‘Healing with Stories’: Four Case Studies

Review of a book about the use of metaphors and creative longer-form stories in psychotherapy

Article originally published in Middle-Pause on Medium on July 31, 2026

I love stories, and for many years now I’ve been a fan of working on stories we tell ourselves as a manner of therapy. I have written poetry and fiction, and have gotten to a point where things are unsettling my mood if I spend too many days without thinking of stories in writing.

Which is why when I found a book titled Healing with Stories, I had to read it. The complete title is Healing with Stories: Your Casebook Collection for Using Therapeutic Metaphors, and the author (more like editor, for most of the chapters) is George W. Burns. (NB: I read this collection in Romanian.)

The stories in this book are pretty simple, yet very effective. Whether they are created by the clients or by the therapist, or by the two of them together, they make the clients feel heard, and they allow them to create something that engages their resources and abilities. That can be longer-form stories or metaphors that aren’t really whole stories, but more like imaginative frames from a possible story that work because they encapsulate a situation and its psychological mechanisms.

I share this review here, in Middle-Pause, because even when the case studies are about children and teenagers, they impact mothers as well. And sometimes the case studies are about women who find themselves struggling while caring for their families and not doing enough for themselves.

So here are some case studies from this book, showing how the therapist used metaphors to guide the client’s thinking and find solutions to their predicaments.

In the case of an eight-year-old girl experiencing separation anxiety from her mother, the suggestions offered by the therapist work because he has already noted in the girl’s play with her dolls that she has in her that power to be more independent. So when the girl, Emily, comes to therapy with her mother, not wanting to let her go from a tight hug, the therapist tells her she should, in fact, hold her mother tight, so as not to lose her until she’s ready to enter the cabinet alone. This puzzles Emily and gets her attention. Then he talks to Emily through one of her dolls, noticing that Emily treated that doll like a caring mother. The doll helps Emily be less fearful and anxious when coming to therapy and separating from her mother.

It’s not clear from this account about Emily if the therapist got to share a story about porcupines, but in the beginning of this chapter about Dr. Julie H. Linden, the narrative she’d chosen to guide her therapy was a metaphor about a family of porcupines and how their quills don’t let them get too close together. It appears, however, that when Emily comes to therapy hugging her mother and then bringing one of her dolls, the therapist gets sidetracked — which is not a bad thing, since Dr. Linden writes that it’s important that therapy responds to the needs of each meeting. Emily’s case study ends with the girl playing with more dolls, teaching them how to connect with horses and care for them, and, in doing so, how to conquer separation anxiety from their parents.

In another case study, from Dr. Valerie E. Lewis, forty-year-old Reina has a car accident, and the moment when she faces death changes her, so that now she is angry at her husband and twin daughters — resentful and furious that she has to care for them, devoting all her time to them. Reina’s story makes Dr. Lewis think of Margrit, who after years of doing all the emotional and physical work for her family found herself in a major depressive episode. At the time, Margrit took some medications and felt better, but then the illness reappeared, so she decided to see a therapist. She told Dr. Lewis that she’d gotten married to escape her strict father, and then ended up with a stern husband that resembled her father in many ways. Now all she wanted to do for herself, she said, was to lie down on the floor. So Dr. Lewis lay down on the floor with Margrit to encourage the latter to relax that way, and not feel guilty about this desire of hers.

When Reina comes to her cabinet and reminds her of Margrit, Dr. Lewis decides to share Margrit’s story with her client in a state of hypnosis. The therapy works. Reina understands that, just like Margrit, she has to give herself permission to relax; that her family can’t make her, in fact, do anything she doesn’t want to do — that it’s her who doesn’t take time to lie on the floor or spend time with hobbies she’d enjoy. Or, for that matter, express her feelings in words or in arts like painting and dancing.

Another story, shared by therapist Joy Nel, is about a girl describing her parents’ fights and divorce with a story involving two snakes hissing and biting each other. It’s a simple metaphor, and yet one so fierce. The girl must have been deeply impacted to describe her parents as snakes. She actually said that she often felt that her parents spat her, too, with their venom, adding that snakes’ venom can kill or maim you, blind you, or leave you paralyzed — a striking enumeration that she completed with a story she saw on TV about an anaconda that spit venomous mucus on a man, leaving him unable to move. Perhaps, we infer, in some ways the girl, Jamé, experienced situations where she also felt stuck when her parents fought. Stuck because she couldn’t react in a way that could stop them when they clashed, much as she said that besides crying, she felt like hitting them.

Eventually, Jamé wrote a story about a family of snakes, where she also gave them positive qualities, keeping her main censure for Divorce, which she inserted as a personified character, and the Monsters Divorce brought with him: the Monster of Fights, that of Sadness, and that of Worry. These Monsters all gain power because of Divorce. The Monster of Fights leads her to believe that if she becomes more scrappy, her parents would quarrel less. It also influences her to be mean to her friends, telling her they don’t like her anymore because she now has Divorce at home. The Monster of Sadness tells her that if she cries enough, her parents would stop fighting and pay more attention to her. And the Monster of Worry wants her to think that if she spends time with her anxiety-inducing insecurities regarding her living situation — whether she would live with her mother or with her father, making the other parent suffer and love her less — Divorce might leave her home.

In the end, Jamé decides to assert her power, telling the Monsters to go away. And she does that because she takes a good look at herself and she learns that she has many positive qualities: she has courage, she’s friendly, she’s a good daughter, she cares for other people, and more. And because she cares for other people, she can help other kids when they live with Divorce, telling them that, even though things will change, life will be good to them again. She also has two friends who offer her comfort: a cat and a rabbit. She only has to pet them to find consolation.

Besides the very well crafted story, this case study shows a principle of much of metaphor-based therapy, that of the client putting in the story, and thereby finding resources and abilities that they haven’t been using. In Jamé’s case, it was her courage and her fortitude to fight Divorce and his Monsters, and help other kids as well.

Jamé’s memorable case study shows how deeply enmeshed with emotions and the realities of their life are children’s stories.

To conclude this book review, I’ll share another kid’s case, for its quirk factor. Dr. George W. Burns shares the story of Cate, an eleven-year-old girl who was about to have spinal surgery involving a week in the hospital and up to four months of recovery at home, time in which she was expected to endure severe pain. Dr. Burns was dealing with a case of pain management and wasn’t sure how to proceed, since he was used to working with adults in such instances, rather than children.

But he accepted the challenge, and he started by asking Cate what she liked to do. One of the things Cate mentioned was that she liked to write, and that she had to do as homework a creative composition about pasta. Dr. Burns used with Cate a guided metaphor, which is to say he helped direct her story with targeted questions, according to a PRO model (moving from a Problem to Resources to desired Outcome). Cate wrote a story about Peter Pasta, who was crumbly and longed to be soft like other spaghetti. But for that to happen, he knew he had to be boiled, and he dreaded that — much like Cate dreaded the surgery and the pain she would suffer after the surgery.

Peter Pasta’s story is simple yet whimsical and wonderfully adept as a metaphor for Cate’s situation. Cate’s mother tries to set him loose from the pasta package into boiling water, but he clings to the margins of the pot. He even jumps onto the woman’s head, before facing the inevitable: that he needs to be boiled. But the water is really hot, and it hurts him. So then he tries to think of something other than the pain, as per Dr. Burns’s guidance for Cate under hypnosis, where he impressed upon her that she can manage the sensation of pain through dissociation, time distortion, hypnoanesthesia, positive feelings, and targeting the focus on pain to control its intensity.

In Cate’s story, Peter Pasta sings to forget the sound of boiling water, and concentrates on the feeling of water bubbles on his skin. He also enjoys that he is moved about by the boiling water. And he thinks about the Outcome: how he’ll be soft and have fun with pasta sauce.

Cate handled post-surgery pain really well and recuperated a month faster than expected.

These are just four stories from this book, but there are several others which made a deep impression on me. I highly recommend this book for all the women who are going through tough times, whether or not they are mothers as well.

Enjoy!

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Thank you for reading!

If you liked this piece, here are two other articles you may enjoy:

‘Broken Country’: A Novel About Missed Chances and New Beginnings

People Inspo: Nora Ephron’s Life as a Writer in Four Interviews, with a Few Lessons to Share

And here are some of my customizable Zazzle designs for the holiday season:

https://happierhealthier.blog/tag/christmas

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To a happier, healthier life,

Mira