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Madness, childhood adversity and narrative psychiatry: caring and the moral imagination.

Authors :
Thomas P
Longden E
Source :
Medical humanities [Med Humanit] 2013 Dec 01; Vol. 39 (2), pp. 119-25. Date of Electronic Publication: 2013 Jun 08.
Publication Year :
2013

Abstract

The dominance of technological paradigms within psychiatry creates moral and ethical tensions over how to engage with the interpersonal narratives of those experiencing mental distress. This paper argues that such paradigms are poorly suited for fostering principled responses to human suffering, and proposes an alternative approach that considers a view of relationships based in feminist theories about the nature of caring. Four primary characteristics are presented which distinguish caring from technological paradigms: (1) a concern with the particular nature of contexts, (2) embodied practice, (3) the dialogical basis of caring and (4) the existential basis of caring. From this we explore the role of the moral imagination and our ability, through narrative, to acknowledge, engage with and bear witness to the injustices that shape the lives of those who suffer. This, we argue, is at the heart of caring. Clinical implications are discussed, including an exposition of the importance of narrative in recovery from trauma and distress. Narrative Psychiatry, The Sanctuary Model of care, and Soteria, are outlined as examples of this type of practice.

Details

Language :
English
ISSN :
1473-4265
Volume :
39
Issue :
2
Database :
MEDLINE
Journal :
Medical humanities
Publication Type :
Academic Journal
Accession number :
23748151
Full Text :
https://doi.org/10.1136/medhum-2012-010268