NARRATIVE EFFECTS ON EMOTIONAL PROCESSING IN HEALTH PROMOTION/THERAPEUTIC CONTEXTS

Larkey, Linda

Purposes/Aims: We propose a model suggesting how narratives influence affective processing associated with health behavior change.

Background: Storytelling has been used increasingly in health promotion contexts, using narrative messaging based on naturalistic stories drawn from the target population. This method captures and delivers culturally relevant messages intended to affect health behavior, in contrast to the usual methods of messaging to address a variety of knowledge, beliefs, and attitudes toward behavior, including perceptions of social norms. Health behavior has been linked to cultural norms as well as to a number of prior, emotion-setting life events that interfere with attempts at behavior change and adherence. Rarely are the prior set-points of emotional interference with healthy behaviors addressed in models of health promotion, not even in the storytelling literature and models of how narratives might “work” to change behavior.

Internal consistency of the model developed: We suggest that one of the most salient factors underlying the barriers to behavior change when presented with logical and motivational options for shifting to healthier lifestyle is pre-existing emotional distress. For example, addictive behaviors (e.g., substance or alcohol abuse), or emotionally charged experiences (e.g., emotional eating, somatic dissociation) may be at play in the barriers to achieving results in dietary or physical activity change. Emotional factors that may enhance or inhibit capacity for making changes may be an appropriate target for interventions in the health context. Storytelling may, in addition to the factors that affect attitudes and perceived norms for behavior change, also influence affective processing associated with emotional health and, subsequently, behavior change.

Logic linking the model: Research suggests that (a) story characteristics, including story appeal and personal/cultural relevance, work as moderators of how narrative messages impact (b) the mediators, or create emotional engagement, identification, and opportunities for emotional processing rehearsal. These mediators, in turn are seen as critical to (c) achieving changes in the individual's emotional processing (e.g., emotional expression and emotional acceptance) and in somatic reintegration, contributing to lifting the barriers to emotional well-being and enhanced capacity for behavior change.

Conclusion: Although health promotion messaging often addresses an important “top layer” of required informational and motivational needs, there may be important deeper layers of emotional distress that hold individuals back from activating inner resources to shift to healthy lifestyles. Health promotion messaging is critical to basic processes of change, but a deeper layer of conditioning may be an important first step to removing barriers to health behavior change. Storytelling, and the emotional content that is raised in narrative messaging, may serve to address this deeper layer of psycho-emotional challenges.