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Narratives in psychiatry: Helping change outlook and outcome

2024; Medknow; Volume: 33; Issue: 1 Linguagem: Inglês

10.4103/ipj.ipj_16_24

0976-2795

Jyoti Prakash, Suprakash Chaudhury, Kalpana Srivastava,

Psychiatric care and mental health services

A narrative, true or inspired, woven around a topic, often facilitates a better grasp of an abstract concept. It brings interest, clarity, and reflection on the issue being taught.[1] Narratives have been found to significantly foster critical thinking and empathetic skills in psychiatry.[2] The pragmatic portrayal of nuances in psychiatric practice has enhanced the learning potential of the listener.[3] Narrative Oh! Not again. "My friends vouch for my capacity. I can easily finish half a bottle of alcohol without being tipsy." Rahul's eyes shone with pride akin to a gallant warrior, who had never lost a battle. In my clinical practice, such pride is very common. "We call it Tolerance. Allow me to explain."[4] "Ya, I know you doctors have a name for everything" Rahul retorted. As if, the welcoming lady has doused the flame of the victory aarti, just before he has stepped down from his horse after the gallant victory! Annoyance is very common in our specialty and "unconditional positive regard," is a dictum of our professional practice. I displayed my forever grateful smile and asked, "What has brought you here?" "My wife feels I have a problem with alcohol. She comes from a conservative background." He was quick to a conclusion and prompt in his defense. My focus shifted to the lady, who looked more withered than her age could be. I have seen alcohol doing this to many a family. The glitter of alcohol has taken away the shine from many a marriage. I shared the same grateful smile with her and added a bit of compassion. I took out my pen and pad, wore my professional look with my reading glasses, and started listening to them. The story brought out an ever-increasing use of alcohol for the last five years and frequent loss of control over his drinking. He spent most of his time in the consumption of alcohol or alcohol-related procurement activities. Since last year, Rahul has been consuming 3-4 bottles of whisky a week. He would take his drink to the office, hidden in a tea flask, and would keep sipping as he worked. At home, he would start by 7 PM, keep drinking till 10, have more snacks and less dinner, and snore off by 11 PM. Overall, the narrative suggested significant alcohol abuse and he appeared dependent on alcohol. I used to wonder initially why we use the term "Alcohol abuse." Over the years, I have come to realize that it is the alcohol and not the person, which is being abused. An effective ingredient of many a medication, it has earned disrepute in the hands of people who try to drown their sorrow in it or bring more fizz to their excitements. Like a nuclear launch code in the hands of the ignorant! His wife brought out that he would not interact with his children for days, despite being in the same house. Whenever he did interact, he would either be too intoxicated to express anything or would get easily irritated. He now gives one-tenth of the money he used to give earlier to run the domestic chores. Most of the domestic work like payment of bills, marketing, etc., she has to perform, as he would either be too inebriated or too tired. ".And he was talking about withstanding alcohol." It has been months now, he has not stood up to his role as a father or husband. His tolerance to alcohol has given in to intolerance on many a front. A father who is often high on spirit and is unable to have a spirited conversation with his children. A husband whose wife looks aged much more than any aged whiskey.[5] ".And he does not think he has a problem with alcohol." This is the disadvantage of socially acceptable intoxicants. Vacuous pride of a drinker who thinks he can withstand any amount of alcohol. As I bent closer for the physical examination, I could smell the residue of the alcohol, which he had ineffectively tried to submerge in his perfume. I felt grateful for his consideration. There was a silver lining, a shimmer in the sky. The skeptic in me soared with optimism. He was ashamed of his drinking habit and had tried to hide this lingering assault of the mighty, from our olfaction. He cared. I asked did he had drinks this morning too. He nodded his head in negation but eyes defied… "Please don't tell my wife". he pleaded. Again, a shimmer. A caring husband was visible. I felt a pang of emotion in me. I could visualize this "Abhimanyu" stuck in the "Chakravyuh" and I was not sure whether to blame the "Abhimanyu" or the "Chakravyuh." I smiled. I knew I had a big journey ahead, but Rahul WILL respond to a calling.of the sorrows of his spouse.of the care, which his children are deprived of. Well, Rahul, let's plan something for you. CONCLUSION A narrative is an innovative and powerful tool in psychiatric education. It not only enhances communication but also instills creativity, impacts empathy, and improves our psychotherapeutic skills. The addition of narratives to our education system will improve high-order thinking and instill reflective habits, all essentials of an efficient therapist.