is reduced to the “chief complaint,” confining the patient encounter to a single issue. Next, the practitioner proceeds with a series of closed-ended questions so he/she can create their version of the story, i.e., the diagnosis.

    The problem is that the real problem usually isn’t the problem at hand. The real problem is the story behind the problem. Take, for example, the diabetic patient who cannot successfully control his/her medical condition, despite the physician’s best efforts to direct the patient to eat right, exercise, monitor blood sugar and take their medications regularly. In this all-to-common scenario the best scientific, evidence-based medicine fails to improve the health of the patient. Why? From the physician’s current medical paradigm, the failure is the patient – the ‘problem patient.’

    The real problem is failing to understand the patient’s ‘logic’ for not adhering to the doctor’s scientific advice. Dale Carnegie once said that “A person has two reasons for doing anything: a good reason and the real reason.” The way patients experience their health situation is “constructed” through culturally mediated social interactions. Patients perpetuate these conditioned ways of perceiving the world through repetitive stories they tell themselves about ‘the way things are.’ These kinds of stories are mental fabrications, judgments or interpretations that put what is happening into a familiar framework. Patients can become stuck in ‘problem-saturated’ stories that they tell themselves, and that society has told them, about who they are and what their lives signify. These stories become “disabling” in the sense that the individual feels they have lost control of their stories and are unable to change their meaning.

    Diagnosing and treating disease is a totally different endeavor than diagnosing and treating ‘illness experiences.’ Doctors as healers must do both. There is a difference between ‘taking a medical history,’ and ‘listening to an illness narrative.’ Patient-oriented outcomes address how long and how well they live, not just how high or low their numbers are. Physicians’ success as healers depends on their ability to integrate the patients’ stories with the evidence. Otherwise, they become slaves to technology. The challenge is for them to be open or willing to listen before having the biomedical story close the door to understanding.

    Narrative interviewing requires the physician to track the patient’s logic (as opposed to theirs) and find what the connections are from the patient’s point of view. Physicians have a hard time and little patience for this endeavor because they want to construct their own story of a disease. Put another way, imagine that instead of a purely problem-oriented approach, physicians integrated a story-oriented approach as well. In this way, the physician could assist the patient to deconstruct problematic behavior, note contradictory occurrences, and wonder about their significance. The objective is to help patients by first challenging their stories then helping them edit their ‘stories.’ Narrative therapy uses focused questions to help patients reconstruct their ‘reality.’ Patient behaviors change when the story changes.

    The New Art of Medicine Workshop (http://worldlinkmedical.com/live-cme-courses/art-of-caring/) is a program I have offered to physicians for several years, providing, among other things, knowledge and experience using narrative medicine skills, to guide them on a journey toward mastering the interface of science with humanity for 21st century medicine. The 2-1/2 day workshop offers a full immersion, hands-on learning experience in a multi-media environment.

    Both a healthy provider-patient relationship and science are necessary, but each is insufficient without the other. Incorporating narrative into a medical practice enables physicians to deal not only with the disease, but also to engage more fully with the illness experience. Physicians can finally reclaim their social role as a ‘healer.’

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