Published online by Cambridge University Press: 17 July 2025
Chapter 3 illustrates the poetics of illness experience by examining clinical conversations during a psychiatric assessment of a patient. Patients’ narratives in clinical contexts are often fragmentary and contradictory, reflecting their ongoing struggle to make sense of inchoate experience and position themselves in ways that elicit care and concern. Metaphors of illness experience open up narrative possibilities, but may be blocked by conflicting agendas or cross-purposes of clinician and patient. In place of an overarching integrative narrative are interruption, miscommunication, and mutual subversion. Focusing on narratives, with close attention to the speakers’ rhetorical aims, can identify situations of tension and misunderstanding, which can be clarified through cognitive and social analysis tracing the models and metaphors used in clinical exchanges to their personal meaning and embodiment and outward into the social world where they function as part of discursive systems that organize institutions and confer power. Close attention to metaphor in lived experience, social interaction, and cultural performance can yield an account of the dynamics of clinical conversations.
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