In a life crisis, like illness, we come to a situation where our old life´s narrative gets stuck. That is because our old way of making sense to our lives are not valid anymore. We are in the situation where we have to rewrite, self-narrate, ourselves. In these stories we have to be truthful to life as it has been lived. To be honest doesen´t mean that we have to tell our story with medical terms. For me medicine is dead poetry.
Sometimes for example fairytails, drama and poetry can express our truthfulness more precisely than cold language of medicine. To be truthful, we have to create our new identity narrative from different kind of rationalities. For me as hypnotherapist it is quite clear that plural ways, like Ego state therapy, gives us opportunity to free us from one sided medical unifying truth.
Waitkin characterizes medicine as an ideological system that ”calls” the patient to be an identity that medicine maintains for him; the diagnosis is the most prevalent form of this identity. The ideological work of medicine is to get the patient to accept this diagnostic identity as appropriate and moral. When the patient accepts this identity he aligns himself as subordinate in a power relation.
To me as a medical professional, it is clear that medical truth can be in many cases useful, but it is not the only perspective. If we want to really give patient-centered health care, the patient have to be able and free to narrate his own story. To be free means that he is free to choose the worldviews he wants for his illness narrative.
A transmodern physician is a dialogue companion of his patient. This is not very pleasent for some professionals, because the paradigm of materialistic medicine, has offered to medical professionals and whole society a asymmetrial power system. The transmodern world, where we are on our way, is more equal. The old power hirarchies seem to be dying. The change appear to be happening first in grass level. It looks like the patients have realized the plurality of worlds before the medical experts.
Medicine is for me an ideological system but often quite useful such one. For me both as a patient and medical professional, patient -physican power relation is symmetrical. Medicine has been a part of authoritarian materialistic culture. We are at the moment moving towards dialogical more equal world, where every creature has a voice. I think that world is liberating for the medical professionals, too.
Medical experts have given – and often their patients have even waited for – their unifying view for narration of the patient´s illness story. To be in dialogue means that two equal persons are communicating and listening to each other. Medical professionals have useful views to their patients but in the transmodern world an adult patient has basic right to choose if he wants, or if he does not want, to take the medical unifying view as a part of their illness story.
The patients are becoming narrators of their own life. That is good because people are taking more and more responsibility of their own health. It has been talked for ages about patient-centered health care. In transmodern world, health care is becaming truly patient-centered.
There are many professionals nowadays who think that the illness narration is a process based on plural identity. We live in the middle of different ideologies. We can be rational in many ways. I think that the perfect way to self-narrate is to find from ourselves ego states and an observing self, out side of our ego states (the director of our inner theater). We can by this way make self availble for ourselves.
New narrative after illness or other life crisis is a self-reflexive process. One quite handy way to do renarration work, is using ego states our ”subpersonalities”. In reflexive monitoring process we readjustment perpetually past and present to sustain a good story in which we listen to our body. By getting to know our plural self – ego-states – by for example metaphoric creative writing, we are often able to build a new coherent and strong identity story.
Audre Laurde, american black feminist an poet, went through breast cancer and mastectomy. Lorde noticed many different worlds she moved through and she also noticed the plurality of the self that is reclaimed needs to be noted. The issue for most ill people seems to be keeping multiple selves available to themselves.
She is really not the only one. My opinion is and more and more people in many kind of life crisis notice the plurality of the worlds they are going through. Also Franklin writes that Stewart Alsop observes that his book after his illness was created by different mes. Actually according to Franklin most ill people seems to be keeping multiple selves available to themselves. Schafer pays attention to the fact that for many ill people, there is an experiential self, who may be seen as a set of varied narratives that seem to be told by and about a cast of varied selves. And yet, like the dream, the entire tale is told by one narrator. Nothing here supports the common illusion that there is a single self-entity that each person has.
Franklin continues: Sue Nathanson went through abortion and tubal litigation. It was a years trauma for her. She could not anticipate how much the loosing of the baby and her fertility would meen to her.´The realization that she is not one person but many, and some parts of her have to act in ways that contradict the values of other parts… Nathanson realizes that her own cast of varied selves includes the destroyer and the nurturer, and these selves can co-exist. The work of telling her self-story is a process of getting rid of what Schafer calls the ”exaggerated impression of single and unvarying self-entities.”
Reynolds Preice recovered from a malignant tumor. He described in detail how the paralysis that results from radiation affects his life. His conclusion is that he now inhabits a body that is fundamentally different, and thus he must be a different person. He advises any who suffer similar fates to become someone else, the next viable you – a cripped-down whole and clear-eyed person, realistic as a sawed-off shotgun and thankful for air. A new body calls for a new self, nothing less will do.
I found my plurality after cancer. In my inner theater I celebrated the plurality of self by using ego states as a tool of creative therapeutic writing. When we have difficult times in our lives, we are called for identities it formulates. Physical illnesses are not the only occasions in our lives where many of us can find the plural self useful.
Ego state therapy is actually mind-body therapy, because it is a tradition of hypnotherapy. Hypnotherapist have long known that our deepest emotions talk body language.
You can use in any crisis of life your ego states for enpowering yourself. By them you can find back your ablity to wonder and be mindful. Augustine writes: ”Reflection on memory makes the self an object of wonder – an astonishment previosly reserved for the contemplation of the world.” The good story end in wonder, and the capacity for wonder is reclaimed from the bureaucratic rationalizations of institutional medicine. Being available to yourself ultimately means having the ability to wonder at all self can be.
(Italic type of text from Arthur W. Frank´s ”Wounded storyteller – Body, illness and ethics”)
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