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Deepening analysis
Rita Charon’s studies on the doctor-patient relationship

The healing power of words

 Le parole  che curano   DCM-006
01 June 2024

The artist is the one who fixes and makes accessible to the most human of men the spectacle they are part of without seeing it."

Maurice Merleau-Ponty,
"Cézanne's Doubt", Sense and Non-sense (1948).

Narrative Medicine was first developed at Columbia University in New York around the year 2000, thanks to the insights of Rita Charon, with the aim of re-founding the doctor/patient relationship on a basis that takes into account the history and “life-world” of the patients, as well as individual pathologies and respective clinical protocols. The training of students, physicians and health professionals is a particular focus of this approach, which is now widely adopted across the globe. It encourages these professionals to engage with their own and others’ inner universes through dialogue with literary and artistic works. According to Rita Charon, the study of the elements at play in a novel, a poem, a painting or a piece of music facilitates the interpretation of the patient’s narrative, recognising it as having equal dignity. Those practitioners who are gifted with such sensitivity will likely be more able to identify individualized and effective treatment pathways.

Narrative Medicine has the potential to transform the complex existential condition of patients and their caregivers into an indispensable element of contemporary medicine. This is because it is increasingly oriented towards an active participation and interaction of all those involved in the care of patients, including patients themselves, family members, general practitioners and specialists, nurses, rehabilitation therapists, psychologists, social workers, and others.  

In Italy, Narrative Medicine has primarily been implemented in the fields of oncology and chronic physical or mental illnesses, as well as in palliative and end-of-life care. It has also proven to be highly beneficial within projects dedicated to operators, volunteers, and users of the Third Sector.

The fundamental principles of Narrative Medicine are aimed at comprehending, interpreting, and motivating action through the narratives of illness. The three “movements” that characterise it are: attention – receptivity, involvement; restitution – the ability to creatively translate what is perceived into words or images; affiliation – with patients and colleagues, in a shared commitment to social justice.

The multi-ethnic context of clinical health institutions in Western societies dictates that Narrative Medicine should take a non-denominational approach. It would be nonsensical and an abuse of power to invite deep communication with a patient who is atheist or of a different faith from mine, while at the same time covertly pressuring her/him to accept my views on life and death. At the same time, the individual and collective vulnerability exposed by the Covid-19 pandemic, for example, urgently demands answers that neither evidence-based medicine nor the humanities seem able to provide. These answers belong to the realm of spirituality.

Of course, there is nothing to stop these answers being sought in explicitly Christian settings or in settings informed by an interfaith dialogue. This is where the techniques of narrative medicine prove very useful in facilitating an ever more intimate understanding of the Gospels, in particular the passages centered on Jesus as Master of empathy and healing.

Guia Sambonet
Theologian and spiritual director, has been leading Narrative Medicine projects since 2014.