The dominance of technological paradigms within psychiatry creates moral and ethical tensions over how to engage with the interpersonal narratives of those experiencing mental distress. This paper argues that such paradigms are poorly suited for fostering principled responses to human suffering, and proposes an alternative approach that considers a view of relationships based in feminist theories about the nature of caring. Four primary characteristics are presented which distinguish caring from technological paradigms: a concern with the particular nature of contexts, embodied (...) practice, the dialogical basis of caring and the existential basis of caring. From this we explore the role of the moral imagination and our ability, through narrative, to acknowledge, engage with and bear witness to the injustices that shape the lives of those who suffer. This, we argue, is at the heart of caring. Clinical implications are discussed, including an exposition of the importance of narrative in recovery from trauma and distress. Narrative Psychiatry, The Sanctuary Model of care, and Soteria, are outlined as examples of this type of practice. (shrink)

Gray zones, which develop wherever oppression is severe and lasting, are inhabited by victims of evil who become complicit in perpetrating on others the evils that threaten to engulf themselves. Women, who have inhabited many gray zones, present challenges for feminist theorists, who have long struggled with how resistance is possible under coercive institutions. Building on Primo Levi's reflections on the gray zone in Nazi death camps and ghettos, this essay argues that resistance is sometimes possible, although outsiders are rarely, (...) if ever, in a position to judge when. It also raises questions about the adequacy of ordinary moral concepts to mark the distinctions that would be helpful for thinking about how to respond in a gray zone. (shrink)