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During a clinical interview, the patient develops an account of psychopathological experiences in the context of his life histories. The patient produces this account through verbal language. This process involves some reorganization of the primary subjective experiences. Such accounts are sometimes referred to as “narratives”, to emphasize they are not always only concerned with depicting “objective facts”. When he is narrating, he acknowledges his intentions, and describes how he reacts to the perceived reality. For example, in a narrative medical account, the patient is often predominantly considered as an object of pathology and treatment, but less often as an active agent responding to illness. As a result, there is a risk of under-recognizing the patient’s choices and actions. The consequences of ignoring these domains is particularly undesirable in mental illness, where the patient’s action often could play a crucial role.

 

進行臨床面談時，病人會跟據他/她的生命歷史和背景，敘述他/她患上精神病的經過。病人透過口語建立他的敘述，這個過程涉及對主觀經歷的重組，可以被視為一種「敘事」。強調「敘事」，是因為病人所敘述的不是「客觀事實」，受病人「動機」的影響，病人其實在描述他/她如何回應個人「看見」的現實。例如在醫學敘事中，病人會視自己為病理和治療的客體，較少視自己為回應疾病的主體。這種「敘事」模式，往往低估了病人的選擇和行動自由。在精神病的治療過程中，病人的積極參與十分重要，忽視這個領域並不可取。