Telling Stories that Promote Health Transformation
We dream in narrative, daydream in narrative, remember, anticipate, hope, despair, believe, doubt, plan, revise, criticize, construct, gossip, learn, hate and love by narrative. In order really to live, we make up stories about ourselves and others, about the personal as well as the social past and future.
– Barbara Hardy, Towards a Poetics of Fiction
Stories are an important part of the human experience. As we go about our days, we tell stories all the time. Yet when it comes to our professional lives, those of us leading change tend to forget the power of a good narrative. We assume that, if our strategy is good and we present compelling evidence, people will get on board. But I’ve learned that no matter how good you are at developing the strategy—even if you back it up with data—you will not be able to implement your plan if people are afraid or are not motivated to join you. To successfully motivate people, I’ve found that I need a different skill: the ability to tell a good story.
It is not accidental that traditions and cultures often are preserved through narrative and storytelling. Stories remind us who we are and what we believe, so we can navigate the complexities and uncertainties of life. Contrary to popular belief, there is no such thing as a purely rational decision; emotions often play a larger role than we think in informing our choices. Our emotions can help us see what we value in the world. We process every call for action or change through that emotional lens, and then we choose to act or not to act.
Public Narrative as a Skill
Communities leading transformation efforts can benefit from this insight, using stories to draw out emotions and motivate stakeholders. At ReThink Health, we have adapted a framework for change that centers on effective storytelling. Public Narrative has been used in many different arenas, from political campaigns to community activation, and in many different places in the world, from Japan and the Middle East to Latin America and the Balkans.
Developed by legendary community organizer and Harvard professor Marshall Ganz, Public Narrative provides a way of thinking through the stories needed to mobilize people for collective action. The framework supports the development of three stories—a Story of Self, Story of Us, and Story of Now—that are meant to shift sentiment from “we have to do this” or “we don’t want to do this” to “we want to do this and we believe we can.” Taken together, the three types of stories can help to build a compelling narrative that motivates change.
Health system transformation, in particular, can benefit from this approach because decades of false assumptions and misguided priorities have resulted in longstanding mistrust and real disagreement among stakeholders. For decades a common misperception has been that the best way to create healthier communities is to spend more money on health care. If only we had better hospitals or could afford more expensive care, this thinking goes, people would be healthier.
The evidence suggests, however, that to really improve health and well-being, we need to look not just at the health care system but at the entire health ecosystem, convincing organizations and communities to invest differently. To make this case, health leaders will need to think more broadly, embrace new tactics, and tap into emotions.
That’s why we are helping the ReThink Health Ventures communities—six highly motivated, multi-sector partnerships already far along the path of health system transformation—to tell their stories using the Public Narrative framework. As these communities mobilize change, the discovery inherent in the Public Narrative help them make the connection between their own experiences as leaders, the experience and values of the people in their broader communities, and the urgent challenge that requires collective action.
Defining Your Three Stories
As I’ve explained, the public narrative framework involves developing and telling stories of self, us, and now.
A Story of Self communicates to others why you personally have been called to do this work. It is important to help people understand your motivations and establish your credibility. The story of self is not about reciting your personal biography. It should answer questions such as: when did you first care about health, and why do you care about it? When the story of self is done well, it speaks to specific moments from your life experience that have determined the choices you are currently making. Usually, these are moments of pain and struggle, and sharing them requires courage and a willingness to be vulnerable. For many people, telling a Story of Self can feel like self-discovery, uncovering one’s internal motivations to do this work.
A Story of Us starts with “remember the time when we…” and articulates the values shared by a community. The Story of Us helps people to identify with each other and with their community, not because they share certain traits—a categorical “us”—but because they share core values—an experiential us. Much like the Story of Self, the key to a good Story of Us is identifying and communicating the shared experiences of the community in order to connect various stakeholders to a common purpose. While the Story of Self requires self-reflection and is inward-looking, the Story of Us is focused on others. To craft a Story of Us, a leader needs to listen well and observe what is happening to other people, and then connect everything that matters to individuals into one shared motivation. As they craft the Story of Us, leaders serve as entrepreneurs of a collective identity.
A Story of Now communicates three elements in a single place: the urgent challenges that we as a community are called upon to face now, the hope that we can face them successfully, and the choices we must make in order to act. A public narrative ends—and often begins—with a Story of Now. There is a tendency in professional communities to talk about the urgent challenges in abstract and vague terms or using just statistical information and data. However, the same general rule about creating an emotional connection applies here: if the story does not have a human face, people will not be able to connect and feel motivated.
In our experience, multi-stakeholder partnerships that are working hard on health system transformation are constantly confronting the unexpected and unknown. Crafting a strong set of stories that define the partnership will help provide the leadership needed to steer the ship through uncertain waters. Effective stories can inspire key stakeholders to join an effort by answering often overlooked, but essential, emotional questions such as: where do I find the courage, hopefulness, and trust to take the risks demanded of me? By sharing their own examples, leaders inspire people to find their own answers to these questions.
Recently, our ReThink Health Ventures communities used Public Narrative to help tell their stories and craft their value propositions. As Kirsten Wysen, a project manager with the King County region, noted after a session: “It’s so interesting for me, as someone with analytical training, to learn storytelling and narrative. Adding the ‘heart’s’ role to decision-making explains a lot about why the ‘head’s’ carefully constructed rationales don’t always make the case.” You can read more about Kirsten’s experience crafting her Story of Self in her recent blog post.
Creating Compelling narrative is a leadership skill and, as with any skill, to get better, deliberate practice is required. ReThink Health has created a Public Narrative Toolkit that includes short videos, worksheets, meeting agendas, and coaching tips—all aimed at helping leaders strengthen their storytelling capability and craft a Story of Self, Us, and Now. As you develop your storytelling capacity, I hope you will share your stories with us! Comment below or email us at ThinkWithUs@www.rethinkhealth.org.