Session 4a: Narratives, Resonance and Identity

Margaret Byrne - Echoes of Heartsongs: the Use and Power of Resonance in Health and Healing
International Institute of Hospice Studies, Flinders University, Adelaide, South Australia

This paper looks at the experience of resonance and its contribution to the narrative mode in health and sickness, with particular relation to care of the spirit in palliative care. It outlines what is meant by resonance, its different forms and uses and its therapeutic value. With reference to a number of case studies it raises issues of safety and danger and the relation of resonance to the therapeutic use of self.

In recognition of the holistic nature of care, particularly at the end of life, practitioners are consistently seeking ways to explore and express the complex character of health and healing. While recognising the enormous benefits the scientific/ medical model has brought to the quest for cure and for pain relief other ways of knowing and acting are being acknowledged and trialled (Kearney 1996; 2000). Among these the narrative mode is taking us back to former silenced ways of engaging the therapeutic self.

Metaphor, myth, and story telling have all gained a certain prominence recently in medical literature as we become more and more familiar with the idea that our perception of reality is constructed imaginally through both metaphor and narrative as much as through rational analysis. The use of narrative construction in revealing the power of silenced stories in people's lives and the therapeutic value of individual narrative reconstruction is being well documented by narrative therapists. However some aspects of the role and nature of the narrative mode, such as resonance, have been barely touched. The term resonance is not limited here to the term psychological resonance as used in humanistic counselling. It also is connected to Benson's(1996) term 'remembered wellness' and to Hillman's 'thought of the heart', and it is through these that a wider application of its therapeutic value in health and healing will be examined.

Marisa Coelho - Narrative, Illness and Personal Identity
Oxford, United Kingdom

The very first patient I was assigned to follow in psychiatry could have been a friend of mine. She was my age, from the same social background, participated in the same sorts of activities, and held the same aspirations and hopes as I. She came in after suffering from her first psychotic episode. We sat and talked, face to face, and I had the image of a road diverging. In some ways I was an icon of success (through struggles), moving with direction (although constantly questioning the direction), and a sense of continued identity (more or less). She sat with her illness, her fragmentation, losses, questions and hopelessness, but with a vivid and striking story.

A road had diverged somehow and neither of us knew why or how. Being in her presence and hearing her story begged a response from me of some kind, and raised questions about my own identity, health, vulnerability and reasons for being in medicine.

This experience and others like it have been the stimulus for reflection on what it means to be human and the question of personal identity. In particular, I have been struck by the dis-integration that occurs in illness. While healthy we usually have a sense of unity within ourselves and define ourselves by our bodies, our character or personality, our relationships, our autonomy and usefulness and job, and our history. We get sick and suddenly that changes. Our bodies change: suddenly we lose weight or put on weight; we have a new bump or we lose a part of our body, our skin changes texture or colour; we lose our hair. Our level of autonomy changes: we can no longer perform our job, or we are confined to bed. Our character and personality change: we develop different moods, are more frightened or temperamental. In addition, our relationships change: suddenly there are power shifts, we lose some friends and recover old ones.

I am interested in exploring how narrative can help one to struggle against such dis-integration. What was 'normal' for a person, how they understood themselves, spoke of themselves, is changed; they experience a change in who they are and what they understand of themselves. I believe that through story telling, in being able to narrate a meaning through their experience of illness, people are enabled to build a bridge of continuity of identity.

What I hope to accomplish in my presentation is to explore what it means to be the same person over time through illness. I hope to explore different philosophical answers to the question of personal identity and show the application and importance of narrative in preserving personal identity through illness.

Sofie Vandamme - Myths and Metaphors of Illness Reconsidered
VUMC, Department of Metamedica

Introduction:
About 20 years ago, Suzan Sontag published Illness as a Metaphor, a book that has become a standard work on illness narratives. In this essay Sontag strips away the mythologies that surrounds experiences of illness as they are expressed in metaphors. According to Sontag metaphors of illness are imposed from what she calles "the country of the healthy people". "The healthiest way of being ill" she argues, "is one purified of metaphorical thinking."

Last year Jean-Luc Nancy, a French philosopher, wrote L'intrus, an autobiographical illness account of his heart transplantation followed by a cancer provoked by the use of immuno-suppressors. In contrast to Sontags thesis, Nancy elaborates in his account the metaphor of the 'intruder' as the only possibility to reconstruct what happened to him.

Questioning:
By opposing both views on using metaphors in illness narratives, we want to question
how we can understand illness metaphors in illness accounts: are they, as Sontag claims, literary vehicles, literary techniques fit to transport the cultural myths of illness? Or is illness, as Nancy explains in his illness narrative, a thoroughly metaphorical experience?

Methodology and aim:
By analysing the personal illness account of Jean-Luc Nancy we want to show how illness metaphors are as well forms of literary imagination as manners of dealing with the personal experience of illness. Subsequently we want to show how illness is experienced through the cultural determined myths on illness and … on healing.