Telling stories

Patients need to tell their stories. One of our primary tasks as analysts is to help patients tell their stories and own them. The freedom of mind to think, to feel, and to know are dependent on the ongoing capacity for storytelling. The analyst's stance plays a major role in the development of the analysand's storytelling capacities.     

Restorying the self,restoring place: Healing through grief in everyday places

In this paper, I think with ecological memoirs about emotion and healing within places and in relationship to place. I argue that by staying with and exploring painful emotions, instead of palliating them, healing transformations become possible for individuals, societies and places. I engage in dialogue with two books: Terry Tempest Williams' Refuge and Linda Hogan's The Woman Who Watches Over the World. Similarly to processes advocated by narrative counsellors, in each of these memoirs the author works through her grief by restorying her self. In both books, the act of restorying the self is only made possible through a concurrent restorying of place. By focusing on the stories people tell about healing, this paper moves away from the dichotomization of therapeutic and non-therapeutic – or even anti-therapeutic – landscapes towards an understanding of how people and places can be healed. I suggest that academics can contribute to healing of and in place through empathically bearing witness to the stories people tell and by the circulating and amplifying alternative narratives of transformation.     

Narrative (Re)Righting: Recovering and Rebuilding a Life Rocked by Trauma

In this paper, I write about and through my recent brush with death to narrate myself out of fear and desperation and into hope and acceptance. Storytelling helps me sort through the rubble and make sense of my life repeatedly rocked by trauma. Narrative reframing takes me a step further, empowering me to rebuild and reinvent my life through the stories I choose to tell as I move forward. Through this work, I am reminded rebuilding is temporary, continual, and precarious; and not only possible, but important and necessary.     

Creative Writing as a Medical Instrument

Listening and responding to patients’ stories for over 20 years as an emergency physician has strengthened my appreciation for the many ways that the skills and principles drawn from writing fiction double as necessary clinical skills. The best medicine doesn’t work on the wrong story, and the stories patients tell sometimes feel like first drafts—vital and fragile works-in-progress. Increasingly complex health challenges compounded by social, financial, and psychological burdens make for stories that are difficult to articulate and comprehend. In this essay, I argue that healthcare providers need to think like creative writers and the skills and sensitivities necessary to story construction deserve a vital space in medical education. A thorough understanding of story anatomy and the imaginative flexibility to work stories into open spaces serve as antidotes to the reductive nature of clinical decision making and have implications as patient safety and risk management strategies. The examples that I have selected demonstrate how thinking like a creative writer functions at the bedside, providing tools for clinical excellence and empathy. This approach asks that we re-imagine the importance of story in clinical care: from a vehicle to a diagnosis to its place as a critical destination.     

A Storytelling Approach: Insights from the <Emphasis Type="Italic">Shambaa</Emphasis>

Narrative medicine explores the stories that patients tell; this paper, conversely, looks at some of the stories that patients are told. The paper starts by examining the ‘story’ told by the Shambaa people of Tanzania to explain the bubonic plague and contrasts this with the stories told by Ghanaian communities to explain lymphatic filariasis. By harnessing insights from memory studies, these stories’ memorability is claimed to be due to their use mnemonic devices woven into stories. The paper suggests that stories can be unpatronising, informative, and appropriate vehicles for communicating medical information to all age groups across all cultures.     

The scholar as activist: Postcolonial feminist film practice as a tool for social development,empowerment and resistance

This article explores the concept of the “scholar as activist” in the context of postcolonial feminist film practice, and the successes and shortcomings of a research design conceptualised to explore the potential that self-reflexive filmmaking offers to articulate the narratives of South African Hindu women (and other suppressed groups). My point of departure was a strong sense of the misrecognition of my own identity as a South African Hindu woman of Indian descent, in stereotypical representations of Hindu women in mainstream film. South African Hindu women, and suppressed groups by extension, have stories that need to be told. The question emerged of how such stories could be told through the medium of film. Could the interface between the medium of self-reflexive film, the academic filmmaker and the narratives of South African Hindu women translate into meaningful social action that would offer a platform for resistance to mainstream (mis)representations? A critical reflection on my initial filmmaking process, and an analysis of the film text itself, illustrated that as an academic with various platforms of expression at my disposal, I had assumed a superficial similarity to and yet privileged position over those whose story I attempted to tell. How then could women use self-reflexive filmmaking to tell their own stories that resist limited mainstream gendered representations and reclaim their own identities? In a play between an academic register and an overtly self-reflexive narrative style, I thus explicate the organic process of developing a revised methodological approach for the postcolonial “scholar as activist”.     

Some Hypotheses about Hesitations and their Nonverbal Expression in Family Therapy Practice

When people seek therapy they have stories to tell. In the course of the therapeutic conversation the clients continually make selections about what they want to tell, and what they want to keep silent. In this article the author focuses on the border zone between the said and the not-yet-said, and proposes three hypotheses about the client's hesitations about speaking in the family therapy session. In these hypotheses 'hesitation' is used as a metaphor to give meaning to some nonverbal utterances of clients in such a way that space is opened up in a respectful way for as-yet untold stories. I suggest that it is fruitful to think of certain nonverbal utterances of the clients as hesitations to proceed with the conversation, and to use these nonverbal utterances, in the line of Tom Andersen's thinking (1995), as a starting point for a respectful dialogue with the family about the good reasons they might have not to speak. Not only can this open up space for as-yet unspoken stories, it can also help the therapist to establish a collaborative therapeutic relationship with the family. These ideas are illustrated with several case studies.     

Researching trauma, the body and transformation: A situated account of creating safety in unsafe places

This paper is based on a study of how childhood trauma can be experienced in the body and the resources individuals have chosen to deal with that. Ten individuals (including myself) wrote stories showing how they had made sense of those experiences and found ways to heal. In this paper, I tell the story of that research, contextualising myself as researcher and researched, against a changing societal, research and practitioner background to show how social constructionist and poststructuralist ideas have influenced the way I undertook and re-presented my study. This paper also provides me with an opportunity to focus for the first time on aspects of the stories that demonstrate how people created safe enough environments as children and as adults in order to heal.     

What I Talk About When I Talk About Teaching and Learning

In this text I discuss two events in which I learned something important about life and about education in order to formulate in a precise manner two propositions for my pedagogical creed. In focus for both are the interrelatedness of theory and life. The stories are told through the lenses of Emmanuel Levinas’s and Jacques Rancière’s thinking, but the stories also are shown to be essential in my understanding of their thinking. The first story is about learning ethics as a consequence of meeting an old man on a remote island and the second story is about teaching, when a young girl in a situation of war taught me something important about political life. In a final section I discuss briefly what those theoretical/practical experiences and memories bring to my understanding of education.     

Victims' Stories of Human Rights Abuse: The Ethics of Ownership,Dissemination, and Reception

This paper addresses three commentaries on Victims' Stories and the Advancement of Human Rights. In response to Vittorio Bufacchi, it argues that asking victims to tell their stories needn't be coercive or unjust and that victims are entitled to decide whether and under what conditions to tell their stories. In response to Serene Khader, it argues that empathy with victims' stories can contribute to building a culture of human rights provided that measures are taken to overcome the implicit biases and colonialist interpellations she identifies. In response to Andrea Westlund, it proposes a taxonomy of types of narrative closure and offers some arguments to strengthen her view that empathy with victims' stories endows audience members with a new reason and new motivation to support human rights.     

Discussion of Kris Yi’s Paper “From No Name Woman to Birth of Integrated Identity: Trauma-Based Cultural Dissociation in Immigrant Women and Creative Integration”

Using a clinical vignette describing her work with a Korean patient, Kris Yi draws attention to the ways in which ethnic minority cultures are not monolithic. Yi offers the theoretical construct of a “cultural dissociation.” When sexual violence or discrimination is infused with cultural practices, people may seek relief by dissociating themselves from the culture that is fused with emotional pain. In this discussion, using examples that range from Sigmund Freud to Henry Louis Gates, I link Yi’s formulation to one I have developed, namely, that race in America constitutes an adaptive problem. When clinicians take into account the adaptive nature of the problem that race and ethnicity constitute in contemporary American culture, practitioners should expect dislocations. I conclude with a call for our profession open ourselves to the different stories differently situated others have to tell in their own voices and on their own terms.     

Tomorrow is the start of the rest of their life — so who cares about health? Exploring constructions of weight-loss motivations and health using story completion

ABSTRACT

In Western societies, health is closely associated with body weight and weight loss, achieved through individual health behaviour. I examined such associations in constructions of weight-loss motivations and health in stories generated using the novel method of story completion. The story stem featured either a female or male protagonist deciding to lose weight; 148 women and 22 men (ages 18–24) provided stories in response. A social constructionist thematic analysis identified five themes: health as clothing size and means to an end; weight-loss activity as good for every woman; tomorrow is going to be the start of the rest of their life; tell me when I’m okay — it’s not about wellbeing; and weight loss as signifier of the “true self.” Considering the adverse social and psychological consequences reflected in the stories and the longstanding elusiveness of successful weight-loss methods, I support calls to review the dominant weight-focused approach to public health.     

Orphan Sunday: Narratives of Salvation in Transnational Adoption

Abstract : The article is a critical analysis of public narratives about transnational adoption that equate adoption with the salvation of “orphans.” The stories I weave together from in‐depth interviews, social science and humanities research, law and policy, and public dialogues make visible the scaffolding of power that shapes families’ lives. I tell a specific story about Korean American adoption that speaks to the power inequalities shaping the transnational transfer of children from developing countries all over the world. These stories reframe the circumstances of adoptees’ births and relinquishments as issues of social inequality rather than as individual choice.     

The Task of the Translator

This discussion reflects closely on Dominique Scarfone’s call to consider psychoanalysis as a practice founded on ethics, and to rely on this premise in charting a fundamental common ground such that has eluded psychoanalysis for most of its history. Out of the three points Scarfone centers on, I dedicate most attention to the third—psychoanalysis as modeled on the notion of translation—because I find his suggestion inspiring, and promising toward the goals he sets for his paper. Building on the basis Scarfone offers in this context with the help of ideas developed by Walter Benjamin and Emmanuel Levinas, I suggest that the vision that can pull us together as psychoanalysts indeed relies on an ethics of attending to the other’s speech, its meaning as well as its fundamental yet complicated striving for comunicability. More specifically, we need to recognize that words can hide our need to say them. That what we say obscures our vulnerability and shame. That when we try to recall, the language we speak is distorted by the personal and historical forces collaborating to make us forget ourselves. I argue that the task of the psychoanalytic translator is therefore to uncover and resignify the scattered, coded fragments; to help us restore our ability to tell our stories; and to recognize that more than everything, we want to tell them.     

The painter and the cameraman: boundaries in clinical relationships

The issue of boundaries in clinician–patientencounters is considered through narrativeanalysis of four clinical stories in whichboundaries crossings are a self-conscioustopic. One story is by a physician as patient,two are by physicians, and one is by apalliative care nurse. The stories arediscussed using Walter Benjamin's distinctionbetween the painter, who maintains distance andsees the whole, and the cameraman, who usestechnology to penetrate realities and thenreassembles fragments. The essay argues thatdistance and closeness are ethical issues thatconstitute the possibility of clinicalencounters but the encounter also changes theclinician's sense of boundaries. The relevantethics of boundary decisions in most clinicalencounters are not procedural ethics but anethics of self-creation: in orienting toboundaries as doctors do, they createthemselves in their relations to others.     

Deprivation/enhancement fantasy patterns in children

Previous studies have shown that females tell stories that change from negative experiences (deprivation) to positive experiences (enhancement) and males tell stories that change in the opposite direction. The current study examines this phenomenon in children using a different story-telling procedure. Results were not consistent with those of previous studies.     

Indelible

Many years ago I grew away from the evangelical Christian faith that had grounded my life (before and beyond death) since my early teens. Or so I thought: the stories my body now tell confront me with the sense that I have – secretly, ambivalently – held on to elements of that faith. Over recent times, through and since my doctoral studies, I have embraced poststructural and Deleuzian sensibilities. These, one might think, run right up against the entrenched binaries and certainties that remain indelibly inscribed. The narrative of progress and development I have been telling myself over the decades – that I have not just grown away but grown up – is no longer tenable. In this paper I examine my doubt at whether I doubt. Amongst the most disturbing stories is one of being beaten in God's name. Its scars remain. I revisit this story in an attempt to dwell more fully in the pain (and pleasure?) of cane on flesh. How am I to (at)tend (to) those scars? What are their meanings? I draw from the psychodynamic and poststructural theoretical frameworks that seem to have failed me, in inquiring into the political, cultural, emotional, psychological and spiritual processes at play in this current disturbance.     

尊重患者的故事及对叙事医学实践的思考

医学除了具有生物科学性外,更有着社会和心理的特性,同样的疾病、不同的患者就会衍生出不同的故事版本。本文通过对一位直肠癌患者的诊治经历进行叙述,尝试着通过“叙事医学”实践来进一步认识、吸收、解释、回应患者的故事,通过医患之间心与心的交流从而加强患者的优质体验。本文还从医患双方、医院管理以及相关行政管理部门就叙事医学更有效可持续发展需要提供的支持做了思考。