Magazine article Clinical Psychiatry News

Life Story Presentations

Magazine article Clinical Psychiatry News

Life Story Presentations

Article excerpt

When we think about the presentation of life stories by people who are in treatment, Alcoholics Anonymous usually comes to mind.

"Speaker meetings" held by AA allow the speakers to feel that they have given something back to the community. These meetings also give speakers a chance to hear positive feedback. For the audience, the meetings teach people about alcoholism and possibly help them identify with the speakers' struggles and successes.

But life story presentations are also therapeutic for selected psychiatric patients. That's why mental health professionals should look for opportunities for some patients to present their life stories.

Take the case of Mr. A., a 50-year-old single, white male who had been seen for several years at our university outpatient clinic. He began treatment there after a hospitalization for suicidal ideation triggered by the death of his lover, with whom he had been in a 25-year relationship. His current axis I diagnosis is bipolar disorder, type I.

He had been hospitalized twice and had made two suicide attempts. He was taking oxcarbazepine (Trileptal), sertraline (Zoloft), and zolpidem (Ambien). In addition to obtaining mental health treatment at the university, Mr. A. was in therapy at a community mental health center.

Mr. A.'s background includes work as a television chef, a ski instructor, a horse trainer, and an artist. Currently, he is on disability because of his mental illness but is working toward a degree in fine arts.

Despite those accomplishments, Mr. A. has consistently struggled with his self-esteem. Before Mr. A.'s loss, his partner frequently had provided him with support. As a result of the void left by the death, various setbacks triggered depressive episodes. Mr. A. often stayed in bed for days.

During those low points, Mr. A. was overrun with thoughts such as "I'm stupid" and "I lack talent." He thought that his negative thinking was connected to difficulties he experienced as a child. Mr. A., who had been adopted by his father, never felt like he completely fit into his father's family. Even now, Mr. A. sees himself as an "imposter" and a "fraud."

He has had several opportunities to share his life story. Soon after Mr. A. started treatment, he was videotaped discussing his story and showing his artwork. Since then, Mr. A. has participated in three clinical case conferences for residents and medical students, and he also presented at a medical student lecture. Before the presentations, Mr. A. was suffering from depression. Afterward, he said he felt less depressed. Subsequently, Mr. A.'s psychiatrists made presentations part of his treatment plan.

Mr. A.'s presentations continued in different settings. For example, he was invited to participate in several pharmaceutical company preceptorship sessions, which allow newly trained reps to learn.

In the sessions, Mr. A. talked about his diagnosis and treatments. He also described the impact of his mood disturbance on his life and art, and displayed several examples of his work. He received positive feedback from the reps and, in turn, said those sessions made him feel less depressed.

Many theories help explain why life story presentations help some patients. Positive experiences can help to create a cognitive shift in which the patient can deactivate unhealthy schemas and activate healthier ones ["Cognitive Case Conceptualization" (Mahwah, N. …

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