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Geoffrey Hunt 《Theoretical medicine and bioethics》1990,11(1):61-78
The paper attempts to account for the confusion over the validity of the concept of schizophrenia in terms of two closely related aspects of conceptual indeterminacy. Firstly, it is identified on the basis of a breakdown in intelligibility, but what constitutes such a breakdown is indeterminate. Secondly, the concept sits between the categories of natural disease or illness on the one hand, and character trait or moral failing or gift on the other. This entails an indeterminacy in attempting to define the role that physiological explanation could have. Light may be thrown on the concept by exploring a distinction between a life story in which the schizophrenic condition emerges as the conclusion of the story and a causal process in which the condition is the end result or final consequence. 相似文献
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Randolph S. Charlton 《The Journal of analytical psychology》1997,42(1):81-97
This paper examines internal objects in their role as theoretical constructs which analysts use to make sense of human experience. Object relations theory is based upon a vision that the personality is divided or split into parts. Clinical experience reveals that such splits are commonly expressed in the language of our analysing. However, a lexical reality is not a thing-in-itself, but a way of organizing and understanding experience. Jung's vision of the dynamics of the split self encompass a unique 'object relations theory' that is both similar and yet quite different from the object relations theories of Klein, Fairbairn, Winnicott and Thomas Ogden A clinical example is used to examine the way in which these different theoretical views explain the same clinical phenomenon. The last section of the paper is devoted to a narrational analysis of the place of internal objects in analytic theory. The split self, dynamic is seen as a narrative device - one that makes sense and provides coherence, but is neither the only view of psychic reality nor necessarily an accurate reflection of the nature of the internal world. 相似文献
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The aim of this study was to apply the narrative approach in analyzing family therapy meetings in cases of acute psychosis. The self-narrative is essential in acute psychosis since it is either collapsed or not coherent enough. The results indicate that it is important to create concrete practices that produce stories concerning the patient in relation to others. The self-narrative must be re-authored by the patient even though it is socially constructed. This is achieved by creating multiple perspectives of self-narratives in so-called therapy meetings with the patient, family members, and staff members representing different professionals. 相似文献
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Dr. J. Paul Gallant PhD Keith Brownlee PhD Rich Vodde MSW 《Contemporary Family Therapy》1995,17(1):143-157
This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room. 相似文献
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This study aims to elucidate cognitive and contextual aspects of the EE (Expressed Emotion) concept. The EE levels of both parents of two first admission psychotic patients were rated from the Five Minute Speech Sample (FMSS), and the emotional responses were further analyzed in narratives of family photographs. The attribution model was found to provide an explanatory framework for understanding relatives' expressed emotions (EE) toward a family member suffering from psychotic disturbances. Four case reports indicated that family photographs induced parents to create narratives in which emotions, attributions, and strategies for coping with stressful aspects of the illness came forward as intertwined phenomena. The method can offer more comprehensive data for intervention strategies aiming to alter the prevailing atmosphere and interaction patterns within the high EE family. 相似文献
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From the narrative point of view the plot of a story configures time. In psychosis, when experiences remain unnarrated, experience being-in-time is also missing. Once experiences are given narrative form, they can be left behind as a part of individual's personal history, thus enabling present experiences to be narrated. Unnarrated experiences do not accumulate. Narrative history contains, however, enough redundancy to invite you to restory your past in a new way if you need to. Hence, from the narrative point of view, early, family- and network-centered intervention is of special value in cases of acute psychosis. 相似文献
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Recently, feminists like Jane Roland-Martin, Elizabeth Young-Bruehl, and others have advocated a conversational metaphor for thinking and rationality, and our image of the rational person. Elizabeth Young-Bruehl refers to thinking as a constant interconnecting of representations of experiences and an extension of how we hear ourselves and others. There are numerous disadvantages to thinking about thinking as a conversation.We think there are difficulties in accepting the current formulation of the conversational metaphor without question. First, there is danger that we will lose important dialectical connections like that between the self and society. Second, the conversational metaphor alone cannot fully express the way conversations are constructed. We will want to take up the notion of narrative as a metaphor for thinking advocated by Susan Bordo, Alasdair MacIntyre, Jerome Bruner, and others, including Mary Belenky and her colleagues.Eventually, we want to champion narrative and the dramatic narrative of culture as a metaphor for thinking that involves such expressions as sights, insights, silences, as well as sounds, moments of mood and poetic moments. The dramatic narrative provides the structural possibilities needed to criticize certain kinds of conversations, in order to talk about the relations of public and private, self and society and most importantly, about the drama of our lives within and without.The dramatic narrative for thinking helps dispel the dangerous dualisms of mind and body that not even conversation or narration alone can banish, and allows us to frame questions about education that do not require us to separate mind from body. The dramatic narrative metaphor for thinking lets us show who we are, act out what we think, and reconstruct rationality to reflect what many women, and some men, do. 相似文献