How 30 Minutes of Storytelling Can Alleviate Pain

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Storytelling may be a drug-free way to boost positive emotions and lower self-reported pain scores, according to a new Brazilian study of children hospitalized in an intensive care unit (ICU).

Reading stories to kids in the ICU for 25-30 minutes also reduced their salivary cortisol levels and increased oxytocin. These findings (Brockington et al., 2021) appear in the June 1 issue of the peer-reviewed journal Proceedings of the National Academy of Sciences.

"We found that, compared with an active control condition [riddle-based games], one storytelling session with hospitalized children leads to an increase in oxytocin, a reduction in cortisol and pain, and positive emotional shifts," the authors write in the paper's significance statement.

On a pain-rating scale continuum, self-reported pain scores by children in the ICU who heard stories dropped an average of 2.70 points (3.85 to 1.15); pain scores for those in the riddle-solving group only fell 1.54 points (3.72 to 2.18).

Storytelling was also about two times more effective than the active control at increasing oxytocin and reducing cortisol levels. After listening to a story for 25-30 minutes, the study participants' oxytocin levels, on average, rose nine-fold versus a five-fold increase with riddles. Additionally, cortisol levels decreased by about 60 percent after kids in the ICU were read stories versus a 35 percent decrease (on average) when they played riddle-based games.

Storytelling facilitates "narrative transport" to an imaginary realm

During the time spent immersed in a fictional narrative, reading fiction with one's own eyes, listening to an audiobook, or having someone read a story out loud can temporarily minimize the pain and suffering of your daily life.

Brockington et al. speculate that fiction readers (or listeners) lose themselves in an imaginary realm via a mechanism called "narrative transport." During this narrative transport process, the "real world" becomes partially inaccessible to the reader or someone hearing a story. As the authors explain:

"We focused on one possible mechanism, namely the transportation function of narratives. This unfolding of stories (e.g., the narrative arc) provides a context that allows individuals to identify with the main characters, become emotionally invested, simulate different mental worlds, and allow a temporal dislocation from the here and now—all of which contribute to the development of adaptive psychological and behavioral reactions when dealing with challenging real-life situations."

The authors also note: "These narrative transportations and mental simulations can help reframe personal experiences, broaden perspectives, deepen emotional processing abilities, increase empathy and regulate self-models and emotional experiences."

In a May 26 Los Angeles Times article about this study, first author Guilherme Brockington said, "You are going to another world through fantasy. For at least a little while, people can find themselves in a better place, a less stressful place."

Narrative Transport May Help Children in Hospitals and People from All Walks of Life

Brockington et al. note that "current psychological and neuroscientific evidence supports the basic premises of this transportation process and its plausible origins based on evolutionarily relevant preadaptations involving mirror neuron systems, conversational language structures, metaphor processing, and imagination."

The mirror neuron system is also activated by listening to music. Anecdotally, as a retired ultra-endurance athlete, I know that imagining myself as the protagonist in empowering songs like "The Promised Land" by Bruce Springsteen or "Lose Yourself" by Eminem transported me to another place and minimized my physical pain during ultramarathons.

In light of the latest (2021) research by Brockington et al., one could hypothesize that, much like written fiction, the storylines of songs on your favorite playlist may also facilitate narrative transport.

In closing, the authors conclude: "Stories possess a symbolic dimension that seems to create a natural bridge to the core of our humanity. We believe that our results provide insight into how physiological, biological, and cultural variables are closely interlinked. Further, they suggest a promising venue for developing safe, innovative, and cost-effective behavioral interventions to improve psychological health and reduce the suffering of hospitalized children."