Engaging in self-narrative is often touted as a powerful antidote to the bad effects of illness. However, there are various examples of what may broadly be termed “aversion” to illness narrative. I group these into three kinds: aversion to certain types of illness narrative; aversion to illness narrative as a whole; and aversion to illness narrative as an essentially therapeutic endeavor. These aversions can throw into doubt the advantages claimed for the illness narrator, including the key benefits of repair to (...) the damage illness does to identity and life-trajectory. Underlying these alleged benefits are two key presuppositions: that it is the whole of one’s life that is narratively unified, and that one’s identity is inextricably bound up with narrative. By letting go of these assumptions, illness narrative advocates can respond to the challenges of narrative aversions. (shrink)

I argue against two popular claims. The first is a descriptive, empirical thesis about the nature of ordinary human experience: ‘each of us constructs and lives a “narrative” . . . this narrative is us, our identities’ (Oliver Sacks); ‘self is a perpetually rewritten story . . . in the end, we become the autobiographical narratives by which we “tell about” our lives’ (Jerry Bruner); ‘we are all virtuoso novelists. . . . We try to make all of our material (...) cohere into a single good story. And that story is our autobiography. The chief fictional char- acter . . . of that autobiography is one’s self’ (Dan Dennett). The second is a normative, ethical claim: we ought to live our lives narratively, or as a story; a ‘basic condition of making sense of ourselves is that we grasp our lives in a narrative’ and have an understanding of our lives ‘as an unfolding story’ (Charles Taylor). A person ‘creates his identity [only] by forming an autobiographical narrative – a story of his life’, and must be in possession of a full and ‘explicit narrative [of his life] to develop fully as a person’ (Marya Schechtman). (shrink)

Can we understand what makes someone the same person without understanding what it is to be a person? Prereflectively we might not think so, but philosophers often accord these questions separate treatments, with personal-identity theorists claiming the first question and free-will theorists the second. Yet much of what is of interest to a person—the possibility of survival over time, compensation for past hardships, concern for future projects, or moral responsibility—is not obviously intelligible from the perspective of either question alone. Marya (...) Schechtman encourages us to adopt a more unified perspective. (shrink)

The past 10 years have seen considerable developments in the use of narrative in medicine, primarily through the emergence of the so-called narrative medicine. In this article, I question narrative medicine’s self-understanding and contend that one of the most prominent issues is its lack of a clear epistemological framework. Drawing from Gadamer’s work on hermeneutics, I first show that narrative medicine is deeply linked with the hermeneutical field of knowledge. Then I try to identify which claims can be legitimately expected (...) from narrative medicine, and which ones cannot be. I scrutinize in particular whether narrative medicine can legitimately grasp the patient’s lived experience of his or her illness. In the last section of this article, I begin to explore the potential usefulness of this epistemological clarification. This analysis allows for a further understanding of what is really at stake with narrative medicine, and thus to identify when it may be convenient, and when it may not. Furthermore, this clarification opens up promising new possibilities of dialogue with critics of the field. I conclude that narrative medicine finds its proper place as a possible tool available to mediate dialogue, which is at the heart of the clinical encounter in medical practice. (shrink)