Storytelling in Clinical Social Work

Forward

            Uniquely, the job of a clinical social worker is to tell the client's own story in a way that they haven't seen it before.  The reason a person goes to a therapist is to get a new perspective of their problems so that they can fix them.  By helping them to understand their own inner workings, the social worker shows them where their levers and pulleys are so they can take control of their own lives.  The key is explaining the story in a way that the patient will easily comprehend it.  The example I will give is the part of the repertoire of my advisor at Wasatch Mental Health that he uses to help people understand how long-standing mental habits can change in a positive way.

Example Story

            Your mind is like a hill made out of dirt.  When you are born, your hill is smooth and unblemished.  As time goes on, you have many thoughts and experiences that are like raindrops trickling down the hill.  When thought patterns are repeated over and over again, it is like streams of water frequently running down the same part of the hill:  tiny ruts become large trenches that are difficult to change.  However, by consciously changing your thought processes and consistently making them a part of your routine, you can re-carve the grooves of your mind and improve your functionality.

Analysis

            The persuasive power of this story is the straightforwardness of the analogy.  It translates the emotional complexity of a mental illness into a simple phenomenon that makes sense to the listener.  Even more, it transforms the overwhelming prospect of deep life change into one basic task that can be completed with some effort.  That idea persuades the listener that they can make meaningful shifts in lifestyle because the connection between the cause and effect of water running down a hill of dirt is so obvious.  It encourages them to believe that hope is on the horizon even though their previous attempts at improving their lives may have failed.

Retelling the Story

            Habits are difficult to change.  It is easy to feel that you are sliding back into the same habits without making any progress.  However, if you follow certain steps, I know that you can rise above your depression.  The process is difficult, but anyone who puts their mind to it can do it.  Let me explain how this is done:

            Your mind is like a hill made out of dirt.  When you are born, your hill is smooth and unblemished.  As time goes on, you have many thoughts and experiences that are like raindrops trickling down the hill.  At first, when you think negative thoughts about yourself it probably didn't make much of a difference, just like a single rivulet of water wouldn't do much to the mound of dirt.  Over time, however, the negative emotions that you return to again and again are like streams of water constantly running down the same part of the hill.  They begin to cut ruts into your mind that are difficult to escape from.  That is why thinking positively about yourself for a day or a week is not enough to change the way you feel overall.  However, by consciously changing your thought processes to make a positive self-image a consistent part of your routine, you can re-carve the grooves of your mind and have the relationship with yourself and your family that you have told me you wanted.

            I put this story in the context of a single person's situation, specifically a patient suffering from depression.  I connected the thought processes they are experiencing to elements of the story to bring them inside of it more deeply and help them see how it relates to what they have already expressed in therapy.

"King of the Hill," no changes made, by Russ Allison Loar. https://creativecommons.org/licenses/by-nc-nd/2.0/legalcode