BLOG: The power of storytelling in patient compliance with treatment
Patients with brain injury tend to have odd symptoms and feel like no one understands or is listening to them. Often, by the time they see me, they are petrified that their symptoms might last for the rest of their life.
So, the very first thing I tell these upset patients is that everything they are experiencing is absolutely normal for an injured brain. I use stories to help put patients at ease, better understand their condition and plan how we are going to treat it.
People are inherently interested in their own brains. You can immediately engage their interest by explaining their brain. And, through storytelling, you can build rapport and give your patients hope that things will get better.
I recently asked my patients which stories I’ve told that resonated best with them. Here are two recurrent favorites.
The city map
Imagine your brain as a city. You spend most of your time in certain areas of that city. You have a particular route you always take from home to work. You know this route well, and it takes you past your favorite coffee shop and the grocery store where you usually shop. Now, let’s imagine that a major street on your route is damaged by a flood or an earthquake. If you were to try to travel on that same route, you would become increasingly frustrated because it would take much longer to get to your destination, and you would be surrounded by other angry drivers. Our treatments help you find a different path to where you need to go. A brain injury is like that earthquake or flood, and our job now is to find new routes so that you can get back to normal and continue functioning while your old route is getting reconstructed (healed).
The tiger
We have the same brains that our caveman ancestors had, but we live in a very different world. When the brain is injured, its goal is to avoid further injury, so it goes into “fight or flight” mode. When the injury is caused by a tiger, fight or flight is very useful. It narrows your attention and floods your system with adrenaline so you can get away from the tiger. Right now, your brain knows there is a tiger out there, but it doesn’t know where. So, you are existing in this constant fight-or-flight state where you probably feel anxious and you can’t sleep and you’re not healing. The brain is doing exactly what it’s supposed to do. What we are going to do is try to shift the stimulation to send that tiger as far away from you as possible so you can go back in your cave and relax, and let your brain start healing.
Storytelling is a powerful part of doctor-patient communications because it allows for these three things to happen:
1. Keeps the patient engaged. Neuroscience is complicated. The minute you start throwing out a lot of clinical jargon, patients can feel overwhelmed or defensive because they don’t understand you. They may clam up, fail to absorb important information or not return to see you at all.
2. Helps patients accept and adhere to treatment. Many of our visual rehabilitation treatments involve some “speed bumps.” That is, patients experience discomfort or hassles while they are adapting and getting better. Good communication gives patients the motivation to put up with and get past the speed bumps.
3. Builds your business. Patients may need to explain their condition and/or treatment plan to a family member, primary care doctor, insurance company or employer. By giving them the tools to explain to others, you help to ensure their treatment can continue — and often generate new business along the way. When a patient tells his pickleball team how much you have helped him, you may suddenly find yourself treating the other pickleball players’ niece, spouse or neighbor, too.
Not everyone is a natural storyteller. Maybe you are the type of clinician who would rather give a quick answer but offer the patient a handout with an explanation for them to digest later. Regardless of your personal style, it is essential to find ways to communicate better with patients.
For more information:
Amy Thomas, OD, FCOVD, has worked with patients with brain injury for the past 15 years since she was in the Army in Germany. She was fascinated by how differently the soldiers and airmen who were coming back from down range perceived vision. Since then, she has been building her practice in Tucson, Arizona, which is dedicated to vision rehabilitation after brain injury and vision therapy for children.
Thomas will be a presenting a talk at the NORA virtual annual conference, Sept. 12-13, on “fixing potholes in the brain” and other ways to explain treatments to patients so they will comply with treatment and be able to explain it to others. For more information on the conference, please visit www.nora2020.com.
Disclaimer: The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of the Neuro Optometric Rehabilitation Association unless otherwise noted. This blog is for informational purposes only and is not a substitute for the professional medical advice of a physician. NORA does not recommend or endorse any specific tests, physicians, products or procedures. For more on our website and online content, click here [link to: noravisionrehab.org].
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