When words are as important as deeds.

• Position: Pain Relief

What does an English professor have to say to a group of pain management specialists? Plenty, as writer, teacher, and scholar David Morris addressed a plenary session of the American Pain Society, Glenview, Ill., and urged his audience to become proficient at using narrative skills.

"Chronic pain patients often can feel out of control and hopeless," notes Morris, who recently retired from a joint appointment at the University of Virginia, Charlottesville, in the English Department and the Medical School's Center for Bioethics and Humanities. "Narrative competence serves medical professionals beyond treatment of illness. It can provide knowledge about lifestyles and preferences as vital as numerical data on cholesterol levels or blood pressure. I believe clinicians with strong narrative abilities can help reduce their patients' fear, lower perceived pain intensity, and improve overall quality of life."

Morris reports that one study showed that patient beliefs about pain correlated directly with treatment outcomes. Dialogue can help patients replace or revise harmful forms of narrative, such as catastrophizing, in which they feel anxious, fearful, and hopeless, as if disaster is imminent. "Every patient has a story, and narrative medicine allows clinicians to work with patients to expose beliefs that may create barriers to effective treatment. There surely are benefits to helping patients replace counter-therapeutic narratives with a new narrative focused on supportive beliefs that promote health and sustain wellness. Patients want a narrative model of hope."

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