Storytelling
Margaret P. Moss
The art and science of storytelling is presented in this chapter as a mechanism that can be used in alternative or complementary therapy. Its historical roots in orality (also known as oralism) are defined and explicated through examples from primary oral cultures. These are cultures that do not have a written language system (Sampson, 1980). In direct contrast, taking the art form into the future, digital storytelling is explored. Storytelling is then connected to its use as an alternative method in which to affect the path of one’s health in terms of education, prevention, and intervention. Finally, concrete recommendations for health professionals close out the chapter.
DEFINITIONS
Orality
“The narratives we live and share everyday are our identity as a storied people and make visible what matters most in our lives” (Heliker, 2007, p. 21). Although there are around 3,000 languages in existence today, only 106 have ever been written and less than one half of those are said to have literature (Edmondson, 1971). Orality is defined as a mostly verbal communication system employed by whole cultures and devoid of the conventions or use of the written word (Olson & Torrance, 1991). The connection of orality or oralism to storytelling is intuitive. Storytelling is as universal in human communication as “the basic orality of language is permanent” (Ong, 2002, p. 7).
Literate societies evolved from oral societies. Each literate individual evolved from an oral beginning (Olson & Torrance, 1991). That is not to say that the formal and informal rules of orality are not as intricate as those in written communication. However, the vast majority of languages have never been translated into a written language (Edmondson, 1971).
The speaker, the process, and the aesthetics of orality are keys to imparting information (Lord, 1960). The rules concerning who speaks and when are defined by the culture. For instance, in some American Indian tribes, certain stories can only be told in the winter, others in the summer. Some words are not to be spoken at certain times of the day or to certain listeners. The process may be as in a prayer, a dance, or a story, and can be in front of a large audience or one on one. Aesthetics may involve the use of masks, rattles, costumes, or specific surroundings. Finally, orality uses postural and gestural tools, as well as silence, as paralinguistic features in the transmission of the communication (Tedlock, 1983). “Formulaicness is valued when wisdom is seen as knowledge passed down through generations. Novelty is valued when wisdom is viewed as new information” (Tannen, 1982, p. 6). Therefore, anyone wishing to impart information through purposive oral means, such as through storytelling, needs to understand the key components, rules, and assigned power of oralism.
Storytelling
Storytelling is defined as the art or act of telling stories (Dictionary.com, 2013). A story is “a narrative, either true or fictitious, in prose or verse, designed to interest, amuse, or instruct the hearer or reader; [a] tale.” Sociolinguist William Labov (as cited in Sandelowski, 1994) states that a complete story typically is composed of the:
Abstract—what the story is about
Orientation—the “who, when, where, and what” of the story
Complicating action—the “then-what-happened” part of the story
Evaluation—the “so-what” of the story
Resolution—the “what-finally-happened” portion of the story
Coda—the signal a story is over
Return to the present (Sandelowski, 1994, p. 25)
It is the instructive nature of storytelling that is of interest for health care as an alternative means to an outcome: improved health. But it must also be understood that lives, including our health, are “shaped by the stories we live” (Heliker, 2007, p. 21). Stories have shaped patients’ current selves; and it is through stories that nurses can “interest, amuse, or instruct” them as listeners. Storytelling has paralleled human endeavors and will continue to evolve through future mechanisms.
Digital Storytelling
Digital storytelling is “the modern expression of the ancient art of storytelling. Digital stories derive their power by weaving images, music, narrative, and voice together, thereby giving deep dimension and vivid color to characters, situations, experiences, and insights” (Rule, 2009).
Although technology in digital storytelling provides the processes and aesthetics, it can also present some difficulties. For those cultures with restrictions on word use, the 24-hour, 365-day availability of words via computer technology brings uncertainty. Matching the listener and the teller and their implicit contract is of utmost importance when choosing the type of conveyance.
Storytelling, whether traditional or digital, whether oral or written, serves multiple purposes across the life span and can be used by nurses. Nurses listen to stories whenever patients tell them what is going on in their lives; and they tell and retell stories every time they pass on information about patients (Fairbairn & Carson, 2002). Whether it is the person being cared for or the nurse, each individual telling the story “is” the story being told (Sandelowski, 1994). It is in the unfolding, intertwining, and connecting that a story becomes my story, your story, or our story. Stories are woven into the threads of life’s fabric in our daily lives (Barton, 2004). We are all connected on a deeper or—if you prefer—higher level and storytelling can take us to these levels.
SCIENTIFIC BASIS
Storytelling “is one of the world’s most powerful tools for achieving astonishing results” in almost any industry (Guber, 2007, p. 55). Through an implicit contract between the storyteller and the listener (Guber, 2007), time is always a necessary ingredient. The storyteller must take the time to fully tell a story through all of its parts, using the necessary gestures, processes, and aesthetics. A story, as a sequence of events with discernible relations between those events and culminating in some conclusion, is a cognitive package (Bergner, 2007) that can be given to the listener. The listener must make time available to be present within the story to hear the message and absorb it. Successful transmission will allow the listener to repeat the story to others in some form. Repetition, of course, leads to stronger transmission on both sides.
Effective storytellers understand their listener(s) and what they already know, what they care about, and what they want to hear (Guber, 2007). The great storyteller will guide the story through essential elements based on the listener’s understanding that the story is larger than the teller (Guber, 2007).
Language and Healing Beyond Health Literacy
“One of the few universals is that humans in all known cultures use language and tell stories” (Ramirez-Esparza & Pennebaker, 2006, p. 216). Storytelling without language is not possible. “Language embodies cultural reality” (Kramsch, 1998, p. 3). Language itself and healing may have a connection not yet fully explored or understood, beyond health literacy bounds. Most of the literature involving language and health surround the idea of health literacy, which has been defined as, “the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions” (Nielsen-Bohlman, Panzer, & Kindig, 2004, p. 4). Although evidence points to greater understanding of health services and all that entails when spoken in the receiver’s primary language (Koh et al., 2012), language as a healing tool and force are offered for consideration in this section.
In many indigenous cultures, for example, medicine and religion lines blur (Moss, 2000). Healing prayers are taken as a means toward optimum health whether in the physical, mental, spiritual, or emotional domain (Moss, 2000). These prayers are likely conducted in the traditional language. A recent study from South Africa offers that, “language creates an image of the unknown to which people attach meaning” (Lourens, 2013, abstract). There is comfort in hearing one’s own language. It takes away a struggle and the required energy needed to accept either information or prayer, presumably then, allowing more energy to be used for healing.
Whereas indigenous examples of language use in prayer and healing may be specifically seen as other examples, the dominant cultures also use language in healing and prayer beyond their use as delivery of information only. We see this in the change in tone, speed, earnestness, and length of delivery that exceeds any aesthetic needed to merely deliver information. This can be from a mother to a sick child, a prayer group to a member, or other cultural convention or relationship.
American Indian Exemplar
The Zuni Indians of New Mexico use storytelling through all parts of their lives. It is used casually and formally. It is used in secular and sacred telling. The teller can be a priest, a kiva group, a grandmother, or another person. A kiva is a “medicine (i.e., priestly) society” to which men are initiated as youths and remain to carry out the work of the kiva (Moss, 2000). The purpose of the dances they perform can be solely to heal listeners from sickness. Through word of mouth, the news may spread that a Rain Dance is called. Unlike what Hollywood portrays, this dance calls listeners to one of the small plazas (flat dirt squares) in the village where they can receive needed healing prayers.
Time is part of the contract. The listener arrives at a loosely determined time and waits. The dancers and lead teller arrive some time later. The teller knows why the listeners are there: the contract is intact. There is respectful listening and targeted telling. The telling is in the form of prayer, song, and dance. The team is in full regalia, with masks and dress from centuries of performances. A formula is employed in the telling. It can take hours. The teller(s), the process, and the aesthetics all come together in dance, silence, and singing to heal the listener.
INTERVENTION
Bergner (2007) writes about the “staying power of stories,” which has obvious benefits when delivering therapeutic messages. He tells of stories that patients have recounted as far back as 8 years earlier.
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