叙事自我:叙事医学人文关怀的伦理基点

Narrative self:ethical basis of humanistic care in narrative medicine

叙事医学将叙事能力融入医学实践环节。叙事直面人的生存状态与生活面貌,关乎一切作为实践主体的人的行为选择与存在方式。进入叙事医学人文关怀视野的个体都应当被看作叙事自我,叙事自我构成叙事医学人文关怀的伦理基点。自我因依赖性理性动物这一叙事性本质而成为叙事自我,在历时性维度上,自我因叙事能力而拥有人生叙事同一性,在共时性维度上,自我因叙事能力而拥有人际叙事建构性。临床中面对因罹患疾病而被打破既定叙事环境和节奏,游离出既往传统与社会心理的患者时,充分把握叙事自我概念,有助于医生审视患者的心理状态,梳理受创叙事,寻找线索,重建环节,帮助其完成心理疗愈。

Narrative medicine integrates narrative ability into medical practice.Narration directly faces people’s living state and life appearance,and is related to the behavior choice and existence mode of all people as the subject of practice.Individuals who enter the vision of humanistic care in narrative medicine should be regarded as narrative self,which constitutes the ethical basis of humanistic care in narrative medicine.The self becomes the narrative self because of the narrative essence of the dependent rational animal.In the diachronic dimension,the self has the narrative identity of life because of the narrative ability.In the synchronic dimension,the self has the narrative constructiveness of interpersonal because of the narrative ability.In clinical practice,in the face of patients who have been broken by the established narrative environment and rhythm due to diseases,so as to free themselves from the past tradition and social psychology,and fully grasp the narrative self-concept,which will help doctors examine the patient’s psychology,sort out the traumatic narrative,find clues,rebuild the gateway and help them complete psychological healing.