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Narrative Medicine and the Treatment-Resistant Patient

  • Eric R. MarcusEmail author
  • Rita Charon
Chapter

Abstract

Narrative medicine is applied to the understanding and technique of psychodynamic psychotherapy with nonadherent, treatment-resistant psychiatric patients. Narrative medicine’s efficacy in aiding differential diagnosis of the illness etiologies of ego dysfunctions and self-synthesis problems in these patients is discussed. The narrative medicine technique of elaborating self-narratives to resolve characteristic transference and countertransference stalemates is shown. Narrative medicine may provide crucial enhancement of adherence for the nonadherent patient. A case illustration is given.

Keywords

Narrative medicine Treatment resistance Enhancing adherence Psychodynamic psychotherapy Nonadherent 

References

  1. 1.
    Marcus ER, Bradley S. Concurrent Ax1 and Ax 2 illnesses in treatment resistant hospitalized patients. Psychiatr Clin N Am. 1987;10(5):177–84.CrossRefGoogle Scholar
  2. 2.
    Rosenbluth M, Kennedy S, Bugby RM. Depression and Personality: Conceptual and Clinical Challenges. Washington, DC: APA Press; 2005.Google Scholar
  3. 3.
    Marcus ER. Psychosis and Near Psychosis: Ego Function, Symbol Structure, Treatment. Revised. 3rd ed. New York: Routledge; 2017.Google Scholar
  4. 4.
    Charon R. Close Reading: The Signature method of narrative medicine. In: Narrative Medicine- Honoring the Stories. New York: Oxford University Press, USA; 2006.Google Scholar
  5. 5.
    Schafer R. Narrating, attending, and empathizing. Lit Med. 2004;23(2):241–51.Google Scholar
  6. 6.
    Genette G. Narrative Discourse: An Essay on Method. Ithaca: Cornell University Press; 1980.Google Scholar
  7. 7.
    Berthof A. Learning the uses of chaos. ERIC # ED 176319; ED.GOV.ies. 1979.Google Scholar
  8. 8.
    Charon R, Marcus ER. A narrative transformation of health and healthcare. In: Charon R, et al., editors. The principles and practice of narrative medicine. New York: Oxford University Press; 2017.Google Scholar
  9. 9.
    Lewis B. Narrative Psychiatry: How Stories Can Shape Clinical Practice. Baltimore: Johns Hopkins University Press; 2011.Google Scholar
  10. 10.
    Easton D, White D. Narrative Therapy: Narrative Means to Therapeutic Ends. New York: WW Norton; 1990.Google Scholar
  11. 11.
    Plakun EM. Treatment Resistance and Patient Authority. New York: WW Norton & Co.; 2011.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Columbia University College of Physicians and Surgeons, Supervising and Training Analyst, Columbia University Center for Psychoanalytic Training and ResearchNew YorkUSA
  2. 2.Medical Humanities and Ethics and of Medicine at the Columbia University Medical CenterNew YorkUSA
  3. 3.Department of Medical Humanities and EthicsColumbia University College of Physicians and SurgeonsNew YorkUSA

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