HXR 2016: Narratives in Healthcare: Stories as Drivers of Change - Jonathan Adler, Olin College of Engineering and Health Story Collaborative

Narrative shapes every aspect of the healthcare experience. It molds our understanding of the past and forms our expectations for the future. Narratives are even being employed as health interventions. This track will explore how narratives have and will drive both personal and systemic change in healthcare from the perspective of the provider, patient, designer, and researcher. We will discover how harnessing narrative as a tool can transform the experience and delivery of care.

1. The Science of Stories Jonathan Adler Olin College of Engineering Health Story Collaborative [email protected] http://faculty.olin.edu/jadler HxRefactored Conference – Boston, MA – April 6, 2016

2. scoopnest.com

3. “We live entirely, especially if we are writers, by the imposition of a narrative line upon disparate images, by the ‘ideas’ with which we have learned to freeze the shifting phantasmagoria which is our actual experience.” Joan Didion , The White Album , 1979

4. The Human Brain is Wired for Coherence

5. themodchik.com

6. themodchik.com

7. everythingzoomer.com

8. ?

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10. Narrative Identity

11. Narrative Identity Reconstructed Past Perceived Present Imagined Future

12. m emory’s reconstructive nature is a feature of the system, not a bug

13. p alimpsest self

14. You : Based on a True Story

15. Narrative Identity: Why Should We Care? Structural Reasons Cognitive Reasons Ethical Reasons Empirical Reasons Adler, Lodi-Smith, Philippe, & Houle (in press ). The incremental validity of narrative identity in predicting well-being: A review of the field and recommendations for the future . Personality and Social Psychology Review

16. The Scientific Study of Stories

17. http://brainblogger.com

18. How Does Your Story (Now) Effect You Over Time?

19. How Does Your Story (Now) Effect You Over Time? Two Studies: 1) Natural tracking of middle-aged adults over four years 2) Special Sample over two-and-a-half years Adler, J.M., Turner, A.F ., Brookshier , K.M ., Monahan, C ., Walder-Biesanz , I ., Harmeling , L.H ., Albaugh, M ., McAdams, D.P., Oltmans , T.F. (2015). Variation in narrative identity is associated with trajectories of mental health over several years. Journal of Personality and Social Psychology, 108(3) , 476-496.

20. How Does Your Story (Now) Effect You Over Time? Natural Tracking Variations in story were associated with different trajectories of mental health over four years Adler, J.M., Turner, A.F ., Brookshier , K.M ., Monahan, C ., Walder-Biesanz , I ., Harmeling , L.H ., Albaugh, M ., McAdams, D.P., Oltmans , T.F. (2015). Variation in narrative identity is associated with trajectories of mental health over several years. Journal of Personality and Social Psychology, 108(3) , 476-496.

21. How Does Your Story (Now) Effect You Over Time? Special Sample Among participants who got sick, Variations in story were associated with different trajectories of mental health over two-and-a-half years Adler, J.M., Turner, A.F ., Brookshier , K.M ., Monahan, C ., Walder-Biesanz , I ., Harmeling , L.H ., Albaugh, M ., McAdams, D.P., Oltmans , T.F. (2015). Variation in narrative identity is associated with trajectories of mental health over several years. Journal of Personality and Social Psychology, 108(3) , 476-496.

22. Themes: Agency Communion Redemption Contamination

23. How Do Changes in Your Story relate to Changes in Your Mental Health?

24. Psychotherapy as a focus for studying change

25. Psychotherapy as a narrative endeavor

26. Changes in Your Story, Changes in Your Mental Health A dults in individual therapy Before first session and in-between each session Wrote story Completed measures of mental health Adler, J.M. (2012). Living into the story: Agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy. Journal of Personality and Social Psychology, 102(2), 367-389.

27. Standardized Score Mental Health Agency Assessment Point Participant 1

28. Changes in Your Story, Changes in Your Mental Health Clients got better Clients expressed more agency over time Changes in agency came before changes in mental health Adler, J.M. (2012). Living into the story: Agency and coherence in a longitudinal study of narrative identity development and mental health over the course of psychotherapy. Journal of Personality and Social Psychology, 102(2), 367-389.

29. Changes in Your Story, Changes in Your Mental Health Themes in therapists’ stories didn’t matter Adler, J.M .( 2013). Clients ’ and therapists’ stories about psychotherapy. Journal of Personality, 86(5) , 595-605.

30. illness as a biographical disruption agency c ommunion redemption / c ontamination c oherence

31. http:// www.healthstorycollaborative.org

32. http://commonhealth.wbur.org/2015/01/doctor-patient-bond

33. Quint Buchholz, “Mann auf Einer Leiter“ We use our stories (our identity) as a foundation. We use them to tell us who we are. We use them to make sense of new experiences. We are not only the main character, but also the narrator.

34. t hank you [email protected] http://faculty.olin.edu/jadler