By Oran Aviv, Creator of Hands-on Dementia & Certified Validation Teacher
If a person keeps repeating the same story, it may signify something profoundly significant to them. They may have unresolved issues or unfinished business that they haven't addressed, or they might be recounting the story to fulfill an unmet need.
Why is a Story Repeated?
Fifteen years ago, when I first started using hand reflexology as a method to connect with individuals living with dementia (see our blog post Can Reflexology Help People With Dementia?) , I observed a common pattern: repetitive storytelling during sessions.
My clients would latch onto a story and tell it at every session, often several times during each session.
Rather than brushing off these narratives as mere repetitions, I became curious about their significance to the individuals. Tracking the stories over multiple sessions revealed interesting insights:
👉🏼 All the repeated stories were about personal events.
👉🏼 Sometimes the story plot slightly changed from session to session.
👉🏼 Occasionally, a character in the story changed.
I also noted that as several of my clients became more relaxed during their hand reflexology sessions, their need to repeat their stories decreased.
Intuitively, I felt that there was something significant about these repeated stories my clients were telling.
Understanding a Repeated Story Through Validation Just over 10 years ago, I watched the video clip of Naomi Feil validating Gladys Wilson, and I realized immediately that I needed to learn Naomi Feil’s Validation Method to deepen my connections with people living with dementia.
Validation is a communication method tailored for individuals living with dementia. It involves entering the other person’s reality and striving to feel and understand their emotions through empathetic listening and truly caring.
Several of Naomi Feil’s Validation Principles now guide me when I work with a client who repeats a story:
Painful feelings expressed, acknowledged, and validated by a trusted listener will diminish. Painful feelings that are ignored or suppressed will gain strength.
While we may instinctively want to avoid seeing an older person upset or angry, it's crucial to allow them to express their feelings. Repeated stories may contain emotions that the person needs to express.
There is a reason behind the behavior of very old, disoriented people.
The reasons underlying the behavior of disoriented very old people can stem from one or more basic human needs.
What is the reason behind this person's repetitive storytelling? Could it be related to a basic human need that they are lacking?
When practicing Validation, I encourage the person to share their story, by asking open-ended questions to explore deeper into their experience. Additionally, I check whether a fundamental human need might motivate their urge to tell this story repeatedly.
Unmet Needs in Dementia Care
According to Naomi Feil, all humans, including individuals who are living with dementia, have various basic needs . These include the need:
To reduce pain and discomfort
To have sensory stimulation
To be nurtured, feel safe, and secure
To belong, to be loved
To express emotions and be heard
To be listened to and respected
To be useful
To be recognized, to have status, identity, and self-worth
To restore a sense of equilibrium
To live in peace
To die in peace
One of my wonderful Validation Teachers, Hildegard Nahum from Austria, taught us that most of our basic human needs fall within these three categories:
The need to feel safe
The need to be useful
The need to be loved
Considering the experience of older adults living with dementia, we can imagine the fear and loss of control they may feel. This loss of control can lead to a profound sense of insecurity. For example, leaving one's home and entering an unfamiliar environment can intensify feelings of vulnerability. Therefore, it is essential to assist older adults with dementia in regaining a sense of safety. This can be a ccomplished by using both Naomi Feil's Validation method and through touch. (See below for more info)
Many individuals diagnosed with dementia may feel a sense of uselessness due to perceived incompetence. Recognizing and facilitating activities that the individual can still engage in, such as bagging items for a local shelter, reading to a young child, or helping by sorting silverware, are just a few examples of how we can help restore a sense of purpose and productivity.
Sadly, many older adults, including those not living with dementia, often experience isolation and loneliness, leading to feelings of being unloved. I recall an instance where an older woman expressed a desire to die because she felt unvisited and unloved. Her words revealed the deep loneliness she experienced, conveying the sentiment, "I may as well be dead since no one visits me."
Finding the Unmet Need in a Repeated Story
To grasp the significance of a repeated story, it's important to ask open-ended questions to explore the story's underlying motives and to check whether there is an unmet need driving the retelling.
A few years ago, I found myself seated at a table in the memory wing at a Senior Day Center, surrounded by a group of individuals. Among them was a man in his eighties who kept repeating the same story about being asked to leave his successful business to return to serve in the Army. His repetitive storytelling was met with irritation from others at the table.
"I had my own successful business abroad," he would say, "and they asked me to leave it all and go back to serve in the Army."
Putting on my "investigator" hat, I began a conversation with him, aiming to discover the significance of his story.
I began by inquiring about his business - what he did, what the city was like where he conducted his business, and how successful it was. Despite providing answers, he repeated the same story just five minutes later.
Undeterred, I tried a different approach, questioning him about his decision to return to the Army. I asked how difficult it was, what happened to his business, and whether he would have made the same decision again if given the chance. Despite our discussion, he repeated the story once more within a few minutes.
Reflecting on why the Army might have wanted him back and why he needed to share this particular story, I decided to acknowledge his accomplishments. I told him:
"You must have been a very important person if the Army asked you to re-enlist. I want to thank you for defending us and the country."
In response, he beamed a big smile, and to my surprise, he stopped repeating the story. It became evident that this former high-ranking officer needed his achievements to be acknowledged. He needed others to recognize his worth, and that was the underlying reason for his repetitive storytelling.
What’s Behind the Repeated Story
One older woman with cognitive impairment always recounts to me how she learned a craftswoman's profession as a very young girl. Her profession helped her and her family survive during the war by providing the means to purchase food.
As I ask questions and search deeper to understand more, this lovely woman shares details about the excellent work she did, which earned her good pay. She also recounts the hardships she faced during those years but emphasizes her resilience and survival.
Initially, it seems that she seeks acknowledgment for her craftsmanship. However, as our conversation progresses, she shifts to the present and expresses gratitude for her current situation at the "camp" (adult day-care center) where food is provided without the need for payment.
While I'm not yet certain of the full meaning behind this woman's repeated story, I believe that beyond her desire for recognition for her craft, the repeated story serves to reassure herself that despite being unable to work in her profession anymore, she is now in a safe environment where her basic needs, including food, are met. I feel it also allows her to appreciate and to be optimistic about her current situation while others would find living with dementia to be difficult.
Another possible reason for this repeated story could be that it serves to reaffirm this woman’s sense of identity and purpose. By retelling her experiences from the past, she may find comfort and validation in reliving these significant moments from her life.
Repeating and Repressed Emotions
I consider myself incredibly fortunate to have met Naomi Feil last August at her home, just a few weeks before she received a diagnosis of terminal cancer. Naomi passed away in December 2023.
During our meeting, I took the opportunity to seek Naomi's insight into a client of mine who consistently repeated one particular story, seemingly unable to talk about anything else. Despite employing Naomi’s Validation Method for months, I struggled to grasp the underlying reason or need behind his insistence on telling this single story.
We discussed the various ways I could validate him, and I very proudly reported to Naomi that I had employed those techniques. To my surprise, Naomi then suggested a different approach – she recommended that I engage the older man in a conversation about his father, an angle I had never even considered.
Naomi explained her theory that repetitive behavior often indicates repressed emotions. She emphasized, “When they repeat over and over, you know something has been repressed or suppressed.”
In the case of the older man's repeated story, Naomi proposed that the character he spoke of, who had behaved poorly, might symbolize his own father.
Upon my return to work, I broached the subject of his father with the older man, but he swiftly reverted to recounting his familiar story. Despite my efforts, I found it challenging to penetrate the surface of his narrative, and I continued to offer empathetic listening, which he greatly appreciated.
However, a few weeks later, something remarkable happened – the older gentleman began telling the same repeated story, but this time, he included his father as a central figure instead of the other character. It was a moment of realization – Naomi's insight had been spot on and she hadn’t even met my client!
Conclusion:
Repeated stories hold significant meaning for older individuals with cognitive impairment. They serve as a means for these individuals to express their emotions and needs, often representing deeper, unspoken sentiments. Therefore, it is important to lend a listening ear and ask open questions to facilitate the exploration of the underlying themes.
While we may not always uncover the exact reason behind these repeated stories, persistent inquiry and exploration can lead to a deeper understanding of what lies beneath. Through empathic listening and by continuing to ask questions, we may unlock hidden truths and provide meaningful support to the repetitive storytellers.
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