HOW NARRATIVE THERAPY WORKS
Hundreds of studies have since been conducted to figure out how writing heals, because it does mend and transform. Social scientists have established that expressive writing decreases anxiety and depression; reduces pain and complex premenstrual symptoms; improves the body's immune functions including boosting antibody production; enhances working memory, physical performance, and social relationships; reduces illness-related doctor's visits; improves the physical and mental states of Alzheimer patients' caregivers, cancer patients, and people with HIV; reduces the symptoms of asthma, rheumatoid arthritis, and eating disorders; and positively addresses a host of PTSD symptoms. In fact, a recent pilot study of eleven veterans diagnosed with PTSD found that after a dozen sessions of narrative therapy, not only did over half of the veterans experience a clinically significant reduction of PTSD symptoms, but a quarter of them no longer met the criteria for PTSD.
That's just a start.
Writing makes everything better.
It's tied to how our brains are wired. We are creatures of habit, evolved animals who perceive stimuli, run it through our limbic system, attach significance to it, and then respond.
Stimulus—significance—response.
Here's an example. Let's say you're stuck in traffic. The traffic jam is a stimulus. It's the job of your amygdala, an almond-shaped glob of neurons housed deep in your brain, to process stimuli, organizing events into emotional memories. Your amygdala codes this particular experience with frustration, which is the significance you attach to it. You respond to this emotion by swearing and mentally squishing the heads of the people in the cars around you. This swearing and mental-head-squishing response becomes your established action pattern any time you perceive a stimulus that your amygdala has classified as frustrating.
Stimulus—significance—response.
Traffic jam—frustration—mental head squishing.
But you don't have to remain a slave to this feedback loop. Thanks to your evolved prefrontal cortex, the big chunk of brain directly behind your forehead that governs executive reasoning, you have the ability to break free of this stimulus-significance-response pattern. (Pavlov's dogs were not so lucky.) Still, as anyone who's tried to quit smoking knows, being aware of the best path and choosing it are two different beasts. And the more intense the emotion, the less blood flow to the prefrontal lobe, therefore the weaker our ability to make rational choices.
To add to the problem, it turns out your neural pathways cement themselves in the case of traumatic events. The result is that some people respond to reminders of stimuli, a condition known as post-traumatic stress disorder (PTSD). This trauma-induced reprogramming of the brain explains why it's impossible for many veterans to enjoy Fourth of July fireworks, for example. Their limbic system, the creamy nougat center of the human brain where our memories and emotional lives are housed, has coded “explosion” with “danger,” and so when these veterans hear fireworks, they react as they would, as any of us would, to a bomb going off nearby.
From the outside, this condition may appear simple to correct. They're fireworks, not bombs, after all. But neuroimaging proves that when people are merely reminded of trauma, blood flow ramps up in the brain structures associated with extreme emotions and decreases in the areas associated with communication. The sufferer essentially becomes trapped in their own fear, at the mercy of neural patterns. The good news is that writing therapy, along with other mindfulness practices, including dialectical behavior therapy, art therapy, yoga, Qigong, tai chi, Alexander Technique, and meditation, allows you to reprogram your brain.
You can literally change your mind.
Drawing on the wide body of research in this area, the three most promising explanations as to how this works are habituation, catharsis, and inhibition-confrontation. I explain all three below.
Habituation
The effectiveness of habituation (note that the root word is “habit”) in changing negative patterns is based on the fact that central nervous system arousal decreases with repeated exposure to a single stimulus. In other words, the familiar becomes boring.
Let me give you an example. Say you show up to your office job next Monday, thinking it's just another day. When you get to work, however, you discover a red-nosed clown sitting in your spare office chair, smiling opaquely at you, his red clown feet so huge that they disappear under your desk.
That would be frickin' terrifying.
You would call people. They would tell you not to worry, that the clown is there as some sort of cost-saving, effectiveness-lacking productivity exercise. You believe them, but Creepy the Clown is still horrifying, particularly because that empty smile remains stapled to his face as he silently watches you type.
Day two he's still there, he'd maybe be a little less freaky, but for sure you keep one eye pinned on him at all times. On day three, because he hasn't killed you yet, you decide maybe it's safe to move both eyes to your computer screen, at least when checking email. Come day four, you're in the middle of texting your friend a photo you've just taken of the front of your shirt, and more specifically the toothpaste smear shaped like a famous singer (#ifoundmintyelvis), before you remember that Creepy the Clown is sitting five feet away.
You see where this is going?
By the end of the week, you're all meh. He's a clown in a chair and you've crap to do.
You have become habituated to the clown.
Like all good programming, habituation has a genetic advantage. If we respond to something that is proven safe with a heightened nervous system, we don't have as much attention to give to what is actually dangerous. Now that we're walking upright, we can use this power of habituation to our advantage. Specifically, by writing about past stressful or traumatic situations, we can gain mastery over them, freeing up room to worry about the actual threats, which are far rarer than our ancient limbic systems would have us believe.
Catharsis
At its most basic, a catharsis is an emotional release or a cleansing. You've likely felt catharsis after confessing to a professional or venting to a friend. My first memory of catharsis came when I was seven. My family had moved from a medium-sized city to the small town of Paynesville, Minnesota, right before I began second grade. I had to hit the ground running. New school, new kids, new rules, and I was the kid wearing homemade jeans and garage sale tennis shoes with teeth stained gray due to an antibiotic I was injected with as an infant. As a scraggly bonus, I fiercely refused to comb any part of my hair that I couldn't directly see, which meant that whoever sat behind me got a real treat.
Suffice it to say, I was not fitting in.
That first day on the playground, three girls, their names mercifully lost to time, cornered me by the slide. The one with rainbow barrettes spoke for them all. “Where you from?”
Probably she was only curious. Maybe she was trying to be my friend. For sure, I blew it.
“St. Cloud. My dad's an actor on TV.”
That's what's called a BIG FAT LIE. My dad had just quit his job as a cartographer to make a go at his dream of being a full-time