Storytelling and Pain Relief

 

By Adrian Sparrow
NeuLine Health

Scientists have long wondered what the purpose of imagination and pretend-play serves on an evolutionary basis. Humans seem to be hard-wired to create and appreciate stories, whether factual or fictitious, but its evolutionary purpose has eluded us. How do stories and make-believe help us survive the world around us? New research suggests that listening to stories can help you feel less pain. 

A Brazilian study of children in ICUs found that 30 minutes of storytelling decreased pain and increased positive emotions. One group of 41 children between the ages of 2-7 were given a 25-30 minute session with an experienced storyteller, while another group of 40 was given the same amount of time with the same people who told riddles instead of stories. Based on saliva samples and pain assessments taken before and after the sessions, researchers found that both groups had lower cortisol levels and more oxytocin (suggesting a decrease in stress). While both groups benefited from their sessions, the results from the storytelling group were twice as strong. 

“Storytelling was also about two times more effective than the active control at increasing oxytocin and reducing cortisol levels. After listening to a story for 25-30 minutes, the study participants’ oxytocin levels, on average, rose nine-fold versus a five-fold increase with riddles. Additionally, cortisol levels decreased by about 60 percent after kids in the ICU were read stories versus a 35 percent decrease (on average) when they played riddle-based games.” (Source)

The kids’ average pain scores also dropped twice as much, with the riddle group dropping by an average of 1.54 points, while the story group fell by 2.7 points. After excluding stories deemed too emotionally loaded, children were given eight choices of stories commonly found in children’s literature. The types of stories told weren’t emotionally altered, and children could choose a different story during their session. 

Narrative Transportation

“We focused on one possible mechanism, namely the transportation function of narratives. This unfolding of stories (e.g., the narrative arc) provides a context that allows individuals to identify with the main characters, become emotionally invested, simulate different mental worlds, and allow a temporal dislocation from the here and now—all of which contribute to the development of adaptive psychological and behavioral reactions when dealing with challenging real-life situations.” (source)

When engaged in a good book or movie, we tend to forget the physical world around us. Narrative Transport happens when we listen to or read a story, connected with mirror neurons that allow us to ‘feel’ what another person is feeling. 

“Mirror neurons are a class of neurons, originally discovered in the premotor cortex of monkeys, that discharge both when individuals perform a given motor act and when they observe others perform that same motor act. “(Source

Physical Symptoms of Fiction
Even a very short story, or flash fiction, can feel as gut-wrenching as this story commonly attributed to Ernest Hemingway: “For Sale: Baby shoes, never worn”; a complete story with a beginning, middle, and end that forces the reader to think of the events that led to selling new baby shoes. Whether a story is laid out in 6 words or 6000 or presented in a movie or television series, we’re inclined to immerse ourselves in these stories. Not because we enjoy feeling pain, but because we are a social species and need to communicate potential dangers to each other and learn how to overcome them. Though we might never face lions, our brains can take those messages of courage and transform them into metaphors and content we can utilize in daily life, like having the courage to ask for a raise, confront a fear or manage an overwhelming task. 

“Storytelling may have begun as a means to coordinate behavior to face a task at hand (“Let me tell you about the wasp nest I saw here yesterday…”), but from there it is a small step to using event stories to teach broader lessons (“Let me tell you about the wasp nest I ran into last year, so that you can learn to keep an eye out for them…”). Further, the ability to simulate counterfactual events—fiction—allows one to teach lessons for which a particular veridical anecdote is not available. Mar and Oatley (2008) argued that the function of fictional narratives is to teach lessons about social behavior and social situations, allowing a listener, reader, or watcher to learn about how people behave without risking the consequences of making an error that could be dangerous—perhaps even fatal—in real life. “(Source)

Stories for Change and Connection
We look to stories to teach us how to overcome the stressors and challenges we face in our daily lives. We also create scenarios in our minds for us to navigate and predict their outcomes. This sort of narrative transportation and teaching can be useful when working through PTSD and phobias: 

“Imagine a barking dog, a furry spider or another perceived threat and your brain and body respond much like they would if you experienced the real thing. Imagine it repeatedly in a safe environment and soon your phobia — and your brain’s response to it — subsides.” (Source)

So why are we drawn to stories? We feel empathy and connection with each other through stories, especially with a well-written protagonist. When we immerse ourselves in a good story, narrative transportation takes us deeper into the realm of fiction and blocks the outside world. Stories broaden our perspectives, reframe our personal experiences, and increase empathy. Even if there was no scientific component, listening to a story or reading to others can help strengthen a feeling of community and familial bonds.

“It is the protagonist’s story, after all, so we evaluate everyone and everything else based on how they affect him… That’s what readers come for. Their unspoken hard-wired question is, ‘If something like this happens to me, what would it feel like? How should I best react?’ Your protagonist might even be showing them how not to react, which is a pretty handy answer as well.” (Cron, 2012).

 

 

Resources:

 

 

Patient-Reported Outcomes Part 1 of 2: A Primer

Patient-Reported Outcomes Part 1 of 2: A Primer

Patient-reported outcomes (PROs) are clinical trial measures that capture the patient’s own perspective on how they feel. While they are commonly used in clinical trials, they are also used in the clinic as another measure to gauge a patient’s health over time.

read more