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The Art of Narrative PsychiatryStories of Strength and Meaning$
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SuEllen Hamkins

Print publication date: 2013

Print ISBN-13: 9780199982042

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780199982042.001.0001

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Starting with Stories of Success: The Initial Psychiatric Consultation

Starting with Stories of Success: The Initial Psychiatric Consultation

Chapter Three Starting with Stories of Success: The Initial Psychiatric Consultation
The Art of Narrative Psychiatry

SuEllen Hamkins

Oxford University Press

If compassionate connection is the heart of narrative psychiatry, then eliciting healing stories is its soul. In narrative psychiatry, we begin seeking stories of strength and meaning from the very first appointment. As we listen to the story a patient brings to us, we also listen for the untold stories implicit in their narrative that may support their well-being. Fleshing out these stories, making them alive with detail, vivid with language and compelling with plot, strengthens them and gives them purchase to eclipse a disempowering, problem-dominated story. What we can know about a patient depends on what we are listening for. The openings for story development that we hear and the questions we ask in the first appointment lead to the cocreation of the narrative of the patient’s life that informs our understanding of the problem and our treatment options. By eliciting narratives that lead to a more nuanced, colorful, and balanced portrait of the patient and a more contextualized view of the problem, we can understand the nature of the problem and the patient with more depth, clarity and subtlety. Tall and thin with a short spiky haircut, and carrying a canvas messenger bag, Amanda Riley spoke earnestly when she first came in to see me for treatment of depression. A sophomore in college, she was mired in a story of how she was making bad decisions and wasn’t living her life right. Amanda had been referred to me by a psychotherapist at the college counseling service where I consulted due to concerns about panic attacks and depressed mood. The hope was that I would be able to help Amanda clarify the nature of the problem and determine if medication might be helpful, a typical workaday situation for many psychiatrists in today’s world. So how would a narrative psychiatrist approach his or her first meeting with Amanda? At the start of my initial conversation with Amanda, I asked her what year of school she was in and what she was studying. She told me she was a sophomore in college, majoring in Chinese and art.

Keywords:   alcohol, collaborative therapeutic alliance, psychiatric consultation (initial)

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