Although there are other interpretations of these data, the central issue is that they show that reconstructions of the past may be in the service of adapting to present circumstances.

The second factor impacting the diminished emphasis on the truth is the growth of narrative theory and its extension into the study of the self. There is a vast literature on these topics and, for reasons of space, I will refer only to the work of McAdams, whose theoretical writing and empirical research on the narrative self has been particularly illuminating for me.3 McAdams suggests that personality can be conceptualized as a 3-level entity. Personality traits occupy the first level, and these partially inherited characteristics are relatively unchanging during adult life. The second level, personal concerns, includes a wide array of important characteristics (eg, values, defense mechanisms) that often change during adult development. The third level is the autobiographical self, the story one tells oneself and important others about one’s life—the past, present, and anticipated future. This narrative is believed to undergo subtle but constant revision, usually outside the person’s awareness. Indeed, if confronted with clear evidence of revisions, most persons become distressed.

The major revisionary process is altering the memories of the past to better fit the present. Many students of the narrative self believe that these reconstructions are in the service of coherence. In order to maintain a coherent sense of self in an often unpredictable world, one modifies the past. Here, again, as in the longitudinal study reviewed above, it is the present that changes the past.

The third influence on the lessened emphasis on the truth consists of the views of some memory researchers. Gilbert reviews this research and describes the picture that comes together of how memory actually works.4 We are unable to store all that we experience over time; there is simply too much to handle, even for our complex brains. Rather, experiences are compressed for storage by being reduced to a few key elements. When we want to recall a particular experience “our brains quickly reweave the tapestry by fabricating—not by actually retrieving—the bulk of the information that we experience as a memory.”4(p87) This happens so quickly that we believe the information was all in our heads all the time.

The laboratory research that documents this process is voluminous and establishes that information obtained after an event may alter the memory of the event. (Here, again, the impact of present on past.) Gilbert suggests that most scientists have become convinced that remembering involves “filling in” details that were not actually stored, and this process occurs outside of the awareness of the remembering person.

In this essay I have suggested some of the factors that have altered the romantic paradigm of my early psychiatric experiences—that the truth can set one free. In its place has crept the paradigm of utility. The objective of some forms of psychotherapy is to assist patients in rewriting their narrative selves into a form that provides both a greater understanding and relief from pain. Almost immediately, however, it is important to point out that not just any revision of the patient’s life narrative will do. The revision must include all that is “known” to have happened to the patient, it should emphasize the importance of the patient’s decisions on one’s life course, and it should represent a collaborative process shared by patient and therapist.

I suspect that some readers will disagree with my formulation of these changes, and, in truth, I hope so. Such would reassure me that these issues are still alive in a field that often seems dominated by diagnoses and prescriptions.
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