Narrative Medicine and the Audience

I am in Stony Rapids at the top of Saskatchewan. I just took off the article from Mothering on Hypnosis and Birth because I thought they had published it long ago and it turns out they haven't yet published it! They saw it up on the blog and asked it to be taken down. What amazed me was that someone actually read my blog (e.g., the editors at Mothering). There's an illusion I suppose that no one is out there. I'll have to check with them if it's ok to leave up the original paper from the American Journal of Clinical Hypnosis 2004, but I suspect that it is. My apologies to mothering. And thanks for giving me the experience that someone actually reads this blog.

That brought my awareness to a message from Renae on Coyote Wisdom discussion group. She was writing about Bakhtin's perspective that all dialogue involves an audience. She wrote about Bakhtin's perspective on our internal, silent dialogue always being for someone. She brought my awareness even further to the importance of the audience in what we do. In our most silent and alone moments, isn't every one of us aware of being watched. Some would say we have created an imaginary audience. Other pre-moderns would say the spirits and the ancestors are always watching us, which is a feeling I have -- of my grandparents and other spirits watching what I do, which, of course, makes me accountable to my perception of what they would think of what I am doing.

So the stories that we perpetually live are being lived for someone. Who is our audience? Who are these "ghosts within" who watch what we are doing and planning. I think what Bakhtin was getting at was the way conversations are memoralized. We don't just store the story. In order to properly store the story, we must store the context in which it occurred and the audience who heard it. Whenever I remember with language, it seems that I am telling a story (silently, of course), but to someone. When I remember without language, then I feel what happened to me, but it seems that there is no way of changing or resolving without language. The non-language parts of the story are immutable without the words themselves which allow us to change the tone. So when I start to tell myself a story, I use words and their associated images and I do imagine an audience. Sometimes it is a friend. Sometimes I have the feeling that my grandfather is listening. Sometimes I imagine some element of the Greatest Mystery being aware of me and my tale. Always there's someone.

So when Renae wondered how changing the audience would change the story, that became central to my meditations today. When a person enters our office, they come not only with multiple stories begging to be heard, but also with multiple audiences who listen as well to these stories and influence their telling. In our interviews and discussions, we need to be more conscious in asking about the audience. Perhaps, we should ask, who do you think about when you are alone? Do you ever have the experience of feeling that you are rehearsing what you will say to someone in your mind? We'll have to be careful because the experience of what actually happens within us sounds psychotic to the conventional psychiatric mind. To me, I suspect voices in part arise from these internally constructed imaginal beings who eventually become able to talk back to us or comment on us. When we lose the story that goes with them, they become "as if disembodied." The voice loses its context and remains to torment the individual. Psychotic voices, by the way, are almost always disturbing and critical these days. Once upon a time, perhaps they were more spiritual.

More later....

Andre Heuer and storytelling in Liberia

I received the following email from an acquaintance, Andre Heuer, who has been working in Liberia. It was so amazing, because I have just come from an 8 day practitioner training in Hawai'i, in which each person's telling his or her story became much more important than any curriculum that I wished to impose. Check this out. Andre writes:

"One of my major tasks in being in Liberia was to explore and experiment with the CVT counselors to find ways to integrate their tradition of storytelling with their clinical training. In Liberia this was important because storytelling is a natural way to teach and communicate. The need was to find a format that would be culturally appropriate and sound clinically. The desired outcome was that the counselors would deepen their clinical understanding by seeing their work through the perspective of storytelling and grow their skills in using story in their counseling practice. In addition the process had to be co-created in conjunction with the counselors to insure ownership. Surprising and what should not have been unexpected was the deep desire on the part of the counselors to tell their stories and to be heard."

This was what was so amazing in Hawai'i with my practitioners: so many people needed to tell their story and to be heard. When people tried to hide in the group, other members came after them to cajole them to talk story.

Andre writes, "They expressed this as a need and as a means of gaining support. Therefore the challenge was to create a culturally appropriate process that enabled the counselors to receive support in a non-therapy group; to cultivate an awareness of and the skills to use cultural, literary, and personal story; and to provide an opportunity to learn new stories.

"The natural format was a group process and was both clinically and culturally appropriate."

Just as happened for Andre in Liberia, a group process emerged in Hawai'i, in which members supported and encouraged each other to tell their stories. Some members even dramatically acted out their stories for everyone else as an audience.

I think what is now being called "Heller Work," and what used to be called "family reconstruction", is just an opportunity to dramatically tell the stories that run through our families' collective consciousnesses.

Andre writes, "Liberians in general feel strong ties to their clan and community. Also the counselors work in teams and usually work clinically with groups. Finally, storytelling and receiving support from others were a natural fit. As we shared and worked out the format the term Story Circles was adopted as the name of the process.

"The counselors developed a ritual of calling each other to attention to begin the group. Each group of counselors chose their own way of doing this. Some chose song, others a call and response, others very simply chose to start with a "Hello" in their own language, and one group chose to begin with "Once Upon a Time." As a fairly religious community with strong ties to Islam and Christianity for the next step each group chose prayer. This prayer could be said or song and they agreed either Christian or Moslem. The telling of personal story would be next and each person would be given three to five minutes to tell their story. Once the story is told the group would acknowledge with a "Thank you" the person sharing the story. The group ends the Story Circle by sharing for fifteen minutes what they personally gained from hearing each other's story. "

What a great format!

The second part of the session is focused on learning a story. The story is told or read and several steps are taken to encourage the learning of the story. The second phase is a discussion about the story and then the circumstances and with whom to use the story. This discussion encourages critical analysis of story both clinically and personally. (I have not fully described this part of the session because of the complexity of the approach.) The session ends with an opportunity for each participant to briefly tell the group one thing they are taking with them from their time together.

As the clinical supervisors experienced how well the process was working for the counselors a decision was made to adopt the Story Circles for use throughout Liberia. In the next two weeks I will be intensely training selected clinicians in the details of the process and conducting story circles in all of the counties served by CVT.