Improving Narrative Skills in Doctoring

David Morris, PhD, urged doctors at a recent American Pain Society meeting to use narrative skills.

“Chronic pain patients often can feel out of control and hopeless,” said Morris, who recently retired from a joint appointment at the University of Virginia in the English Department and UVa Medical School’s Center for Bioethics and Humanities.

“Narrative competence serves medical professionals beyond treatment of illness. It can provide knowledge about lifestyles and preferences as vital as numerical data on cholesterol levels or blood pressure. I believe clinicians with strong narrative abilities can help reduce their patients’ fear, lower perceived pain intensity, and improve overall quality of life,” he said.

Morris reported that one study of 100 patients showed that patient beliefs about pain correlated directly with treatment outcomes. He observed that dialogue can help patients replace or revise harmful forms of narrative, such as catastrophizing, in which pain patients feel anxious, fearful and hopeless, as if disaster were imminent.

“Every patient has a story, and narrative medicine allows clinicians to work with patients to expose beliefs that may create barriers to effective treatment,” he said. “There surely are benefits to helping patients replace counter-therapeutic narratives with a new narrative focused on supportive beliefs that promote health and sustain wellness. Patients want a narrative model for hope.”