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Articles    H3'ed 2/2/12

On the Nature of Afflictions

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A member of the workshop speaks up about using narrative methods with women who have received violence from a romantic partner.   She now approaches them with genuine curiosity, with what Harlene Anderson and Harry Goolishian of the Houston-Galveston Family Center called a "not knowing" stance.   She learned she could ask legitimately about the ways in which the women recipients of violence still loved their partners.   In her old model, victims were not allowed to love perpetrators.   Through narrative means, she could embrace the rich complexity of relationship in which love and violence can co-exist   She shared how this awareness removed her from the frustration of being a social worker who was angry at women who returned to men who beat them.   She could be less judgmental.   She could be curious about how they would do this and the value of love over battery.   She came to understand violence as a visitor into a situational relationship which deserved query.   A part of us hates the violence.   A part of us is angry at the person who is violent.   A part of us still loves this person.   How can these parts, these characters negotiate?   How can you, the person who receives the violence, balance your anger, your love, and your desire to avoid being hit?   How can we negotiate this?   She told us how this approach was so much more effective than her previous black and white stance.   When she allowed her clients to acknowledge the love, they could actually more successfully problem solve about how to avoid the violence.

 

Narrative paradigms do not oppose biomedical therapies, only the blind reliance upon them.   We realize that more levels can be considered beyond the merely biochemical.

 

"What about athlete's foot?" one participant asked.   "That can be quickly treated with an anti-fungal medication."

 

"But there is a story there," I countered.   "I have had this problem and it came from a story in which I was too busy to dry between my toes after showering at the gym.   Going a little slower and doing self-care became an important theme that had manifestations in other areas of my life.   I could take a narrative approach to athlete's foot by wondering about all the other areas in which bit of self-care could prevent a more serious problem from developing."

 

Here I was proposing that everything that happens to and inside of our bodies involves story.   Because our bodies are our lives, whatever happens to and in them has ongoing meaning and purpose, even if it didn't when it occurred.

 

Illness takes place within a field that remains to be discovered and explored as potentially part of the healing process.   This is also the message of Brian Broom, a professor of rheumatology at the University of Auckland Medical School in New Zealand, in his book, Meaning-full Illness.   He writes how exploring the field of relationships, locales, and situations surrounding the illness can allow its meaning to appear and lead to its healing.   Again, for him, illness serves as an invitation to enter into a dialogue.

 

Even when illness appears to have no intrinsic meaning, we can seize the opportunity to construct meaning , to re-vision ourselves, to re-construct our lives.   Brushes with mortality have that life-changing effect.   Professor Hardy in the UK studies spiritual transformations and found a common antecedent to be near-death experiences.   We humans have the unique capacity, as existentialists like Victor Frankl have written, to create meaning where none was before.   This arises from our inherent, intrinsic capacity for storying, for applying our biologically primed narrative capacity to the physical world in which we are embedded.

 

I'm happy to live in a storied world of magic and purpose more than a material world of randomness and meaninglessness.   I'm happy to believe that my efforts at elucidating the field around an illness and identifying the characters who move in that field, matters.   The rules of evidence also differ for me.   I'm not as interested in mass produced, randomized, controlled trials, as I am in whether or not the people I see grow and change in meaningful and important ways which others can recognize.   I use outcome measuring instruments like the MYMOP (My Medical Outcome Profile), Duncan and Miller's Outcome Rating Scale, and more.   I do care if I'm effective or not.   But I also listen to the stories I'm hearing and ask whether or not they're changing.

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Lewis Mehl-Madrona graduated from Stanford University School of Medicine and completed residencies in family medicine and in psychiatry at the University of Vermont. He is the author of Coyote Medicine, Coyote Healing, Coyote Wisdom, and (more...)
 
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