For many of us, our early experiences with language came through the stories read to us by our parents, caregivers, and teachers. Even nursery rhymes tell a story. This is important for therapists to understand because as language is acquired in the brain, it is inextricably paired with a narrative structure. Language is one of the primary mechanisms by which we understand our universe and process our various and continuing sensory experiences. All the sciences are our best attempts to create a story about the universe in which we live. We have observed that gravity pulls objects towards the center of the earth, so it makes sense to us when our phones fall out of our hands and smash on the ground by our feet. Were our phones, upon being dropped, to fly upward and into space, we would truly be disoriented. It is not random; there is an explanation for the phenomena we encounter, and that is the core function of story—it is everyone’s explanatory language.
Storytelling as an approach in and of itself dovetails quite nicely with such popular approaches as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Narrative Therapy, and Eye Movement Desensitization and Reprocessing (EMDR), to name a few. Regarding DBT in particular, aside from its documented effectiveness, Dr. Marsha Linehan’s life story is intimately connected to how and why she developed the approach.
As you read, I’d like to tell you a story about some of my own thinking that went into this piece. I do not present myself as an expert on this subject, but rather as an excited student. My hope is that you find these concepts energizing and useful in sessions, and they increase your ability to help your clients deal and heal. The story I’m telling myself is that if you know I am writing with humility in my heart, even if any hubris shows up on the page, you’ll give me the benefit of the doubt. Ok (deep breath)…that felt good to write. I’m also telling myself that you will be very sick of the word “story” by the time this is over.
Understanding through Stories
We understand everything under the sun in more or less a linear fashion, proceeding in time from past to present, with a clear beginning, middle, and end. Most of our stories, real and imagined, are populated by heroes, villains, allies, and red herrings, and they follow fairly predictable rules in terms of plot development, character arcs, climaxes, and resolutions. There are exceptions in narrative form, of course, and many great works of art have played against the observer’s expectations. Think of Salvador Dali’s paintings, the films of David Lynch, or any number of time-travelling scenarios depicted in literature and film. Works of art without clear linear narratives are often stimulating, if confusing, because we are very accustomed to viewing things through this narrative lens. They challenge our ingrained perceptions of how things are supposed to play out.
Just as it is difficult to imagine watching a movie with no coherent plot, character arcs, or resolution approaching (I’m looking at you, Lynch), imagine living your own life under similar conditions. This is to imagine a life without progress, goals, structure, or narrative cohesion. Many of our clients come to us in this state, whether it is recognized as such or not. It is common for clients who have experienced trauma, for instance, to show up in session with a fragmented narrative, reflecting perhaps not only literal missing information but also an unconscious belief that the universe itself is chaotic and unpredictable. They are not quite sure how or why the traumatic event happened, or how to prevent it from happening again. These narratives can contribute to feelings of fear and powerlessness. It is also common for trauma survivors to show up in session with a finely crafted, fixed narrative—one that puts themselves in the position of blame. These stories can contribute to feelings of shame and resignation.
One of the great strengths of approaches like CBT, DBT, Narrative Therapy, and EMDR is that they compel us to admit that there are several ways to look at any one event in our lives, even if they achieve this feat through differing approaches. Fortunately, we have been doing that on our own for millennia, well before these approaches existed. These disciplines discovered something new about humanity while tapping into something very old within us. We can help our clients access this endless reservoir and capacity for reflection when life presents with challenging events. This is one of humanity’s true superpowers—deciding how we see something.
Viktor Frankl understood this well as he developed logotherapy, which is focused on making meaning in life. Meaning springs forth from narrative. In Dr. Frankl’s case, his ability to make meaning helped him to endure the Holocaust rather than give in to despair. He had a reason to live, and this gave him purpose. Part of that purpose included telling the stories of those who perished in the concentration camps. The crafting of a compelling story was central to Frankl’s own survival and success after the war. He was not tinkering with his thoughts myopically; he was looking at the grand, sweeping current of his entire life. His frame was large, not small.
Our work with clients must include helping them to shape a coherent narrative that promotes health and mastery within their lives, and it must by necessity also keep the large arcs of their lives in mind, even as we address the smaller phenomena of their daily experience. If my client gets mugged on the street, is the story built around how they should never walk down that street again, or is it built around how they should study martial arts after that event? Will this story close possibilities or open them? When a loved one passes away, do the loved ones construct their story around the missed opportunities or the wonderful times that were experienced with that person? Does this narrative focus on what is missing or what was present? If my client is rejected by a potential partner, does it mean they are unlovable…or is the other person missing out? Does the story provoke a shame response or result in ego integrity? It is not difficult to see how certain narratives tend to arrive at certain conclusions, and those conclusions are accompanied by a series of decisions and behaviors that will have very real impacts on any person’s life. Using a storytelling approach in therapy considers that a narrative must be crafted, or in many cases altered, before a person’s outward reality can be improved.
Anticipating Resistance
Anecdotally, I have encountered some resistance in my clients to the rubber-meets-the-road work of CBT: identifying negative cognitions and self-limiting beliefs and building awareness of when those thoughts show up, so they can actively replace them and practice thinking in new ways. Once I had experienced the work as a client myself, I understood…it just seemed small. When we are dealing with powerful internal and external realities that are shaping our lives, it can feel somewhat uninspired to be examining the tiny and ethereal thoughts that flit through our minds like innumerable hummingbirds through the hedgerows. It can be hard to even catch one sometimes. A similar resistance can arise when attempting to utilize narrative therapy techniques with clients; it is not necessarily evident or intuitive to everyone that changing one’s story can result in the reduction of suffering. We must be able to demonstrate and then apply this concept to their real lives.
Before this resistance shows up, we can utilize the power of human storytelling by doing some simple psychoeducation, encouragement, and proactive framing. When conducting our intakes and assessments, we can already begin to introduce elements of storytelling and narrative structures with our clients. This could be as simple as saying “I am very interested to hear your life story,” or “Tell me about how your journey brought you into this office.” Such statements are already starting to prompt the client to see life through a narrative lens, which means that there will be a story with some coherence no matter who walks in the door. This gets them thinking about when the problems started, the times before there was a problem, and how their behaviors or choices have changed in relation to or because of the problem. It gets them thinking about other things besides the problem, such as their joys, their successes, the love they have had in their lives. Because all of that is part of the story.
We must have a story to understand our relative universes. In terms of what we find helpful as a species, this tendency in us predates the field of psychology by tens of thousands of years. The field of psychology is the quaking autumn leaf in the aspen grove that is human storytelling. Before we developed symbols to write and record language, the only way human beings passed on any intergenerational information was via storytelling. People are good at this, and it has been working to soothe primate psyches for, well, a long time.
Encouraging Storytelling
There is a truth that I have naturally come to understand myself: For better or worse, in the absence of a coherent, explanatory narrative, the average person will craft one.
We know there is going to be a story. I see storytelling and meaning-making as powerful tools in facing whatever the malady may be. I want clients to understand it is in their DNA to create and interpret stories, so we are accessing an inherent human strength immediately. Most people show up to therapy as strong storytellers, and we are doing incredible clinical work if we slow down enough to hear the story…to listen to the themes, to identify the allies, the mentors, the heroes, and, more often than we would like, the villains.
If you are with me so far, then you have heard three main ideas by now. The first is that we understand the known universe through stories. Science is a story. The universe is composed of planets and stars made up of various elements that sit all together in a big stew we are all in, and a part of. That is comforting, right? It sure beats my saying “Nobody has any idea about anything.” The second is that there are any number of stories a person can tell about one singular event. A past tragedy can be the reason a person is struggling now, or it can be the source of their strength. The third is that people will create stories to explain their experiences, even if those stories are inaccurate or damaging. Trauma survivors will often blame themselves for incurring the trauma, even if the outside observer can plainly see that they bore no fault. In the absence of a coherent explanation, we will certainly craft any explanation so as not to be left in the emotional purgatory of narrative nihilism.
Accessing Imagination
It has taken me many years to even begin to understand the role that our imaginations can play in relation to our experience of suffering or thriving. I think Mark Twain may have captured this best when he said, “I've lived through some terrible things in my life, some of which actually happened.”
Most of us can easily recognize the absurd validity of this statement; so much of what torments us is generated in our imaginations. We are somewhat prone to believe in the more negative aspects of our imaginations and discredit some of the more positive aspects. People ruminating on worries often believe they need to do this to be ready or prepared for a bad outcome. The same person may feel incredulous if you ask them to visualize positive outcomes, even though this is fundamentally the same exercise in reverse. Some of this is adaptive; we need to be prepared for threatening or uncertain outcomes, whereas we do not always need to prepare for positive outcomes. If it’s going to rain, I’ll need to bring a raincoat. If it’s going to be sunny, I don’t really need to do much ahead of time. Our prefrontal cortexes are always running simulations for us so that we have good information available when we need to make decisions. We are evolved to give our perceived problems more real estate in the grey matter.
To communicate the power of imagination to clients, there is a simple way to have them practice calling on this resource to produce very short-term, minor distress or calming properties and regulation. With their permission, and for clients who can tolerate some distress, we can have them visualize the last time they got into an argument or a conflict and report the sensations they feel in their body. Unsurprisingly, they tend to report feeling their heart beats faster, maybe getting hot, and feeling tension in their chest, neck, or back. All they did was imagine something, and then physiological changes showed up. Next, we can ask them to take a couple of deep breaths, settle into the chair, and describe their favorite place on earth in detail. Usually, they report feeling calm and pleasant at the thought, with more or less an associated reversal of those physiological changes. Doing these exercises together in this way helps to illustrate that, depending on how we employ and deploy them, our imaginations are quite effective at both increasing and decreasing our suffering. Having had the visceral experience, it becomes easier for clients to integrate the idea that our imaginations can be harnessed for positive outcomes that support their goals. We can use our imaginations to reduce our distress and create powerful emotional connections to the imagined lives we have for ourselves.
I have more than once pointed out to clients that they seem to have no reservations about using their imaginations to be miserable, but they seem hesitant to use them for joy. I communicate my curiosity about why they have come to believe in this one-sided relationship. This can help to motivate clients who sometimes believe that positive thinking or visualization is somehow naïve or unrealistic. We know intuitively that people feel better when they believe they did the best they could (control, finality, resolution) when compared with thinking that they should have done more (overwhelmed, unresolved). The vast difference in these two mental postures, and eventual behavioral outcomes, comes down to how they are imagining themselves in that situation.
A Brief Case Study
Martin (not his real name) was a 37-year-old man who came to counseling to grieve over his mother’s death and address powerful feelings of shame and anger, and what he termed a “budding alcoholism.” Martin was highly intelligent and sensitive to those around him. He had grown up in a family full of addiction, conflict, broken trust, and insecurity. He was grappling with the legacy of his mother, who was both very dear to him and alternatively a source of great pain.
Martin’s story was that he had come from poor genetic source material, as evidenced by his family’s struggles with addiction and the broken home to which he was accustomed. Martin believed he was destined to be an angry alcoholic, like a few people in his family. We discussed much of the arc of his life, from early memories to current events. He could easily recall that when he was a child, he still believed in himself. He was able to recognize that as a teenager, this confidence began to slip, and as he accumulated the large and small traumas of adolescence, the story he told himself began to change. He began to lower his expectations of himself as his awareness of his family’s dysfunction became clear. As the story changed, so did his behavior in the world. He began to skip school more often, which resulted in his grades suffering. His parents’ addictions further alienated him from them, despite his attempts to stay in relationship with them. He was physically abused at times.
When Martin came in, he believed he was no good, and that just by having born into the family he was, he had no chance of happiness or success. A large part of our work involved rewriting his story and bringing his adult life experience and perspective to bear on his upbringing. Ten-year-old Martin had a very hard time understanding why his parents were unreliable and alternatively loving or abusive. In many ways he blamed himself, crafting a very damaging narrative for himself in the absence of a more obvious one…one that the older Martin could grow to see. The grown version of Martin spent significant time in sessions contextualizing his experience, taking numerous incidents from his past and processing them. I would ask him things like, “What if that ten-year-old kid was your nephew? Would you blame him for the dysfunction of his parents?”
Like so many of our clients do, he was able to conclude that kids aren’t responsible for what their parents do. His work then became about telling versions of his origin story that incorporated his present insights. He started to believe that despite his suffering, he had done the best he could, and his tumultuous upbringing became a source of connection with others. He was capable of a very deep level of empathy based on his experiences, and his peers sensed and valued this. He also desired connection with people; having been deprived of it for much of his life, he was a ready and willing friend to most. The difficulty of his early life had instilled these qualities, and hard-won as they were, he came to appreciate them.
What Does It All Mean?
It is important to help our clients from the very beginning of therapy to craft meaningful stories that assist them in regaining control or that foster some sort of learning, and therefore adaptive behavior. In Martin’s case, the story he ultimately crafted was that his difficult upbringing had helped him develop into a better human being in relation to others. He could have easily landed on any number of conclusions that would have fostered healing in him. There are in fact innumerable adaptive options to almost any problem. Adaptive learning weaves in with healthy changes and progressions in narrative quite beautifully, and this can all occur when our clients understand what conditions were present and how sequences of events in their lives have played out. I am fond of diagramming aspects of any story or event with clients, as once an event is thoroughly examined, numerous opportunities for learning and growth present themselves organically. Anything with a beginning, middle, and end can be comprehended. Patterns can be interrupted, future mistakes can be avoided, future opportunities can be seized.
EMDR makes great efforts in the direction of making sure the client lands on a healthy story, which is healing in and of itself. It is critical that clients actually change their beliefs (story) about how the trauma happened and what it means for them to successfully reprocess it. We can wave the wand around all we want, but if the client still thinks “I am unlovable” at the end of the session, not much healing is going to take place. We simply must get to “I am lovable,” and other positive cognitions ad infinitum.
Conversely, we need to be vigilant and cautious to not overinterpret our clients’ narratives or inject too much of our thinking and biases into that process. This can be a very fine line indeed. Our desire to help can become its own blind spot, and managing our own countertransference is critical to fostering positive narrative outcomes in therapy. Clients do not need to overcome our traumas as clinicians, nor do they need to satisfy our own narrative expectations. I really like my own ideas, but they may not be the best for my client. I will often ask how my clients come to the conclusions that they do, and inevitably, the answer comes back in story form. This provides a wonderful opportunity for strengthening therapeutic alliance, as we acknowledge and validate the client’s experience. Our empathy for our own clients is deepened as we encounter more and more of their story. We can understand how a person who experienced x can easily end up believing y and, significantly, engaging in behavior z as a result. This also provides ample opportunity to put those CBT and/or Narrative Therapy caps back on and start to draw connections between the clients’ thoughts, feelings, behaviors, and decisions.
For example, I might say to a client, “I’ve noticed that every time you think [x], you tend to feel [y], and then you often go and [z] to try and get some relief. From where I’m sitting, I am wondering about what if you decided to think about [a], and then feel [b], which would likely lead you to go do [c]. People mostly come in because of their [z]’s and [c]’s, so it’s important to make sure those are good.”
Or, “Ok, so the story is you can’t walk down that street anymore. Some people would conclude they should study martial arts, or that walking down the street on Tuesday is the real problem, or that they should only go if they are with friends. Tell me more.”
I am putting the client in a position to give external voice to their internal reality, where we can examine it together in a safe and supportive way. I’ve also not-so-sneakily thrown in the possibility that there could be several ways to interpret whatever they are about to tell me, which might prompt some reflection prior to the tale’s coming out.
Bringing it Home
What’s really exciting about utilizing a storytelling approach in therapy is at least partially that it is easy, and it works. Personally, I find the following question to be layered and motivating: What story do I want to tell about my life?
It really should not be too hard for us to help anyone become interested in the story of their own lives. The complexity captured in that question is unmistakable, but it is also imminently attainable. Because we humans are all good at stories, therapists have a natural, inherent strength to draw on from the first minute of the first session. People are desperate and willing to rewrite their stories; they are positively crying out for it. As one of the oldest known mediums for communication that we have, story is beautifully layered with significance, feeling, and memory. It is infinite in the sense that there is no limit to how many ways it can be interpreted or integrated…even if it has a grand finale, as all our stories do.
I believe therapists do exceedingly well in how they continually draw out their clients’ stories, week after week. Where I aim to orient the reader is this: perhaps we should not think of storytelling as a smaller intervention to use in the course of CBT, or Narrative Therapy, EMDR, and DBT. Rather, we should think of those disciplines as interventions to use during the course of storytelling.
