困境与希望：新冠肺炎疫情下的医学叙事

数月以来,新冠肺炎疫情之下的中国医务人员及患者在这场抗疫之战中形成了许多独具特色的医学叙事,其中的文本意义既具有深刻的社会属性,亦具有极强的个人属性。采用参与式观察法,收集、记录自然条件下不同的患者在疫情期间前来医院就诊的疾病故事,共计29个案例,并根据患者就诊中的不同心态将这些案例分为恐慌、无奈和乐观三类,最后尝试以医者的视角,通过三个医务人员的平行病历对疫情之下这三类不同的患者心态进行解读,借此重新审视特殊时代背景之下医者的责任和医学的意义,旨在为后疫情时期的医患关系研究提供一些理论基础和思考空间。     

生命健康视野下的叙事闭锁

从弗里曼的叙事闭锁理论出发,将“叙事闭锁”重新定义为“将自己禁锢在停滞的故事空间里,无法吸纳推动叙事进程向前发展的生命状态”,并将其进一步分为职业型、创伤型、疑虑型和老年型四种类型。叙事闭锁不仅在老年人群中高发,在其他年龄阶段人群中也不少见,以至于人生故事提前进入结束状态或者处于无法更新的停滞状态。对叙事闭锁者开展叙事介入可以帮助他们提升叙事素养,重启再次体验和阐释人生的按钮,赋予他们由内而外突破闭锁的能量。当人处于一种叙事稳定性和叙事开放性的平衡状态之中时,主体经历的就是一种健康和谐的生命进程。     

Loving the World We Are: Anthropology and Relationality in Laudato si’

There is a tension between Laudato si's consistent emphasis on relationships and interconnectedness and its acceptance of anthropocentrism. While Laudato si’ does reject certain problematic forms of anthropocentrism, the encyclical does not assert an alternative to this traditional framework. This article contends that “relatiocentrism” provides the best avenue for developing the convictions expressed within Laudato si’ while moving beyond the limitations of the encyclical itself. In so doing, this essay explores the use of narrative as a means of shaping identity by mapping significant relationships and points of meaning. It examines the central anthropological claims of the encyclical and the tensions these create with anthropocentric narratives. And it examines relatiocentrism in light of the biblical creation accounts, the eschatological perspective of Laudato si’, and virtue ethics. The essay concludes by suggesting further theological and moral implications of this shift in perspective.     

以叙事医学实践促教学医院医学人文教育

叙事医学可以作为大学教学医院进行医学人文教育的重要手段。医学院可以进行细读训练,进入临床后,通过阅读和书写平行病历培养医学生的叙事能力。临床带教教师在医学人文教育中具有关键的示范作用,通过叙事性问诊、用叙事的方法与患者和家属建立关联,用叙事方法协助患者和家属做出临床决策,以及提供案例、点评升华其中的价值元素等叙事性带教方法,实现医学人文教育的言传身教, 这也是医学人文教育的重要组成部分。

     

重构叙事病历在银屑病患者健康管理中的应用

通过阐述重构叙事病历在银屑病患者健康管理中的应用,探讨了重构叙事病历在银屑病患者健康管理中应用的模式和意义,并分析了该模式存在如部分患者对参与重构叙事病历的必要性认识不足等问题。认为将重构叙事病历应用于银屑病患者的健康管理中,有利于医务人员通过叙事医学为患者提供帮助,改善患者的沟通能力和认知能力,使患者保持良好的心理状态,以正确、积极的态度面对周围环境,提高了银屑病患者的临床疗效与生存质量,拓展了叙事医学及重构叙事病历的临床领域。

     

叙事医学本土化的若干思考

叙事医学为人文社会学科介入医学范畴提供了建构性方案,使技术至上的医疗实践逐渐转向重视患者个体的生活价值、痛苦关怀的人文实践,对于医患主体间的鸿沟消弭、理解改善具有独到之处。然而,在中国式现代化的路径视角下,依然需要对西方语境中的叙事医学方法论进行审慎反思,尤其是要考虑国别体制下的文化差异与社会现实,避免造成简单化搬运与应用。在扎根中国本土情境的基础上,探索适应我国的医疗卫生实践、构建和谐医患环境的叙事医学模式。

     

Redefining the Meaning of Negative History in Times of Sociopolitical Change: A Social Creativity Approach

This article explores the role negative history plays in political discourse on crisis management and how times of sociopolitical change in turn influence the strategies that can be employed to write a positive historical charter. Choosing Germany as a case study, we analyzed how political leaders negotiate Germany's narrative and political role during the European “refugee crisis” in speeches (n = 332) held between 2015 and 2018. Applying a combination of corpus-based and qualitative narrative analysis, we found that the context of a crisis is used to attach new meaning to Germany's role in World War II. By focusing on the lessons learned from history and pointing out the parallels between the current crisis and sociopolitical developments that took place 80 years ago, Germany is presented as the ideal advocate for a free and united Europe, a narrative that legitimizes its advancingly dominant role within the EU and beyond. The analysis demonstrates how times of change can facilitate social creativity strategies for nations whose past is dominated by negative history, with implications for the theory of identity management.     

A narratological methodology for identifying archetypal story patterns in autobiographical narratives

Based on Jung's definition of archetype the concept 'archetypal story pattern' is developed as well as a research method drawing on narrative analysis and biographical research to identify these archetypal story patterns in life stories. Jung pointed out that personal myths, archetypal patterns found, e.g., in mythology, can govern the life course of individuals unconsciously. In the Theory of Narrative Identity comparable concepts have been mentioned but were never fully developed. In my research I try to combine Jung's concept of the archetype with the elaborated methodology of narrative analysis. Archetypes can manifest as narratives and the identity construction of a person via narrating the life story can be influenced or even totally structured by archetypal stories which give a specific form as well as a specific meaning to the person's identity. The method of extracting an underlying archetypal pattern from an autobiographical narrative is demonstrated. The results of the research on 20 autobiographical interviews and the inherent archetypal patterns are summarized. The major aim of this paper is to describe in detail the application of a well established method of the social sciences on a key concept of Jungian psychology to show that these concepts can be integrated into recent research frameworks of academic sciences. On the other hand it shows that Jungian concepts can be investigated through established and well defined research methods in empirical research settings.     

Narrating career, positioning identity: Career identity as a narrative practice

In contrast to traditional definitions of career identity as an individual construct, this article argues for a discursive approach to career identity as a narrative practice. Career identity is conceptualized as a practice of articulating, performing and negotiating identity positions in narrating career experiences. By using the concept of positioning, this approach situates identities within particular historic, cultural and interactional contexts via the discourses and master narratives that position identity. It also leaves space for individual agency and change via the reflexive capacity of the person to modify and negotiate the competing positions available. The methodological implications are considered, and illustrated with an empirical case analysis. The contribution of the proposed approach is in offering contextualized understandings of actual practices, resources and constraints of identity construction while also allowing for in-depth analyses of the particularities of identity work and possibilities for change in careers.     

The Spirit(s) of Science: Paradoxical Positivism as Religious Discourse among Spiritualists

This article examines a narrative dilemma that popular texts on evolution face. On the one hand, popular science tends to privilege linear and culturally familiar narrative structures, as previous studies of popularization have often emphasized. On the other hand, however, the Darwinian idea of natural selection resists linear narration, as narrative theorist H. Porter Abbott has argued. This resistance arises from the fact that evolution by natural selection lacks proper narrative entities and narrative events and that it relies on two parallel narrative levels, the levels of species and organism. This paper explores how two popular science books on evolution negotiate this narrative dilemma by introducing a third narrative level. Both texts appropriate characteristics from the narrative levels of species and organism and project them on molecular and minute scales by portraying evolution as a micro-narrative that takes place in chromosomes, genes, cells and microscopic details of human organs. While this textual strategy produces a coherent and compelling narrative that for the most part succeeds in masking the structural gap between the narrative levels of species and organism, it also risks naturalizing cultural imagery. In particular, this micro-narrative tends to represent popular gender ideologies as biological truths embedded in molecular processes within our bodies.