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Annals of Psychiatry and Mental Health

The Reconstruction of the Narrative in the Illness Experience

Short Communication | Open Access

  • 1. Federal University of Cariri – UFCA, Brazil
  • 2. University of São Paulo – USP, Brazil
  • 3. Department of Health Sciences, Faculty of Medicine of ABC - FMABC, Santo André, São Paulo, Brazil
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Corresponding Authors
Modesto Leite Rolim Neto, Suicidology Research Group, Federal University of Cariri, 284, Divino Salvador Street, Centro Barbalha, Ceará, Brazil
Abstract

The story telling it has proven essential in improving patients who use the clinic, both in strengthening relations between doctor and patient, as in the understanding of the circumstances and acceptance of the sick; it is helpful in the healing process or mental health awareness; and also in supporting the pain and suffering of the patient, as it enables this to become an active subject in the modification of its history. The urge to re-story may proceed from significant or triggering life events. The connection capacity between the speaker and the listener will strengthen the exploration, understanding and effectiveness of this method of research.

Citation

Amorim JG, de Andrade Saraiva M, Advincula Reis AO, Loiola ME, Rolim Neto ML (2017) The Reconstruction of the Narrative in the Illness Experience. Ann Psychiatry Ment Health 5(6): 1122.

Keywords

•    Narratives
•    Illness experience
•    Life story

INTRODUCTION

Individuals have an unlimited number of stories, they are divided into perspectives as in the personal dimension and the social or outward refers to the environment [1]. Those stories produce narratives that are qualitative methods that doing collecting and analyzing the accounts people tell [2], what can be a process of reflecting on and reconstructing experience narrated [3].

There are different ways of using narratives, at school, in psychoanalysis, clinical, among others. The use of stories in the classroom helps in understanding the material, facilitates cultural expression, instigates the exchange of experiences and empowers students to build a thematic assimilation with cultural and personal refinement. Those experiences incorporate interaction patterns that reflect community life [4]. In psychoanalysis, Freud argued that psychotherapy intended to rebuild the patient’s life story to provide a deeper understanding of the life events and their meanings [5].

Already the clinical narrative has two aspects, one from the perspective of the patient and the other by the doctor, it can be used for the emancipation of sick or to formulate diagnoses. The connection capacity between the speaker and the listener will strengthen the exploration, understanding and effectiveness of this method of research. Seen in this light, the medical consultation becomes an opportunity for dialogue between [6] the vision of the patient and the perception of the professional. It should be mentioned that there is equity in the construction of these stories and use them in the clinic, since none of the idea makers can be considered a superior view. Personal stories provide a helpful way for both to understand and recognize the uniqueness of each person [1].

Narratives are a way of sharing them viewpoints, perspectives, and personal challenges [4]. They provide an ideal vehicle for assessing the subjective meaning-making that individuals bring to their experiences [7]. The narrative can be “told” by patient or written by him or by listener; when the narrator expresses his story embodies their pain or experience. Note that a narrative approach values the individual experience and voice and puts a human face on the experience [1].The narrative study may be affected also by the culture and customs of each region, so this is the study of the ways humans experience the world [8].

The creation of narrative research is given by the interaction between the interviewee and the interviewer, the storytelling is perceived to be an interesting and creative mode of self-expression [5].The interviewer has to use an active listening, because he has to know remove specific parts of speech, which will direct writing. The narrative method lends itself to a global view of the human experience [2].

The narrative is still used as a form of therapy because the narratives conveyed a sense of relief about getting through the treatment [9].The patient feels better just with the fact of tell his story, this is a human activity par excellence, allows them to create order from disorder, resulting from [10] the daily. From the moment that the patient formulates his story he also becomes able to analyze your situation or experience, so he can see that he is the “master of its history” and that just him has the power to change it. For example, therapies narratives can be of great value to people diagnosed with chronic diseases, since these can help them cope with the acceptance, stress, anxiety.

There is the use of these stories as a way to demystify the vision of society regarding people with mental illnesses. A narrative is operative in mental illness with the discrimination and stigma of mental illness [1]. Since many underestimate and marginalize these people, believing that they have no intellectual capacity to wage a simple conversation or develop an activity, giving way to psychophobia already consolidated today. However, through the use of narrative, those people are able to discuss their individual sense of identity as well as choices and expectations [2]. Such stories help both the recovery of the patient, who can talk about their difficulties, as the community, which began to be made aware and abandon this stigma.

The narratives that people use in everyday explanation are a rich source of the meanings that they bring to their experiences [11]. Culture is able to influence both in the narrative of the formulation as the therapeutic use of this story. The customs instigate the narrative construction because they modify directly the construction of human identity. In matches cultural interference therapy, the effectiveness of such changes according to the individual behavior of each and how that individual interacts with others. It was noticed that individuals who do not naturally talk about their emotions may benefit more than those who are more naturally open [12].

The narratives are seen as invalid by some researchers because they are produced by the narrator himself. But others argue that if there is a methodology that guarantees empathy interviewee to the interviewer or the researcher is prepared to listen and interpret the facts, having notion that stories are simulations of participants’ meaning, and not the meaning itself [13]. If there is no such deep interaction between the interviewer and interviewee can truly believe that this frozen story line can be a narrow view of the patient [1]. Thus, more analysis is needed insightful of all the patient’s history, as well as associate the disease to the reality that this is inserted.

Despite the good results reported, the narrative is not yet seen as a reliable method for many researchers, because the effects of additional mechanisms by which writing might induce cognitive changes outcome remain to be tested [12]; not having, therefore, a strong empirical evidence. However, despite the limitations the form of narrative research is a method that can be used by researchers who are ready to explore beyond the traditional paradigm [5].

It follows that the narrative therapy is a method that emancipates the patient and makes it able to cope with their traumas and difficulties. The narrative is important in enabling this empowerment of the narrator. This stories help repair the physical and mental damage that illness has done to the body [2]. Recognizing this, health professionals have an important role to play in helping in the illness experience [1].

The storytelling it has proven essential in improving patients who use the clinic, both in strengthening relations between doctor and patient, as in the understanding of the circumstances and acceptance of the sick; it is helpful in the healing process or mental health awareness; and also in supporting the pain and suffering of the patient, as it enables this to become an active subject in the modification of its history. The urge to re-story may proceed from significant or triggering life events. Thus, re-storying may be employed to help people make better sense of significance of the under examined past life events [14]. We believe the narrative method is a particularly rich approach to the study of everyday understandings [5].

REFERENCES

1. Kirkpatrick H. A Narrative Framework for Understanding Experiences of People with Severe Mental Illnesses. Arch Psychiatr Nurs. 2008; 22: 61–68.

2. Overcash JA. Narrative research: a review of methodology and relevance to clinical practice. Crit Rev Oncol Hematol. 2003; 48: 179– 184.

3. Suárez-Ortega M. Performance, reflexivity, and learning through biographical-narrative research. Qualitative Inquiry. 2013; 19: 189– 200.

4. Martin KJ. “Oh, I have a story”: narrative as a teacher’s classroom model. Teaching and Teacher Education. 2000; 16: 349-363.

5. Callahan C, Elliott CS. Listening: A narrative approach to everyday understandings and behavior. J Econom Psychol. 1996; 17: 79-114.

6. Launer J. A narrative approach to mental health in general practice. BMJ. 1999; 318: 117-119.

7. Adler JM, Turner AF, Brookshier KM, Monahan C, Walder-Biesanz I, Harmeling LH, et al. Variation in narrative identity is associated with trajectories of mental health over several years. J Pers Soc Psychol. 2015; 108: 476-496.

8. Ozy?ld?r?m I. Narrative analysis: An analysis of oral and written strategies in personal experience narratives. J Pragma. 2009; 41:1209-1222.

9. Simpson J, Heath J, Wall G. Living with a pituitary tumour: A narrative analysis. Psychol Health. 2014; 29: 162-176.

10. Ville I, Khlat M. Meaning and coherence of self and health: An approach based on narratives of life events. Soc Sci Med. 2007; 64: 1001-1014.

11. Chamberlian K, Christine SC, Lyons AC. Encompassing experience: meanings and methods in health psychology. Psychol & Health. 1997; 12: 691-709.

12. Graybeal A, Sexton JD, Pennebaker JW. The Role of story-making in disclosure writing: The Psychometrics of Narrative. Psychol & Health. 2002; 17: 571–581.

13. Polkinghorne DE, Validity Issues in narrative research. Qualitative Inquiry. 2007; 13: 471-486.

14. Grant A, Leigh-Phippar H; Short NP. Re-storying narrative identity: a dialogical study of mental health recovery and survival. J Psychiatr Ment Health Nurs. 2015; 22: 278–286.

Amorim JG, de Andrade Saraiva M, Advincula Reis AO, Loiola ME, Rolim Neto ML (2017) The Reconstruction of the Narrative in the Illness Experience. Ann Psychiatry Ment Health 5(6): 1122.

Received : 26 Sep 2017
Accepted : 14 Dec 2017
Published : 16 Dec 2017
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