Narrative Psychiatry

Book excerpt: Psychiatry has lagged behind many clinical specialties in recognizing the importance of narrative for understanding and effectively treating disease. With this book, Bradley Lewis makes the challenging and compelling case that psychiatrists need to promote the significance of narrative in their practice as well. Narrative already holds a prominent place in psychiatry. Patient stories are the foundation for diagnosis and the key to managing treatment and measuring its effectiveness. Even so, psychiatry has paid scant scholarly attention to the intrinsic value of patient stories. Fortunately, the study of narrative outside psychiatry has grown exponentially in recent years, and it is now possible for psychiatry to make considerable advances in its appreciation of clinical stories. Narrative Psychiatry picks up this intellectual opportunity and develops the tools of narrative for psychiatry. Lewis explores the rise of narrative medicine and looks closely at recent narrative approaches to psychotherapy. He uses philosophic and fictional writings, such as Anton Chekhov’s play Ivanov, to develop key terms in narrative theory (plot, metaphor, character, point of view) and to understand the interpretive dimensions of clinical work. Finally, Lewis brings this material back to psychiatric practice, showing how narrative insights can be applied in psychiatric treatments—including the use of psychiatric medications. Nothing short of a call to rework the psychiatric profession, Narrative Psychiatry advocates taking the inherently narrative-centered patient-psychiatrist relationship to its logical conclusion: making the story a central aspect of treatment.