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Narrative psychiatry empowers patients to shape their lives through story. Rather than focusing only on finding the source of the problem, in this collaborative clinical approach psychiatrists also help patients diagnose and develop their sources of strength. By encouraging the patient to explore their personal narrative through questioning and story-telling, the clinician helps the patient participate in and discover the ways in which they construct meaning, how they view themselves, what their values are, and who it is exactly that they want to be. These revelations in turn inform clinical decision-making about what it is that ails them, how they'd like to treat it, and what recovery might look like. The Art of Narrative Psychiatry is the first comprehensive description of narrative psychiatry in action. Engaging and accessible, it demonstrates how to help patients cultivate their personal sources of strength and meaning as resources for recovery. Illustrated with vivid case reports and in-depth accounts of therapeutic conversations, the book offers psychiatrists and psychotherapists detailed guidance in the theory and practice of this collaborative approach. Drawing inspiration from narrative therapy, post-modern philosophy, humanistic medicine, and social justice movements - and replete with ways to more fully manifest the intentions of the mental health recovery model - this engaging new book shows how to draw on the standard psychiatric toolbox while also maintaining focus on the patient's vision of the world and illuminating their skills and strengths. Written by a pioneer in the field, The Art of Narrative Psychiatry describes a breadth of nuanced, powerful narrative practices, including externalizing problems, listening for what is absent but implicit, facilitating re-authoring conversations, fostering communities of support, and creating therapeutic documents. The Art of Narrative Psychiatry addresses mental health challenges that range from mild to severe, including anxiety, depression, despair, anorexia/bulimia, perfectionism, OCD, trauma, psychosis, and loss. True to form, the author narrates her own experience throughout, sharing her internal thoughts and decision-making processes as she listens to patients. The Art of Narrative Psychiatry is necessary reading for any professional seeking to empower their patients and become a better, more compassionate clinician.

Narrative psychiatry brings the muscle and agility of narrative theory and the spirit of compassion and social justice to the practice of psychiatry. What makes narrative psychiatry different from psychiatry-as-usual? Rather than focusing only on finding the source of the problem, narrative psychiatry also focuses on finding sources of strength and meaning. The result is compassionate, powerful healing. Narrative psychiatry combines narrative and biological understandings of human suffering and well-being. It begins with compassionate connection with patients, understanding that we live our lives in relationships and connect with one another through the stories we tell. It relishes discovering untold but inspiring stories of a person’s resiliency and skill in resisting mental health challenges while dismantling narratives that fuel problems. It examines what the doctor’s kit of psychiatry has to offer in light of the values and preferences of the person seeking consultation, authorizing the patient as the arbiter of what is helpful and what is not. Psychiatry as a field is seeking a more positive and patient-centered approach, which narrative psychiatry exemplifies. In his address at the American Psychiatric Association’s annual meeting on May 6, 2012, President-Elect Dilip Jeste, M.D., said that “ ‘positive psychiatry’—a psychiatry that aims not just to reduce psychiatric symptoms but to help patients grow and flourish—is the future.” Likewise, in 2012 the U.S. Substance Abuse and Mental Health Services Administration called for a focus on “recovery” that includes collaborative and culturally sensitive care that seeks to honor the patient’s values, self-determination, and preferred relationships and to foster not just the absence of symptoms, but also well-being. Narrative approaches to psychiatry, psychotherapy, and medicine have been burgeoning in the last decade, inspired by the wave of narrative theory that has progressively suffused philosophy, anthropology, literature, and the arts over the last fifty years. Training programs and courses teaching narrative approaches to mental health treatment and to medicine are flourishing.

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“Anxiety is ruining my life,” Addie Markiewicz had said to me at her first appointment at age sixteen. Now, four years later, she entered my office, dropped her backpack on the floor, plopped down comfortably on the couch, picked up one of my blue throw pillows and began fiddling with the zipper. A junior in college, Addie had long, dark hair, blue eyes, fair skin, wholesome good looks, and a dry, at times mischievous sense of humor. In our weekly sessions, she could be alternately reticent and forthcoming. A gifted student with lots of friends, she volunteered at a daycare facility for children with special needs and was a respected and beloved babysitter for several families in the area. She had helped to form an advocacy group at her college for students who were dealing with mental health challenges. She had a loving relationship with her parents, whom she called her “best friends,” and her life had been free of any major trauma; on the contrary, her childhood had been characterized by a loving, supportive family and a close-knit community of which she was a cherished member, many of whom shared her Polish American heritage. For the first three years of our work together, I met with Addie for twenty minutes every week or two and she also met with a psychotherapist. After he moved out of the area, I became her primary psychotherapist, meeting with her weekly for fifty minutes. She had made great strides in overcoming profound despair, an ongoing sense of unreality, severe anxiety, and unwanted compulsive urges that had dogged her since she was twelve, but at times one or more of these problems flared up again, and we were still chipping away at them, working toward a fuller recovery. From our first appointment, she had identified a problem of feeling an overwhelming urge to spend hours and hours on her homework until it was flawless, accompanied by a keen anxiety lest there were any mistakes.