Narrative Medicine Program Coordinator, University of Kentucky HealthCare, Lexington, Kentucky, USA.
Seizure. 2021 Mar;86:96-101. doi: 10.1016/j.seizure.2021.01.017. Epub 2021 Feb 5.
Narrative Medicine (NM) sessions draw out the patient's narrative of illness or injury and treatment in the context of the patient's whole life story. The focus is to discover topics and areas in the patient's narrative that the patient needs to explore. PNES may be understood in many cases as a communication disorder in which distress is expressed somatically in a pathological way instead of an adaptive and verbal manner. Patients with PNES are frequently misdiagnosed, and accurate diagnosis may be delayed for many years. PNES may cause severe disruption of the patient's quality of life in terms of employment or schooling as well as relationships and activities of daily living. NM sessions encourage patients to communicate more effectively about their unspeakable distress and reclaim their lives from the communication disorder of PNES. Narrative writing exercises have also proven helpful for patients facing a variety of traumas and major stresses in situations similar to those faced by patients with PNES. This paper is a narrative review with an illustrative case report indicating NM applications to help a patient with PNES to communicate about a traumatic past that has been avoided and address psychogenic symptoms.
叙事医学（NM）课程从患者的整个生活故事背景中引出其疾病或伤害以及治疗的叙述。重点是发现患者叙述中患者需要探索的主题和领域。在许多情况下，可以将PNES 理解为一种交流障碍，其中痛苦以病理性的方式而不是适应性和言语的方式表现出来。PNES 患者经常被误诊，并且可能需要多年才能进行准确诊断。PNES 可能会严重影响患者的生活质量，包括就业或上学、人际关系以及日常生活活动。NM 课程鼓励患者更有效地沟通他们难以言喻的痛苦，并从 PNES 的交流障碍中重新掌控自己的生活。叙事写作练习也已被证明对面临各种创伤和重大压力的患者有帮助，这些患者的情况与 PNES 患者相似。本文是一篇叙事性综述，附有一个说明性病例报告，表明 NM 的应用可以帮助 PNES 患者就被回避的创伤过去进行沟通，并解决心因性症状。
