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Bradley Lewis. Narrative Psychiatry: How Stories Can Shape Clinical Practice. Baltimore, MD: Johns Hopkins University Press. 214 pp. Clothbound, $50.00.
Bradley Lewis, psychiatrist and professor at New York University, seeks to position narrative as the unifying force in contemporary psychiatry. Narrative Psychiatry is a manifesto for a narrative consensus in psychiatric practice, a tour through multiple forms of psychotherapy, and not least, a demonstration of the heuristic power of fictional examples to illustrate therapeutic issues. Particular readers might wish the book offered more or less of any of these three objectives, but I cannot imagine anyone being bored. Not least of Lewis's talents is his capacity to keep the story moving.
Lewis's psychiatric colleagues, after reading his earlier book, asked: "'What do you do differently in your clinical work with these insights from postpsychiatry?'" (xii). His present book does not attempt to answer that question with systematic descriptions of narrative practice, and that might disappoint some readers. But readers will finish the book with an expanded sense of clinical possibility, and that seems Lewis's best answer to the question of what he does differently: he imagines the broadest range of possibilities for what he might do. Narrative is presented as the common denominator of these multiple therapeutic options.
Lewis begins with Chekov's play Ivanov, framing his discussion as a response to Peter Kramer's argument that "the play has been 'sapped of any moral consequence'" for the simple reason that "what Ivanov needs today is an antidepressant" (5). Lewis is at his best showing all that such a reductive comment neglects. The issue is not that Kramer is wrong; antidepressants might have helped. "Both in the play and in the extension of the play to today's psychiatry," Lewis writes, "the issue is not the medical interpretation in and of itself but the overconfidence with which it is asserted" (10-11). Ivanov "scolds Dr. Lvov [his physician] primarily because he oversells his diagnosis" (10), and Lewis scolds Kramer, and by extension, contemporary psychiatry, for the same reason.
Narrative, in Lewis's particular usage, unfolds as a generalized antidote to such overconfidence. Narrative is a perspective that sees clearly what Lewis neatly describes as "the challenge of a polyphonic world and . . . the multiplicities of consciousness and experience"...