Accounts of Self: Exploring Relationality Through Literature

2016 ◽  
Author(s):  
Maura Spiegel ◽  
Danielle Spencer
Keyword(s):  
Clinical Practice ◽  
Narrative Therapy ◽  
Narrative Medicine ◽  
Critical Perspectives

Literature offers the opportunity to study relationality in many different forms and contexts. This chapter discusses relationality in creative works—Colm Toíbín’s “One Minus One”, Dostoevsky’s Notes from Underground, Alison Bechdel’s Fun Home, and Kazuo Ishiguro’s Never Let Me Go—in combination with selected criticism and theory, exemplifying one approach to the narrative medicine classroom. In these texts characters offer an account of self in contrasting ways—from the vexed, distrustful address of Dostoevsky’s Underground Man to the richly inviting tapestry of Bechdel’s graphic memoir—provoking different readerly experiences. Critical perspectives such as Bakhtin’s analysis of the dialogic nature of the Underground Man’s apparent soliloquy, Rita Felski’s conception of readerly recognition, Michael White’s description of Narrative Therapy, and Judith Butler’s discussion of the ethics of giving an account of self—all enrich our experience of these works and deepen our understanding of relationality, particularly as it relates to clinical practice.

scholarly journals Narrative Medicine to integrate patients’, caregivers’ and clinicians’ migraine experiences: the DRONE multicentre project

2021 ◽  
Author(s):  
Maria Clara Tonini ◽  
Alessandra Fiorencis ◽  
Rosario Iannacchero ◽  
Mauro Zampolini ◽  
Antonietta Cappuccio ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Social Impact ◽  
Care Pathway ◽  
Narrative Medicine ◽  
Illness Experience ◽  
Caregiving Burden ◽  
Written Narratives ◽  
Pathway Evolution ◽  
Effective Care ◽  
Headache Centres

Abstract Background Although migraine is widespread and disabling, stigmatisation and poor awareness of the condition still represent barriers to effective care; furthermore, research on migraine individual and social impact must be enhanced to unveil neglected issues, such as caregiving burden. The project investigated the migraine illness experience through Narrative Medicine (NM) to understand daily life, needs and personal resources of migraneurs, their caregivers and clinicians, and to provide insights for clinical practice. Methods The project involved 13 Italian headache centres and targeted migraneurs, their caregivers and migraine specialists at these centres. Written narratives, composed by a sociodemographic survey and illness plot or parallel chart, were collected through the project’s webpage. Illness plots and parallel charts employed open words to encourage participants’ expression. Narratives were analysed through Nvivo software, interpretive coding and NM classifications. Results One hundred and seven narratives were collected from patients and 26 from caregivers, as well as 45 parallel charts from clinicians. The analysis revealed migraine perception in social, domestic and work life within the care pathway evolution and a bond between chaos narratives and day loss due to migraine; furthermore, narratives suggested the extent of the caregiving burden and a risk of underestimation of migraine burden in patients’ and caregivers’ life. Conclusion The project represents the first investigation on migraine illness experience through NM simultaneously considering migraneurs’, caregivers’ and clinicians’ perspectives. Comparing narratives and parallel charts allowed to obtain suggestions for clinical practice, while NM emerged as able to foster the pursuing of migraine knowledge and awareness.

scholarly journals The Role of Reflection in Narrative Medicine

2018 ◽  
Vol 5 ◽  
pp. 238212051878530 ◽  
Author(s):  
John W Murphy ◽  
Berkeley A Franz ◽  
Christian Schlaerth
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Patient Care ◽  
Potential Role ◽  
Patient Empowerment ◽  
Narrative Medicine ◽  
Medical Encounter ◽  
Medical Practitioners ◽  
Vital Part

Reflection has become an important tool for physicians and other medical practitioners. However, many forms of reflection exist in the health care literature, with each having particular implications for successful clinical practice. Very little attention has been given to whether reflection is a vital part of narrative medicine and which forms of reflection might be compatible with this approach to patient care. In this article, the most common types of reflection are compared and discussed, specifically regarding their potential role in narrative medicine. Reflection that encourages practitioners to focus on the various perspectives shared within a medical encounter is both in line with the tenets of narrative medicine and has important consequences for patient empowerment.

Narrative Medicine and Emerging Clinical Practice

2009 ◽  
Vol 27 (2) ◽  
pp. 248-271
Author(s):  
Julie Reichert ◽  
Brian Solan ◽  
Craig Timm ◽  
Summers Kalishman
Keyword(s):  
Clinical Practice ◽  
Narrative Medicine

Philosophical, conceptual, and ethical perspectives on working with goals in therapy

2018 ◽  
pp. 15-34
Author(s):  
John McLeod ◽  
Thomas Mackrill
Keyword(s):  
Clinical Practice ◽  
Free Will ◽  
Practical Knowledge ◽  
Moral Dilemmas ◽  
Human Experience ◽  
Contemporary Theory ◽  
Therapeutic Goals ◽  
Critical Perspectives ◽  
Ethical Perspectives ◽  
Power And Authority

This chapter explores the underlying assumptions that inform goal-oriented therapy, with the aim of examining the relevance of different critical perspectives on contemporary theory and research into therapeutic goals. An appreciation of what it means to talk about goals requires thinking about some of the basic questions around human experience and existence, including the nature of free will, time, causality, and explanation; and the ways in which realities are constructed through language and conversation. The chapter also discusses important ethical and moral dilemmas associated with processes through which goals are co-created within relationships characterized by differences in power and authority, and the forms of research and inquiry that might yield practical knowledge of relevance to clinical practice in this area.

Deliver Us from Certainty: Training for Narrative Ethics

2016 ◽  
Author(s):  
Craig Irvine ◽  
Rita Charon
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Virtue Ethics ◽  
Narrative Medicine ◽  
The United States ◽  
Narrative Ethics ◽  
Close Reading ◽  
Clinical Settings ◽  
Rule Based ◽  
Ethics Of Reading

This chapter summarizes the application of philosophical thought in healthcare with the rise of bioethics in the United States. The dominant approach, a rule-based principlism, is described, with a summary of challenges to principlism including casuistry, virtue ethics, and narrative ethics. Narratologists examine the ethical relationships between readers and texts, while clinicians and bioethicists practice narrative ethics through a “ground-up” attention to each patient’s particular needs and desires. Revealing the commonalities between the ethics of reading and the ethics of clinical practice, the chapter proposes the fruitfulness of putting them side by side. Training in narrative medicine may be the optimal training for those who practice narrative ethics in clinical settings, for the major tools of narrative ethics are those fortified by close reading, use of the imagination, radical humility, and the capacity to represent situations so as to fully perceive them.

Narrative therapy in a learning disability context: a review

2015 ◽  
Vol 20 (3) ◽  
pp. 121-129 ◽  
Author(s):  
James McParland
Keyword(s):  
Learning Disabilities ◽  
Clinical Practice ◽  
Learning Disability ◽  
Outcome Measures ◽  
Narrative Therapy ◽  
Disability Services ◽  
Validity And Reliability ◽  
Content Type ◽  
Adults With Learning Disabilities ◽  
Therapy Interventions

Purpose – Narrative therapy is aligned with government priorities for learning disabilities as it promotes inclusion and seeks to empower. While research on narrative therapy in learning disability services is emerging, it has not been critically evaluated. The purpose of this paper is to identify, summarise and critique the extant literature that has explored narrative therapy for adults with learning disabilities, and consider the implications for research and clinical practice. Design/methodology/approach – A literature search identified seven relevant case studies that described individual narrative therapy interventions for adults with learning disabilities. A qualitative review of these studies was carried out. Findings – Overall, the reviewed studies offer tentative evidence for the short-term usefulness of narrative therapy for difficulties with anger and qualitative benefits for ritualistic behaviour, social anxiety and stealing behaviour. Research limitations/implications – A number of methodological issues are identified, particularly concerning the use of outcome measures and the generalisability of findings. The research is limited due to a reliance on case study evidence and outcome measures that lack validity and reliability. Both larger scale and more robust research, and high quality practice-based evidence, are required. Practical implications – Learning disability services could consider providing narrative therapy for people with learning disabilities experiencing anger problems and other psychological difficulties. Clinical practice suggestions are identified, such as choosing relevant metaphors and including the individual’s wider system. Originality/value – This paper provides an up-to-date, comprehensive review of the literature on narrative therapy for people with learning disabilities that will be of use to clinicians providing therapeutic support and to people commissioning such services.

The Principles and Practice of Narrative Medicine

2016 ◽  
Author(s):  
Rita Charon ◽  
Sayantani DasGupta ◽  
Nellie Hermann ◽  
Craig Irvine ◽  
Eric R. Marcus ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Narrative Medicine ◽  
Theory And Practice ◽  
Care Practice ◽  
Columbia University ◽  
Patient Centered ◽  
Narrative Skills ◽  
Clinical Methods ◽  
Intellectual Foundations ◽  
Worldwide Network

Narrative medicine is a clinical practice fortified by complex narrative skills that equip healthcare professionals to recognize, absorb, interpret, and be moved to action by patients’ and colleagues’ stories of illness. Founded in 2000 at Columbia University by the authors of this volume, narrative medicine provides rigorous conceptual frameworks and practical clinical methods to increase the accuracy and scope of clinicians’ knowledge of their patients and to deepen their therapeutic partnerships. This book presents the authors’ views, enriched by collaboration with a worldwide network of colleagues, of the workings of the narrative, relational, and reflexive processes of healthcare. Literary theory, narratology, continental philosophies, aesthetic theory, and cultural studies provide the intellectual foundations of narrative medicine, while primary care practice, patient-centered care, psychoanalysis, and interprofessional practice supply the clinical foundations.The book provides both principles and practices of the central tenets of the discipline—relationality and emotion, the philosophies of embodiment, ethicality, participatory pedagogy, close reading, creativity, and clinical practice. Each Part of this volume explains the conceptual foundations of its subject and demonstrates the pedagogic or clinical methods of putting those principles into action. Narrative medicine has grown since its inception into an international movement including many health professional disciplines, patients, families, and institutions.The overarching goal of narrative medicine is to improve the effectiveness of healthcare. This volume provides the standards of the field’s theory and practice as a guide to all who are now joining in this creative commitment to improve healthcare for all.

scholarly journals Project NAME: not alone with my emotions

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
R. Di Matteo ◽  
T. Bolgeo ◽  
Maria Teresa Dacquino ◽  
M. Bertolotti ◽  
D. Gatti ◽  
...  
Keyword(s):  
Content Analysis ◽  
Clinical Practice ◽  
Quantitative Data ◽  
Narrative Medicine ◽  
The Real ◽  
Qualitative And Quantitative ◽  
Different Types ◽  
Normal Clinical Practice

Aim and objectives: The aim of the project will be to acquire and understand, through storytelling (writing), the emotions of women who have recently given birth and their families during hospitalization. Materials and methods: The trial involves a population of 100 patients divided into three arms: women who have given birth according to normal clinical practice; women who have given birth supported by the tool of narrative medicine by operators trained by the project NAME; women who have given birth supported by the tool of narrative medicine by operators trained by the project verba curant. Results: The collection of narratives will offer qualitative and quantitative data: the content analysis will be able to offer a very detailed profile of the narrative under examination. Conclusions: From the data of the study will emerge the basis for the conduct of a project aimed at defining on a larger scale, in different types of patients, the real benefit of the introduction of the tool.

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