Breaking the spell: narrative medicine applications for Psychogenic Nonepileptic Seizures (pnes)

Statement of the Problem: Psychogenic Non-Epileptic Seizures (PNES) can be understood 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. Methodology & Theoretical Orientation: This is a narrative review with an illustrative case report indicating Narrative Medicine (NM) applications to help a patient with PNES to communicate about a traumatic past that has been avoided and address psychogenic symptoms. Conclusion & Significance: 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. NM sessions can help patients communicate more effectively concerning their traumas and overwhelming experiences. They can discover how to speak about the unspeakable in their lives, and experience improvement as they face their dilemmas and causes of distress. Patients can begin a process of communication and self-reflection about traumatic subjects that continues beyond the NM sessions. Patients may overcome family or personal barriers and taboos about communication on those difficult topics. NM sessions encourage patients to become more open to help and less inclined to hold their pain inside. Patients can discover new perspectives and insights to reframe their understanding of traumatic events. They can renegotiate self-identity with new hope, leading to improved resilience and quality of life. NM sessions encourage patients to communicate more effectively about their unspeakable traumas to reclaim their lives from the communication disorder of PNES.

Biography :

Robert B. Slocum, Ph.D., is the Narrative Medicine Program Coordinator at University of KentuckyHealthCare, Lexington, Kentucky. He has taught undergraduate courses in religious studies and ethics. He is currently appointed and in good standing as an Assistant Professor within the voluntary faculty title series in the Department of Behavioral Science and Department of Internal Medicine at the University of Kentucky College of Medicine. He is a member of the Hospital Ethics Committee. He teaches an elective rotation for senior medical student on the narrative basis for patient are and resilient practice. He leads journal workshop groups for patients and staff. He is the author, editor, or co-editor of 13 books, including a journal of reflections. He is interested in the clinical application of narrative and the significance of narrative for identity formation.

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