Narration is the use of a written or spoken commentary to convey a story to an audience. Narration is conveyed by a narrator: a specific person, or unspecified literary voice, developed by the creator of the story to deliver information to the audience, particularly about the plot: the series of events. Narration is a required element of all written stories (novels, short stories, poems, memoirs, etc.), presenting the story in its entirety. However, narration is merely optional in most other storytelling formats, such as films, plays, television shows, and video games, in which the story can be conveyed through other means, like dialogue between characters or visual action.
The narrative mode, which is sometimes also used as synonym for narrative technique, encompasses the set of choices through which the creator of the story develops their narrator and narration:
- Narrative point of view, perspective, or voice: the choice of grammatical person used by the narrator to establish whether or not the narrator and the audience are participants in the story; also, this includes the scope of the information or knowledge that the narrator presents
- Narrative tense: the choice of either the past or present grammatical tense to establish either the prior completion or current immediacy of the plot
- Narrative technique: any of the various other methods chosen to help narrate a story, such as establishing the story's setting (location in time and space), developing characters, exploring themes (main ideas or topics), structuring the plot, intentionally expressing certain details but not others, following or subverting genre norms, employing certain linguistic styles, and using various other storytelling devices.
Thus, narration includes both who tells the story and how the story is told (for example, by using stream of consciousness or unreliable narration). The narrator may be anonymous and unspecified, or a character appearing and participating within their own story (whether fictitious or factual), or the author themself as a character. The narrator may merely relate the story to the audience without being involved in the plot and may have varied awareness of characters' thoughts and distant events. Some stories have multiple narrators to illustrate the storylines of various characters at various times, creating a story with a complex perspective.
Narrative point of view Edit
An ongoing debate has persisted regarding the nature of narrative point of view. A variety of different theoretical approaches have sought to define point of view in terms of person, perspective, voice, consciousness, and focus. Narrative perspective is the position and character of the storyteller, in relation to the narrative itself. There is, for instance, a common distinction between first-person and third-person narrative, which Gérard Genette refers to as intradiegetic and extradiegetic narrative, respectively. Intradiegetic narrators are of two types: a homodiegetic narrator participates as a character in the story. Such a narrator cannot know more about other characters than what their actions reveal. A heterodiegetic narrator, in contrast, describes the experiences of the characters that appear in the story in which he or she does not participate.
Most narrators present their story from one of the following perspectives (called narrative modes): first-person, third-person limited, or (third-person) omniscient. A first-person narrator offers the potential for unreliability, which means it can both reveal and obscure the narrator's actions and feelings. A third-person limited narrator, otherwise known as close third-person, is also focused on a character's perception and experience of the world, but without the ability to lie. A third-person omniscient narrator can give a panoramic view of the world of the story, revealing the thoughts and actions of more than one character, and into the broader background of a story.
Literary theory Edit
The Russian semiotician Boris Uspensky identifies five planes on which point of view is expressed in a narrative: 1) spatial, 2) temporal, 3) psychological, 4) phraseological, and 5) ideological. The American literary critic Susan Sniader Lanser also develops these categories.
The temporal point of view can refer to narrative tense, or it can refer to how detailed or summarized the narration is. For example, when events are narrated after they have occurred (posterior narration), the narrator is in a privileged position to the characters in the story and can delve into the deeper significance of events and happenings, pointing out the missteps and missed meanings of the characters. The temporal point of view also focuses on the pace of the narration. The narrative pace can either be accelerated or slowed down. Narrative retardation (slowing down of narration) foregrounds events and suggests what is to be noticed by the reader, whereas summation or acceleration of narrative pace places events and happenings in the background, diminishing their importance.
The psychological point of view focuses on the characters' behaviors. Lanser concludes that this is "an extremely complex aspect of point of view, for it encompasses the broad question of the narrator's distance or affinity to each character and event…represented in the text." Negative comments distance the reader from a character's point of view while positive evaluations create affinity with his or her perspective.
The phraseological point of view focuses on the speech characteristics of the characters and the narrator. For example, the names, titles, epithets, and sobriquets given to a character may evaluate a character's actions or speech and express a narrative point of view.
The ideological point of view is not only "the most basic aspect of point of view" but also the "least accessible to formalization, for its analysis relies to a degree, on intuitive understanding." This aspect of the point of view focuses on the norms, values, beliefs, and Weltanschauung (worldview) of the narrator or a character. The ideological point of view may be stated outright—what Lanser calls "explicit ideology"—or it may be embedded at "deep-structural" levels of the text and not easily identified.
A first-person point of view reveals the story through an openly self-referential and participating narrator. First person creates a close relationship between the narrator and reader, by referring to the viewpoint character with first person pronouns like I and me (as well as we and us, whenever the narrator is part of a larger group). That is, the narrator openly acknowledges their own existence. Frequently, the first-person narrator is the protagonist, whose inner thoughts are expressed to the audience, even if not to any of the other characters. A first person narrator with a limited perspective is not able to witness or understand all facets of any situation. Thus, a narrator with this perspective will not be able to report the circumstances fully and will leave the reader with a subjective record of the plot details. Additionally, this narrator's character could be pursuing a hidden agenda or may be struggling with mental or physical challenges that further hamper their ability to tell the reader the whole, accurate truth of events. This form includes temporary first-person narration as a story within a story, wherein a narrator or character observing the telling of a story by another is reproduced in full, temporarily and without interruption shifting narration to the speaker. The first-person narrator can also be the focal character. The viewpoint character is not necessarily the focal character: examples of supporting viewpoint characters include Doctor Watson, Scout in To Kill a Mockingbird, and Nick Carraway of The Great Gatsby.
The second-person point of view is a point of view similar to first-person in its possibilities of unreliability. The narrator recounts their own experience but adds distance (often ironic) through the use of the second-person pronoun you. This is not a direct address to any given reader even if it purports to be, for example in the metafictional If on a winter's night a traveler by Italo Calvino. Notable examples of second-person include the novel Bright Lights, Big City by Jay McInerney, the short fiction of Lorrie Moore and Junot Díaz, the short story The Egg by Andy Weir, and Second Thoughts by Michel Butor. Sections of N. K. Jemisin's The Fifth Season and its sequels are also narrated in the second person.
You are not the kind of guy who would be at a place like this at this time of the morning. But here you are, and you cannot say that the terrain is entirely unfamiliar, although the details are fuzzy.
Mohsin Hamid's The Reluctant Fundamentalist and Gamebooks, including the American Choose Your Own Adventure and British Fighting Fantasy series (the two largest examples of the genre), are not true second-person narratives, because there is an implicit narrator (in the case of the novel) or writer (in the case of the series) addressing an audience. This device of the addressed reader is a near-ubiquitous feature of the game-related medium, regardless of the wide differences in target reading ages and role-playing game system complexity. Similarly, text-based interactive fiction, such as Colossal Cave Adventure and Zork, conventionally has descriptions that address the user, telling the character what they are seeing and doing. This practice is also encountered occasionally in text-based segments of graphical games, such as those from Spiderweb Software, which make ample use of pop-up text boxes with character and location descriptions. Most of Charles Stross's novel Halting State is written in second person as an allusion to this style.
In the third-person narrative mode, the narration refers to all characters with third person pronouns like he, she, or they, and never first- or second-person pronouns.
Third-person narration can include an omniscient narrator; close or limited points of view; or a combination of the two. Sometimes, third-person narration is called the "he/she" perspective, and, on even rarer occasions, author/omniscient point of view.
A third person omniscient narrator can convey information about multiple characters, places, and events in the story, including any given character's thoughts, and a third-person close or limited narration conveys the knowledge and subjective experience of just one character. Third person narration, in both its limited and omniscient variants, became the most popular narrative perspective during the 20th century.
Omniscient or limited Edit
Omniscient point of view is presented by a narrator with an overarching perspective, seeing and knowing everything that happens within the world of the story, including what each of the characters is thinking and feeling. The inclusion of an omniscient narrator is typical in nineteenth-century fiction including works by Charles Dickens, Leo Tolstoy, and George Eliot. It sometimes even takes a subjective approach. One advantage of narrative omniscience is that it enhances the sense of objective reliability (that is, apparent truthfulness) of the plot, which may be important with more complex narratives. The third-person omniscient narrator can have its own personality, offering judgments and opinions on the behavior of the story characters.
Some works of fiction, especially novels, employ multiple points of view, with different points of view presented in discrete sections or chapters, including The English Patient by Michael Ondaatje, The Emperor's Children by Claire Messud, and the A Song of Ice and Fire series by George R. R. Martin. The Home and the World, written in 1916 by Rabindranath Tagore, is another example of a book with three different point-of-view characters. In The Heroes of Olympus series, the point of view alternates between characters at intervals. The Harry Potter series focuses on the protagonist for much of the seven novels, but sometimes deviates to other characters, particularly in the opening chapters of later novels in the series, which switch from the view of the eponymous Harry to other characters (for example, the Muggle Prime Minister in the Half-Blood Prince).[non-primary source needed]
Examples of Limited or close third-person point of view, confined to one character's perspective, include J.M. Coetzee's Disgrace.
Subjective or objective Edit
Subjective point of view is when the narrator conveys the thoughts, feelings, and opinions of one or more characters. If this is just one character, it can be termed third-person limited, in which the reader is limited to the thoughts of some particular character (often the protagonist) as in the first-person mode, except still giving personal descriptions using third-person pronouns. This is often the main character (for example, Gabriel in James Joyce's "The Dead", Nathaniel Hawthorne's Young Goodman Brown, or Santiago in Hemingway's The Old Man and the Sea). Certain third-person omniscient modes are also classifiable as using the third person, subjective mode when they switch between the thoughts and feelings of all the characters.
In contrast to the broad, sweeping perspectives seen in many 19th-century novels, third-person subjective is sometimes called the "over the shoulder" perspective; the narrator only describes events perceived and information known by a character. At its narrowest and most subjective scope, the story reads as though the viewpoint character were narrating it; dramatically this is very similar to the first person, in that it allows in-depth revelation of the protagonist's personality, but does not permit the same level of unreliability.
Free indirect speech is a literary term that refers to the presentation of a character's thoughts in the voice of the third-person narrator.
Objective point of view employs a narrator who tells a story without describing any character's thoughts, opinions, or feelings; instead, it gives an objective, unbiased point of view. Often the narrator is self-dehumanized in order to make the narrative more neutral. This type of narrative mode is often seen outside of fiction in newspaper articles, biographical documents, and scientific journals. This narrative mode can be described as a "fly-on-the-wall" or "camera lens" approach that can only record the observable actions but does not interpret these actions or relay what thoughts are going through the minds of the characters. Works of fiction that use this style emphasize characters acting out their feelings observably. Internal thoughts, if expressed, are given through an aside or soliloquy. While this approach does not allow the author to reveal the unexpressed thoughts and feelings of the characters, it does allow the author to reveal information that not all or any of the characters may be aware of. An example of this so-called camera-eye perspective is "Hills Like White Elephants" by Ernest Hemingway.
This narrative mode is also called third-person dramatic because the narrator, like the audience of a drama, is neutral and ineffective toward the progression of the plot—merely an uninvolved onlooker.
Alternating- or multiple-person Edit
While the tendency for novels (or other narrative works) is to adopt a single point of view throughout the entire novel, some authors have utilized other points of view that, for example, alternate between different first-person narrators or alternate between a first- and a third-person narrative mode. The ten books of the Pendragon adventure series, by D. J. MacHale, switch back and forth between a first-person perspective (handwritten journal entries) of the main character along his journey as well as a disembodied third-person perspective focused on his friends back home. Margaret Atwood's Alias Grace provides one character's viewpoint from first-person as well as another character's from third-person limited. Often, a narrator using the first person will try to be more objective by also employing the third person for important action scenes, especially those in which they are not directly involved or in scenes where they are not present to have viewed the events in firsthand. This mode is found in Barbara Kingsolver's The Poisonwood Bible. In William Faulkner's As I Lay Dying, even the perspective of a deceased person is included.
Audrey Niffenegger's The Time Traveler's Wife alternates between an art student named Clare, and a librarian named Henry. John Green and David Levithan's novel Will Grayson, Will Grayson rotates between two boys both named Will Grayson. It alternates between both boys telling their part of the story, how they meet and how their lives then come together. K.A. Applegate's Animorphs series contains four special-edition books, the Megamorphs books, in which narration alternates among the six main characters, Jake, Rachel, Tobias, Cassie, Marco, and Ax.
A writer may choose to let several narrators tell the story from different points of view. Then it is up to the reader to decide which narrator seems most reliable for each part of the story. See for instance the works of Louise Erdrich. William Faulkner's As I Lay Dying is a prime example of the use of multiple narrators. Faulkner employs stream of consciousness to narrate the story from various perspectives.
In Indigenous American communities, narratives and storytelling are often told by a number of elders in the community. In this way, the stories are never static because they are shaped by the relationship between narrator and audience. Thus, each individual story may have countless variations. Narrators often incorporate minor changes in the story in order to tailor the story to different audiences.
The use of multiple narratives in a story is not simply a stylistic choice, but rather an interpretive one that offers insight into the development of a larger social identity and the impact that has on the overarching narrative, as explained by Lee Haring. Haring analyzes the use of framing in oral narratives, and how the usage of multiple perspectives provides the audience with a greater historical and cultural background of the narrative. She also argues that narratives (particularly myths and folktales) that implement multiple narrators deserves to be categorized as its own narrative genre, rather than simply a narrative device that is used solely to explain phenomena from different points of view.
Haring provides an example from the Arabic folktales of One Thousand and One Nights to illustrate how framing was used to loosely connect each story to the next, where each story was enclosed within the larger narrative. Additionally, Haring draws comparisons between Thousand and One Nights and the oral storytelling observed in parts of rural Ireland, islands of the Southwest Indian Ocean, and African cultures such as Madagascar.
"I'll tell you what I'll do," said the smith. "I'll fix your sword for you tomorrow, if you tell me a story while I'm doing it." The speaker was an Irish storyteller in 1935, framing one story in another (O'Sullivan 75, 264). The moment recalls the Thousand and One Nights, where the story of "The Envier and the Envied" is enclosed in the larger story told by the Second Kalandar (Burton 1: 113-39), and many stories are enclosed in others."
Narrative tense Edit
In narrative past tense, the events of the plot occur before the narrator's present. This is by far the most common tense in which stories are expressed. This could be in the narrator's distant past or their immediate past, which for practical purposes is the same as their present. Past tense can be used regardless of whether the setting is in the reader's past, present, or future.
In narratives using present tense, the events of the plot are depicted as occurring in the narrator's current moment of time. A recent example of novels narrated in the present tense are those of the Hunger Games trilogy by Suzanne Collins. Present tense can also be used to narrate events in the reader's past. This is known as "historical present". This tense is more common in spontaneous conversational narratives than in written literature, though it is sometimes used in literature to give a sense of immediacy of the actions. Screenplay action is also written in the present tense.
The future tense is the most rare, portraying the events of the plot as occurring some time after the narrator's present. Often, these upcoming events are described such that the narrator has foreknowledge (or supposed foreknowledge) of their future, so many future-tense stories have a prophetic tone. An example being Story of Your Life by Ted Chiang.
Narrative technique Edit
Stream of consciousness gives the (typically first-person) narrator's perspective by attempting to replicate the thought processes—as opposed to simply the actions and spoken words—of the narrative character. Often, interior monologues and inner desires or motivations, as well as pieces of incomplete thoughts, are expressed to the audience but not necessarily to other characters. Examples include the multiple narrators' feelings in William Faulkner's The Sound and the Fury and As I Lay Dying, and the character Offred's often fragmented thoughts in Margaret Atwood's The Handmaid's Tale. Irish writer James Joyce exemplifies this style in his novel Ulysses.
Unreliable narrator Edit
Unreliable narration involves the use of an untrustworthy narrator. This mode may be employed to give the audience a deliberate sense of disbelief in the story or a level of suspicion or mystery as to what information is meant to be true and what is meant to be false. Unreliable narrators are usually first-person narrators; however, a third-person narrator may be unreliable. An example is J.D. Salinger's The Catcher in the Rye, in which the novel's narrator Holden Caulfield is biased, emotional, and juvenile, divulging or withholding certain information deliberately and at times probably quite unreliable.
See also Edit
- Hühn, Peter; Sommer, Roy (2012). "Narration in Poetry and Drama". The Living Handbook of Narratology. Interdisciplinary Center for Narratology, University of Hamburg.
- Chamberlain, Daniel Frank (1990). Narrative Perspective in Fiction: A Phenomenological Meditation of Reader, Text, and World. ITHAKA. ISBN 9780802058386. JSTOR 10.3138/j.ctt2ttgv0.
- James McCracken, ed. (2011). The Oxford English Dictionary (Online ed.). Oxford University Press. Retrieved 16 October 2011.
- Boris Uspensky, A Poetics of Composition: The Structure of the Artistic Text and Typology of Compositional Form, trans. Valentina Zavarin and Susan Wittig (Berkeley, CA: University of California Press, 1973).
- Susan Sniader Lanser, The Narrative Act: Point of View in Prose Fiction (Princeton, NJ: Princeton University Press. 1981).
- Lanser, 201–02.
- Uspensky, 8.
- Lanser, 216–17.
- Wyile, Andrea Schwenke (1999). "Expanding the View of First-Person Narration". Children's Literature in Education. 30 (3): 185–202. doi:10.1023/a:1022433202145. ISSN 0045-6713. S2CID 142607561.
- "Halting State, Review". Publishers Weekly. 1 October 2007.
- Charles Stross. "And another thing".
- Paul Ricoeur (15 September 1990). Time and Narrative. University of Chicago Press. pp. 89–. ISBN 978-0-226-71334-2.
- "Ranjbar Vahid. The Narrator, Iran: Baqney 2011" (PDF). Archived from the original (PDF) on 24 December 2012. Retrieved 17 February 2012.
- Herman, David; Jahn, Manfred; Ryan (2005), Routledge Encyclopedia of Narrative Theory, Taylor & Francis, p. 442, ISBN 978-0-415-28259-8
- Rowling, J.K. (2005). Harry Potter and the Half-Blood Prince. London: Bloomsbury. pp. 6–18. ISBN 978-0-7475-8108-6.
- Mountford, Peter. "Third-Person Limited: Analyzing Fiction's Most Flexible Point of View". writersdigest.com. Writer's Digest. Retrieved 28 July 2020.
- Dynes, Barbara (2014). "Using Third Person". Masterclasses in Creative Writing. United Kingdom: Constable & Robinson. ISBN 978-1-47211-003-9. Retrieved 28 July 2020.
- White, Claire E. (2004). "D.J. MacHale Interview". The Internet Writing Journal. Writers Write. Retrieved 25 January 2023.
- Piquemal, 2003. From Native North American Oral Traditions to Western Literacy: Storytelling in Education.
- Haring, Lee (27 August 2004). "Framing in Oral Narrative". Marvels & Tales. 18 (2): 229–245. doi:10.1353/mat.2004.0035. ISSN 1536-1802. S2CID 143097105.
- Walter, Liz (26 July 2017). "When no one was looking, she opened the door: Using narrative tenses". cambridge.org. Cambridge University Press. Retrieved 28 July 2020.
- Schiffrin, Deborah (March 1981). "Tense Variation in Narrative". Language. 57 (1): 45–62. doi:10.2307/414286. ISSN 0097-8507. JSTOR 414286.
- "stream of consciousness – literature".
- Murphy, Terence Patrick; Walsh, Kelly S. (2017). "Unreliable Third Person Narration? The Case of Katherine Mansfield". Journal of Literary Semantics. 46 (1): 67–85. doi:10.1515/jls-2017-0005. S2CID 171741675.
Further reading Edit
- Rasley, Alicia (2008). The Power of Point of View: Make Your Story Come to Life (1st ed.). Cincinnati, Ohio: Writer's Digest Books. ISBN 978-1-59963-355-8.
- Card, Orson Scott (1988). Characters and Viewpoint (1st ed.). Cincinnati, Ohio: Writer's Digest Books. ISBN 978-0-89879-307-9.
- Fludernik, Monika (1996). Towards a "Natural" Narratology. London: Routledge.
- Genette, Gérard. Narrative Discourse. An Essay in Method. Transl. by Jane Lewin. Oxford: Blackwell 1980 (Translation of Discours du récit).
- Stanzel, Franz Karl. A theory of Narrative. Transl. by Charlotte Goedsche. Cambridge: CUP 1984 (Transl. of Theorie des Erzählens).


01 Nov The Semmelweis Effect
WHEN HEALERS ARE AHEAD OF HISTORY
While historians credit Louis Pasteur with articulating the germ theory of disease, many others came before him who began to tease out the ideas that led to this deeper understanding of illness. One of these doctors, the 18th century physician Ignatz Semmelweis, spent much of his time taking care of women who developed puerperal fever (childbed fever) after giving birth at a hospital in Vienna. The hospital where he worked had two delivery areas. In the first, physicians came to deliver babies after spending mornings doing surgeries as well as autopsies; many of which were done on women who had died of puerperal fever. The second birthing area was run by midwives who solely focused on helping with childbirth. Semmelweis noticed that a higher rate of women who gave birth with a doctor died of fever, and that only half as many who went to midwives did (16% compared to 7%). He wondered if there was a connection between doctors moving from surgery and autopsies to entering the delivery room and the illness. He ran an experiment where he had doctors and midwives wash their hands before helping with delivery for a year. Subsequently, the percentage of women who died of fever went down to around 2% in both groups. However, despite the evidence that the washing of hands somehow prevented the disease, his colleagues rejected his findings as being akin to witchcraft. While this kind of resistance to change can be seen within all systems, it also appears that Semmelweis was not a great communicator. According to one article:
Semmelweis with his undiplomatic behavior made more professional enemies than friends in Vienna and had to leave for Budapest to work in a city hospital for the rest of his life. Semmelweis published a book “Etiology, the concept, and the prevention of puerperal fever” in 1860, after 13 years of his study. The book had an unwelcome response; it was criticized for poor language and unprofessional writing style. Semmelweis could not tolerate the criticism and suffered with bouts of depression, rage, paranoia, and forgetfulness. He ended up in a mental asylum and died in 1865.
History is often written by those with the most power, as well as the best communication and social skills. Those who are better able to walk a fine line – gently challenging systems that they are a part of rather than attacking the system – often have more success at changing a system than those who are not.
DR. SARNO AS A MODERN DAY SEMMELWEIS
A more recent corollary to this problem is the story of Dr John Sarno, who came to believe that back pain was often a mind body problem which was caused by the repression of emotions rather than structural issues like a “herniated disc”. While Dr. Sarno did not have as much difficulty communicating as Dr. Semmelweis, his profoundly progressive ideas about his field were not embraced in his lifetime. Being pushed to the edges of the medical system was difficult for Dr Sarno, but he found a way to reach patients, as well as a handful of other practitioners, through a series of books that examined the mind body connection.
While he had well documented success in treating patients through both his practice and his books, his ideas were dismissed by those in his field because he didn’t support his work with randomized control trials. Dr Sarno came to question the overriding paradigms of rehabilitation medicine because he found little success treating his patients with the methods that he had been taught to use: bed rest, traction, physical therapy, surgery etc. When he looked at the literature to support these treatments, he could find no compelling evidence that justified any of the practices he had been taught to use. A great fan of Sherlock Holmes, he went to look at his patients’ charts for clues. He found that over 80 percent of them had a history of 2 or more other illnesses that were believed to have a emotional or psychosomatic connection. He spent a couple of years talking with his patients about what was going on in their lives and he came to see that many of them were clearly repressing uncomfortable emotions, thoughts, and feelings. For example, he had one patients who thought his back pain was from his increased weight. It turned out that his weight had shot up because his wife and mother didn’t get along very well, and several nights a week he snuck over to his mother’s house where he ate dinner with her and then went home and had dinner with his wife. His real problem was that he had two overly controlling women in his life and he couldn’t say “no” to either of them.
He began to instruct his patients to bring their attention to their emotions rather than the physical pain because he saw these problems as a distraction from, or a manifestation of, more complex emotional issue that they were too afraid to confront, or even see. When he got patients to embrace the emotional underpinning of their pain problem, he found that he had a great deal of success with healing their pain. One of these patients was a book agent who got Sarno a deal for his first book, “Mind Over Back Pain” in 1984. That book and the ones that followed, including the best seller “Healing Back Pain”, reached millions of people. Not every person had a miracle cure from reading the book, but plenty did. If you’re curious, you can search for “Dr Sarno” on twitter where you will find thousands of testimonials. You’ll also find a lot of people calling him a “quack”. While neither these tweets nor the thousands of wildly positive reviews of his books on Amazon (90% positive ratings – 69% 5 star) constitute “scientific data”, it’s hard to argue that he’s a total quack after reading through these thoughtful reviews.
While he had no luck in convincing medical colleagues that the mind body connection was relevant to their work, several people that he helped went on to become doctors and carried on his work. Some of them – including Dr David Schechter, Dr Howard Schubiner, and Alan Gordon – have carried on his work and begun to publish studies based on methods grounded in his work. Dr Schubiner, who recently was involved in a very compelling study that is largely based on his work had this to say about Dr Sarno’s place in history: “Thomas Kuhn wrote about this in The Structure of Scientific Revolution. What he showed through all of these paradigm shifts in science was that ridicule occurs first. Then comes discrepancies in the science…something’s not right, something’s wrong in what we’re doing… and then comes the data. And now we have the data. We know how the brain works. We know that the back’s not broken most of the time. This paradigm is going to shift and Dr. Sarno is going to get the credit that he deserves. And when it shifts, everyone will say, ‘Oh yeah- we knew it all along.’” While Dr Sarno’s name is not yet written in the history books, I believe that he will get the credit he deserves for starting a deeper conversation about the power of mind body medicine.
MIND BODY MEDICINE BEGINS TO ENTER MAINSTREAM AWARENESS
A little over one year ago, on Sept 29, 2021, JAMA published a study authored by Yoni K Asher PhD, Alan Gordon LCSW, and Howard Schubiner,MD, Effect of Pain Reprocessing Therapy vs Placebo and Usual Care for Patients With Chronic Back Pain. Both Gordon and Schubiner, who were mentioned above, were patients of Dr Sarno. After finding healing themselves, they built on Dr. Sarno’s mind body approach and devoted their practice to continuing his work, and building upon it. Alan Gordon published the book “The Way Out” just a few weeks before the study came out and Dr Schubiner’s book “Unlearn Your Pain” came out in 2010. Asher, Gordon, and Schubiner’s study was met with profound interest, yet it also faced a great deal of skepticism. Still, it was one of the most read studies of 2021. A Washington Post piece by Nathaniel Frank, the director of the “What We Know Project” at Cornell University which aggregates scholarly research for the general public, was published on Oct 15, 2021. This article made it clear just how important the study was.
The latest evidence comes in a peer-reviewed study just published in the journal JAMA Psychiatry that includes striking results from a randomized controlled trial conducted at the University of Colorado at Boulder. In the study, 151 subjects with persistent back pain were randomly assigned to one of three groups. A third of them were given no treatment other than their usual care (the control group), a third were given a placebo, and a third were given eight one-hour sessions of a new treatment called “pain reprocessing therapy” (PRT). Developed by Alan Gordon, director of the Pain Psychology Center in Los Angeles, the technique teaches patients to reinterpret pain as a neutral sensation coming from the brain rather than as evidence of a dangerous physical condition. As people come to view their pain as uncomfortable but nonthreatening, their brains rewire the neural pathways that were generating the pain signals, and the pain subsides. […]
This new research is the latest to validate Sarno’s theory that much chronic pain is not structural but is a mind-body phenomenon, and that changing our perceptions — gaining knowledge, altering beliefs, thinking and feeling differently — can dramatically reduce the pain.
This does not mean the pain is imagined or “all in the head.” It’s a brain response, like blushing, crying or elevated heart rate — all bodily reactions to emotional stimuli. “Pain is an opinion,” neuroscientists often say, suggesting not that pain isn’t factually present but that all pain is generated by our brains, and is thus reliant on the brain’s fallible perception of danger.
I’d been waiting for the study to come out for years and hoped that it might move the needle on awareness of Dr. Sarno’s work. I’m a filmmaker, and with my partners Suki Hawley, and David Beilinson, I made a documentary about Dr. Sarno that is also very personal, so I was very excited about the impact this study was having.
The previous year I had pitched Erik Vance, the editor of the Well Column in The New York Times, about doing an article about Dr Sarno and our film. He had recently taken over the position at Well and had put out a call for pitches on twitter. I sent him a request that he run something about the impact of Dr. Sarno’s work. My note confused him a little; he was unsure about whether or not I was a “writer” pitching a freelance article. I was happy to write one, but I was not really a freelance journalist; I was writing more with a pinch of hope that a new editor might consider recognizing Dr Sarno’s contributions to the field. For some context: the Times had never written about Dr Sarno until they published an obituary the weekend that our film about his work opened. While the film got a decent review in the Times, we were unable to get anyone, in any outlet whatsoever, to write a substantive article about his work. Still, in the years since the film had come out, awareness of the impact of trauma on health had increased dramatically, and that in turn has led to a greater awareness of an evolving understanding of pain that was more in line with Dr Sarno’s thinking. I figured that a new editor might be interested in looking at this shift. I was wrong.
He was deeply skeptical of Dr Sarno’s work and explained that it was “a little late to write about Dr Sarno”. This response was both expected and a little shocking. I pushed back on Vance’s contention that it was too late to give Dr Sarno credit for his work. After several increasingly exasperated responses, the editor explained that he might be interested in covering Dr Sarno’s work if an eminent neurologist like Tor Wager were to do a study of his methods. I was aware that Wager was involved in the previously mentioned study. He was doing FMRI’s of patients brains to see how the mind body treatment impacted them vs placebo, or standard care. So, when the study came out a year after we first talked, I immediately sent it to the editor. I did not get a response. I believe I also sent him Nathaniel Frank’s piece as well when it was published two weeks later.
A few weeks after that “The Well” section ran a multi article series on chronic pain which included a piece written by a science writer who was healed by using Dr. Sarno’s methods. While the author states that she was “cured” by following Dr. Sarno’s recommendations, her piece begins by undermining the validity of the work, revealing the kind of bias against the impact of emotions that has been pervasive in the fields of “science” and “medicine” over the past 70 years,
“Every time someone tells me their back’s been giving them trouble, I lower my voice before launching into my spiel: “I swear I’m not woo-woo, but … ”
“Woo” is a term used to denote “unscientific science”: ideas that have not been sufficiently proven using randomized control trials. One problem with randomized control trials is that, for the most part, the impact of emotions on physical health has been largely ignored as part of these studies for decades. Emotions are messy, individualistic, and seemingly disconnected from classifications of genetics, gender, race, and class, and therefore difficult to account for. So, when studying drugs, surgeries, or other treatments, emotional factors were simply not included in data sets that determine the effectiveness of various treatments. In some sense, this is like being a car mechanic and only focusing on mechanical systems while ignoring the fluid systems. If you pretend that the fluid systems are not important because you can’t quantify how they work, then it’s very likely your car will die much earlier.
After explaining her pain, as well as Dr. Sarno’s basic ideas, DeMelo closes the first section of the article with,
I appreciated the tidy logic of Dr. Sarno’s theory: emotional pain causes physical pain. And I liked the reassurance it gave me that even though my pain didn’t stem from a wonky gait or my sleeping position, it was real. I didn’t like that no one in the medical community seemed to side with Dr. Sarno, or that he had no studies to back up his program.
But I couldn’t deny it worked for me. After exorcising a diary’s worth of negative feelings over four months, I was — in spite of my incredulousness — cured.
Rather than doing further research on Dr Sarno’s work, or how it is connected to a host of other doctors who have made the connection between the repression of emotions and illness, DeMelo centers her own skepticism. By taking an N of 1 approach – wherein the focus is on the author’s experience only, proceeding under the assumption that this experience is not “fully valid” and can’t be considered data because it is anecdotal – the piece undercuts any argument that Dr Sarno’s work was valid. Taking a similar approach, writer Nathaniel Frank, the author of the above mentioned Washington Post Piece about the JAMA study (this piece includes discussion of a separate study by Michael Doninno that sought to confirm Dr Sarno’s work ) also writes from a personal perspective, but has different conclusions. Frank was saved by Dr. Sarno, and uses that understanding to highlight the increasing drumbeat of science that is beginning to emerge that strongly confirms his basic ideas about mind body medicine. The fact that the medical community has completely ignored this work says a lot about the problems of science writing and skepticism.
The Times article is titled “I Have to Believe This Book Cured My Pain”, and the subheading is “A science writer investigates the 30-year-old claims of an iconoclastic doctor who said chronic pain was mostly mental.” It seems somewhat problematic to me that the author is declared to be a science writer, but writes the piece more from the perspective as a skeptical patient rather than as a “science writer”. Unfortunately, DeMelo leans into the skepticism and fails to do any substantive research into Dr. Sarno’s work nor his evolving understanding of pain. DeMelo only mentions that she read Dr. Sarno’s most popular book “Healing Back Pain” which was published in 1991 and written for patients rather than practitioners. In 2006, Dr Sarno published “The Divided Mind”, which included contributions from many other doctors, and focuses much more on the theories that support the work. It makes very little sense that a “science writer” chose to ignore the ways in which Dr Sarno’s ideas evolved as he continued to practice and publish for more than two decades after writing “Healing Back Pain”. It doesn’t help that the editors chose the subheading that they did. DeMelo interviews a few pain experts, but only mentions the 30-year-old book written for a popular audience while failing to research whether or not the work continued to evolve, or how it might be connected to other work that was being done.
What made me most disappointed is that the article goes on to quote two people who were central to the groundbreaking JAMA study that had come out six weeks earlier, yet it fails to mention the study. After the opening discussion of the author’s personal experience of healing using the book, the next section beings with a quote from Dr Tor Wager, whose FMRI’s readings are part of that JAMA study.
“The idea is now mainstream that a substantial proportion of people can be helped by rethinking the causes of their pain,” said Tor Wager, a neuroscience professor at Dartmouth College and the director of its Cognitive and Affective Neuroscience Lab. “But that’s different than the idea that your unresolved relationship with your mother is manifesting as pain.”
Dr Sarno’s theories were rooted in an understanding of Freud. While Dr Wager might be intending to distance himself and his work from Dr Sarno, the article also quotes Dr Schubiner who was a principal investigator in the study,
The bottom line, according to Dr. Howard Schubiner, a protégé of Dr. Sarno, is that “all pain is real, and all pain is generated by the brain.” Today Dr. Schubiner is the director of the Mind Body Medicine Program in Southfield, Mich., and a clinical professor at the Michigan State University College of Human Medicine.
“Whether pain is triggered by stress or physical injury, the brain generates the sensations,” he said. “And — this is a mind-blowing concept — it’s not just reflecting what it feels, it’s deciding whether to turn pain on or off.”
While the article treats Dr Schubiner respectfully, it fails to mention that Wager and Schubiner had been part of a study that delivered powerful confirmation of the import of Dr Sarno’s work. Given my previous back and forth with Mr Vance, I was not surprised, but I was disappointed.
Both the author and the editor are part of the science writing system. In order to be a part of that system, one has to have faith in the rules of that system. Over the past 70 years, the randomized control trial has become the “gold standard” for advancing knowledge. The problem with this system is that, like many other systems, it often becomes stuck in its basic tenets and has trouble recognizing how this can create profound barriers for those who question the basic tenets. Over the past 70 years, people’s emotions have been shunted off to psychology, and any mention of them in regards to “medicine” are dismissed as “woo”.
SYSTEMS AND KNOWLEDGE
For many years I’ve been thinking a lot about how systems simultaneously create pathways to knowledge and profound limits to the expansion of knowledge. To thrive within a system one has to (on some level) both understand and accept the “rules” of that system. Often these rules aren’t entirely clear, but those who do thrive understand them even if they can’t articulate them. I’ve often found myself understanding what’s expected but uncomfortable conforming to those expectations. As I’ve gotten older, and perhaps a little wiser, I’ve stopped caring as much that I don’t fit in them, and that I don’t have the power to change them. Some of this illumination has to do with my work around our film about Dr Sarno, but it’s related to all of the various work I do, including posts like this one. As a filmmaker, I’ve never made films that fit within the expectations of the various film systems, so I’ve always had to figure out how to work outside of those systems to get them seen (we have self distributed all our own work which means that those within the system don’t feel compelled to engage with that work). As a photographer I’ve never made work that has been embraced by the photo system. So, social media has helped me get that various work into the world. I appreciate social media for that reason but also see the perils of it. Without social media the mall work I shot in 1989 would not have been seen, and even with the continued viral nature of it, no gallery has been interested in showing it. It exists in the world but not within that system because it isn’t of that system. Dr Sarno’s work was viral before social media, and it still exists and impacts people but largely outside of the medical system – which also means it exists outside of the media system. So, as filmmakers who aren’t of the film system, who made a film about a doctor who was shunned from the medical system, we made a film that no one in the media system would write about. Systems rely on other systems for confirmation. This leaves a great deal of knowledge stuck outside of general awareness. While Dr Sarno’s work impacts so many, it has largely been left out of the medical conversation, even as it’s a driving force of the change taking place within the system.
THE HISTORY OF MEDICINE IN THE 20th CENTURY
To make sense of what has taken place in the 20th century, it’s important to look back at the the 17th century. At that time, Rene Descartes got into some trouble with the church when he began to discuss consciousness and the brain. In order to keep his own head he agreed to leave the brain to the church and focused his attention in the body. It wasn’t until the late 19th century when Freud presented his ideas of the unconscious that the brain moved back into the realm of science. However by the second half of the 20th century, the bio-technical approach to medicine gained increasing traction, and all discussion of the emotions was squeezed out of the medical realm. This approach was data driven and relied on randomized controlled trials to prove that medicines, and other medical techniques worked better than a placebo (placebo was dismissed as not being a “real effect,” when in fact the placebo represents the power of belief). For the most part, these trials focused on how a physical, chemical, or biological intervention impacted healing. These randomized control trials rarely included data on emotional factors (because the inclusion of emotional factors makes the data less clear), and as this approach to medicine gained more ground, any discussion of emotional impacts, or treatments that involved a focus on the emotions, was pushed to the outskirts of the scientific community.
The result of this history is two-fold: the medical community has no interest in embracing awareness of the mind body connection, and also limited incentives – there is a relatively minuscule amount of funding for medical studies that focus on emotionally-based treatments. It’s hard to get the the same kind of clarity from an emotionally based study as one can from one that simply focuses on how a chemical compound affects people. There’s also very little financial upside for the systems that might “invest” in mind body treatments. The fact is, everyone has different stressors and different reactions to stressors, so everyone will react/respond to different ways. The conundrum we have is that for decades we have pushed discussion of emotions to the edges of our society. It’s not simply a medical reorganization we need, but a cultural one as well.
It was not always like this. In the late 19th century and the early part of the 20th century, Sigmund Freud’s theories of the unconscious led to an increase in the awareness of the impact of emotions on physical health. It wasn’t just Freud though; doctors like Hans Selye wrote papers of the impact of stress on the human body; and there was widespread awareness that our thoughts and the stress we struggled with, impacted our physical bodies. However, after World War 2 the practice of medicine increasingly became focused on finding cures using chemical compounds, surgeries, and physical interventions. There was a belief that if we just figured out what was going on in the body on the cellular and molecular level, we could find the cure for almost any illness. Ideas related to emotions were cordoned off into the fields of psychology and psychiatry. While psychology continued to focus on talk therapy, psychiatry became more focused on finding pharmaceutical interventions than emotional ones. While people continued to see therapists, they were not considered medical doctors like the psychiatrists who proscribed chemicals to cure depression and other “mental illnesses”. To be clear, some of these chemicals had profound effects. Lithium helped people to balance out their bipolar disorders and new drugs helped schizophrenics keep their illness in check. We also saw increasing effectiveness of certain drugs for cancer. This is not an argument that all medical interventions are bad or wicked. Instead, the point being made is that these successes often blinded the system to other ways of approaching the problems.
By the 1970’s medical doctors became increasingly distanced from their patients’ emotional lives, and this pattern continued to grow more profound as the bio-technical approach increasingly diminished awareness of how emotions, and the repression of them, might affect the physical body. This situation was exacerbated by the fact that there was very few, if any, randomized control trials being done that might illuminate the connection between emotional stress/trauma and physical health. Without this data, any discussion of the emotions was deemed “unscientific” and dismissed as “woo”. This is where our first paragraph becomes important. If a system doesn’t have a way to integrate, or explore, ideas that don’t fit within a systems overriding paradigms, then the possibility of incorporating new knowledge gets limited.
THE STORIES WE TELL
Our brains are wired to tell stories, and from the moment we are born we take in stimuli and try to make sense of it through the process of storytelling. First we begin to make sense of our immediate surroundings through touch, smell, taste, hearing, and sight. I would add that I believe that we also have a sixth sense, we sense the energy of the people around us. If our caretakers have a calm energy then we might feel more safe. Early on, those surroundings are literally what’s right I front of us, and for the first few months we are either sleeping or searching for a breast or thumb to comfort us. Our genes, which shape much of who we are, have already wired us to develop in specific ways, and our brain first pushes us to meet our immediate core need for nourishment and comfort. For the few minutes between feedings that we are not sleeping our other senses take in more stimuli and begin the storytelling process. We many not remember these moments in words but they certainly have an effect on the stories that shape us. These stories become the stories that we tell ourselves about ourselves.
We can see the breadth of this problem very clearly when we look at the chronic pain epidemic in America. Since 1985, when America first measured the cost of chronic pain, there has been an exponential spike in both the cost breadth of the problem. Dr Sarno came to see that many “medical” problems, often have a connection to emotional problems, was shunned and ignored for trying to bring attention to this connection. Yet, in the 70’s he predicted the coming epidemic and explained why it would happen. He understood that since the repression of emotions is a major causative factor in many instances of chronic pain his cure involves addressing the emotions directly. He asks patients to recognize the pressures and stresses that they put on themselves to be perfect and good, and make the connection between how this pressure creates a kind of internal unconscious rage at the expectation that they be so perfect. At the same time, trauma from childhood creates fear that these feeling will rise to the surface. So, he suggests that we turn our attention away from the symptom (pain), and redirect it towards accepting our emotions. This post is not meant as a dissertation on his work so I’ll point readers to his many books on the subject, or our film, for more complex explanations. The first line of the film is a personal one. I state in voice over, “The stories that we tell ourselves about about ourselves shape our sense of who we are.” For the last line we hear Dr Sarno state, on his final day in his office, “It all comes down to one simple idea; the mind and body are intimately related. That’s it, that’s the whole story.” The main problem that we faced for much of the 20th century and well into the 21st is that the medical system completely ignored the role of the mind. Like Semmelweis before him, Dr Sarno noticed a problem within the practice of medicine and he set out to figure out the solution by asking questions and trying out ideas.
Dr Sarno was dismissed because he took a “trauma informed” approach to treating pain syndromes in an era where trauma wasn’t considered or discussed. While it is very quickly becoming normalized to discuss trauma (thanks to people like Bessel Van Der Kolk and Dr Gabor Mate) he developed his ideas 50 years ago when it was not. In short, he came to see that the origin of the back pain that so many of his patients suffered with had its roots in emotions that were being repressed due to childhood trauma, and that this was causing their pain. While this ideas is hard for many people to believe, when his patients worked to connect with those emotions they often had profound and long lasting relief from pain. As someone who has a long family history with him and his work (40 years), it made a lot of sense for me to become part of the story. In the end, his agreement to work with us to help tell his story put an incredible amount of responsibility on my shoulders to not give up on telling his story. It also means that in some ways I have a responsibility to not allow his contribution to get lost in the current rush of interest in trauma informed approaches to healing.
The good news is, when I can get the film in front of people, it has a tremendous impact. Every week I get notes from people letting me know that the film has changed their lives. At the same time, despite all of the resources I have put into getting the film seen and written about, there has not been a single article written about the film or Dr Sarno. That’s not entirely true; Dr Sarno passed away the day before the film opened on what would have been his 94th birthday. Given that the film had opened that week, The NY Times ran an obituary about him on the Sunday of that first weekend of screenings. A couple of years later the website Vox ran a long article about back pain, and they failed to mention Dr Sarno. The author explained that she had heard about Dr Sarno, but “didn’t buy” his ideas. Still, she ran a largely skeptical follow up article with the headline, “America’s most famous back pain doctor said pain is in your head. Thousands think he’s right.” I begged the author to correct the headline because it was factually wrong. He never said that pain is all in your head, and this insinuation is damaging. She refused to change it, “We don’t agree with your interpretation of the headline, however, and the story is quite clear about his ideas, so we think it’s fine to leave.” This is the only piece that was written, and it started off with a profound bias against him. While an inflammatory title gets more clicks, it also further amplifies the kind of inaccurate narrative that leads to greater resistance to the simple idea that the mind and the body are intimately linked.
Dr Sarno did a great deal of work to illuminate these very simple ideas. As a filmmaker involved with telling Dr Sarno’s story, I’ll continue to make the point that, like Semmelweis, he deserves much more credit than he’s received.


A recent article in The Atlantic (Christakis, 2016) lamented the overemphasis on academics that characterizes much of early childhood education today, noting that the preschool and kindergarten years serve more as gatekeepers than supporters and “welcoming mats” to the elementary school years, particularly for children at risk. Indeed, the first five years of a child’s life are dedicated to the preparation for “kindergarten readiness,” and many teachers today are under pressure to engage in didactic teaching practices aimed at promoting young children’s literacy and math competencies.
Unfortunately, such teaching methods often require young children to sit for long periods of time and reflect the use of highly structured teaching methods, paperwork and worksheets that are not in tune with the developmental needs of young children. Even more concerning is that less developmentally appropriate practices are not only ineffective but also stressful for young children. In fact, studies have shown that children in classrooms characterized by developmentally inappropriate practices show twice the level of stress (and stress-motivated behaviors) than their peers in more developmentally appropriate classrooms (Hart et al., 1998). What do we mean by developmentally appropriate practices in early childhood? For young children, play in the context of warm, supportive teacher-child relationships characterizes an optimal learning environment.
David Elkind once said, “Learning teaches us what is known, play makes it possible for new things to be learned. There are many concepts and skills that can only be learned through play.” Unstructured play, also known as free play, provides so much opportunity for growth. As Horne (2018) explains, play allows young children to acquire and master skills across a variety of developmental domains. Further, children are free to invest their full emotional energy in their exploration and learning when they share predictable, warm relationships with their teachers, and teacher-child relationship quality is related to children’s more advanced play.
What skills are learned through play?
Play builds a variety of skills! Play in all areas of the early childhood classroom (e.g., centers such as the block area or pretend play area) offers opportunities for solitary play as well as play near and in collaboration with others. Such experiences help children build important social skills and mastery motivation (the desire to learn a new skill or master a new competency, for example). Allowing children to make their own choices about play promotes autonomy and mastery. In a world in which children have little power, play allows children to make choices according to their interests and goals. Additionally, play promotes communication and language skills — critical competencies given that it is through communication and language skills that our needs are met and desires are known throughout our lives. Language skills such as holding a conversation, negotiation, vocabulary, and listening skills are supported in play in all areas of the classroom. Moreover, through play, emotional skills — the foundation for so much learning — are also challenged and developed. The following are examples of skill development supported through play:
Blocks and Manipulatives
Building block towers invites opportunities to experiment with cause and effect and practice balance and eye-hand coordination. Building structures involves planning and reasoning, opportunities to notice and sort blocks by shape and size (categorization, seriation, classifying objects, parts and wholes) and provides practice in spatial orientation (e.g., how blocks fit together). Working with puzzles involves experiments with spatial orientation, problem solving, and eye-hand coordination. Explorations with Duplos, chunky Legos and similar materials invite experimentation with planning and problem-solving as well as exposure to sensory experiences. Toys that produce interesting effects, like a jack-in-the-box, promote young children’s more rapid cause and effect learning and application of that knowledge in later play (Hauf & Aschersleben, 2008). Over time, block play and play with manipulatives expose children to mathematical concepts in meaningful ways. For example, observing that two small square blocks equal one rectangular block is math, specifically fractions, at work!
Sensory, Art and Music Experiences
Painting, play dough, water play, sand play and other sensory experiences engage all five senses and provide cause and effect experimentation (e.g., what happens if I use a light stroke versus a heavy stroke; what happens when I keep pouring water into the cup?) Zero to Three (www.zerotothree.org) describes the development of cause and effect understanding as one of the foundational cognitive discoveries in the early childhood years. Like other areas of play, sensory play offers opportunities to explore rich new language as teachers and children notice interesting textures and scents and engage in visual exploration of interesting materials.
Music experiences such as songs and chants promote literacy and language skills and also give young children practice in sequencing and memory skills (i.e., what comes next in this familiar story or repetitive chorus). The development of these types of cognitive skills creates a positive early foundation from which the child can grow; such skills are related to a variety of later school-readiness and academic outcomes.
Pretend Play Experiences
Pretend play promotes perspective-taking and has been linked with the development of children’s self-regulation skills.
For example, as pretend play becomes more advanced, it requires children to modulate their emotions and behaviors in response to others so that the play continues. Self-regulation, the ability to alter our emotions and behaviors in response to internal (e.g., our thoughts) or external (e.g., others’ behaviors) signals play a role throughout life in helping us navigate social relationships, school and work environments. Pretend play also offers opportunities for practicing language skills, and children’s language acquisition is richer in the context of play than in other classroom activities (Cohen & Uhry, 2007). Stanley Greenspan explained that through pretend play children also explore major themes in life, such as what it means to love and be loved. The child cradling and feeding a doll in the pretend play area is not only imitating observed behaviors but also enacting how loving relationships look and feel.
Motor Play Experiences
Learning about our bodies is a fundamental task of early development. Through physical activity, children learn spatial awareness skills (e.g., imagine a toddler learning how to move her body around another child rather than walking into the other child), balance and how to be safe. Opportunities to practice fine and gross motor skills are also associated with children’s acquisition of strength and motor coordination. Moreover, providing interesting and novel materials promotes motor exploration. For example, infants make different types of stepping movements on coarse textures than they do on smooth textures. Motor play also offers opportunities for language exploration and for developing cognitive concepts, such as opposites (in/out of the sandbox; over/under the slide). Additionally, motor skills are related to many other areas of development. For example, the ability to crawl or walk allows a young child to move away from a caregiver or teacher and return, allowing infants and toddlers to practice managing brief separations. Even this type of brief separation and reunion reinforces that infants and toddlers can be effective in finding their “safe base” whenever needed. So, in short, motor skills are related to attachment relationships!
Books provide opportunities for motor and sensory explorations as infants and toddlers explore books with their eyes, hands, and mouths. Books and storytelling invite toddlers and preschoolers to hypothesize what will happen next (e.g., “If you give a mouse a cookie…. What do you think he’ll want next?”) Books and storytelling proving opportunities to practice cognitive skills like sequencing (e.g., the repetitive text of “Caps for Sale” provides practice in sequencing). Young children’s stories addressing affective experiences (joy, sadness, anxiety) provide important openings to talk about the emotional cues, the contexts of emotions, empathy and perspective taking. From manipulating books, children acquire literacy knowledge including understandings of written language, letter and word identification and book knowledge. Sharing books and stories together, as with other forms of play, offer relationship building experiences as children, their peers, and teachers share interests and joy in being together.
Cooperative Mealtime Experiences
Mealtimes also offer developmental opportunities. Meals build a sense of community as children engage in prosocial behaviors such as setting the table, passing bowls of food around the table, talking and being together. Sensory explorations of food textures, scents, sights, and tastes promote sensory development and language skills. Math concepts, such as one to one correspondence, are supported as children place one cup and one plate at each place setting or as a teacher or other children notice: “I had three crackers. I ate one and so I have two crackers left.” Children’s sense of self and autonomy are supported as children serve themselves in family-style dining in the classroom.
What does play look like?
Play offers many developmental benefits when supported and promoted in ways that are sensitive and responsive to children’s cues and interests. Rymanowicz (2015) summarizes many of the key characteristics of high-quality play.
- Self-chosen and self-directed. The beauty of play is that it is based on children’s emerging interests and goals rather than on those of the adults. This is a critical feature of play. For example, studies have shown that child-selected activities predict greater vocabulary skills than do teacher-directed activities (Lippard, Choi & Walter, 2019).
- The process, not the product. It is through the process of play that skills are practiced and acquired regardless of what a final product might be. For example, it is the joy of feeling grass on the feet that promotes sensory development not the end result of walking outside. It is not a completed block structure that promotes skills development; it is the journey of selecting blocks, stacking them, determining what makes the structure balance or topple, and so on that builds competencies. Some play is exploratory with no particular goal in mind outside of experiencing the moment. Other play has a goal determined by the child, and, often such goals are more about the creation process than a particular product (e.g., consider how many times you notice a child’s process and ending outcomes change and morph as the child engages in play).
- Individually constructed. The child or children in play together determine the structure of the play — that is, the organization, pace and boundaries of play. As I explain below, teachers can support and scaffold children’s experiences but their actions should be guided by children’s processes and cues.
- Imaginative, Active, and Fluid. One of the most interesting things to watch in children’s play is that it is not always tied to the rules of the “real world.” In their play, children will escape the bounds of reality and, at other times, they will practice their understanding of the real world as expressed in their play. Play themes morph frequently, and these are examples of creative thinking and problem-solving. Teachers can learn a great deal about how children are feeling and what they are thinking by observing their play.
It is important to understand that every child develops differently and because of this each child’s play will look differently. It is through play that young children learn about our “symbolic world” and the themes and subjects we experience every day. Child psychiatrist Stanley Greenspan created the Floortime approach, which emphasizes the importance of child-led floor time to engage the child in complex play scenarios that build on real world readiness skills. Floortime encourages children to take initiative but also learn to negotiate and tolerate frustration, to engage in longer play episodes as skills are acquired, to communicate interests and needs, and to plan and carry out actions. Greenspan’s model has most often been applied to children with special needs, but the principles of his approach are relevant to children of all developmental abilities. Greenspan’s approach also emphasizes the importance of the symbolic world and recommends identifying and supporting real-life experiences (e.g., encouraging role playing) that are known to the child and are of interest to the child.
How do we support learning in play using a relationships-based approach?
In an early childhood classroom, play should comprise the majority of the day. When children are enacting their own choices, they are fully engaged, which means their focus and attention are in full bloom and the opportunities are endless. Not only does this promote brain development and skill development, but it makes a young one want to come to school, want to learn and want to explore. But how is play best supported by relationships? Relationships promote play in two key ways.
First, from an attachment-based perspective, young children’s experiences reflect a balance between the need for autonomy and exploration and the need for emotional security.
When the needs for emotional security are not met, emotional and physical energy is channeled to security needs at the expense of autonomy and exploration.
So, building close, predictable, warm relationships with young children affords them greater energy to devote toward autonomy and exploration, and that equates to greater learning and more optimal development. For example, research has shown that warm, secure teacher-child relationships promote preschoolers’ self-regulation skills (Cadima, Verschueren, Leal, & Guedes, 2016), and teachers’ responsive interactions with children are linked to children’s cognitive skills (Hamre, Hatfield, Pianta, & Jamil, 2014).
Second, relationships provide the context in which teachers scaffold children’s play in individualized ways. As we observe young children in play, an infant mental health perspective leads us to ponder not only “What about the baby?” but “What about this child?” We ask ourselves, “What is the child thinking, feeling, experiencing in this moment? What does this child want and need in this moment?” From this reflective stance, with the goal of understanding the child’s internal states (e.g., thoughts, feelings, needs, goals), teachers respond with intention to support and scaffold children’s play in ways that are aligned to the child’s interests and goals. By carefully considering what children need from us, teachers communicate respect and appreciation for young children as individuals each with their own unique experiences, interests, and goals.
In short, teacher-child relationships enable the child to feel felt and heard, and, in turn, children are emotionally fueled to learn and grow.
Below are teaching practices that use the relationship to scaffold play and learning.
- Be physically and emotionally present. Teaching is complex, challenging work. Given high rates of teacher stress, it can be difficult to be fully present in the moment with the child. Teachers have the difficult task of managing competing demands for their time, attention and support while also regulating their internal thoughts, emotions, and perceptions of stress. Yet, it is the teacher’s emotional presence and participation with children that promote children’s learning in the most optimal ways.
- Watch and Respond to Cues: As noted by Rymanowicz (2015), teachers participate most sensitively by watching and responding to children’s cues. This allows the child to stay in the lead of play while also helping children to form connections between concepts in play. When teachers allow children to take the lead and wait for invitations to play, children are more likely to feel felt and heard.
- Use Open-Ended Questions and Comments Wisely: Research has shown that teachers’ sensitive (well-timed and not intrusive) open-ended questions promote children’s more complex block building and pretend play skills. Well-placed questions and comments (e.g., observations about children’s activities) promote and extend play.
- Value the Importance of Observation: Sally Provence once wisely advised, “Don’t just do something. Stand there and pay attention!” Sometimes being physically and emotionally present does not always involve direct interaction with the child. Sometimes supporting play means observing and learning about the child’s development from your observations. Being an active observer and learner alongside the child gives teachers important insights into children’s developmental needs and interests. These observations come in handy when planning future learning experiences. Sometimes supporting means interacting and scaffolding sensitively.
- Share the Same Level in Space: Finally, being physically and emotionally present also extends to where and how teachers place themselves in the classroom. Taking time to talk with children at their eye level and using open body position/body language communicates to children that their thoughts, communicative intentions and/or words are valued and desired.
- Respect the child’s discoveries. From our adult perspectives, we know how things are “supposed” to work; we understand the most effective and efficient ways to engage materials. We want to see children succeed. Collectively, this means that teachers may be tempted to show children the “right” way to engage materials or carry out play. Yet it is the creative process, the mistakes, the rethinking and execution of a new plan and “owning” the experiences and discoveries that promote children’s critical thinking, problem solving skills, conceptual development and sense of mastery (Rymanowicz, 2015). Support the child by using well placed open-ended questions to allow deeper investigations to take place. Early childhood teachers are most effective as partners in children’s play rather than as supervisors or leaders of the play.
- Trust the process. Growth and development progresses in each child in unique timetables. A “one size fits all” approach to curricular development and teaching rarely works. Individualizing experiences for children and tailoring our interactions to each child’s temperament, prior experiences, interests and goals is most effective in promoting early development.
- Avoid interruption and be flexible. As a teacher, I’d like to add another important attribute to this section. Play needs to be uninterrupted. Uninterrupted play means allowing a child to be an explorer and learner and being flexible when young children are immersed in play. For example, teachers who allow a child to finish play or come to a natural pausing or stopping point before inviting the child to diapering or toileting communicate respect for the child as an individual. Extending free play time for a few minutes to allow children to complete their play or supporting children who wish to bring a toy with them for self-care routines are other examples of flexibility.
Finally, relationship-based approaches also inform how teachers create the early childhood environment. The environment is thought of as the third teacher and reflects teachers’ perspectives about relationships. Here are some aspects to think about when setting up a learning environment.
- A classroom should be an inviting space that the children see as their own. Spaces for personal belongings, such as a cubby, and spaces for community belongings, such as where the watering can for the class plants is stored, help children know what to expect and to feel welcomed and valued. Other strategies include displaying children’s work throughout the classroom, involving children in care of the classroom, and creating photo books featuring children in the classroom, families, and shared experiences reflect high-quality relationship-based practices. Experts also suggest using the language of community, such as referring to the children in the classroom as “friends” and referring to “our classroom” to build relationships and emotional closeness (which translates into emotional energy for well-being and learning).
- Another important element is the design of the room. Materials should be chosen for a reason rather than to fill shelves. Making materials easily accessible to children builds autonomy. The room should be created to inspire and promote wonder and curiosity.
Play is for a critical component in healthy, early development. When supported and facilitated in effective ways, play has a dramatic impact on cognitive, language, physical and social-emotional development. As early childhood educators we have a huge job on our hands. A job that when done in effective, relationship-based ways contributes to children’s bright futures. I challenge you to imbed play into your curriculum. Allow children the time for uninterrupted, meaningful play and you will see the results! Good luck!
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Christakis, E. (2016). The new preschool is crushing kids. The Atlantic, January/February. Retrieved from https://www.theatlantic.com/magazine/archive/2016/01/the-new-preschool-is-crushing-kids/419139/.
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Hamre, B., Hatfield, B., Pianta, R., & Jamil, F. (2014). Evidence for general and domain‐specific elements of teacher-child interactions: Associations with preschool children’s development. Child development, 85(3), 1257-1274.
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Horne, A. (2018). All Work No Play. Bridges Care and Education Center https://www.bridgescareandeducationcenter.com/single-post/2018/11/15/All-Work-and-No-Play?fbclid=IwAR0UrQsUzJt3mGFDqaX32T1-to0tZ5CCJcvrRjcoL56a_wumdMvhsg2M_E4
Rymanowicz, K. (2015, Oct. 19). The power of play — Part 2: Born to play. In Michigan State University — MSU Extension. http://www.canr.msu.edu/news/the_power_of_play_part_2_born_to_play