Patients’ written life stories: A gateway for understanding

Abstract

Objective. To explore how statements drawn from patients’ written life stories can help general practitioners understand their patients’ maladaptive thought patterns and their negative schemata. Design. Qualitative study of written life stories. Setting. General practice in Copenhagen, Denmark. Subjects. A total of 22 consecutive patients aged 23–49 years, who were invited by their GP to participate in cognitive therapy owing to depressive or anxiety-related disorders, including unexplained bodily symptoms. Theoretical frame of reference. Beck's information-processing model of anxiety. Results. Analysis of the written life stories disclosed aspects of negative expectations of life, the self, or the values and capabilities of others or of the patient him- or herself. Three main beliefs were identified: (1) the world is evil, (2) only the perfect is of value, and (3) emotions are dangerous. The patients describe events and experiences in negative terms that others might have interpreted as neutral or positive. For some this translated into a sort of all-or-nothing kind of thinking. Anger and other strong feelings were forbidden. Responsibility for the life of others was a dominant feature. Conclusions. Written life stories reveal knowledge of the patient's dysfunctional thought patterns. This may be a useful shortcut in therapy.