Storytelling 

We all tell stories. Stories allow people to sew the fabric pieces of their lives together into a quilt. While some stories organize experiences of a short time period, others integrate the experiences of a lifetime. Stories function to:

1. organize and shape human experience and thought, give it meaning;
2. allow humans to reflect on experience;
3. convey human values and beliefs; and
4. help leave a legacy ( Taylor , 1997).

As theologian Henri Nouwen stated, “In the telling of their stories, strangers befriend not only their host but also their own past” Oncology nurses can nurture spiritual well-being by hospitably listening to clients' stories, but also by helping these clients to make sense of their past. Because many oncology patients are facing the end of their life, there is an urgency to the spiritual need to make sense of life and finish “sewing the quilt.” The nurse who encourages the telling of the life story and receives it graciously will mitigate this spiritual need.

Case Study

At each stage of Diane's illness, the nurse could utilize the technique of story-telling to help Diane make sense of her illness. Although with Diane's depressive symptoms, the nurse may need to choose an approach with sensitivity (see below). One approach that may be helpful and less likely to intimidate a depressed person is that of asking about pictures, memorabilia, jewelry, or other objects in the patient's environment. The nurse can then ask gentle, probing questions that may help the patient clarify emotions or identify issues. 

Tips for eliciting life stories:

• Can start with openers like: “If I were to write a biography about you, what would I need to know about you?”
• Can follow chronologically or skip around. Follow the path that they are taking.
• Use follow-up questions or probe more directly (as seems comfortable) to get details (e.g., “Tell me more about getting married”).
• Ask about pictures, memorabilia, jewelry, room decorations—objects that symbolize, in part, who that person is.
• Although a client can make a voice recording of their oral history, make a scrapbook, or draw a diagram to describe the events of their lives, it likely is more therapeutic to have a “live” listener who allows them to hear themselves at deep levels.
• Remember it is their story. What they don't or can't say, is just as meaningful as what they do or can say.
• Although you will have a counter story, refrain from sharing it unless you intuit it will be therapeutic (vs. social).
• If nurses are too busy to listen to their clients' stories, they can work to train volunteers in the art of story listening (see Rybarczyk & Bellg, 1997).

Not only can the client gain insights about his or her life, but the nurse can also collect invaluable information about the spiritual themes or issues of the clients' life. The following questions ( Taylor , 1997) can help the nurse to analyze the client's story:

• How does this person want me to perceive him/her?
• Is the tone of the story optimistic or pessimistic?
• Does the person portray self as a martyr, fool, hero, victim, or warrior?
• What life themes emerge? (e.g., betrayal, craving love)
• What parts of the story were given importance? (i.e., given time, energy)
• What unresolved conflicts surfaced?
• What values and beliefs are expressed in this life story?
• How distant (abstract) or close to reality is the story?

The answers to these questions will inform the nurse as to how to proceed with questions that encourage the client to “connect the dots” and make sense of the story, and possibly cognitively reframe the meaning of the life story. For example, a nurse whose analysis concludes the client has felt betrayed throughout life, might consider asking follow up questions such as: As I listen to your story, I hear about how you've been betrayed by the people closest to you. How has that affected your heart? Your relationships with others? Or with God? Can you think about persons or a God whom you have been able to trust during your life? How have these betrayals made you a better person?

References :

Rybarczyk, B., & Bellg, A. (1997). Listening to life stories . New York : Springer.

Taylor, E. J. (1997). The story behind the story: The use of storytelling in spiritual caregiving. Seminars in Oncology Nursing, 13 , 252-254.

Taylor, E.J., (2005)