Rick Kirschner, ND

In 2004, Southwest College of Naturopathic Medicine & Health Sciences (SCNM, Tempe, Arizona) president Dr Paul Mittman asked me to create a class for incoming students that would be “everything you wish you’d known when you started school.” This led to the creation and development of the Healthy Communication Workshop, which I now present at SCNM twice a year to incoming freshmen. It is about treating yourself wisely, getting along with your classmates and professors, and knowing how to talk persuasively to your teachers and administrators and, ultimately, how to click with your patients and get great results. I am so convinced of the necessity of the workshop that I have a dream that one day it will be built in to every school’s curriculum and that all our students will be able to attend.

Healthy communication enhances lives, moves people forward toward their desired outcomes, and empowers the individuals who learn it to bring about change for the better, first in themselves and then in others. In clinical practice, in community relations, and in relationships with others generally and with the world at large, the need for progress and lasting change is simply too great to leave to chance. If you want a change, something different to happen, or some positive result, your competence in communication makes all the difference.

The Healthy Communication Workshop takes place over two 8-hour days. My business is The Art of Change LLC, so naturally the workshop begins with the following words: “The purpose of healthy communication is to bring about positive change.” I invite students to answer the fundamental question “what do you want to change?” We then explore 10 skills that effective communicators develop in themselves, each represented with a keyword. They are as follows:

Word: Making and keeping commitments to yourself and others
Story: Using stories to learn about, affirm, and empower yourself and others
Resonate: Connecting to and building successful relationships with others
Understand: Finding the map of reality that hides beneath the surface
Influence: Sharing and getting interest and engagement for your ideas
Habit: Creating automatic patterns that help yourself and others
Purpose: Knowing your values and vision for a personally meaningful life
Support: Giving and being able to receive help when it is needed
Connect: Working and playing wisely and well with others
Integrity: Matching habits to values and words to deeds

In this article, I would like to talk a bit about one of those skills, the use of stories.

Personal Narratives Produce Results
Everyone has a story to tell. In our chosen profession, the narrative we tell is that we are “physicians who listen.” What do we hear when we listen? Stories. Stories have a powerful role in our own health and in our patients’ health. In the Healthy Communication Workshop, we examine what the stories we tell are and how they shape identity, ability, and experience.

Our stories reveal much about who we think we are, how we think of ourselves, and what we think we are able to do or not do. Just by changing your story, or somebody else’s, you can change the world.

If you are wondering what exactly I mean by story, let me summarize it as follows:
What is, is.
What was, was.
What will be, will be.
Everything else is a story.

Different stories lead to different results. When people have trouble with change, it is likely because their story is based on a map of reality that blinds them to the many options and resources they have available. Maps of reality are constructed through the mental processes of generalization, distortion, and deletion. Our personal narratives represent core beliefs about ourselves and our world. Most problems that occur in life are not because of reality but because of the stories we tell about our experience of reality.

People’s lives do not change because you tell them to, no matter how convincing you think you are or how easy it would be for them to make the change. Even if making a change is within someone’s behavioral range, just because somebody can do something does not mean he or she will.

That is because our personal narratives run on the motor of self-fulfilling prophecy. Whatever you assume to be true, you act like it is true and then look for proof. You find proof because, in a field of infinite possibility, evidence can and will be found to support every story, no matter how flawed the story, if someone is invested enough in the story’s being true.

What is your story? How would you describe the path that led you to this moment? Is your story a true story? Are you sure?

The idea I am about to share with you is almost a no-brainer: You miss far more than you notice.

In a 1956 article, psychologist and American Psychological Association president George Miller proposed that the limit of conscious awareness, of what we could pay attention to successfully in any moment of time, was about 7 ± 2 bits or chunks of data.¹ A chunk is any meaningful unit of information.

Miller postulated that the field of possibility from which 7 ± 2 chunks are chosen consists of 7 billion bits of sensory input.

Infants attend to all of the sensory input simultaneously. That sensory overload is why they sleep so much! The process of growing from an infant to a child is one of learning how to filter all that data into a manageable 7 ± 2 chunks of information. The problem is that, once you focus your spotlight of attention, everything that is not in the light fades into the background and then disappears. It is as if you are in a huge cavernous room (the deep structure of your experience), and because you have such a narrow beam on your flashlight, all you can see is what is in front of you (the surface structure of your experience).

What is in front of you? Whatever you aim at! Usually, it is what is most familiar to you or supportive of your story unless there is sudden movement, light, or sound. The possibility of danger then draws your attention. The point is that if you shine the spotlight of your attention on one place, you are going to miss what is happening everywhere else. While you are focused, if you suddenly hear a loud enough crash outside, your spotlight will automatically move toward the sound and then seek to come up with a story to explain or dismiss it.

From Surface Structure to Deep Structure
Making sense of all the potential information seems to be the prime directive for infants and children. Little by little, that sense becomes a set of generalizations about who you are, where you are, and what is going on, including beliefs, decisions, and assumptions about time, money, love, feelings, work, play, mistakes, and family. Much of this early understanding persists, as the decisions we have made rarely get revisited and instead remain active in our lives. Our personal narratives get built on such foundations.

How powerful are childhood decisions in the way our lives work out? Some studies indicate that they are powerful enough to be used as a therapeutic agent.

Learning to hear a story—to understand that the person telling it to you believes it, while remembering that it is not the truth, the whole truth, and nothing but the truth—empowers you to do what that person might never do on his or her own. Go deeper! Get back to the source material from which the decisions were made, the beliefs were formed, and the generalizations were created to make new distinctions and to find missing details and underused resources. In healthy communication, that is half of the value of understanding the psychology of storytelling.

The rest of the value is found in using the values, motivations, and needs discovered in hearing the story to tell stories for effect.

Story in Your Pocket
Told well, your story can win sympathy, gain interest and support, or change someone’s mind, behavior, or life. On a larger scale, your story can make the difference between advancement and retreat, between a successful practice and a struggling one, or between a stellar reputation and a nonexistent one. To these ends, it becomes useful to know at least a little about the anatomy of a story. You can then design and tell stories that connect with people and click with their understanding, while allowing desired change to unfold.

The skeletal structure of a compelling story is simple. It has a beginning, a middle, and an end. It has a setting that creates the context in which the story takes place (location, time, and atmosphere). Its flesh and blood are found in the plot, a series of events with a beginning, a middle, and an end that highlight the main idea or desired effect of the story. It has conflict because that creates interest in a story. The conflict could be between people, between a person and a circumstance (health, relationship, or money), between a person and society (norms, biases, or attitudes), or within yourself (beliefs, decisions, choices, or limitations). A compelling story has a theme, a central insight that the whole of the story is meant to reveal, such as “believe in yourself,” “tomorrow never comes,” or “the only way out is forward.”

I believe that every ND should have at least a few compelling stories to tell and should practice them frequently to develop them. These include stories about why you chose this kind of medicine over others and what challenges you have faced and lessons you have learned, stories about what makes helping people interesting and worthwhile, and stories about how to help yourself and others advance, achieve, and take aim.

As NDs, we are usually not in the business of heroic medicine, of rescuing people from their choices. That is the purpose of emergency medicine. We are not often going to “fix” our patients by cutting off their troublesome body parts either. That is the domain of surgery. Instead, our role in patients’ lives is to help them achieve their desired outcomes, primarily through their own efforts, with our assistance. Our role is to be of service to them but not to be in charge of them. If we can make a real connection, hear the deep structure behind their story, and then offer them compelling stories that give them new hope, reveal fresh possibility, and help them make better choices, then our narrative of being physicians who listen is a credible claim and our treatment an invaluable service.

Rick Kirschner, ND, has delivered motivational speeches, training, and coaching programs on The Art of Change Skills for Life (http://theartofchange.com/) to some of the best-known organizations in the world, including NASA, Progressive Insurance, Starbucks, and Texas Instruments. He is author of the comprehensive communication program Insider’s Guide to the Art of Persuasion and is coauthor of Life by Design and the international best seller Dealing With People You Can’t Stand: How to Bring Out the Best in People at Their Worst. His next book, How To Click With People: The Secret To Better Relationships In Business And In Life, is scheduled to be published in June 2011 by Hyperion Books.

Reference

1. Miller GA. The magical number seven plus or minus two: some limits on our capacity for processing information. Psychol Rev. 1956;63(2):81-97.