“Narrative medicine is like water, it can seep into the cracks and heal and nurture,” -Laurie Kovens
It’s late morning on the second Wednesday of the month, and inside her office at Duke University Health System in Durham, NC, Laurie Kovens is logged into a Zoom workshop. She’s leading a group of 70 to 100 employees on a "Mini Mental Makeover."
As a licensed clinical social worker and Employee Assistance Professional with Duke’s Personal Assistance Service department, Laurie, LCSW, CEAP, is on the front lines of American healthcare and public health — and she’s tasked with helping doctors, nurses, CNAs, hospital administrators, public health researchers and other Health System and University employees who find themselves grappling with burnout.
As the glue that connects Duke healthcare providers, educators and its 40,000-plus employees with essential services and to empower them, Laurie and her EAP colleagues help employees thrive in their work and in their lives.
To that end, Laurie practices the narrative method in working with these employee groups to help build empathy, communication, better care, and mindfulness.
What is Narrative Practice?
Laurie is among a growing number of healers who are bringing a very specific skill set to the growing field of Narrative Medicine and Narrative Practice. They aim to address the relational, emotional and social factors that occur in tandem with physical illness to improve people’s lives. Narrative practices emphasize the importance of storytelling and encourage healthcare professionals, social workers, and narrative practitioners to listen deeply to people’s stories, to understand the person’s experience beyond just the medical symptoms, and to incorporate narrative techniques into practice to enhance empathy, communication, and understanding.Narrative Therapy is an extension of that approach and centers on the stories people tell about their own lives, along with the stories of gender, class, race, culture and sexual identity that are told within the broader social context and help to shape individual life stories.
“I’ve been listening to people deeply for as long as I can remember,” says Laurie.
Close listening and paying close attention to people’s stories are practices already deeply woven into the rich heritage of the social work profession.
“The practice of narrative, through expressive writing and storytelling, dovetails with what I do as a social worker,” says Laurie, a licensed social worker for more than 25 years. She also holds a Master of Arts in Creative Writing from Lenoir-Rhyne University and a Narrative Medicine Certificate of Completion from the private liberal arts institution in Asheville, North Carolina. (She developed and taught a full-semester Narrative Health class for her capstone project at her alma mater.) “I integrate narrative practices into the ways I help people. Even as we talk about their wellness, stress management, and problem-solving, narrative practice helps them ground themselves and remind themselves why they support this mission in healthcare.”
In addition to the Mini Mental Health online programs in collaboration with Duke’s Live for Life Employee Wellness program, Laurie uses a longer Narrative Medicine-informed workshop for groups of Duke employees including residents, nurses and fellows, along with researchers in public and population health who face secondary trauma through their day-to-day experiences with people in underserved neighborhoods. She also holds workshops centered on grief and loss for Duke’s annual Grief Symposium.
“Narrative medicine is like water, it can seep into the cracks and heal and nurture,” says Laurie.
“It’s so crucial to notice how language matters in healthcare,” says Laurie. “Instead of the word ‘hospitals,’ we talk about ‘health systems.’ We need to get back to the place where we focus on the people and not just the business and systems. We’ve lost the hospitality implied in ‘hospital’ care.
“In pockets of places across the world, Narrative Medicine helps us rediscover and center the humanity in health care and that is very exciting. Narrative Medicine is so portable, so it is hard to understand why it is not being embedded more rapidly in health care,” she adds. “At the same time, even in the decentralized way it exists in my institution, it has a way of seeping into cracks and crevices and making an impact.”
Laurie selects texts for her Narrative Medicine practice based on the audience and theme of each session, to help participants tap into their deeper insights and feelings. Following the 2020 murder of George Floyd, Laurie has delved deeper into the issues of equity, inclusivity and cultural humility with writing prompts from poet Lucille Clifton, Rita Dove, and Naomi Shahib Nye, and others whose work illumines the experiences of marginalized groups and experiences.
“Participants in the Mini Mental Makeover (MMM) often show up feeling stressed or overwhelmed or exhausted,” says Laurie. “By the end of the practice, they wind up feeling uplifted, and have found themselves feeling inspired, grateful, and refreshed.”
The goal of the innovative Mini Mental Makeover is to help health care workers reflect on how they came to be doing this work and in doing so, find purpose and meaning. Typically about 75 to 100 Duke employees attend each session.
“It’s the gateway to other practices of Narrative Medicine,” says Laurie.
Laurie follows a system developed by Dr. David Thoele, a pediatric cardiologist at Advocate Children’s Heart Institute in Park Ridge, Illinois, for health care providers to use with patients and families. As founder of Advocate Health’s Narrative Medicine program, Dr. Thoele’s technique, the 3-Minute Mental Makeover, is being practiced across the globe. Dr. Thoele’s associate is traveling to Barcelona this July, to present the 3-Minute Mental
Makeover as a therapeutic modality for former cult members, he said.
How the Mini Mental Makeover Works
Each virtual Mini Mental Makeover session begins with a check-in with participants to ask how they’re feeling in a word or an emoji, and the results are displayed anonymously in a word cloud.
“Although you can practice Mini Mental Makeover on your own, the group allows you to see what you have in common with other people,” Laurie says. “And you can also be reminded of the range of human experience, and you can inspire each other.”
Laurie asks attendees to identify one thing they need that day, to recognize three things they’re grateful for, and then share a six-word “story of their life.” And the final step is to share three wishes.
“The value of that is to step outside of all of the expectations that we are all dealing with all the time – whether those are expectations that other people have of us or expectations that we have of ourselves,” says Laurie. This is a time to be creative and ambitious and let yourself see a bigger picture.
A word cloud at the end of a Mini Mental Makeover session shows how participants' mood has improved.
“This is where we see tremendous transformation,” Laurie says.
Narrative Mindworks Questionnaire
- What is your idea of perfect happiness?
If we’re talking about my “madeleines,” I have an embarrassment of riches. I once went out to a local culinary school restaurant with a friend. The first bite of risotto, which we had both ordered that night, was so perfect, we both burst out laughing. Sometimes I find those moments with food or friends or both. Or just being present and taking in the feel of the air on my skin in the mountains or at the beach. I feel it when I watch a “lightbulb” come on for a client or a student, when they discover a new way to understand themselves. I get the same feeling of quiet (or not so quiet) elation when I go to hear live music or singing on the car or while I was the dishes. For me, it’s anytime I can tune in to the sacredness of the everyday.
- Which living person do you most admire?
My mom, who has been a role model to me for her ability to reinvent herself, learn new ways of being and thinking, her commitment to social justice, for her curiosity and lifelong habit of learning, her love of whimsy, and her ability to find just the right gift.
- What do you consider your greatest achievement?
I don’t know whether this is an achievement, a gift to me from others, or both, but I would say my greatest achievement is the web of family and friends who care for me, laugh with me, hold me lovingly accountable, and include me in their families of choice.
- Who are your favorite writers?
Madeline L’Engle, whose Wrinkle in Time books I go back to again and again. I’ve read and reread that series countless times in the last 50 year. The lessons about love, self-confidence, and a world in which science, spirit, and love all have plenty of room stick with me and never get old; Alice Munro, for her beautiful writing and the economy of words with which she conveys a story. Audre Lord, bell hooks, Maya Angelou, and Judy Grahn, who have taught me so much about what it means to be a woman living in this time, how to make revolution from wherever we are, and how much the personal is political with all the pain and joy implied in that concept.
- Describe yourself in six words.
Midwife of Souls, dwelling in the in-between.
- What are you most grateful for?
Family and friends, hands down. I have close relationships with people I have known all my life – friends who have “stuck” and stuck with me from every phase of my life, every job I’ve had, everywhere I have lived. It’s a joy and a privilege to see myself through their eyes, and to celebrate and mourn together and just have so many people whose company I cherish.
- What’s next on your bucket list
Travel adventures with family and friends to favorite places and new ones!
