PROJECT WORK at MASTER COURSE in APPLIED NARRATIVE MEDICINE by Emanuele Martignoni
The narrative laboratory at the CPA Villa Forzinetti of ASST Sette Laghi of Varese (Italy) is a “protected” sharing place, concerns to guests of the “Protected Community”. Here, we are not talking about creative writing, nor auto-biographical educational courses, but speaking about the use of practical relational techniques, which can improve the comparison and the reflections among the group. Furthermore, this techniques can be diffused in the personal relationship between the healthcare professional and the patient, or shared among a small working group. It is important to inform readers on the fact that CPA guests are chronic psychiatric patients, elders, and generally suffer from a withdrawal and isolation psychiatric condition, so it makes the “telling” particularly difficult for them – although I have to admit that the work done at the narrative laboratory in these years has contributed to create a trusty environment, of respect, thanks to that we could observe strong sharing of deep personal living.
THE UGLY DUCKLING: a fairy tale … to live
I proposed to guests of the Community to write their personal version of the fairy tale “The ugly duckling” since it is very simple in comparison to their real life. Tools used for this project was: one schedule with “the elements of the telling” and one schedule with “the temporal structures of the telling”.
The healthcare team support was fundamental: the pathway was composed of five team meetings and several individual interviews. Six CPA guests and one ex-patient participated in the project (of whom we will speak in the next paragraph).
Brief extracts of narratives collected:
“Dear ugly duckling, you can do it!”; “I felt myself as the ugly duckling for all my past life, but when I was pregnant of S. I became a swan”; “Now, I am a bit shabby, so I probably have to say I am an ugly duckling: but, I always think positive, so finally I can say I will be a swan.”
Narratives were totally free, with the only request to explain just one element of changing; it is not the first time they discuss personal issues among the group, but exposing themselves always need courage for them, so I really would like to acknowledge them.
Also professionals, present at the meeting, reported to be grateful to them: “Wonder feeling with positive emotions of honor: being there to listen to guests’ narratives who shared their deep emotions”; “They amazed me very much, because anyone of them was afraid about telling about themselves, even if I was listening to them there; this is a pleasure for me, I felt me of value because they have trust of me”
The case of A.
A. was at the center since she had an intensification of an obsessive-compulsive syndrome after double trauma for the loss of her job and of her mother in a brief period of time. Initially, she hadn’t wanted to share these group moment with other guests of the center. However, she was then enthusiastic to participate in the narrative laboratory, since it was a protected environment in which she could tell her story, her pain, her talent… In this context, she revealed her identity as “poet A.”, creator of deep and moving verses. She has been living in a small but nice flat in the center of the town, is autonomous and independent, since 2014; she is diffusing her poetry, and restoring her personal identity through her verses that are testimonies of her personal fight with the existence.
AN ENDLESS FIELD –
WITH UNEQUAL PERIMETRY.
INTO ITSELF
A RECITAL OF POWERS –
AS IN ITS VALUE
HAS ITS ROOTS.
IN THE GREY HYPOTHESIS
EMPTYING OUT GREEDY THOUGHTS –
THE FOGGY LANDSCAPE PLACE
HAS RECOVERED ITS APPEARANCE –
INDUCED A FRAME
TO SUFFER THE TRUTH.
AND ONE MAN STANDS IN THE MIDDLE –
BREAKING HIS VANITY AGAINST THE LIGHT.
OR MAYBE NOT –
IS JUST THE EXAMPLE THAT MAGNIFIES
ITS CREDIT
ITS WAXY PLASTICITY.
The end part of this pathway with “the ugly duckling” will not be a real end.
Each analysis done, of which several were shared among the healthcare team of CPA, leads to a structured methodology to improve interventions on guests at the center.
Concerning the field about the project work, the residential psychiatry, I would like to add that the patients’ narratives are precious into the shared daily routine in which guests act, or not act. Psychiatric patients’ actions could be similar to their narratives, sometimes fragmented, other repetitive, other times blocked or hyperactive, and so on… Listening to their stories, which explain such actions, allows exiting from the simplistic judgment of “appropriateness/inappropriateness”, helping to make guests feel welcomed, respected that gives values to them. I don’t really appreciate the “common languages” construction, although useful when shared parameters of the relation are needed: each of us is a language themselves, a telling, a daily narrating in different contexts and with unique and original modality; the first form of comprehension of others is indeed into the ability to welcome their language itself – so the person, their personal Being, as a sort of “listening at 360 degrees”.
Photos and contents by Emanuele Martignoni,
Professional educator at Ospedale di Circolo Fondazione Macchi Varese (Italy)