narrative psychiatry: how stories shape clinical encounters bradley lewis new york university...

19
Narrative Narrative Psychiatry: Psychiatry: How Stories Shape How Stories Shape Clinical Encounters Clinical Encounters Bradley Lewis Bradley Lewis New York University New York University Gallatin School of Gallatin School of Individualized Study Individualized Study

Upload: kimberly-schroeder

Post on 28-Mar-2015

217 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Narrative Psychiatry: Narrative Psychiatry: How Stories Shape Clinical How Stories Shape Clinical

EncountersEncounters

Bradley LewisBradley LewisNew York UniversityNew York University

Gallatin School of Individualized Gallatin School of Individualized StudyStudy

Page 2: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Narrative Medicine

Narrative Psychotherapy

Narrative Psychiatry

Page 3: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

What is Narrative?

Page 4: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

What is Narrative?Metaphor

Page 5: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

What is Narrative?Metaphor

Plot

Page 6: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

What is Narrative?Metaphor

Plot

Character

Page 7: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 8: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Danielle... felt like a teenager, as she used to feel in the kitchen of her parents house in Columbus, before the divorce of course, and she was suddenly, powerfully, aware of the profound oddity of Marina’s present life. A life arrested at, or at least returned to, childhood. Danielle couldn’t imagine eating nightly with her parents, not only because they now lived in different states and didn’t speak to each other, but because she was entering the fourth decade of life and hadn’t been through the wearying rigmarole of family life for anything more than an almost supportable day since she was seventeen and had gone off to college.

Emperor’s Children, Claire Messud

Page 9: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

What is Narrative?Metaphor

Plot

Character

P.O.V.

Page 10: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Freitag’s Triangle

 

Page 11: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 12: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 13: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 14: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Although in general Gary applauded the modern trend toward individual self-management of retirement funds and long-distance calling plans and private-schooling options, he was less than thrilled to be given responsibility for his own personal brain chemistry, especially when certain people in his life, notably his father, refused to take any such responsibility. But Gary was nothing if not conscientious. As he entered the darkroom, he estimated that his levels of Neurofactor 3 (i.e., serotonin: a very, very important factor) were posting seven-day or even thirty-day highs, that his Factor 2 and Factor 7 levels were likewise outperforming expectation, and that his Factor 1 had rebounded from an early-mourning slump related to the glass of Armagnac he’d drunk at bedtime.

Page 15: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

He had a spring in his step, and agreeable awareness of his above-average height and his late summer suntan. His resentment of his wife, Caroline, was moderate and well contained. Declines led key advances in key indices of paranoia (e.g., his persistent suspicion that Caroline and his two older sons were mocking him), and his seasonally adjusted assessment of life’s futility and brevity was consistent with the overall robustness of his mental economy. He was not the least clinically depressed.

Corrections, Jonathan Frazen

Page 16: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study

Pat burst in the door, having come straight from a frustrating faculty meeting. “She said, ‘Paul, don't speak to me, my serotonin levels have hit bottom, my brain is awash in glucocorticoids, my blood vessels are full of adrenaline, and if it weren't for my endogenous opiates I'd have driven the car into a tree on the way home. My dopamine levels need lifting. Pour me a Chardonnay, and I'll be down in a minute.’”

New Yorker

Page 17: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 18: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study
Page 19: Narrative Psychiatry: How Stories Shape Clinical Encounters Bradley Lewis New York University Gallatin School of Individualized Study