OBJECTIVE: The authors aimed to determine if writing narratives in psychiatric training can foster empathy for severely and persistently mentally ill patients. METHODS: One resident wrote first-person narrative pieces about three different patients at a community mental health clinic. She reviewed these pieces with a writing supervisor weekly. The supervisor and resident examined the style of writing, choice of words, and story line to help the resident learn about her feelings about the patient. RESULTS: In each narrative, different choices were made that provided clues about that particular resident-patient relationship. These writing exercises helped the resident become more connected to her patients, develop interviewing skills, and engage in more self-reflection. CONCLUSION: Narrative writing effectively fostered empathy in a PGY-1 psychiatric resident working with severely and persistently mentally ill patients. This exercise also fostered understanding of countertransference and improved psychiatric history-taking skills. Psychiatry training programs may want to consider incorporating narrative writing exercises into their curriculum.