Rita Kristin Klausen

“The Lady in the Coffin” – Delusions and Hearing Voices A Narrative Performance of Insight

This article is based on a study of user participation and insight among 30 patients in community health centres in northern Norway. The living conditions of the patients have changed because of mental illness. Through a case study, we analyze the meaning of contexts in a meeting with Sverre, an older man, who was diagnosed with schizophrenia many years ago. One of the core features of schizophrenia is the patient’s lack of insight. Case studies have a valuable place in illness narratives, giving voice to suffering in a way different than the biomedical voice. Sverre’s narrative performance represents a different insight, which challenges the perception of everyday life in the clinic and our work with this patient group. By using a performative narrative perspective, the concept of insight emerges as a relational term and something that is developed in the dialogue, rather than through the static characteristics of the patient.

Shared decision making from the service users’ perspective: A narrative study from community mental health centers in northern Norway

ABSTRACT This article aims to contribute to the understanding of shared decision making as an important aspect of user involvement in mental health care from the perspectives of service users. A thematic analysis of interviews with 25 individual service users in three different community mental health centers in Norway identified different understandings of shared decision making. Shared decision making was identified as essential in four contexts: 1) during admission, 2) in individualized treatment, 3) in different treatment contexts, and 4) in user-professional relationships. We consider shared decision making to be intertwined with treatment from the service user perspective.

Motherhood and mental distress: personal stories of mothers who have been admitted for mental health treatment

There is a need for qualitative studies on motherhood and mental distress. Many mothers have a diagnosis of mental illness, and their motherhood exists in constant tension with their distress. This paper focuses on 10 mothers’ stories about motherhood in relation to being admitted as mental health service users in three different Norwegian community mental health centers. The study has a narrative approach, and through a thematic analysis of personal stories, we emphasize how the 10 women make sense of their experiences of admittance to mental health services in relation to dominant Discourses of good motherhood. Themes identified were: (1) being able to put oneself in the child’s shoes; (2) the emotional impact of being admitted; (3) being open with the children about the admission; and (4) being an emotionally available and present mother. Based on the results of our analysis, we suggest the mothers experienced their distress as a natural reaction to life strains over time, and that they relate to the admissions as interruptions. This underlines the necessity of a more holistic approach, with a support system that focuses on both personal and social aspects of motherhood and mental distress.

“Why did I try to kill myself?”: A narrative context analysis of Marianne’s story

ABSTRACT This article is based on one case study, drawn from a larger qualitative study of 30 mental health service users (MHSUs) in three Norwegian community mental health centers. The meaning of context is analyzed from a meeting with Marianne, a 31-year-old mother of three children diagnosed with bipolar disorder three years before the interview. Faced with dominant narratives that define mothers diagnosed with a mental illness in negative terms, Marianne provided a personal story that created a contextualized understanding of being a mother and an MHSU. Critical analyses of case studies play a valuable role in illness narrative research by giving another voice to otherwise silenced marginalized groups that are primarily described in terms of biomedical characteristics. Using a performative narrative perspective within a social constructionist approach, the present study developed a concept of “good mothering” as a relational term that is explored through a dialog with the MHSU.