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Talk Therapy

Boston Globe (Boston, MA) , March 21, 2011


A recent study led by University of Massachusetts Medical School researcher Dr. Thomas Houston found that patients could better control their blood pressure if they heard stories from other patients who were successfully controlling theirs.

“Storytelling is a natural human thing. We live by stories and through stories we make meaning of our lives," Houston said.

Houston’s study, published earlier this year in the Annals of Internal Medicine, looked at 299 African-Americans with uncontrolled blood pressure. Those who listened to stories from others in similar straits lowered their pressure more over the next six months than those given factual data only, the study found.

Matthew W. Kreuter, director of the health communication research laboratory at Washington University in St. Louis, says that the two methods, giving patients stories and factual data, can complement each other.

He would like to see a “story rack" alongside the pamphlet rack found in nearly every doctor’s waiting room, allowing people to choose stories from patients with similar problems and demographics.

Simply telling or writing a personal story can be cathartic, whether there’s an audience for it or not, according to James W. Pennebaker, chairman of the Psychology Department at the University of Texas at Austin.

There have been more than 200 studies over the past 20 years confirming the benefits of putting one’s medical story into words.

“Almost anyone, if they find themselves thinking or worrying too much, and especially if they don’t have someone to talk to — writing is beneficial for them," Pennebaker said.

Internist Rita Charon thinks that good patient care simply can’t happen without letting patients tell their stories.

“The only way to know what’s the matter if you’re sick is to tell someone else about it. It’s in giving the account of self that the sick person comes to know what’s the matter," said Charon, director of the Program in Narrative Medicine at Columbia University. “When we deny them that, not only do I the doctor not find out what’s the matter but she the patient doesn’t [either]."

When Charon meets her patients for the first time, she quizzes them not about their symptoms but about their story. “Please tell me what you think I should know about your situation," she’ll ask.

Within five minutes of posing the question — fast enough to fit into even a harried doctor’s schedule — one recent patient told Charon everything she needed to know to understand the woman’s health.

“I got a sense of what’s wrong with her, what’s right with her, what her pleasures are," Charon said. “There’s nothing more urgent for a doctor to know than what matters to you."

Subjects Covered: medicine

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