Co-constructing the story

asian-therapist-and-patientPREVIOUS: Making connections, seeing patterns

Throughout this series on Listening I have emphasised the two-person nature of the clinical encounter. The patient has a story, a narrative of experiences, meanings and feelings that is unique to him. The clinician has a life of experience, meanings and feelings unique to her. And in this consultation they are bringing those two unique ‘sets’ together in a unique, ‘never been done before’ way. This is, of course, true of all interpersonal encounters. They are co-constructed. This means that the story will emerge in a somewhat different way with every clinician. Therefore, while we can state principles of exploration, we cannot provide a structured algorithm for the sometimes delicate, always nuanced, intimate process that is needed for emergence of the story.

I never know what is going to happen before I enter a consultation because my attitudes are of ‘not knowing’, of trusting that we will connect, and of assuming that if we open a safe ‘space’ then both he and I will find a way to say what needs to be said and hear what needs to be heard. Some clinicians don’t like this lack of sense of control, but it is creative, and interesting, and in the sense of being with the patient and with one’s self it is both challenging and very rewarding.

I never know what is going to happen before I enter a consultation because my attitudes are of ‘not knowing’, of trusting that we will connect…

It also means that if we happen to be sharing the care of the patients with another clinician we will find that each of us has a slightly different version of the same story. But, if both clinicians are truly dedicated to being with the patient’s story, there will always be significant congruence and complementarity.

Brian Broom

NEXT: The power of summary

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