2023 Kill List: Narrative Therapy
I'm going to be sharing a few pieces I worked on this last year that got killed for various reasons out of my/my editors' control.
These specific pieces not getting published as intended are not directly collateral in the ongoing saga of private equity killing the news, but the environment in which these stories were killed (either left unfinished or finished but never run) is the result of unrealistic expectations on outlets and editors put on them by detached investors driving the show for clicks. Some of these pieces probably should have been written by a staff writer, but it's easier to call in a freelancer like me than to get a staff writer salary green-lit. So freelancers take on the tax burden of being contract workers, and we all do our best with what we've got.
I loved working on these pieces and with these editors. I got paid for my work, in most instances. I got paid for this one, which was supposed to run as part of a larger package about chronic illness for a beloved culture outlet. I could have tried to re-home this piece, but decided not to. This was months in the making and my sources have been waiting to see it in the world since this summer.
A big thanks to the editors and sources whose time and care went into this piece. A peek behind the curtain: this story was pitched to me by the editor (which is unusual! I loved it!) as "This story will draw on the field of narrative medicine, Rachel Aviv's research about how mental illness diagnoses and the stories we tell about our mental health symptoms can drastically affect outcomes ... The idea is to examine the language we use and the stories we tell ourselves about our physical and mental wellbeing, and how we can make those stories work for us."
Obviously, I was intrigued.
Please enjoy.
Today is going to be a good day, I tell myself most mornings. It’s not so much that I am willing the day to be good, but rather that when I wake up feeling on edge, braced for the worst, saying this phrase is like stretching out a stiff muscle. It allows me to relax my jaw, lower my shoulders, and breathe deeply — to treat the physical symptoms of trauma by reminding myself that my present life takes place in a wildly different reality from the one my body remembers. The phrase acts as an override code.
I live with a chronic mental health condition, Complex PTSD (C-PTSD), as a result of growing up in a cult, which affects me both physically and mentally. Today will be a good day, I say, and usually it is: I am safe, I have stability, I am able to choose things freely.
This meditation is, I have learned, something straight out of narrative therapy — a practice introduced in the 1980s which helps individuals reframe the stories they tell themselves about their lives. Narrative therapy is usually practiced with the guidance of a licensed therapist, either individually or in a group setting, but the framework used in this practice is easily applied in daily life. People with chronic health conditions often struggle with their mental health as well, but narrative therapy can help individuals trade thoughts like “I became sick and now I am helpless,” for more self-advocacy focused narratives, like, “This is my reality, but I can trust myself to work within my circumstances, make good decisions, and advocate for my needs.”
Melissa Ortiz, a 57-year-old living in Chevy Chase, Maryland who has spina bifida, Epstein Barr virus, diabetes, and is a cancer survivor, among other things, has been a narrative therapy client for over a decade. She used to find herself going in circles with GI doctors, feeling like they weren’t clearly hearing her needs. After gaining familiarity with narrative therapy tools, Melissa devised a method for communicating her needs clearly to her friends and family, and eventually also her doctors: speaking about herself as if in third person, as if she was speaking of a friend’s needs. “It helps me detach in a way that I can manage it in small pieces,” says Ortiz. The modality has also improved her mental health. “I journal as part of narrative therapy, which helps me focus on the storytelling aspect of it.”
Often, narrative therapy requires questioning one’s own internalized assumptions, which are shaped by the larger culture. “It's just constantly asking myself, ‘What assumptions am I making about what's healthy?’” says Jenny Goldberg, a Brooklyn-based clinical social worker who uses narrative techniques in her practice. For example, receiving a mental health diagnosis can affect some patients negatively, but insurance companies require diagnoses. “I talk to clients about what they want that diagnosis to be and how they want it to appear on their insurance bill, rather than me saying, ‘You have this,’” she says. “If a language or label or term gives you access to something or makes you feel more connected to other people like yourself, those are great things… I'm really interested in the meaning someone is making of a diagnostic label, and if that meaning is helpful for them and allows possibility, allows expansiveness, or [that label] is keeping them in a very narrow story about who they are.”
Goldberg also stressed that in a narrative approach, the patient is seen as the expert of their own experience, not the therapist — and this informs every session. In particular, patients are given control over the language used in the therapist’s office. “A basic [approach] is using the language that my clients use, and also staying curious about what words mean to them,” she says.
Another key to the narrative approach is a focus on community. In 2015, Dr. Zain Shamoon, PhD, now a professor of Couple and Family Therapy at Antioch University Seattle who practices narrative therapy in his clinical work, co-founded a narrative therapy-inspired event series called Narratives of Pain in Michigan, where he was living at the time. The events were designed to give members of his Muslim community a place to reckon with the political anxieties they experienced during Trump’s campaign for president, where they could talk “without worrying about the voyeurism of somebody else, [who could misuse] that story,” Shamoon says. The events, held regularly until the beginning of the Covid-19 pandemic became a space for communal care, where individuals could tell their stories as they saw them, and audience members, by witnessing these stories, could reaffirm them. Even as the community saw themselves become further disenfranchised during Trump’s campaign, they reminded themselves that, as Shamoon says, “life is always bigger than the main script.”
I may not be able to trick my brain into embracing yet another day in the life of a body living with C-PTSD on my own, but by putting myself in community with other survivors of similar traumas, who are also trying to live lives not entirely defined by our trauma, I can reinforce the story I am telling myself and support others doing the same kind of mental work. I can’t always control my symptoms, but I can control how patient I am willing to be with myself, how I can leave my future as open as possible, and how I hold that same kind of compassion for others, too. I can make today a good day.