Quantum


HEALTH


Issue 11 April 2011


T


his month we talk with Dr. Lewis Mehl- Madrona about how personal narrative informs health, illness and healing. There is a creation story for every illness–and a different one for every cure. Dr. Mehl-Madrona explores with his patients how changing their stories can potentially change the state of their health, often in miraculous ways. Since he is part Native American and has studied with many Native healers, Dr. Mehl-Madrona also engages many of his patients in indigenous healing practices and ceremonies, including the Sweat Lodge and vision quest.


Lewis Melh-Madrona, MD, PhD, graduated from Stanford University School of Medicine, and is board-certified in family medicine with added qualifications in geriatrics and in psychiatry. He is the author of a number of books, including Coyote Medicine, Coyote Healing, and Coyote Wisdom. His most recent book is Healing the Mind through the Power of Story: The Promise of Narrative Psychiatry. He is currently a core faculty member in the clinical psychology doctoral programme at Union Institute & University and is in private practice in Brattleboro, Vermont. He is also the Director of Education and Training at the Coyote Institute for Change and Transformation in Brattleboro, Vermont.


Q


You are a psychiatrist by training, yet treat patients with all kinds of physical diseases, from MS to cancer to anorexia. In your book Coyote


Wisdom, you call your primary approach “narrative medicine” or the “storied” approach to health. What is that and how does it apply to physical and emotional health and healing?


L M-M: Well, first I should say that I was a family doctor before I trained in psychiatry, and so I still have that identity, as being a family doctor. Rita Charon is the first person I know to use the term ‘narrative medicine.’ It’s an idea that comes out the narrative paradigm, which is as ancient as the indigenous cultures. It’s the idea that everything is story, that everything that really matters is part of a story, the story of the story, presented as a story and memorised as a story. So in medicine, then, the notion of history is the notion of story. When people come to us they give us “the story”


8 Quantum Health


of the illness, the history/his-story of the illness. In many languages the word for “history” and “story” is the same word.


So we are really looking for the story of the illness, and the idea is that there is something about the story of the illness that contains really important clues about how to treat the illness. So, in conventional medicine, you would say that all you need to know is the diagnosis, and the story doesn’t matter. Just treat the diagnosis. You can get away with that for a while. But only in acute illness, like if you are riding on your motorcycle and fell off and broke your arm. You can get away with that until the person goes to rehab to recover function back in their arm. As soon as we need human participation in treatment, the story becomes crucial. As long as I believe that I don’t need to know how you think and feel, or what it means to you, for me to treat you, then I don’t need a story. I can pretend that I don’t need story. I’ll counter that argument in a minute, but let’s keep it simple for now. The minute you start working with a life-threatening illness, chronic illness, or one that requires patient participation, then the story is really important because the story tells us what the patient will believe is possible to help the illness. If I offer you a treatment that doesn’t fit your story, you’re not going to do it, accept it, participate in it, be enthusiastic about it, or take advantage of the self-healing response, also called the placebo response. And so, anytime I am treating human beings . . . story matters.


So the idea in medicine is that if you really want to understand the illness, you have to get the full history of the illness, meaning what story the person tells about getting sick, the story other people in that person’s environment would tell, you could even whimsically or metaphorically get the story the illness would tell about afflicting that person. There are multiple perspectives about the illness, and if I really want to be a good doctor, I need all those stories to help that person. And if I really want to help that person get well, then I have to have a story that matches that person’s story.


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