Narrative, Ethics and People with Severe Mental Illness

Abstract

Starting from the premise that people are essentially narrative beings, I argue that the onset of severe mental illness compromises the narrative enterprise of being able to construct one's Self and one's relationships in meaningful and coherent ways. This is due to both the curtailment of opportunities for narrative engagement and the dispossession of those whose narratives do not conform to the current conceptualization of narrative and narrativity. In these circumstances, supporting the narrative enterprise is an ethical endeavour that requires that we examine not only which narratives we construct, but also how we construct them. This requires a re-thinking of what might constitute narrative and how we might facilitate or enhance the narrativity of people with severe mental illness. Following this, I suggest four means to support the narrativity of people with severe mental illness: through maintaining narrative continuity, maintaining narrative agency, countering master narratives and attention to small stories.

Forensic Psychiatric Patients' Narratives of Their Offense

“…After that, patients begin to prepare or position themselves for a return to a life of active engagement in occupation (Polkinghorne, 1995). Baldwin (2005) emphasizes the significance of maintaining narrative identity and agency among people with mental illness, and argues that the onset of severe mental illness compromises the narrative enterprise of being able to construct one's self and one's relationships in a meaningful and coherent way.…”

The intersubjectivity of spiritual experience in the art practice of people with histories of mental distress: a phenomenological study

“…This prised experience gains poignancy if one considers the multiple descriptions in much research in the field of mental health (e.g., Stickley, 2012) of experiences of disintegration and loss of coherence (Baldwin, 2005) rendered acute by mental illness. Participants in this research also spoke of the vivid sensations of disruption, chaos and void which mental illness had invoked, and such narrative lent a fervency to descriptions of how making art was felt to help integrate "parts" and "bits" of oneself, a self that was relentlessly threatened by illness (Yanos, Roe, & Lysaker, 2010).…”

Operationalizing autonomy: solutions for mental health nursing practice

“…The authors suggest that psychiatry is inextricably linked with the notion of personhood and that certain acts have a meaning in the context of a persons' narrative. Baldwin (2005) describes personal narrative as a means of creating and maintaining a sense of self. He urges practitioners to pay attention to this and challenge the traditional ‘master narratives’ (narrative based on medical orthodoxy) of an inevitable decline in personhood attributable to the effects of serious mental illness.…”