Book contents
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 Narrative in psychiatry, theology and spirituality
- 2 Spirituality and transcultural narratives
- 3 Psychopathology and the clinical story
- 4 Helping patients tell their story: narratives of body, mind and soul
- 5 Gods lost and found: spiritual coping in clinical practice
- 6 Stories of joy and sorrow: spirituality and affective disorder
- 7 Stories of fear: spirituality and anxiety disorders
- 8 Stories of transgression: narrative therapy with offenders
- 9 Narratives of transformation in psychosis
- 10 My story: a spiritual narrative
- 11 God's story revealed in the human story
- 12 Meaning without ‘believing’: attachment theory, mentalisation and the spiritual dimension of analytical psychotherapy
- 13 Stories of living with loss: spirituality and ageing
- 14 Beginnings and endings
- Index
3 - Psychopathology and the clinical story
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- List of contributors
- Foreword
- Preface
- 1 Narrative in psychiatry, theology and spirituality
- 2 Spirituality and transcultural narratives
- 3 Psychopathology and the clinical story
- 4 Helping patients tell their story: narratives of body, mind and soul
- 5 Gods lost and found: spiritual coping in clinical practice
- 6 Stories of joy and sorrow: spirituality and affective disorder
- 7 Stories of fear: spirituality and anxiety disorders
- 8 Stories of transgression: narrative therapy with offenders
- 9 Narratives of transformation in psychosis
- 10 My story: a spiritual narrative
- 11 God's story revealed in the human story
- 12 Meaning without ‘believing’: attachment theory, mentalisation and the spiritual dimension of analytical psychotherapy
- 13 Stories of living with loss: spirituality and ageing
- 14 Beginnings and endings
- Index
Summary
A craggy cliff with the rock strata vertical rather than horizontal records some cataclysmic event in the distant past: a story from an observation. So it is also for psychopathology: the method of descriptive psychopathology in psychiatry is informed observation. It links the patient's abnormal meanings and experience to past happenings inside or outside the person – descriptive psychopathology is narrative; the clinician is inevitably looking for patterns, and patterns tell stories. John tells his vicar that Satan is blowing a vapour through the village; this gives him a ‘screwed up feeling’ that makes him attack his family against his will. On careful enquiry of his experience and its meaning for him, a psychiatrist decides that this is a passivity experience and that this young man has a psychotic illness: the story here is the onset of mental illness inside. Another man, Ron, suffers from severely depressed mood and thoughts of suicide. His story is that he was supporting a young family, after his wife left him, on a low income from a small firm making components in the motor industry. The car manufacturer moved its sourcing overseas; the firm went into liquidation; Ron lost his job and his income stopped. He took a loan at exorbitant interest and applied for nearly a hundred jobs without success. After a day working on his house he developed a frozen shoulder and could no longer use his arm. His depressive illness was largely provoked from outside, and with his story this becomes understandable.
Descriptive phenomenology
Descriptive phenomenology implies informed observation of another's account of their inner experiences and behaviour: what it means to the subject – not what interpretations the observer puts on it; this was comprehensively described by the psychiatrist/philosopher Karl Jaspers (1959). It aims to achieve understanding by looking at the subjective experience, the personal meaning of thought and behaviour of the subject. It uses empathy, feeling oneself into the position of the other, and so understanding involves using our inner capacity, as human beings, for feeling someone else's experience (Sims, 2003); this is contrasted by Jaspers with explaining, which is the process undertaken by a scientist observing an outside occurrence, an apple falling from a tree, and explaining why it falls.
- Type
- Chapter
- Information
- Spirituality and Narrative in Psychiatric Practice , pp. 25 - 38Publisher: Royal College of PsychiatristsPrint publication year: 2016