The dominance of technological paradigms within psychiatry creates moral and ethical tensions over how to engage with the interpersonal narratives of those experiencing mental distress. This paper argues that such paradigms are poorly suited for fostering principled responses to human suffering, and proposes an alternative approach that considers a view of relationships based in feminist theories about the nature of caring. Four primary characteristics are presented which distinguish caring from technological paradigms: a concern with the particular nature of contexts, embodied (...) practice, the dialogical basis of caring and the existential basis of caring. From this we explore the role of the moral imagination and our ability, through narrative, to acknowledge, engage with and bear witness to the injustices that shape the lives of those who suffer. This, we argue, is at the heart of caring. Clinical implications are discussed, including an exposition of the importance of narrative in recovery from trauma and distress. Narrative Psychiatry, The Sanctuary Model of care, and Soteria, are outlined as examples of this type of practice. (shrink)

Henriksen et al. use phenomenology as a tool to clarify the status of what they regard as the abnormal experiences of the condition called schizophrenia. This reveals phenomenology as a method of detailed scrutiny of these experiences to establish a theory about them in terms of the “dissolution of certain structures of self-consciousness” and “morbid objectification of inner speech”. Our commentary is in two parts. In the first, we set out a contrasting view of phenomenology, and its use in madness.1 (...) In the second, we exemplify this use of phenomenology and the meaningful nature of voices through evidence that links.. (shrink)