I think that psychiatry is perhaps the most narrative of all medical specialities but here, as elsewhere, clinical skills are in danger of being lost as evidence-based medicine becomes the dominant paradigm in medical culture. Psychotherapy is a quintessentially narrative discipline.
A psychiatrist reported; ‘When my new patient first came in see me, he was suffering from depression and was mired in a story of how he was making bad decisions and was simply not living a life as others know it. Rather than focus on his problem, narrative psychiatry focuses on finding and developing stories of strength. In this young man’s case, the untold story of success lay in his writing. Despite his depression, he’d managed to write articles and then books. When I pursued his story, I discovered how in his approach to writing, he’d made many bad decisions on the way to making good ones. When I pointed this out to him, he found this idea so healing that he reported feeling relaxed and optimistic for the first time and was no longer interested in hearing about anti-depressant medications.”
New York psychiatrist Brad Lewis points out that neuroscience has restricted the ability of psychiatrists to practice, especially when it comes to working with people empathetically and on a deeply personal level.
