RW: The Illness Narrative

Question 1

Narrative

Answer 1

A way to understand and organize the events of life

• an account and arrangement of events
• function as a window/mirror to our inner emotional, relational and psychological worlds
• make the inexplicable comprehensive

Question 2

The illness narrative

Answer 2

Make sense of illness and interpret the significance/implications

• onset of illness causes biographical disruption
• threat to sense of self/identity

Question 3

Ways of knowing

Answer 3

“illness”
Understand the subjective experience
- conveyed by the afflicted in a narrative account
- patient is the expert

“Disease”
Objective, rational, empirical
- clinical recognition of alterations in biological structure or functioning
- clinician is the expert

Question 4

In pursuit of curing and healing, how do subjective and objective forms of knowledge help?

Answer 4

Subjective
- embodied knowledge
Objective
- biomedical knowledge

Reorient care towards practical coping
Engages us in relationship of mutual knowing

Question 5

Why explore the meaning?Arther Kleinman

Answer 5

• break vicious cycle that amplify distress

- contribute to the provision of more effective care

Question 6

3 questions to ask someone after they receive diagnoses of life threatening illness

Answer 6

1. What kind of treatment do you think you should receive?
2. What are the most important results you hope for form this treatment?
3. What do you fear most about the sickness?

Question 7

Practices of Wondering

Answer 7

Relational practice of curiosity
Stay open and not rush to conclusions
Discover the unexpected by:
- viewing from different perspectives
- attend to context in which we perceive info
- create new categories through which to understand info

Question 8

Humility

Answer 8

Recognize that we have limits to our knowledge

Wisdom comes from knowing what we know and recognizing what we don’t know

Question 9

Guiding principles of Practices of Wondering

Answer 9

• notice and inquire, not interrogate
• accept, not judge
• discover, not assume
• stay open, not rush to conclusion

Question 10

Deep Listening

Answer 10

• honouring the person who is ill
• giving space to make sense of what’s happening
• hold the utterly sincere belief that the story you are hearing needs no change
• let experience become an object for what is now mutual involvement, for interpretation and having alternatives

Question 11

Types of Illness Narratives

Answer 11

a. Restitution story - get sick, overcome and get better
b. Chaos story - no cure, no “happy ending”
c. Quest story - growth, making sense of new reality and personal change caused by the illness

Question 12

Why is it important to distinguish types of illness narratives?

Answer 12

• listening device
• make sense of stories
• understand our reactive impulse
• help us regulate those impulse, to bear witness rather than fix