Narrative Formation as a Practice

Narrative formation is the process by which one writes about events and experiences in one’s life. This process helps to identify one’s important relationships, goals, and motives, thus contributing to meaning-making. ^* ^* Narrative writing has been shown to improve quality of life, such as through increasing a sense of social connection. ^* ^* ^* Anyone in a patient’s community can create a narrative. Having a group of people intentionally focusing on narrative formation as a form of meaning-making helps result in a shared meaning, which becomes a unique central point of connection for the community (see the “Collective Soul” section). Particularly at the end of life, narrative formation is an impactful, accessible method of meaning-making which can involve as many people as would like to participate.

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Patients

There are many ways to approach narrative formation. Ultimately, what matters is the reflection upon one’s life experiences. It can be helpful to think of one’s life through either first person, second person, or third person approaches. The following perspectives and questions are adapted from Rodriguez-Vega ^*

First person perspective:
- Think through your life, trying to find experiences that may help you answer the question, “Who am I?”
Second person perspective:
- Identify the relationships that are most important to you. What makes these relationships meaningful?
- What does your loss of health and impending death mean to you?
- What has it been like to transition from being a caregiver to being a recipient of care?
Third person perspective:
- How have your values changed during the course of your illness?

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Caregivers

First person perspective:
- Think through your life, trying to find experiences that may help you answer the question, “Who am I?”
Second person perspective:
- Identify the relationships that are most important to you. What makes these relationships meaningful?
- What does the impending loss of your loved one mean to you?
- What has it been like to transition into being a caregiver?
Third person perspective:
- How have your values changed during the course of your loved one’s illness?

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Community

First person perspective:
- Think through your life, trying to find experiences that may help you answer the question, “Who am I?”
Second person perspective:
- Identify the relationships that are most important to you. What makes these relationships meaningful?
- What does the impending loss of your loved one mean to you?
Third person perspective:
- How have your values changed during the course of your loved one’s illness?

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Healthcare Team

“With narrative competence, physicians can reach and join their patients in illness, recognize their own personal journeys through medicine, acknowledge kinship with and duties toward other health care professionals, and inaugurate consequential discourse with the public about health care” ^*

First person perspective:
- Think through your life, trying to find experiences that may help you answer the question, “Who am I?”
Second person perspective:
- Identify the relationships that are most important to you. What makes these relationships meaningful?
- What does the impending loss of your patient mean to you?
- What has it been like to transition into being a caregiver?
Third person perspective:
- How have your values changed during the course of your patient’s illness? During the course of becoming a healthcare professional?

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Collective Soul

“By bridging the divides that separate physicians from patients, themselves, colleagues, and society, narrative medicine offers fresh opportunities for respectful, empathic, and nourishing medical care.” ^*

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