What’s the point of stories that aren’t even true?

   When you think, you think in stories.  Try it.  Think about something, anything.  Think about that Thanksgiving meal you just had, about the jerk who cut you off in traffic this morning, about the flu shot you’ve been meaning to get.

     In your mind, did you see a single image of a turkey (or a stuffed squash?), did you think of only that one, colorfully descriptive phrase about the morning commuter’s ancestry and dietary preferences?  Did you have a vague and isolated feeling of guilt?

   Or did you maybe start with that, and then move on to the thought of your aunt simultaneously cooking the turkey and monitoring your toddler nephew’s first discovery of mashed potato art?   Did you replay that peaceful feeling you had as you listened to Ira Glass’s dulcet tones on the 285, only to be disturbed by that texting jerk, and just how long it took you to wind back down again?  Did you think, “Well, yes, I should get that flu shot, but I just know that I’ll have to go to the clinic, and wait in line, and then it really will sting a bit, and they’ll make me sit for 15 minutes, and then I might be late…”

Did you, in short, think of a story?

     Joseph Petraglia, along with many others (myself included) is pretty sure that you did. 

Stories – narratives – are one of the basic tools that people use for making sense of what is happening around us.  We don’t see the world in black, or white, or gray, we see the world in stories.  We construct narratives about what happened to us this morning, about what we want to happen to us next week, about the tasks we are engaged in right now.  We have narratives for what happens when we go to the doctor, narratives for what happens when we go on a date.  Those narratives might bend and twist from situation to situation (no two doctor appointments ever go exactly the same, no two relationships ever follow the same path), but the point of a good story-form (an ur-story, if you will) is that it can be overlaid onto situation after situation, and keep making sense. 

Are you with me?  Good.  But what then, you might be asking yourself, do stories have to do with public health?

Well, think about the narrative in your head for why you have or haven’t gotten a flu shot this year.  If you have gotten a shot, I’m willing to bet that your reasons were along the lines of, “oh, well, I had the flu a few years ago and I was sick, and uncomfortable, and grouchy, and I didn’t want that to happen again this year.” Or, “Well, I spend a lot of time with kids and it would be terrible if I infected little Aidan (or if little Aidan infected me).”  If you haven’t gotten a shot, maybe it’s because Michelle Bachmann knows a lady who has a cousin who heard that her uncle’s neighbor’s daughter got a vaccine once, and…  In other words, your reasons for doing or not doing a health related behavior probably exist either because of or within a story.  (A story doesn’t have to be a 700 page Homeric epic to be a story, by the way.  It just needs to have a somewhat logical sequence of cause and effect.  A plot.)

        As public health practitioners, as researchers and interventionists, one of our jobs is to figure out what it is that makes people engage in healthy behaviors (or reject unhealthy behaviors) and how we can encourage them to do that.  Thinking about the narratives that surround a behavior can help us to do that better.  First of all, knowing how people see the story of a behavior – the characters, the setting, the plot – helps us know where the best place to intervene might be.  But more importantly, stories have power.  The most fundamental way we teach our children is not by sitting them in a chair in front of a whiteboard, but by saying “Once upon a time.”  The narratives that become embedded in our head are the narratives that shape our actions.  By embedding new narratives, by tweaking those ur-stories, we as public health practitioners can hope to shape new actions.

These story tweaks can happen in almost as many different ways as there are stories.  In South Africa, a story line about date rape on a popular soap opera sparked dozens of conversations about what should and shouldn’t happen in a usually consenting relationship.   In a Native American community in the Pacific Northwest, a program was created in which small groups would listen to a traditional folktale, and then find the parallels (extend the metaphor) between those stories and their individual ability or desire to seek help when they were ill. 

                And if you’re not in the business of convincing the public to protect their health, what does this mean for you?  Personally, as a life-long lover of stories, I think it’s just plenty interesting in its own right.  But the next time you need to explain to someone why you really need to finish your work before going out for a drink, why some people require more caution than others, or the importance of true love and high adventure…try a story.

Main source:

Petraglia, J. “Narrative intervention in behavior and public health” Journal of Health Communication  (2007) 12:5, 493 – 505.

Becca Fielding-Miller starts every story she can with “Once upon a time.”  In past lives she’s been a 5^th grade teacher, a Tomacco water-er, a bus driver, a bookseller, a Peace Corps volunteer, and general manager of the California Aggie Marching Band-uh! (Go Ags!).  She’s enjoying her current iteration as a doctoral student quite a bit.