What brings you to my office today?

A narrative is the story of what has happened in a person’s life. It is a construct of events created to facilitate communication, and it is influenced by emotion, perception, and motivation.

Cheryl Mattingly (2000) describes a narrative as a transformative mechanism giving importance to something that might have been otherwise been forgotten. Your story is the culmination of moments that have transcended into something with ‘phenomenological weight’ connecting the past to the future solidifying its construct. Since it is created by both the listener and teller, conflicting motives can and will influence the architecture of the story.

The narrative is therefore much more than just the story told or an accounting of events. It is driven by varying personal backgrounds and agendas that are present long before the inception of communicating to one another (Kirmayer, 2000). The narrative is a residual manifestation of the motivational differences between teller and listener indicating a preconceived notion held by both to ensure they are part of the final construct, and perhaps even to win the ‘contest.’

What also complicates the process is the way a story is told. When emotionally charged stories are shared, information can be skewed. When people have experiences that are dramatically out of their typical normal scope, they manufacture truths in order to make sense of what they’ve been through in order to survive (O’Brien, 1998).

The construction of narrative is a complicated process that requires one to be aware of the many factors involved that can either hinder or help. This is especially true between doctors and their patients. The effect illness has on a person is quite profound and because of this there is an intimate human intersection between a patient and a doctor. There will always be moral implications when treating human beings, regardless of how either party frames illness and pain, because human interaction of any kind will impact personal identity in some way.

The following video is based on true events. The patient was put on antidepressants by her internist who assumed her symptoms were more psychosomatic and a manifestation of depression, when in fact she had a low grade viral infection.  She said that although she didn’t agree with the doctor’s assessment, she didn’t know how to convey to him her discomfort with taking the medication, and thought maybe the doctor was right. As a result, she started to define herself as a depressed person.

Kirmayer, L. J. (2000). Broken Narratives, Clinical Encounters and the Poetics of Illness Experience. In C. Mattingly & L. Garro (Eds.), Narrative and the Cultural Construction of Illness and Healing (pp. 153-177). Berkeley and Los Angeles California: University of California Press.

Mattingly, C. (2000). Emergent Narratives. In C. Mattingly & L. Garro (Eds.), Narative and the Cultural Construction of Illness and Healing (pp. 181-211). Berkeley and Los Angeles California: University of California Press.

O’Brien, T. (1998). How to tell a true war story. In The things they carried (pp. 65-81). New York: Broadway Books.

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