Narrative Therapy to Prevent Illness-Related Stress Disorder

Narrative Therapy to Prevent Illness-Related Stress Disorder

More than 94% of cancer patients describe the experience of having cancer as the most traumatic event they have ever faced and 13% of those individuals have posttraumatic stress disorder (PTSD) in the aftermath. Evidence supports the idea that certain behaviors lead to more positive health outcomes. Some patients automatically take on these behaviors, others do not. Treatments tend to focus on short-term, symptom-focused strategies. The type of therapy discussed in this article is Narrative-Expressive Therapy, which is an intervention designed to address the long-term, underlying stress and prevent posttraumatic stress disorder in patients with serious illness. [Petersen, Bull, Propst, Dettinger, Detwiler 2005]

Adjustment to living with or having had cancer is a multidimensional experience involving emotional, cognitive, behavioral, physical, and social features. [Stanton, Collins, & Sworowski, 2001] The aspects and overall demands of the adjustment to life with or after cancer include the existential components of reevaluating the meaning of life and the purpose of one's life and setting priorities that coincide with those meanings and purposes; the behavioral demands include role fulfillment or changes and meeting the demands of the illness; cognitive components including a sense of foreshortened future, the inability to concentrate, and preoccupation; emotional components take their toll in the form of depression and anxiety; the social components things like personal relationships, social comparisons, and the stigma of cancer. [Stanton, Collins, & Sworowski, 2001]

Many patients are minutely adept and immediate coping; they are able to function well without symptoms and furthermore are able to minimize their symptoms to their physician for fear of being seen as difficult and not receiving the treatment they require. A disease such as cancer threatens a person's cohesive sense of past, present, and future – also known as the personal narrative. [Cohler, 1982]

Narrative therapy meets the needs of cancer patients in the reappraisal, meaning making, and integration of their experience. To more clearly specify, narrative therapy is characterized by telling one's story; examining the roots of that story; seeking aspects of the story previously overlooked; exploring how incorporating new aspects of the story changes the meaning attributed to different events; anticipating how self-image, priorities, and relationships change as a result of new meanings, and finding an appreciative audience for new growth. [Petersen, Bull, Propst, Dettinger, Detwiler, 2005]

Narrative therapy is much like a creative arts therapy. Narrative therapy addresses the inability to put feeling into words that is common in traumatized individuals by providing a means of expressing a fuller range of emotions that words make otherwise