Writing a Script for Recovery

by Laurence Guinness

I’m delighted to be here and before I start I would just like to say how much I appreciate the wonderful and important forum for the exchange of ideas that William Pryor has created with the Unhooked conference.When William told me the theme of this conference is Love and Baggage I started to think about the baggage question.

What exactly is baggage and is it important? And if so why?

So today, in a round about way, I want to try and answer a couple of simple self posed questions related to the subject of baggage handling that I’ve found fascinating.

How important is story and self-narrative to the addict in transition and if it’s important why?

These are two little questions that I’m going to try and shed some light on primarily by asking a whole bunch of other questions and in doing so will hopefully provide some ways of answering these two questions.

I’ve been thinking about the transformation of the self.

Having experienced self transformation it’s a subject dear to my heart, but I’ll talk about myself in a bit.

Those of you in the recovery business, which I’m assuming is a large part of the audience, well, you’ll know firsthand what I’m talking about when I use the word transformation.

What is actually happening between the point at which a person presents themself as helplessly unable to behave in ways that they say they want to and the point at which they feel they are free from the behaviours and thoughts that they were unable to control?

It is another perplexing question, and one that I’d like to explore from both a subjective and objective position using the idea that “The Self” may be viewed as a flexible narrative entity that is contextually constructed to order by consciousness.

In other words when I look for my self, or think about myself through introspection what I may find and how I make sense of it, me, can vary depending on where I am, who I’m with and how I’m feeling.

Like at the moment I’m trying to construct a self narrative that portrays me as confident, clever and not at all anxious, and, as I keep telling myself that I’m not anxious then I feel I’m lying to myself because at this moment in time I feel pretty anxious.

But last night, in the luxury of my hotel room – I not only fully believed the story – but felt it too.

Was I the same self then as I am now? What’s changed, the story or me? Are they one and the same thing?

If I’ve changed yet the story remains the same then is my anxiety compounded by this cognitive conflict? This is another one of things I’m going to talk about in a while.

For the moment… If it’s true that the self is to some extent a flexible construct, dependent on social context and experienced emotions then the mode of self awareness as a narrative becomes all the more important when considering the plight of an addicted person in transition.

If the narrative holds or is strong enough in a variety of contexts then identity can be stabilised and personal wholeness can be experienced.

The story we tell ourselves and others and how we and others construct that story from the baggage of our lives could come near the top of the hierarchy of levers that professionals need to fiddle with in order to empower clients to think, feel and behave in ways that make sense for themselves and their social relations.

Or alternatively, are stories about the self, just that, stories and is introspection based on the recall and editing of our experiences akin to archaeology – you may find a lot of artefacts but no real idea of what purpose they actually served, like the case of a stone bowl found in an archaeological dig in Chile,

Was it a sacrificial blood vessel?

Was it a mortar for grinding herbs?

Was it a funerary object for use in the afterlife?

All these are rich and evocative stories that direct our attention and imagination down narrow allies.

The truth was eventually discerned through electron microscopic examination and the stone bowl turned out to be the natural product of the forces of water on stone.

The need to make sense of the bowl was compelling in itself and our minds can’t help filling in the gaps whenever we lack information.

This may be fine for stone bowls and archaeology but a little more important when faced with a person who sincerely and urgently wants and needs to change their lives for the better.

So the business of storytelling is actually be quite a serious one, both to the addicted individual who wants to change and to the professional hoping to motivate that change.

This begs the question, that if story is so important and the mind so willing and eager to make up stories then is the dogged pursuit of truth through the archaeological process of rooting around in a person’s baggage, actually the pursuit of a jolly good story?

Could it be that this is what’s already happening between addiction service users and the vast array of addiction workers?

In my experience of working with substance misusers I found that most of the people I engaged with were fantastically open and willing to having me help them make sense of their baggage for them, which is exactly what I was told not to do during my counselling training.

So being told not to do something set my alarm bells ringing.

I’m always suspicious when I’m told not to do something, I was raised in the Jewish faith and was told not to eat Pork – why, I still don’t really know? I ate pork and I’m still alive, although I do feel anxious…

My wife was told by her priest not to have sex before marriage and she told me it was actually very good, at least that’s what my best man told me…

So what could be the harm in helping someone make sense of their lives – a little more actively – if that’s what the addiction professional is already facilitating?

How far should an addiction professional go in directing the service user? In a politically correct, professionally standardised environment counsellors and key workers are most definitely discouraged from directing the client.

Let me try and unpick this idea because I believe it’s important to try and understand what’s going on between not just a counsellor and a client but between any human relationship – functional or otherwise.

If we take the general sociological idea that one’s self perceptions are an internalization of the perceptions of the views of others as conceptualised by Charles Cooley and George Herbert Mead and somewhat empirically confirmed by current research, and accept that the “looking glass self” is a very real phenomena whereby a person views themselves through others’ perceptions and in turn makes sense of themselves and then we apply some of the most recent research by Yeung and Martin at Rutgers University that confirms Cooley’s assertion that we are more influenced by those we feel are “ascendant over us” then we can start to see that the relational encounters of a person desperate to make or should I say remake sense of themselves are profoundly important.

They are at the point whereby any interaction with a professional or someone viewed as ascendant to them can literally help them to create a new self.

So whether they like it or not the counselor is a story maker and hence life builder of sorts.

The counselors own life story and self narrative informs their world view and is the basis for all counter transference between themselves and their client. Which is why counselors train to recognize this and do their best to mitigate against it.

But counselors and counseling do not an addiction industry make. The addict in recovery may never have counseling and may spend the bulk of their time in structured day programmes, rehabs and groups with other recovering addicts.

How many addiction professionals do you know who will honestly say that they actively or even unconsciously direct their clients and help them to make up stories about their lives?

I believe that the positive relationships that an addict in transition experiences are the the most important factors to their construction of a non addict identity and hence ongoing recovery and that story and self narrative construction are powerful relational processes that are best mutually acknowledged and actively pursued.

So if new pro-social relationships are so important to the addict in transition what else is really going on between a service user and addiction worker.

Cognitive psychology tells us that we have dozens of cognitive biases, I counted 66 on Wikipedia. Reading the list I was struck by biases such as;

Confirmation Bias -the tendency to focus on or interpret information in a way that confirms your own preconceptions,

or

Optimism Bias – the tendency to be over-optimistic about the outcome of planned actions

and

Hindsight bias – the tendency to interpret past events as having been inevitable.

If these are just a few of the universal filters of the human cognitive architecture then it’s no wonder that psychoanalysis takes nearly 6 years on average.

If it takes this long to establish some kind of fundamental self knowledge that makes sense of the self to the self then what can really be achieved in the average 6 weeks of CBT or 12 weeks in a Structured Day Programme?

My own experience of psychotherapy and subsequent training in the integrative model was highly informative. I came to realise that whatever we believe and however we choose to help those in recovery whether we like it or not we become part of their story.

To deny this is to deny the heart of what is happening during the transformative process.

Now let me change tack for a bit…

Like the war in Iraq, where the presence of British soldiers was politely described by General Sir Richard Dannat as exacerbating the difficulties faced by British soldiers could the onward standardisation of the way the UK implements solutions to addiction in itself perpetuate addictions for which we need a solution?

In other words does the cumulative effect of Integrated Care Pathways, DANOS, and Models of Care create a powerful pre-scripted story in which the addict and professional both have their characters and roles already written?

If you take the view that any organization is an objective social construction that organises and legitimates its functional ideas through the narrative interactions of its members then the aspiring recoveree either enacts their part through the methodology offered by the organisation or doesn’t.

If they don’t then like snakes and ladders it’s back to the bottom again.

So one of my ideas is that self-narrative, organisational narrative and story in general may be useful tools when thinking about addiction, treatment, and self transformation and that the story of the organization and its workers may be at odds with the story required by the addict trying to change.

Before I continue I’m going to tell you a little about myself and then try and explain some of my other ideas about the role of narrative in recovery and attempt to shed some more light on the two questions I asked earlier.

Namely: – How important is story and self-narrative to the addict in transition and if it’s important why?

I was sexually abused by my step father from the age of 6 until I was 12. From the age of 8 I was sold for sex by my step father and forcibly addicted to Rohypnohl. I was placed into residential care at the age of 14 and managed to run away by the time I was 16. I got out of the country and ended up in Abuja in Nigeria, working in a pizza parlour whilst I studied for a bachelors degree in Political Science.

I graduated with a first and moved to Sydney, Australia where I became a successful film-maker then a homeless drug addict subsequently spending 2 years in a secure psychiatric facility. Having successfully beaten insanity I returned to the UK and resumed my film making career.

Now you’re probably thinking, God, what a life story this guy’s got and now you’re all ears.

Well its certainly some story but with no truth whatsoever I’m afraid.

But it got your attention… and this is the next part of what I want to discuss – how do people use stories to get not just the attention of others but their own attention?

And more specifically, like I suggested earlier is the real job of the addiction worker best conceptualised as a kind of writer-director, helping the fragmented or incoherently formed self to construct a personally meaningful story that can purposively inform subsequent thought, identity and hence behaviour.

Now for a true story about myself, true from the perspective that you and I all, hopefully agree that I exist, that what I am about to describe either happened or it didn’t but couldn’t happen and not happen at the same time and true because I believe in the power of my own mind to discover and relate aspects of my own experience.

I am a documentary film producer. I’m currently working on three different projects.

One film explores religious fundamentalism from the perspective that it may well be thought of as an addiction, the second film explores the nature of reality and consciousness and the third is a TV film that documents and explores the psychological processes behind self transformation.

I’m also a somebody that has experienced the crushing emptiness and utter confusion of identity dissolution, diffusion, fragmentation or whatever other terms you choose to use to describe an isolated self that has become unable see itself meaningfully anymore.

It’s been the careful phenomenological discovery and examination of my life trajectory that has led me to become fascinated by the processes of self transformation and the self state change that occurs when a “so called” drug addict stops using drugs.

I use the words “so called” because I believe that the word addict like the word love, is an inadequate linguistic unit of representation for the incredible diversity of emotional, cognitive and behavioural states collectivized under the label addict.

The way we use words and the meanings we ascribe to them can have important consequences for both ourselves and those we are communicating with.

Take the debate about the word “disease” in addiction as an example of the power of words to symbolize negative meaning and thus facilitate negative stories.

As a filmmaker my job is to tell stories. Even the documentaries that my colleague and I are producing, whilst being recorded representations of reality they are presented in constructed narrative forms, that is to say – that the Writer, Director and Editor all collude, sometimes unwillingly, mostly unconsciously to manipulate and construct sounds and images in order to communicate with and tell a story to the audience.

When we want to make a film we set out with a considered purpose that informs our subsequent actions. We have a plan that we try and stick to.

Much like you could say an addict sets out in the morning, or if they’re anything like I was at the height of my using, the late afternoon, with a considered purpose that informs subsequent actions.

Addicts, like the rest of us have a plan that will enable them to achieve their aims, usually on that involves generating money to buy and use drugs.

The plan is also part of a self narrative that is functional just as our film making plan in the form of a shooting script and schedule is functional.

Whether or not the narrative truly makes sense of the addicts’ objective state and by this I mean the state that an external consensus majority would agree upon, it is a subjectively experienced story that provides some degree of congruence and meaning for the self.

Let me give you an example of a current self narrative that was given to me recently by Chris a 28yr old polydrug user and then unpick the narrative threads.

I’m on the brown so I need to score at least twice a day to stay well. If I don’t I get really fucking sick. I shoplift so I have to make sure that I’ve always got a bit of gear in me so I can graft otherwise I’m fucked and then I might have to do anything so I can score”

This short, seemingly simple narrative is packed with functional components that enable Chris to construct and confirm his identity as well as helping him to execute his plan to satisfy his experienced need to use drugs.

He has a “need to score” otherwise he cannot stay well. He shoplifts so he can make sure he scores. If he can’t shoplift then he’ll have to do anything.

All in all it is a rather satisfying and quite logical story… that is if you think and feel and tell yourself that you cannot live without using drugs, but that is not the end of it in terms of making sense.

Whilst it makes perfect sense to Chris, to the wider society of non-heroin and crack users it makes little sense.

How can heroin keep Chris well when it’s use is a contributing factor in his slowly declining health?

Why does he have to shoplift? Why can’t he just get sick and then get better?

Chris’s story whilst making perfect sense to himself makes no sense to anyone else.

This discrepency between Chris’s subjective, personal system of making sense of his world and the objective reality of the wider social system that Chris is in is at the heart of both Chris’s cognitive and social dissonance.

Chris wasn’t always an addict and he still psychologically embodies a self concept that conflicts with his current behaviours. Whilst his narrative is an attempt to reduce his subjective internal conflict it does nothing to reduce the social conflict that Chris experiences.

The story he tells himself both facititates his identity and behaviour and objectively seperates him from those that can’t or won’t understand him.

Let me unpack Chris’s story a bit more.

It was Aristotle who realised that all good stories have to have a conflict. Ancient greek literature used the term AGON to describe the act of conflict. There are six basic categories of conflicts that every protagonist in a story can face these are: 1) Self vs. Itself; 2) Self vs. others; 3) Self vs. Society; 4) Self vs. Nature; 5)Self vs. Supernatural; 6) Self vs. God.

Chris’s story, like my own story and like every other addict that ever existed or will ever exist overwhelmingly faces the first conflict…

The Self Vs Itself.

Yes the addict eventually comes into conflict with all the others categories but to my mind True addiction is a condition of the self in conflict with the self.

The awful battle for position and control that raged within me for many years was a battle of two different and utterly conflicting narratives. Using drugs would temporarily quash the opposing narrative until the next major conflict and so the conflict raged on and on.

Conflict is I believe at the very heart of addiction and addictive behaviour just as it’s at the heart of every satisfying story.

If this is the case then could it be that the resolution of conflicts in Chris’s overarching story of himself, including his explanatory framework of how and why he’s ended up like this might just resolve the conflict he now faces with himself and society.

Let me further qualify my idea that conflict is at the very heart of addiction and swiftly jump from the metaphorical mode of explanation to the neurophysiological.

If we look at addiction from a reductionist cognocentric perspective and understand that repeated drug use or behaviour causes genetic, molecular and cellular adaptations to selectively occur within some bits of the brain such as the Nucleus Accumbens, Amygdala, Prefrontal and Cingulate Cortices to name but a few – and less or not at all to other bits of the brain like the Occipital Lobe or Hippocampal formation then we can understand how the biological drive towards homeostasis can create an unconscious and non volitional physiological conflict between parts of the brain responsible for emotional and reward processing and other parts responsible for impulse control, executive function and the construction of self and identity.

This conflict eventually intrudes upon consciousness and is experienced as an overwhelming and unfathomable force compelling the addict to use.

I wasn’t always an addict and I didn’t always want to continue using drugs but I always felt a silent unseen compulsion to use drugs that I struggled to explain to myself.

The compulsion to use drugs has been investigated by some researchers along with another serious condition, that of Obsessive Compulsive Disorder and it is the neurosciences that have demonstrated that the intractable conditions of addiction and OCD are both typified by dysfunction within two highly interconnected cortical systems – the Anterior Cingulate Cortex and Orbital Frontal Cortex, both critically involved in self-regulation.

In other words the inhibitory system.

Addiction is indeed an inability to inhibit ones behaviour. It was Nora Volkow’s and Peter Kaliva’s 2005 paper “The Neural basis of Addiction, A pathology of motivation and choice” that demonstrated to me so well the cognitive conflict stemming from neurobiological adaptation leading to dysregulation that typifies an addicts inability to control their drug seeking and drug consumption behavior, despite reporting that they wish they could.

If this isn’t major cognitive conflict then I don’t know what is. This neurophysiological conflict also tells us something very important about the nature of consciousness – the bit we think of as us, the “I” is indeed an observer of the whole self and in times of physical and mental conflict we struggle to make sense out of the unexplainable yet personal conflict we experience.

So if the addict faces a neurobiological conflict that could be construed as non-volitional we start to see that only concerted external balancing inputs in the form of positive social interaction and support may help to readapt the dysfunctional neurobiological system back in line with the other parts of the addicts internal cognitive and experiential landscape.

This is basically what the addiction theorist Robert West proposes in his 2006 “Synthetic Theory of Motivation” where he uses the analogy of the human mind as a fly by wire system that requires constant balancing inputs to maintain homeostasis.

If this is the case and all the neurophysiological evidence points towards it being so then to my mind it’s vitally important that there is a top down influence that reorientates the self in a meaning making narrative system.

In other words, at the point that an addict is desperate for a way out of their self made trap it’s vital that they can quickly construct a story that makes sense.

The ambivalence that an addict often experiences of wanting to stop using yet continuing to use reflects this epic internal and hence social struggle against which the construction of a meaningful self narrative becomes difficult but not impossible.

If it’s true that the construction of a good story, one that satisfactorily resolves Chris’s conflicts can help Chris achieve psychological and physical well being then it tells us something very important about the nature of free will.

Namely, that through Chris’s willing participation in the process of constructing a story, be it through counseling, Key-working or any other pro-social interactivity it means that Chris, through the activation and strengthening of different neural pathways to the ones he’s previously used, is literally reshaping his perception of himself.

Which means that If Chris is changing then so is the world that Chris constructs and if Chris changes so does the way people who encounter Chris relate to Chris thus solving his social dissonance problem. This becomes a positively reinforcing feedback loop, motivating Chris to try and not use drugs whilst he makes sense of himself and his life.

Chris will still face cravings and negative emotional states but if he has embodied a socially constructed self narrative that helps shape an identity that places him in a new intersubjective space then he may be able to imaginatively project himself within a new story that includes activities like getting and maintaining a job or being a better parent.

Each new conflict, as well as the ongoing self identity struggle of the recovering addict can be placed within a new satisfying meaning making narrative.

This is why I believe that the resolution of an addicts internal conflicts through dialogue and dialectic leading towards a new positively intersubjectively verified self-narrative is fundamental to the process of self transformation.

Self narrative construction is the process of life making as orchestrated by and presented to consciousness.

So, the big question is how can we go about facilitating the construction of a story that makes sense to someone whose sense making makes no sense to others?

This is an epic conflict to resolve and takes a lot of effort from all those involved in the construction process.

I use the word “construction” from a viewpoint that human cognition doesn’t just happen – It is a dynamic, predominantly unconscious process of neural interaction that reliably “constructs” and “reconstructs” our feelings and perceptions of the world from not just the reflexive interaction with the whole of our present world but also the internal interaction of our past and present ideas, experiences and imaginings.

So, let’s start at the beginning – Autobiographical story making begins with the cognitive construction of embodied symbolic representations into a world making narrative.

In other words we all learn to make sense of the world through the eyes of others but in ways wholly unique corresponding our own experiences and feelings.

I like to think that Reality is socially constructed and personally disputed.

When I first started using heroin I believed it was the best thing I ever did. My self narrative quickly changed to fit my actions. I believed that I had the right to use heroin to make me feel better. And feel better I did.

The change in my self narrative disputed my previously socially constructed narrative that heroin use is a very bad thing for a person.

Things happen, we react, the mind, quite independently, organises and structures these experiences into a meaning making form, both before during and after the act.

After I stopped using heroin I was objectively helped by my counsellor to perpetuate my pre-using idea that heroin is indeed a bad drug to take.

But I’ve since come to my own conclusion that heroin is neither good nor bad, on its own it’s an inert substance. It’s me that had the conflict. I’ve come to see that my conflict was the embodiment of another conflict, namely the irresolvable death of my mother.

This is one of the most powerful realisations that I’ve come to understand about addiction, that the internalisation of unresolved conflict is a major contributing factor in the development of addiction.

An external conflict can create an internal conflict and vice versa.

If this is the case then identifying and resolving the conflicts through story construction and self narrative change is a necessity for the addict in transition.

You can see how my own story changed, first from the social interaction with my counsellor and secondly from my own dialogic reasoning.

The resolution of my internal conflicts allowed me to move forward and build a new non addict identity that includes and makes sense of my past experiences.

I’ve talked a lot about story and self narrative without really breaking down how we intuitively create autobiographical stories. Let me just sketch out what I think we do when we tell our story to our self and others.

Human beings are for the most part unique from the perspective that we very rarely live in the present. We incessantly think about tomorrow, next week, next year or alternatively about last night, yesterday, last weekend, last year.

We’re rarely right here, right now. When we start to tell our story, the story that informs our identity to ourselves we naturally look to the past. We insert ourselves into a first person narrative in which we as agents were part of and were affected by the events that we believe occurred to us.

We then recall these events in a temporal order from the earliest to the most recent. We may elaborate by recalling details about the setting and context but usually the heart of the story involves the people we interacted with, the conflicts we were involved in and what we did and what happened to us.

When shaped as narratives, stories give our lives credibility and form; – we come from somewhere to here and are going somewhere from here.

We like to think that Here is always here, even though it’s always there, but that’s another discussion.

If I break a story down into a list of ingredients we get: the settings, the characters, the actions, the conflicts, and, lastly, the resolutions or lack of them. So we have the all the ingredients of the story but with one huge and vital piece missing. The emotions!

Emotions are the subjectively felt intrusions into consciousness of the unconsciously produced response to a stimulus. Which all sounds rather dull for something that feels so important to us.

Emotions, like hurricanes, have a transitory power to make us act in ways that are astonishing to ourselves. Even more astonishing is the idea of self attribution and self perception theory whereby our emotions are unconsciously constructed through observing our own and others actions.

In other words if I’m not sure why I’m feeling the way I do I can attribute how I feel to what I’m doing, or learn to feel the way I do by observing how others feel about something.

Just like I can attribute my anxiety to the fact that I’m giving a presentation. Or you can attribute your boredom to the fact you’re listening to a presentation.

Recent studies by the Neuroscientist Antonio Damasio not only confirm this idea but another important finding…

which is that the observance of others experiences and emotions produces a mirroring effect in the observers brain whereby the observer unconsciously simulates the emotional state of the other person.

In a Positron Emission Tomography study designed to measure empathy the scientists found that “there were virtually no differences in brain activity between imagining an emotional episode from one’s own past and imagining an episode from the past of another”

This is a significant leap forward in understanding the psycho-social dynamics between people in a group setting.

This is relevant because if I come back to story and we recall that an important element of the life history story is the recall and retelling of past events.

Which is an important part of what the addict is expected to do in treatment, usually in a group setting and we throw into this process of narrative construction the fact that autobiographical memory, also known as episodic memory is not the rock solid unchangeable true record of events we tend to think it is then we start to see what a shifting sand type of cognitive foundation to identity, selfhood and meaning making we truly have.

Research is beginning to help us understand how false memories of experiences are created and the results show that its incredibly easy for a person to be misinformed and misled about what actually happened to them. If we mislead and misinform ourselves it seems obvious that others can do so too.

Memories of events that happened a long time ago, are impossible to accurately match to what actually happened without unbiased corroboration, couple this with the fact that the merest hint from someone else about what may of happened or why something happened can easily be taken as fact we see that the life history approach to making sense of ones story can be fraught with difficulty.

The phenomena of false memories can be our friend if we work with it or our enemy if we ignore it.

If you recall earlier I said that you have to be incredibly creative in order to construct a meaningful story from the baggage that the addict brings into recovery, well the fact is that this is what we do anyway and we do it because it serves our needs to make sense of the world around us.

We fill in gaps and our inexhaustible imaginations help us understand the possibilities contained in our world. This is an evolutionary adaptation that has ensured our species is firmly at the top of the food chain, albeit with some odd tendencies such as believing in ghosts or superstitions like the number 13.

All autobiographical stories and indeed self-narratives involve the selective achievement of memory recall. It is impossible to remember let alone tell everything about our life history both to ourselves and to others.

I believe that the selection and editing of the memories that inspire both the autobiographical story and the self narrative are again context sensitive, dependent on setting, expectation, motivation and objective.

We edit and select to suit ours and others purposes.

If this is true then as I said when I started out today the Addiction professional’s job really is helping along the construction of a good story, one that satisfyingly explains and makes sense of the conflicts at the heart of addiction.

So to recap..

The addict in transition needs to be able to reliably order and recall the baggage of their lives, they need to do so in way that resolves all their major conflicts and be aware that this is the process they are engaged in.

If they can be helped to do this perhaps the conflict they have experienced will begin to make sense.

I’ve spoken a lot about making sense, and before I finish I’d just like to explore what “making sense” actually is and why it is so important.

I have a one-year-old child and he is currently engaged full time in the process of making sense of the world. Little by little, every day his picture of his world gets a little bigger and a little more certain. His world is actually very small, he moves from one familiar place to the next and is relatively secure in his own sheltered environment.

However when we take him somewhere new his excitement is tempered by caution. With each new experience comes a positive or negative feeling.

The vacuum cleaner most definitely elicited a negative feeling when he first encountered it.

His sense making relies on the sedimentation of experience and emotion. This is the neural organisation and shaping that constructs his internal representation of the world.

This natural process continues throughout our lives allowing us to organize and remember the shifting objective and subjective landscape of our lives in a coherent way, integrating categories of physical things like people and places with non physical things like ideas and emotions.

The human brain is a powerful and flexible social learning device, this is what it does and this is what enables us to survive in a socially ordered world.

Our minds naturally create schemas, these are embodied neural maps of our perceptions, who we are and what we are. As my son emerged from the womb and even before that he was and still is building up a somatosensory schema whereby his body is becoming represented in specific parts of his brain which in turn are becoming consciously available to him in awareness.

These schema’s or maps facilitate the predictable response both to ourselves and our environment, including our relationships.

They provide the structure both literally and metaphorically for the way we interact and create our worlds. Without such schemas we would be insane and unable to reliably predict or interact with the world.

Imagine every morning having to discover your body anew and then start the day having to make complete sense of everything again. We would be unable to function and would wither away very quickly.

An autobiographical story then is another kind of schema for the ordering and integrating of ourselves in the world. It’s embodiment in our neural cells saves us the inordinate amount of cognitive effort required to constantly make and remake sense out of ourselves in the world and indeed the world within us.

So if this is what a story does what happens when we don’t have a good one.

The idea that a dysfunctional self story or lack of existential meaningfulness can be harmful is not new. It has been explored by all the different schools of psychotherapy and each branch aims to help an individual put together a story that makes sense.

But what is fairly new is the understanding of why a lack of a coherent story or having a story that doesn’t resolve conflict creates such problems for the individual.

If the easy ordering of experience and integration of experience reduces the cognitive load on our brains then the disordering of experience and emotional responsiveness creates the opposite - a mind that works overtime trying to make sense of something, or even itself.

Imagine if we had to guess our pin code each time we wanted to use our credit card, the world would grind to a halt. Traffic would build up, fights would erupt in shops and anarchy would ensue. Society would break down and we’d probably all starve to death.

Our pin code is a tiny little amount of information that we embody and can usually recall very quickly. Now imagine a vast amount of unordered information swirling around in our heads like the lost baggage mountain at Heathrow.

Trying to make sense of this without a coherent story with which to make sense of it uses vast amount of mental energy which isn’t just a metaphor as the mind is exactly like a muscle in that it’s cells operate via the conversion of glucose to fuel their activity.

This expenditure of energy on thinking that goes nowhere can in itself can reduce the energy required to inhibit action which is basically the mechanism behind willpower depletion and there has been fascinating research done on glucose depletion and the failure of self regulation which I won’t go into now, suffice to say the old cliché hungry, tired, lonely or angry really does have some basis in fact when it comes to mitigating against relapse.

There is another and more potentially threatening condition that can arise from not having a coherent story or self narrative with which to communicate with.

This is an immunological effect resulting from actively suppressing negative thoughts or feelings. James Pennebaker an American Psychologist with an interest in Narrative Psychology demonstrated in a classic experiment that the conscious suppression of strong emotions leads to a significant decrease in CD3 T lymphocyte levels, the cells that form the backbone of our immune system.

Conversely he found that the expression of emotions through daily short writing assignments significantly bolstered CD4 T lymphocyte levels, these are the helper cells that help our immune systems combat disease.

The writing assignments basically facilitated the construction of sense making narratives that helped to explain and express emotions to the self about the self.

Once explained and expressed the writer could effectively feel satisfied that they have processed their emotions. The fact that this process measurably boosted their immune system is a huge empirical clue to how important the business of self story making really is.

I’ve experienced first hand the debilitating physical and psychological effects of years of not having a good enough story to make sense of who I was or what had happened to me. It was no wonder I took drugs to make my self feel better when my own body was at war with me.

Using drugs is of course just one way in which a person can dysfunction, there are many other possible negative outcomes for a person who can’t make sense of themselves.

To my mind this last piece of research confirms all the other evidence that having a good story, that is… one that allows the mind to reliably and efficiently organise and recall experiences,

a story that satisfactorily makes sense to the self and others, a story about the self that resolves and makes sense of conflicts, past and present…is absolutely vital.

And that, I think answers my question.

Thank you very much for listening.