Ethics Explored Discussion Series

Increasingly, pediatric, adolescent, LBGTQ+, and ob/gyn patients who experienced trauma seek primary care for other health problems. Studies have shown that although trauma exposure significantly impacts psychiatric and physical health, as well as health behaviors, it often is unrecognized by providers.[i] Some avoid discussing psychosocial factors for fear of offending patients, eliciting negative patient reactions, and blaming patients, in addition to inadequate training and resources.[ii]  Yet, patient trauma exposure that is not recognized may result in clinical professionals becoming “second victims” who experience trauma-related symptoms that can lead to burnout.[iii] One clinical tool that has proven valuable for both patients and providers is narrative. “[I]llness amounts at least in part to suffering from an incoherent story or inadequate narrative account of oneself”[iv] As physician Howard Brody notes, “putting a stressful life event into written words organizes the event in one’s mind in a way…that suggests both the power to distance oneself reflectively from the event rather than to be immersed in or overwhelmed by the event and also the power to control the event and place it within the overall context of one’s life.”[v] 

Leading our discussion will be Sarina Furer, B.A., M.Ed., a teacher, writer and artist who uses narrative in workshops she leads at the Center for Resilience in Jerusalem, Israel.  She will talk about narrative techniques she has found beneficial when working with individuals exposed to trauma.  Questions we may discuss include:

• How can clinical and non-clinical health professionals use narrative to create a safe space that invites patients as well as themselves to construct a personal story that helps make sense of a bad event?
• Do you encourage individuals who have experienced trauma to construct “counternarratives,” stories that may oppose prevailing beliefs and attitudes yet proclaim their identity and self-worth?  Is this an essential component of resiliency?
• Can personal narratives help enact social understanding, as some scholars claim?  Does the literary element of “personification” in the background reading work in this way?

[i] Van den Berk-Clark, C. et al. Identifying and overcoming barriers to trauma screening in the primary care setting.  Families, Systems & Health:  The Journal of Collaborative Family Healthcare 2021: 39(2): 177-187.

[ii] Reichman, Mira et al. What Are Orthopaedic Healthcare Professionals’ Attitudes toward Addressing Patient Psychosocial Factors? A Mixed-Methods Investigation.  Clinical Research & Related Research 2022: 480(2):  248-262.

[iii] Rivera-Chiauzzi, E. et al. Factors influencing second victim experiences and support needs of OB/GYN and pediatric healthcare professionals after adverse patient events.  Patient Safety & Risk Management 2023: 28(6):  253-259.

[iv] McAdams, Dan P.  The Stories We Live By: Personal Myths and the Making of the Self. New York:  The Guilford Press, 1993.

[v] Brody, Howard.  Stories of Sickness, 2nd ed.  New York:  Oxford University Press, 2003.