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I have a friend who, from my perspective, has a great life: fabulous job, cool wife, close family.
Still, this guy sees himself as perpetually at the mercy of life's twists and turns. When work is hard, he feels like "a failure." When his relationship gets complicated, he becomes "unloveable." I've always wondered why he perceives such ugliness looking into the mirror.
Well, it appears that the stories he — that we all — tell ourselves about our lives have a huge impact on our mental health.
Indeed, a study of patients in therapy suggests that taking control of your own personal story, that is, spinning a narrative in which you are in the driver's seat of your life, can clinically improve your mental health and sense of well-being.
The actual things that happen to you may have less of an impact on your mental health than the things you tell yourself about them.
The study's big takeaway, says Jonathan Adler, its lead author and an assistant professor of psychology at the Franklin W. Olin College of Engineering in Needham, Mass., "is for people to realize that they are the main character in their story — but they are also the narrator. That means it's possible to re-write the episode with a greater sense of agency," or power and autonomy over one's life.
Another way to think about it is this: The actual things that happen to you may have less of an impact on your mental health than the things you tell yourself about them.
Writing The Story of You
In the study, published in the Journal of Personality and Social Psychology, Adler followed 47 people as they underwent about 14-weeks of therapy at mental health clinics around Chicago. (Adler was a graduate student at Northwestern at the time and this is his Ph.D. thesis.) Each patient was asked to write about their feelings and experiences in treatment with prompts such as this:
Please write at least 2–3 paragraphs describing how you feel your therapy is affecting you this week. Please do not give a re-cap of your most recent session. Instead, we are interested in how you are thinking about your therapy, its impact on you, and how these thoughts and feelings about therapy are changing over the course of time. Examples of what you might write about could include: how you are feeling about being in therapy, an account of the parts of therapy that are helping or not helping, and how you see the therapy fitting into your overall life or sense of self.
Adler collected these short narratives before patients started therapy, and again between every session. In the end he gathered nearly 600 such accounts. Once all the narratives were in, an outside transcriber assigned a random identification number to each; then a team of coders rated all of the stories with numbers between 1 and 5 based on how much "agency" was evident. The narratives were then plotted against the patients' mental health changes measured with several established quantitative tools.
A Stronger Sense Of Self
Overall, Adler found that people's narratives grew more "empowered," and with more of a sense of agency and control as patients progressed in treatment. And perhaps most strikingly, the stronger, more in-the-driver's-seat personal stories came before the measured improvement in mental health status.
"It's like they told a new story and then lived their way into it," Adler says.
Sandy's Journey
Here's one example from the research. It tracks the progress of Sandy, an 18-year-old, and one of the youngest participants in the study:
Sandy...began her first course of individual therapy for depression and eating disorder symptoms, having previously participated in brief and unsuccessful family and group therapy experiences in her earlier teens. Prior to her first session, Sandy was feeling particularly low. In her initial narrative she wrote:
"I’m 18 and I’m already messed up enough to have been in 3 different kinds of counseling?! How did I let that happen to myself?!?! I guess I’m a little disappointed in myself that as a person who always thought of herself as strong-willed and independent, I have sunk low enough to depend so much on other people."
But by the end of the study, the language Sandy uses to tell the story of her mental and emotional state has totally transformed. She writes:
I have a joy-filled freedom in my OPENNESS to self exploration, self awareness and self expression that I have not seen in many, many years, if I can remember having this reality at all. I am making a tremendous sacrifice to get this processing done. And I just feel an increase in the intensity in the heat, time commitment, and personal sacrifice to get through to the other side of pain, confusion and discontentment. I feel enlightened and inspired and encouraged and EMPOWERED for GREATNESS!!!!
Adler reports: "It is hard to imagine a stronger use of agentic language than that contained in Sandy’s concluding, all-capitalized remark. Indeed, her dramatic writing style elegantly demonstrates the degree to which her own sense of personal agency had helped her find her way to positive mental health."
Storytelling: Better Than Drugs
Adler says his results point toward new therapeutic tools for improving mental health, with patients re-casting their stories to take on a more active lead role. In the medical arena, too, the health benefits of story-telling are starting to emerge. One recent study found that when a group of African-Americans with high blood pressure listened to personal narratives of others with similar problems, they were able to control their illness as effectively as another group taking extra drugs for the condition.
All of this makes a lot of intuitive sense, and draws me back to a series of posts here, in which Dr. Annie Brewster, a Boston internist, compassionately leads patients grappling with severe illness to tell their own stories. In these retellings, Annie's subjects — a woman with cancer, a heroin addict, another with a severe eating disorder — hopefully gain a greater understanding of their illness and feel a bit more power when facing sickness and disease.
