Narrative Medicine

Kirmayer, Laurence J.; Gómez-Carrillo, Ana; Sukhanova, Ekaterina V.; Garrido, E.

doi:10.1007/978-3-031-17650-0_14

Cited by 4 publications

(2 citation statements)

References 67 publications

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“…Significant intellectual disability and Down syndrome were excluded. We take this variable to indicate long-standing differences in how clinicians and researchers frame mental distress, in either cognitive behavioral ways or through open-ended psychodynamic and narrative methods [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Béhague,

Gonçalves,

da Cruz

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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Purpose In this paper, we explore how Brazilian socially sensitive therapy can respond to care-users’ desire to change the social and political forces shaping their lives. We use this case to demonstrate the limits of the “social determinants of health” agenda which, when operationalized, tends to leave questions of lasting structural change aside. Methods We report on mixed methods ethnographic and epidemiological results from the 1982 Pelotas (Brazil) birth cohort study, a prospective study of 5914 children. Ethnographic analysis explored the cyclical relationship between schooling, mental health care, conceptualizations of mental distress, social and political engagement, and experiences with diverse forms of discrimination. Epidemiological bivariate and multivariate analyses examined differences in socio-political participation and the reporting of discrimination at different time-points for participants who used therapy with those who did not. Effect modification analysis tested the hypothesis that the socially empowering effects of therapy were greater for marginalized and minoritized youth. Results Most young people living in situations of precarity experienced therapy, particularly when based in schools, to be a blame-inducing process. A more fulfilling and impactful therapeutic experience took shape when young people were able to shift the focus away from symptom reduction and behavioral management toward narrative life analyses, social debate, and political agency. Use of socially sensitive therapy was statistically associated with increased political participation and reporting of discrimination after controlling for confounders. The empowering effects of therapy were greater for those with less formal education and family income, but not for young people who identified as black, brown, or non-white. Conclusion The findings underscore the importance of considering agency, sociality, and politics when theorizing “the social” in clinical practice, and health and social policy.

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Section: Methodsmentioning

confidence: 99%

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Béhague,

Gonçalves,

da Cruz

et al. 2023

Soc Psychiatry Psychiatr Epidemiol

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“…It hinges on the recognition of "human capacity to tell stories as central to health care", note researchers. 72 Patient narratives are essential to understanding their health concerns, life experiences, and circumstances. They provide a platform for patient active engagement in their own treatment and development of coping mechanisms, while the clinician develops listening skills that enhance the portrait of the health problem.…”

mentioning

confidence: 99%

Frozen in Time, a Focused Review of Autism Prevalence in Canadian Indigenous Communities

Hus

2023

NDT

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The unprecedented global continuous rise in autism prevalence is often referred to as a Pandemic while its parallel cost increase to society portrays a Tsunami. Autism data originates mostly from industrialized High-Income geopolitical regions in Europe, North America, and Asian regions. Although efforts to determine autism data from regions in Low and Mid-economies are ongoing, prevalence information from geographically remote and economically vulnerable communities within the privileged regions is largely undetermined, as is the case of the Canadian Indigenous communities, the First Nations, Inuit, and Métis highlighted in this focused review. The underlying theoretical approach adopted here is Transcultural Psychiatry with its emphasis on Context including sociopolitical circumstances, considered the gateway to understanding health, illness, and recovery in groups and individuals. Accordingly, the review includes a concise relevant government system description and history of the relations with Indigenous peoples to provide context to present indigenous relations to Canadian government agencies. Scores in these communities face a myriad of survival challenges encompassing meagre health resources and services. Establishing autism prevalence data in these communities are exceedingly difficult due to multiple factors. While prominent among them are their strong ties to traditional approaches to health, illness, and autism conceptualization, the crucial obstacle is Crown and Provincial government authorities' and agencies' historically rooted colonial response to the needs of families with autistic members. It embodies a posture of infantilization, an attitude that is "frozen in time" in the approach, practice, accommodations, and services for these families. The review provides the preferred autism terminology, information sources, article flow, and Future Directions, all found in the Introduction's first paragraphs.

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Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students’ reflective writing

Valestrand,

Kvernenes,

Kinsella

et al. 2024

Adv in Health Sci Educ

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Medical students’ efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians’ life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one’s future professional practice can inform first-year medical students’ initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students’ processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients’ vulnerability, (3) experiencing the healing function of sharing stories, and (4) transforming personal experiences into professional strength. Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.

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Narrative Medicine

Cited by 4 publications

References 67 publications

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

The politicizing clinic: insights on ‘the social’ for mental health policy and practice

Frozen in Time, a Focused Review of Autism Prevalence in Canadian Indigenous Communities

Transforming self-experienced vulnerability into professional strength: a dialogical narrative analysis of medical students’ reflective writing

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