Using narrative perspectives in the clinical setting of physiotherapy. Why and how?

Abstract

The aim of this chapter is to show the potential of narrative approaches in the practice of critical physiotherapy. By combining a narrative approach with gender perspectives, we focus on the significance of social context and gender for how illness stories may develop in the clinical encounter. The empirical data are drawn from interviews with 10 men undergoing a rehabilitation program for chronic pain in Norway. The findings highlight how the men’s stories usually present pain in terms of a localized physical disruption caused by forces outside the men’s influence and control. Their stories adhere to a traditional norm of masculinity which highlights the importance of staying independent and in control. However, the men’s stories also refer to changes at work, worries about sick children, divorce and loss of contact with children: in other words, social disruptions and relational and emotional distress. In the men’s recovery stories, a traditional masculine emphasis on the importance of building muscle strength is intimately interwoven with a profound human need for relational support and help from others. By focusing on how the men’s stories are told, the chapter reveals how changes in family relations and working conditions enter into the men’s illness narratives through a process of ongoing negotiation between interviewer and participant. We argue that narrative perspectives are important to critical physiotherapy as a way of promoting individualized treatment and care that transcend traditional gender norms.