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Perspectives

Storytelling and Narrative Truth in Science

September 27, 2019

Dishonesty is a widespread topic in the news today, with headlines ranging from the lies of politicians to the denials of sexual predators. It may be timely to revisit the question of how we know what is true, but it is one of the original challenges for the social sciences. Compare a biology experiment with a psychology experiment and the conundrum quickly emerges. When can we believe what people tell us? Can we treat someone’s personal statement as relevant to science?

Our belief system is challenged every day with awful stories in the news featuring victims and perpetrators. How do we discern truthtellers? Some people put great weight on the facts, others on the storyteller. A story is a totality, and we respond to how elements fit together or seem discordant. Therapists may inquire about one odd detail in a story, to find a surprising connection to highly important thoughts and feelings.

Stories have long been vehicles for conveying complicated ideas in a compelling way. The leading concepts from mythology, religion, etc. emerge from stories and inspire devotion. People communicate in both mundane and life-changing situations through stories. This is the dilemma of narration. It is a fundamental characteristic of how we function as humans, but it can serve to promote truth or deception. How do we ever know the truth of a story? Should we not trust them and instead put our faith in science?

Asking for data and hoping for a good story

I have spent many years studying the data on psychotherapy outcomes. One sturdy research finding is that changes in patient self-report measures over time can better predict treatment outcomes than the judgment of the treating clinician. This has generated a collective sigh of indifference from many professionals. They seem to place greater faith in their personal sense of how therapy is progressing.

I have seen a similar debate during presentations of new clinical products to clinician executives. I have been a consultant for companies developing new products for disease management, telehealth, wellness and a variety of digital health solutions. Clinician executives routinely request data that validates the product being presented. This is a reasonable request that is always met with a combination of published and unpublished analyses.

My surprise when I share these analyses is that no one wants to pick them apart. They ask for the data, check the box and then move onto other issues. Their need for validating data is easily dismissed, in part because statistics are not what really makes them comfortable with a product. I have learned that they are looking for a good story about how the product works and how someone might benefit from it.

In fact, this is the way IT professionals seem to validate products as well. They have many obligatory questions about technical specifications, and then they too want to hear about how the product works for people. Wanting to first understand how a product is used makes sense, but there is more going on here. The story of a satisfied customer is the pivotal piece of evidence for many experts. A good story provides justification that can’t be shaken. It exists on a plane of reality we should better understand.

Historical truth and narrative truth

These issues have a long tradition of being discussed within the discipline of history. The historian starts by acknowledging there is something we generally understand as historical truth. This term describes what has actually happened in the world, and we come to know it through the collection of facts and data. This may differ from the personal memories of people. The term narrative truth has been applied to the veracity of how a story is told by an individual.

An example from history can clarify the relationship between the two. A person preserving the history of the holocaust (https://provingtheholocaust.wordpress.com/personal-and-narrative-truth/) describes how these truths intersect in the story of the Warsaw Ghetto:

Society would remember the Holocaust differently if there were no survivors to tell the story, but only data, records and photographs. The stories of victims and survivors weave together the numbers to create a truth that is tangible to the human experience… The combination of the personal and narrative truth gives human context to the grainy black and white photos. As a result, the narrative truths combine with factual truth create a holistic picture of the Warsaw Ghetto and the Holocaust.

There is no attempt here to rank the relative importance of each domain of truth. The contention is that we gain a better understanding of history when we can integrate objective and subjective information. The goal is to have high quality information of both types.

We need the narration of human experience

Mathematicians trust their equations. When experiments in the physical world can confirm those equations, they feel an even higher level of certainty. Professionals within behavioral healthcare trust data, some more than others. Yet most don’t feel they have the complete clinical picture until they hear how human experience accompanies the “grainy black and white photos” of statistics.

This need for the narration of human experience seems innate in that it keeps psychologists of every stripe grounded. Problems arise mainly when people take extreme positions, such as when this narration becomes the only explanatory system clinicians will consider or when they refuse to incorporate changes in clinical measures into the therapy process.

What do we gain with a narration of human experience? We can more readily establish an emotional connection with the people and situations under discussion, and we can leverage other analyses from this foundation. Much as we gain a “holistic picture” of the Warsaw Ghetto, noted above, we are better able to understand what is happening, why it is happening, and how it feels to the participants when we use all sources of information.

The final conundrum here regarding narrative truth is that we must appreciate both terms, narration and truth. We should not abandon narrative truth because dishonesty is occasionally uncovered. We should not abandon narrative truth because stories are messy and objective facts are tidy. We should embrace narrative truth because it is core to the human condition. Say what you want about stories and storytellers, but they will always be with us. Science needs to embrace and understand narrative truth, not find an alternative.

Ed Jones, PhDEd Jones, PhD, is senior vice president of the Institute for Health and Productivity

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