Narrative and Health

     Going through the readings, I obtain a general idea that at the personal level, narratives can be described as telling a story of the lived experience of the teller. Furthermore, I think in health care narrative also is formed at other levels. Specifically, at the interpersonal level, the interpretation of physicians towards patients’ stories, and co-constructing meaning in dialogue are narratives too. For example, I think the presentation of doctors’ prescription, including suggestion of changing life style, might be one kind of co-constructing narrative, which is based on hearing the narratives of patients. The narrative is a result of an interaction in which both of the actors are engaging. In addition, at the societal level, different social positions of physician and patient shape divergent narrative. They both tell stories with the sense of their positioning which is linked to the ethnicity. To understand the narrative, we need to understand the positional context. Locate ourselves within the story to obtain a meaningful sense.

     Basically, narrative is a way to make sense of the world. The process of constructing a narrative allows people to impart meaning to the life change, to address disorder. Thus, it seems that narrative is used to make sense of the disturbance in the life brought by the illness. The plot of narrative varies across tellers. Narrators arrange a set of events in their own particular ways, forming different development, and different results. The process involves different values and cultural norms. An individual may interpret some details as important parts that others may neglect. For example, I remember in an interview on SSB I conducted recently, the Chinese participant narrated her experience of consumption of SSB focusing on the concept of “moderation”. She described that she was aware to restrict the intake of SSB within the extent of moderation – neither too much, nor too less – even thought when she had strong desire to drink SSB. This perception is associated with the “moderation” ethos in Confucian thought. Moderation here means a harmony condition between ritual (Li) and desire, avoiding indulgence. Culture constitutes a structure of customs, ideas, and norms that offers individuals patterns for responding to the world. The selection of events in the narrative usually represents the teller’s personal idea of the issue.

     I was reminded of one question that how patients with painful experience construct narrative? Do they encounter difficulties? What if the narrative is absent for people without power? How is narrative created by power? And how is the narrative creating power? The process of narrative enables an individual to organize events in a coherent pattern and integrate thoughts. It provides people a sense of control over the chaotic, obscure, and silent life. Constructing stories lead to less rumination. On the other hand, painful experiences in some cases may not be put into a narrative form and therefore result in negative feelings and emotions. It might happen especially when patients have no access to narrate or without power, and awareness to tell others’ their stories and experiences. Illness is an event that creates chaos to the everyday life. If constructed, illness narrative plays a role in asserting responsibility of patients and producing a clear picture which reassesses identity, reevaluating their own position in the world. Maybe that is one avenue in which narrative creates power.

      Narrative is a basic mean of individual interaction. We communicate with other through telling stories in the daily life. It is a natural and acceptable way of communicating information and knowledge. Therefore, not only health professionals need to understand the ethical narratives of patients, but also we can use narrative approaches to promote health behaviors change. I am thinking that maybe different types of stories can be used for different goals. For example, tell culturally common stories to pervasive in a cultural atmosphere. Hence, narratives are not merely a personal method, but an attempt to engage with other actors to co-construct narratives within positional context, understanding the power structures that uphold them. Providing support for development of narratives, I think, also might be an important way to increase confidence and awareness of the marginalized.