Illness Narrative in Psychosomatic Medicine:Qualitative Research in Cultural Anthropology

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  • Suzuki Katsumi
    Department of Health and Environment, Graduate School of Social Sciences and Humanities, Chiba University
  • Tsujiuchi Takuya
    Department of Health and Environment, Graduate School of Social Sciences and Humanities, Chiba University:Department of Health Science and Social Welfare, School of Human Sciences, Waseda University
  • Tsujiuchi Yuko
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
  • Kumano Hiroaki
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo
  • Kuboki Tomifusa
    Department of Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo

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Other Title
  • 心身医療における病いの語り : 文化人類学による質的研究(第1報)
  • 心身医療における病の語り--文化人類学による質的研究(第1報)
  • シンシン イリョウ ニ オケル ヤマイ ノ カタリ ブンカ ジンルイガク ニ ヨル シツテキ ケンキュウ ダイ1ポウ

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Abstract

Objectives:This research attempts to examine illness narrative as health resource in psychosomatic medical treatment. In clinical process, illness narratives in which explanatory models are implicated show considerable plasticity reflecting doctor-patient relationships. We argue for relevance of Narrative-Based Medicine, through detailed analysis of this plasticity in illness narratives. Subjects and Method:Illness narratives were collected from 20 outpatients at a clinic in Tokyo. From March 2000 to August 2000, we conducted non-structured interview in order to examine illness narratives qualitatively from an anthropological point of view. Results:We found that these illness narratives should be considered as health resources for every patient to cope with various stress-factors in their daily life. We hypothesized four-stage model of clinical process according to the observation on transition of doctor-patient relationship and changing contents of a patient's illness narratives. At the beginning of illness symptom, all patients suffer deeply from not being able to express their mind-body discrepancy verbally. At the first stage, they visit medical facility to seek an orthodox explanatory model of medical science. In the second stage, they begin to ask personal explanatory model of the doctor in charge. Finally, they become able to narrate their illness experience fluently, since they have developed a definition of their health conditions while maintaining mind-body discrepancy in certain degree. In the third stage, patients become an expert of "illness experience", while medical doctors remain as a specialist of "disease". Conclusion:It is clear that to continue narrating illness experience has important meaning and function for a patient's health care. In the third stage, some patients become enable to narrate their feelings and sensations particular to their bodily experience. At the same time, medical doctor respects their knowledge of bodily experience and shows proper attitude as audience in their illness narrative.

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