Narrative in psychiatry and psychotherapy: the evidence?

Psychiatry is perhaps the most "narrative" of all medical specialties, but here as elsewhere clinical skills are in danger of being lost as evidence-based medicine becomes the dominant paradigm in medical culture. Psychotherapy is a quintessentially narrative discipline. Starting from an "attachment" perspective, the uses of narrative in psychotherapy are outlined. These include the importance of metaphor, story-telling, the search for event-scripts, and the role of "narrative competence" as a mark of psychological health. Life history research, the "adult attachment interview" and other research approaches to narrative in psychiatry and psychotherapy are described. The paper calls for an integration of narrative and evidence-based medicine.