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The Art of Narrative Psychiatry: Stories of Strength and Meaning

by HamkinsSuEllen. New York, Oxford University Press, 2013, 240 pp., $27.95.

Reading this book has been a wonderful experience because it becomes a trip through a psychotherapeutic approach about mental disease from a comprehensive perspective but mostly about the person.

Dr. SuEllen Hamkins, whose training in psychiatry included the orientation of psychoanalytic psychotherapy and psychopharmacology with an intensive study of family therapy, discovers later on in narrative psychiatry that this therapeutic approach is a source of tools to help her patients, even those with severe mental disease. Narrative psychotherapy includes the role of human biology and contemplates psychotherapy and psychopharmacology as nonexcluding tools. Furthermore, it differs from other psychotherapeutic approaches because it is focused on searching for the sources of strengths in the persons, rather than finding the root of their problems. Narrative psychiatry takes into account the stories patients bring to the consultation and how the stories are influenced by their values, intentions, feelings, and cultural context; likewise, the richness each patient teaches in his or her story is taken into account. Another important aspect is the lineal relation between therapist and patient in which both participate in decision making, since, according to Hamkins, it is the patients who know the most about themselves and their lives.

In the introduction, Hamkins comments, “Narrative psychiatry, like narrative therapy, is animated by the idea that we experience our lives and our identities through the stories we tell about ourselves and the world. It combines the understandings that meaning is socially created, that we can question the narratives that influence us, that we are embodied creatures fortified by and beholden to our biology, and that when these ideas are gracefully combined in compassionate practice, tremendous healing is possible” (p. xiv).

The book has great strengths, among them is the story of the author’s experience with her patients. She shows how the treatment is developed, and at the same time she presents the dialogues held with her patients, their successes, frustrations, challenges, and positive emotions. Also, she shares her subjective experiences as a therapist, which is well reflected in her analysis about her clinical experience.

Another innovative aspect is the series of reflections, points to highlight, and recommendations accompanying each chapter, turning the book into very didactic material. In every chapter, psychiatry in action can be appreciated, and elements of its great use and easy application are presented.

The book constitutes two parts. In the first part, chapters 1–6, the first chapter is titled “What is Narrative Psychiatry? This chapter describes a general panorama, key concepts, and bases for the comprehension of the other contents. The following chapters, 2–6, are focused on the central elements of narrative psychiatry and offer elements applicable to the clinical practice. The second part of the book, chapters 7–9, enriches the work with the presentation of a challenging and complicated clinical case. Additionally, the author recounts how the supervision with other colleagues helps in critical moments when the tools the therapist has seem to be exhausted.

This book is an eminent, human, and experiential work with excellent academic support.

Dr. Gaviria is Head of the Department of Psychiatry, CES University, Medellín, Colombia.

The author reports no financial relationships with commercial interests.