Each and every ache, pain, illness, emotion, thought, image, dream and action has a story behind it and that tale is unique to the individual person. When we address only the particular symptom, inner or outer phenomena, we are highly likely to misinterpret what is going on for the individual and we may either rush in to offer advice and attempt to rescue the person or we may react aggressively or passively. Of course, these reactions have a story behind them that lies at an unconscious level waiting for the emotional safety to bring the sad tale of their origin to consciousness. In the majority of relationships there are so many stories that have not been told – between child and parent, husband and wife, lover and lover, student and teacher, priest and parishioner and manager and employee. Secrets abound in unhappy relationships, whilst openness and authenticity are typical of mature relationships.
Sensitivity to story is critical to mature relationships; insensitivity results in stories being more deeply hidden and human misery sadly endures. Naturally, sensitivity to the possible sufferings of another has its story and it is a human quality that is often moulded in the melting pot of human conflict and its eventual resolution.
When you think that 75 per cent of Irish families have been touched by suicide in one way or another; that one in four adults were sexually violated when children; that, in spite of amazing medical technological and therapeutic developments, the overall rate of illness has not been reduced by even one per cent; that cancer and heart disease are the leading causes of death; that addictions to alcohol and drugs are still highly prevalent in Ireland and that the majority of individuals mask many emotional, social, sexual, intellectual, physical and behavioural insecurities – it behoves each one of us to be highly and kindly sensitive to story.
In the clinical context the medical doctor or the psycho-social health professional need to receive, not take, a history (the story) from a client. Not only does the health professional need to hear and see the verbal and visual presentations of the person’s story, but is advised to record the essence of them. The professional who sees himself as the expert of the client’s world is likely to interrupt the client in order to clarify perceived ambiguities or to obtain more details – but these tendencies are best curbed until the person has finished his or her story.
I came across a wonderful example of listening in a book, Listening and Medicine by Michael Livingston. He tells the story of a 45 year old woman, who in the presence of a Consultant Physician and four medical students, smiled and with her opening words said: ‘I’m happily married, but I have the most terrible headaches.’ The Consultant stopped her from saying anything further and he then asked the four students to write down the woman’s exact words. Three recorded that she had severe headaches; only one that she was happily married and had severe headaches, none had noticed the smile on her face.
The Consultant asked the students why she said she was happily married before mentioning her headaches. The students had no answer. It transpired (not surprisingly) that the woman was most unhappily married and this fact was a major factor in her headaches. Her smile revealed her tendency to mask what she was really feeling. Doctors and other healthcare professionals who believe in a person-centred interview thankfully resist the enchantment of technology. I wrote of the illness I underwent myself before Christmas and its misdiagnosis by a local doctor, I was astounded that when I entered his office – he had never met me before – he immediately went to his computer and began to ask for personal and illness details without face-to-face contact. I also felt that how I described the symptoms was not picked up – the focus was more on the physical examination, I have no doubt the said doctor was doing his best, but, sadly, I felt he was dazzled by technology and he neglected listening and, most of all story. Some critics argue that listening to clients takes too much time; however, the evidence is to the contrary, that listening and story receiving saves both time and resources; most of all it strengthens the relationship between the caring professional and the person seeking help. It is that quality of relationship that can often be a determining factor of good therapeutic outcome.
Dr. Tony Humphreys is a Clinical Psychologist/Author, National and International Speaker. His recent book with co-author Helen Ruddle, The Compassionate Intentions of Illness is relevant to today’s topic.