Narrative therapy represents a fundamental approach to dealing with chronic pain, a condition that, in syndromes such as vulvodinia manifests itself with a physical impact many times disabling. As Dr. Elisa Stefanati, psychotherapist at the AEsthe Medica Outpatient Clinic in Ferrara, points out, “this suffering should not be understood only as a prolonged symptom, but as a complex experience that with important implications on self-image and memory.
Pain, even in its physicality, merges with emotions and interpretations that become part of the biographical history of the sufferer. It is precisely here that narrative therapy intervenes: the goal is to restructure the illness narrative so that pain, transforming itself into a shared word, loses some of its destructive force and stops being the sole totalizing element of the patient’s life.”
Narrative therapy: what it is about
“Narrative therapy assumes that the person is not the problem: the problem is solely and only the problem,” the psychotherapist explains. “This makes it possible to reduce the totalizingidentification with suffering, whether physical or psychological, restoring centrality to the person and loosening the constant focus on pain.”
Work on meanings, not just symptoms
“A large part of suffering is kept alive and intense by the meanings attributed to the experience (“I am defective,” “I will never heal,”” Stefanati explains. Narrative therapy helps revise and transform these narratives: by rewriting one’s own story, the person regains the role of author of his or her own life, rather than feeling like a passive victim of events or illness. Experiences, even painful ones, are re-read in the light of new meanings, more consistent with the person’s values, resources and desires.”
Integrates mind, body and relational experience
“The stories we tell about ourselves and our suffering also influence the way we experience the body, emotions, and relationships, making the narrative approach particularly suitable for taking on complex issues such as vulvodinia,” the expert concludes.
Why it can be useful in cases of vulvodinia
Narrative therapy can prove to be a valuable support in cases of vulvodinia, effectively fitting into the articulated framework of intervention that is the most correct approach to dealing with such a complex pathology.
Reduces identity fusion with pain
“In chronic pain syndromes, and in vulvodinia in particular, pain is likely to become the central element of the identity of the woman suffering from it,” comments the psychotherapist. “Externalization helps create distance: pain is no longer ‘my totality’ but ‘a part of my experience,’ and the moment pain is named, described and observed as something separate from the person, the sense of overwhelm it provides is reduced.”
Contrasts narratives of guilt, shame and helplessness
“The vulvodinia is often accompanied by stories of failure and misunderstanding, partly because it touches the sphere ofintimacy, always a highly inflated area of stigma,” Stefanati continues. “Narrative therapy makes it possible to recognize the context (medical, cultural, relational) in which these stories were constructed by managing to give voice to the subjective experience, which is too often overlooked. Telling and reorganizing one’s story allows the person to feel believed, legitimized, and acknowledged, which are key elements in experiencing persistent pain in a less dramatic way.”
It fosters a more welcoming relationship toward oneself and one’s body
“Told pain opens the way to the search for “alternative stories”: this allows the identification of episodes of resistance, competence and self-care that often remain invisible in dominant narratives,” Stefanati explains. “The new story that is brought to life is not a ‘positive story at all costs,’ but is nonetheless a more complex story that can include pain without being defined by it. And through these new, richer and more flexible narratives, the body can stop being seen only as ‘traitorous’ or ‘defective’ and become an ally that communicates needs to be accommodated.”