A Defense for the Acquitted?

Serpa, Leal, and Muñoz’s article proposes that learning through narrative is fundamental in the field of mental health, including clinical practice, caregiving, and research. The reason is that mental health patients’ experiences are marked by pain, suffering, and stigma, and are of themselves a call for stories, a call to be heard and socially legitimized. The narratives, whose relevance should be situated in the broader movement of the narrative turn, therefore have a key role in overcoming epistemic injustice—a concept put forward by the feminist philosopher Miranda Fricker—by offering a place for the speech and legitimacy for the accounts of mental health sufferers. The authors’ thesis is presented as an outcome of their involvement in public mental health services in the state of Rio de Janeiro, Brazil, in group settings such as groups of people who hear voices and groups of users and their families. Because these services are provided in a large Brazilian city, we may assume that the sample offers a good range of socioeconomic, ethnic, and gender diversity. The authors question how the hegemony of the broad, standardized classifications used in psychiatry nowadays, in which hyponarrativity is prized, can be challenged. Working with storytelling seems to be an apt methodological response to this question, giving the research subjects the chance for their first-person stories to be heard and constructed collectively.

Theoretically speaking, the rich experience of the authors as clinicians and researchers of the subject has the paradoxical effect of inducing them to produce an article somewhat lacking in originality. And this leads me to my first point: the importance of telling and listening to stories, especially in a setting grounded in interpretive hermeneutics and phenomenology, is not a novel enough subject to sustain a thesis, unless it introduces new propositions or strategies that are as yet unknown to the international and Brazilian academic communities.

Another point I would contend is worthy of further clarification is the difference between autoethnography (and collaborative writing) and the production of narratives of the self—a distinction that is not duly elucidated in the article. In the specific case of the goal of autoethnographic approaches, the researchers’ emotional responses and expectations are likewise included in the data collection process (Ellis, Adams, & Bocher, 2011; Waller, Farquharson, & Dempsey, 2016) in a clear bid to overcome the epistemological distinction between researcher and research subject. This challenge would seem more feasible if the participants shared the same place of speech, at least in the case of the experiences of suffering under study here. Such is the case, for instance, of several noteworthy autoethnographies, like Ellis’s (2007) study of abortion decision-making and its impacts in families, Liggins, Kearns, and Adams’ (2013) account of a New Zealander acute care mental health service and LeMaster’s (2014) multivocal investigation of the coming out process of queers. In the case of this article, the researchers seem to occupy a separate place from the one occupied by those experiencing mental suffering: “we assume the place of guardians and protectors of the process, helping the subject explore a territory that, up to the moment, he had not known” (p. 161). What impact does the researcher’s occupying the place of the guardian or the protector have on the collective development of the collaborative autoethnographies?

Another point worth considering is the absence of any problematization of the debate about what narratives can actually do. The propositions given in the text demonstrate an unresolved, poorly presented, wavering position on this subject. Drawing on the work of Paul Ricoeur, Jérome Bruner, and others, the authors explain that narratives can sometimes “forge bonds between what is common and what is extraordinary,” and that “The narrative’s role is to give meaning, context and perspective to the patient’s problems” (p. 157). I would not put the case so strongly. It is not that I am against narratives per se, but that I question whether their potential is so great. The argument that narratives are a methodological and clinical strategy that can enhance qualitative research in psychiatry, especially in the field of phenomenology...