Narrative, ethics and people with severe mental illness

Area of Science:

• Psychology
• Narrative Therapy
• Mental Health Studies

Background:

• Humans are fundamentally narrative beings, constructing self and relationships through stories.
• Severe mental illness can impair this narrative capacity, affecting coherence and meaning.

Purpose of the Study:

• To explore how severe mental illness impacts the narrative self.
• To propose ethical strategies for supporting the narrative enterprise in individuals with severe mental illness.

Main Methods:

• Conceptual analysis of narrative theory and severe mental illness.
• Examination of narrative engagement and dispossession.
• Identification of methods to enhance narrativity.

Main Results:

• Severe mental illness compromises the ability to form coherent self and relationship narratives.
• Existing narratives may be invalidated, limiting opportunities for engagement.
• Four key strategies can support narrativity: continuity, agency, countering master narratives, and valuing small stories.

Conclusions:

• Supporting the narrative enterprise is an ethical imperative in severe mental illness care.
• Rethinking narrative construction and facilitation is necessary.
• Practical approaches include maintaining narrative continuity and agency, challenging dominant narratives, and attending to individual stories.