Theoretical foundations of narrative care: Turning towards relational ethics

Abstract

In the past decades, narrative practices have been developed, and care has been conceptualized as being narrative in nature. More recently, narrative care has been developing both as a practice and a field of study. It is necessary to make the theoretical foundations of narrative care visible to avoid the risk of narrowly defining narrative care as a matter of storytelling and listening. In this article, we develop an understanding of narrative care grounded in early feminist pragmatist philosophy, with a focus on social and political activism and experience. Pragmatism holds the possibilities to open spaces for realities that are constantly in flux and for emergent situations that must be considered across time, diverse places and social contexts. With the aid of Vera’s stories about her relationship with Tammy, we demonstrate the importance of recognizing that realities are multiple, complex and uncertain. Furthermore, we discuss how the stronghold of formula stories and issues of power, positioning and inequities, restrict people’s possibilities to be, become and co-author their stories. We also argue that the playfulness, imagination and world travelling of narrative care are in line with early feminist pragmatism, which draws on a wide and diverse range of experiences. Jane Addams linked democracy to dialogue, joint experiences and social equality. This calls for the development of ethical frameworks grounded in care that are more specifically focused on relational ethics and a commitment to dialogical and relational democracy and the prioritization of community.

Keywords

Experience Jane Addams narrative care narrative ethics pragmatism relational ethics

Sitting in the corner on the tucked away sofa chair, I listened to Tammy sleep. The rhythmic sound of her breath was a relief to the worries that so often filled our relationship. Tammy has been a research participant in two different studies stretching over the past 17 years. We now live in separate cities, and both of our lives have changed in many ways. This morning I walked her young son, Aiden, to kindergarten, which allowed Tammy a much desired sleep-in during the hectic days of being a single mother. Yesterday, we had all walked together and I had met his new kindergarten teacher for the first time. Tammy always introduced me as ‘my friend the university professor’ – over time I had become increasingly aware of the power embedded in this introduction and how attentive Tammy was to this. I loved walking with Aiden – first for several years to daycare, and now to kindergarten. Aiden and I would sing together and talk about the animals and flowers we saw along the way – it was an uninterrupted time we shared whenever I came to visit. In his life, I had become ‘Auntie Vera’. Today had been no different; we sang and talked along the way and both arrived smiling at his kindergarten classroom. The kindergarten teacher came to the door when she noticed us. Rather than the expected morning greeting, she said ‘Is Tammy OK?’ While it was framed as a question, the tone spoke more to an underlying sense of seeing Tammy as an unfit mother, as someone who made poor choices. When I responded with ‘well, I am so lucky that Tammy trusts me with Aiden and that Aiden and I can have our special morning walk’, I could sense her hesitation and disbelief. I wondered what stories the teacher carried of Tammy. What notions of care shaped her stories of Aiden, of Tammy, of me, and of us? Sitting quietly in the corner of Tammy’s living room after I returned, listening to Tammy’s breathing, I tried to calm my uneasiness from leaving Aiden in the care of his kindergarten teacher.

Tammy, Aiden and Vera have shared a relationship for a long time. Vera first met Tammy as part of a narrative study that inquired into the experiences of indigenous women living with HIV. More recently, Tammy had joined a study that inquired into the experiences of homeless or precariously housed pregnant or early parenting women who are either living with or at risk for HIV. In their ongoing work together, Vera and Tammy often discussed notions of care; in particular, care that recognized not only who Tammy was but also who Aiden was in her life, who her community was and also the person she was becoming. In this article, we will think alongside Tammy and Vera to explore our understandings of narrative care. While turning to our theoretical understandings, we are aware that what we understand is grounded in experience and that we invariably return to experience as a way to make sense of our lives.

Narrative practices have been around for years, and care has been conceptualized as being narrative in nature.¹ Narrative care has been developing both as a practice and a field of study. According to Baldwin,² narrative care ‘focuses on the uniqueness of individual lives and roots care in the stories that people tell’ (p. 183). Approaches typically associated with the umbrella term narrative care include life story work, reminiscence work, life-writing workshops and biographical interviews with residents in long-term care. While, elsewhere we have reflected on narrative care in gerontological contexts¹, in this article, we further develop our theoretical understanding of narrative care. Moreover, we highlight our theoretical foundations to demonstrate that narrative care extends beyond the interest for and celebration of people’s stories and that care itself is narrative in nature.

Turning towards narrative

As humans, we are narrative beings.^3,4 Our stories are of great importance; through the stories, we each tell, we construct who we are and what we are becoming, that is, we shape our past, present and anticipated futures.^5

–8 Telling stories to and with others shapes our identities and ongoing identity development.⁷ Importantly, our experiences are created, negotiated and shaped through the act of storytelling. According to Randall,⁹ memories are ‘not just straight recordings of what took place; they are edited interpretations, storied reproductions, odd blends of fact and fictionalization that could more fairly be called factions’ (p. 182). Stories are always told in social, historical, political, cultural and interpersonal contexts. Holstein and Gubrium¹⁰ have described this as a narrative interplay between discursive practice and discourse in practice. Discursive practice is ‘the interactional articulation of meaning with experience’ and ‘the artful procedures through which selves are constituted’ (p. 94).¹⁰ Discourse in practice encompasses ‘the discursive possibilities for, and resources of, self construction at particular times and places’ (p. 94).¹⁰ In other words, as we story our lives, we are simultaneously also part of others’ and broader stories. Circulating discourses and power relations influence what can and cannot be told. Hence, storytelling is both actively constructive and locally constrained.¹⁰ For us as humans, lives are lived and told in relations and are marked by co-composition and co-authorship:

Thinking with the possibility of co-composing stories alongside Tammy, I take a deep breath. My body and heart carry so many stories of and with Tammy. I vividly recall the very first time I met her. It was a beautiful fall day, with trees changing colors and the evenings cooling off. I recall carefully finding a parking space in front of the house Tammy lived in on my first visit. I learned that day that she lived with her partner and his two young daughters; she was so proud of her two stepdaughters. Her energy swirled through the air and occupied all of the spaces in the house. Tammy seemed to have boundless energy and her presence was intense, remaining palpable even after so many years. Listening to Tammy sleep now, I think about the past 17 years; the places I have travelled to alongside Tammy, the people we have met, and the joy we shared in welcoming her last three children into her life. Yet, there have also been the more challenging times; the time where I have metaphorically pulled Tammy out of a drug house to give birth, the times when she had to choose between seeing me and working the streets (which was never a real choice – the danger of repercussions and poverty were always present), the times when her older two children were apprehended by child welfare, and the times when I know it was too hard for Tammy to tell me that she had used illicit substances. Life alongside Tammy was complex and often marked by my wonders about care.

Turning towards care

Care is particularly difficult to define. We view care as a narrative and an embodied practice marked by ethics and relationships. Fisher and Tronto¹¹ defined care as

…a species of activity that includes everything we do to maintain, contain, and repair our ‘world’ so that we can live in it as well as possible. That world includes our bodies, ourselves, and our environment. (p. 40)

Tronto¹² associated four moral elements with the different phases of care: (1) attentiveness (caring about), (2) responsibility (caring for), (3) competence (caregiving) and (4) responsiveness (care-receiving). In a later work, Tronto¹³ also added a fifth phase and moral element of care: (5) trust and solidarity (caring with), which – in our opinion – is particularly pertinent to narrative care.

We are also called to revisit the work of early American feminist pragmatists, such as Jane Addams.¹⁴ This turn towards feminist pragmatists resonates with us, as we also view care in relation to social and political activism and experience. For Addams,¹⁴ care is linked to wider social concerns and social change; for her, as well as for Tronto,¹³ care has a socio-political dimension. Addams’ writings make ‘a significant contribution to what might be called the demand of care: to seek out experiences of others toward the possibility of building a better society through caring’ (p. 92).¹⁵ Particular care practices, such as ‘active listening, participation, connected leadership, and activism’ (p. 93), can contribute to a better society.¹⁵ Addams’ understanding of care is closely linked to the political sphere. For instance, Hamington¹⁶ noted that Addams expanded other care ethicists’ understandings of experience as a necessary condition for care by stating that the avoidance of others’ experiences (e.g. avoiding people in pain and misery), violates the democratic spirit. We will argue, with the aid of Tammy’s and Vera’s story, that narrative can play a key role in the understanding of others’ experiences; experiences that call us to care within the context of individual lives. Moreover, we argue that neglecting others’ stories or refraining from engaging in narrative co-construction is essentially the avoidance of others’ experiences, which is neither ethical nor good. Within this argument, we perceive that when refraining from engaging with others, when we fail to recognize their and our experiences and when we do not engage in political and social advocacy, we indeed fail to care.ⁱ

Thinking with narrative care

Over the past few years, particular attention has been drawn to how narrative ideas could be integrated in care practices.¹⁷ In our opinion, this necessitates perspectives on experience being not inherent in and expressed through stories. Rather, we must consider narration as the ‘[connection of] threads of our experiences in new ways’ (p. 3),¹⁸ in ways that summon imagination and a sense of becoming. Kenyon and Randall¹⁹ have noted that narrative practice involves a never-ending process of becoming better story listeners. Story listening involves paying close attention to the stories people tell, to the way they tell them and to the circumstances under which stories are told – the narrative environments, so to speak. Although we agree that story listening is crucial, our conceptualization of narrative care is somewhat broader.

First, we believe that narrative care goes beyond the telling and listening of stories. Stories live in both landscapes²⁰ and in our bodies. For Connelly and Clandinin,³ ‘story, in the current idiom, is a portal through which a person enters the world and by which their experience of the world is interpreted and personally meaningful’ (p. 375). Here, the central focus is experience, which calls us to attend to worlds in which people live. Hydén²¹ argues that experiences are embodied – that they ‘reside in the actual ways the body moves, the voice or artefacts that are used’ (p. 235). Moreover, storytelling is an embodied activity, ‘a bodily communicative event and activity that involves other – embodied – persons and the social and cultural situation’ (p. 235).²¹ Bodily communicative events are perhaps even more salient when the capacity to tell coherent stories about oneself and others becomes somewhat compromised. Consequently, narrative care is also a matter of being attentive to and acknowledging the movements and gestures that are indeed integrated in the stories we all live.

Second, we are concerned that the reduction of narrative care to a matter of being good story listeners may fixate our attention to the told and draw our attention away from the process of telling and the relational aspects of narration. Several narrative scholars have argued in favour of devoting attention to ‘small stories’; that is, the narrative co-constructive activity occurring between people.^1,22
–24 Hence, narrative care is not merely a matter of facilitating and listening to stories about the past, but rather the active, dynamic and dialogic co-construction of forward-looking stories that have the capacity to change all involved. Considering experience as being co-constructed between people in specific situations, rather than something inherent in people’s stories, makes narrative care relevant, attainable and manageable for a wide range of people in a variety of contexts:

It was a little over a year ago when I was diagnosed with breast cancer – it was an unexpected turn of events in my life. Cancer was an unwelcome guest and so were the medical appointments and treatments. Tammy and I had been thinking about spending some time together in the spring, but my breast cancer diagnosis made that impossible for now. When I called Tammy to tell her about my diagnosis, the other side of the telephone went silent. There was no chatter, no questions, and no wonder about our next visit – instead, there was a long silent pause. Like Tammy, I did not know what to say, and mostly I turned inward and became quiet. The silence was finally interrupted by Tammy. ‘Well, this is the first time anyone has ever needed me’, and she continued after another pause, ‘and I am going to be there for you!’ I was struck by her sense of care for me in that moment – so much shifted in that moment. Perhaps Tammy was right, and this was the first time I needed her. Tammy called me in this moment to attend to our unfolding relationship in new ways; she called me to attend to the silences we each carried.

We believe that narrative care is about being sensitive to the circumstances under which stories are left untold. Baldwin²² noted that narrative agency is a matter of both being able to express oneself in a form that is recognizable as narrative and having the opportunity to express oneself narratively. In our opinion, narrative care is a matter of providing such opportunities to those in need of care. We are concerned that many care situations are strongly characterized by task-oriented routines and heavy professional care provider workloads, which does not promote nourishing narrative environments. Moreover, our conceptualizations of narrative and narration may impoverish people’s narrative opportunities. Notably, Hyvärinen et al.²⁵ argued that ‘the coherence paradigm’ – the idea that coherence is a norm for good and healthy life stories – may result in the neglect of challenging stories and the marginalization of those who have difficulty telling coherent stories. ‘[The] imperative of coherence works to legitimize certain narratives while excluding or marginalizing others from the narrative canon’ (p. 7).²⁵ Persons in need of care may indeed experience difficulty in telling coherent stories. As Andrews²⁶ noted, ‘Traumatic testimony is marked by what is not there: coherence, structure, meaning, comprehensibility’ (p. 155). Hence, narrative care requires a more comprehensive understanding of narrative, described by Baldwin²² as ‘a way of experiencing, relating, thinking and, ultimately, being in the world’ (p. 101). The acknowledgement of coherence not as an objective feature, but rather as something produced in interaction implies that care providers could be ‘coherence-creating or coherence-declining agent[s]’ (p. 10).²⁵

The equation of narrative care with story listening rests on the assumption that telling is an indisputable human good, referred to by Andrews^26,27 as ‘the myth of healing’ or ‘the myth of the empowerment narrative’. According to Andrews,²⁶ for some people, the narration of suffering is impossible, as it was for Vera on the phone after revealing her cancer diagnosis. (‘I did not know what to say and mostly I turned inward and became quiet’.) Framing narrative care as story listening implicitly places responsibility on the person in need of care. Paradoxically, the reasons behind a person’s lack of storytelling ability may be linked to that person’s need for care. Furthermore, Georgakopoulou²⁴ noted that ‘allusions to telling, deferrals of telling and refusals to tell’ (p. 123) should also be considered narrative activities. In our opinion, narrative care could also be a matter of acknowledging that some experiences are untellable. Consequently, narrative care could be a matter of protecting a person’s right not to tell, allowing the person to be silent or enduring long painful silences (‘…there was a long silent pause’).

Narrative care situated in pragmatism

For us, narrative care is grounded in pragmatist philosophy with a focus on experience.^14,28 The affirmation of the centrality of experience was the point of departure for the early pragmatists. For pragmatist, such as Dewey, philosophy ‘began in response to experience problems – situations marked by confusion, doubt, indeterminacy – and then returned to these problems, aiming to transform and reconstruct them in ways that allowed the inquirer to go forward, to encounter still more experience’ (p. 3).²⁹ Clandinin et al.³⁰ have noted that pragmatist philosophy is sometimes conflated with attention only to the practical. For us, pragmatism entails a commitment to lived lives. According to Dewey,³¹ to live is to experience – it is akin to breathing, ‘a rhythm of intakings and outgivings’ (p. 62). In other words, we cannot not experience, and we are ‘alternately consumers and producers, receivers and makers’ (p. 71).³² Building on Dewey’s theory of experience, Clandinin and Connelly³³ developed a narrative view of experience emphasizing that individuals are always in relations, in social contexts, and that experiences grow out of other experiences, which lead to further experiences. Consequently, experience is always personal, relational, social and continuous. We agree with Clandinin and Rosiek³⁴ who, with reference to Dewey, describe experience as ‘a changing stream that is characterized by continuous interaction of human thought with our personal, social and material environment’ (p. 39).

Building on Dewey’s understanding of experience, Clandinin and Connelly³³ defined narrative inquiry as ‘a way of understanding experience’, a ‘collaboration between researcher and participants, over time, in a place or series of places, and in social interaction with milieus’ (p. 20). According to Clandinin,³⁵ performing narrative inquiry ‘is walking into the midst of stories’ (p. 47). In this sense, narrative care and narrative inquiry are closely related. Encounters between people are always ‘in the midst of stories’; care recipients’ stories, care providers’ stories and the stories they co-create and live in the here-and-now. Moreover, such encounters are framed and shaped by broader cultural, historical, linguistic and social narratives. Like narrative inquiry, narrative care is not merely about facilitating storytelling and listening to stories. It is also about observing, living alongside and inquiring into experience as a way to make sense of the world. Moreover, narrative care is about acknowledging that all parties in a particular situation are involved in the activity of narrative co-construction and co-composition. Pragmatism holds the possibility to open spaces for realities that are constantly in flux and for emergent situations that must be considered across time, diverse places and social contexts. It is important to recognize the multiple, complex and uncertain realities of people, which necessitate people being continuously involved in the process of telling, listening, retelling and relistening of their experiences.

Thinking with Vera, Tammy, Aiden and the kindergarten teacher

Vera’s story about Tammy, Aiden, the kindergarten teacher and herself touches upon several issues pertinent to narrative and care. When introduced to the story, we were immediately struck by the portion describing the encounter with the kindergarten teacher. (‘The kindergarten teacher came to the door when she noticed us. Rather than the expected morning greeting, she said “Is Tammy OK?” While it was framed as a question, the tone spoke more to an underlying sense of seeing Tammy as an unfit mother, as someone who made poor choices’.) The encounter with the teacher appeared to be charged with narratives beyond the immediate situation. Such narratives could certainly be based on previous experiences, both the teacher’s, Aiden’s and Vera’s. However, they could also represent broader dominant narratives regarding motherhood, single mothers, at-risk families, indigenous peoples and dominant narratives about caring and teaching.

According to Frank,³⁶ ‘Stories provide an imaginative space in which people can claim identities, reject identities, and experiment with identities’ (p. 45). Loseke³⁷ used the term formula stories to describe the ‘collective representations of disembodied types of actors […] stories producing such categorical identities associated with families, gender, age, religion, and citizenship’ (p. 663). We argue that formula stories may impose limitations on the imaginative space, as they represent parts of the discourse in practice that provides possibilities and resources for the discursive practice of narrative co-construction.¹⁰ The kindergarten teacher’s narrative constructions of Tammy and Aiden may have been framed by formula stories regarding motherhood and ‘the good mother’ (and consequently also ‘the bad mother’). Previous research has demonstrated the persistence of dominant ideologies regarding motherhood that ‘sets the standard for what is a “good” mother and what is a “bad” one’ and the resistance of ‘lone motherhood’ to the efforts of family theorists to deconstruct the concept of family.^38,39 As stated by Goodwin and Huppatz,⁴⁰

Images of ‘the good mother’ appear as prevalent as ever. These images persist in public policy, the media, popular culture and workplaces, and saturate everyday practices and interactions. They continue to powerfully shape women’s lives. (p. 1)

This notion subsequently shapes the lives of children. Drawing attention to formula stories, it becomes evident that there is a turn away from experience. In turning away from experience, it is easy to dismiss the ordinary and imaginative spaces that reflect who Tammy and Aidan are and are becoming. Moreover, such formula stories may also have shaped Tammy’s own narrative constructions of herself as a mother, leaving her with experiences of not meeting the standards by which she is judged. Tammy’s response to Vera’s cancer diagnosis (‘this is the first time anyone has ever needed me’) is striking, considering that she is a mother. How does Tammy view herself as a caregiver? What has shaped her perceptions? Has constant surveillance that Tammy has experienced from child welfare agencies determined how she views herself as a mother? Has the message been that her children do not need her?

As stated by Elliot,⁴¹

While each person has the capacity to produce a narrative about themselves that is creative and original, this narrative will take as its template existing narratives which each individual has learned and internalized. (p. 127)

Nonetheless, in the story involving the kindergarten teacher, there were also traces of Tammy attempting to resist being positioned as ‘marginalized’ or ‘socially deprived’. Perhaps Tammy’s introduction of Vera as ‘my friend the university professor’ was her way of stating ‘You may know my cover, but you don’t know my stories?’ Was this her attempt at disrupting the stories always and already positioning her? Was this counter-narrative⁴² perhaps Tammy’s attempt to challenge others’ ‘story-o-types’⁸ and insistence on being a co-author of the stories about herself and her family? However, the possibilities to become and co-author one’s stories are not equally distributed. Rather, such possibilities are influenced by issues of power, positioning and inequities.¹⁸ The formula stories always and already at work positioning us are more difficult to resist and negotiate for some people.

Yet, the encounter with the kindergarten teacher is not easily dismissed. We wonder if her question that morning (‘Is Tammy OK?’) was also framed and shaped by formula stories about teaching and caring – stories that have been given to her, which have shaped her practices. We wonder what expectations shaped her practices and the ways in which she perceived her relationship with Tammy and Aiden. Did she view Aiden as her primary responsibility? Did she view herself as someone protecting Aiden from potential child neglect and harm? Was she viewing herself as rescuing Aiden from a ‘risk trajectory’? In the kindergarten teacher’s narrative, was Tammy a villain and not a care partner or mother? If so, she may have contributed to the shaping of Tammy’s perception of herself as a poor caregiver (cf. ‘this is the first time anyone has ever needed me’). Moreover, the teacher’s understanding of care would be marked by the ethics of justice, with an emphasis on rights and duties rather than an ethics of care with an emphasis on the relational.⁴³ Here, it is important to consider Gilligan’s⁴³ argument that we need to deal with ‘how concerns about fairness and rights intersect with concerns about care and responsibility’. And in thinking with Addams work, we remain attentive to care practices that are called forth when thinking with experiences.

Vera’s and Aiden’s morning walks stand in stark contrast to the encounter with the kindergarten teacher, which appeared to be charged with narratives beyond the immediate situation. Vera’s and Aiden’s walks appear as an uninterrupted space for the playful co-creation of new stories. (‘Aiden and I would sing together and talk about the animals and flowers we saw along the way – it was an uninterrupted time we shared whenever I would come and visit’.) Lugones⁴⁴ described playfulness as an attitude that turns an activity into play. She wrote,

The playfulness that gives meaning to our activity includes uncertainty, but in this case the uncertainty is an openness to surprise […] we are not fixed in particular constructions of ourselves, which is part of saying that we are open to self-construction. (p. 16, [original emphasis])⁴⁴

In our opinion, this playful uncertainty is the essence of narrative care. It is the opening to others’ experiences and involves allowing the other to be and become the person they want to be in a particular situation. Engaging in such playful uncertainty also implies that we do not avoid others’ experiences of pain and misery, which is a necessary condition for care according to Addams.¹⁶

We wonder if care, rather than taking on a moralistic stance based on an arbitrary definition of a good or bad character with associated punishment (such as the apprehension of children or government-sanctioned surveillance) can include imagination and world travelling.⁴⁴ To provide the possibility of world travelling, we are called to think along the perspective of Lugones,⁴⁴ who stated,

There are ‘worlds’ that we can travel to lovingly and traveling to them is part of loving at least some of their inhabitants. The reason why I think that traveling to someone’s ‘world’ is a way of identifying with them is because by traveling to their ‘world’ we can understand what it is to be them and what it is to be ourselves in their eyes. (p. 17)

Playful engagement and thinking with stories is also shaped by imagination. Imagination allows us to create forward-looking stories and a sense of future possibilities. Lugones⁴⁴ helps us understand that imagination requires world travelling, which opens up possibilities for playful imagination. Thus, world travelling creates a sense of becoming and opens up the possibilities of ‘what if…’.¹⁸ For Sarbin,^45,46 questions of ‘what if…’ were critical when thinking with imagination. He viewed imaginings as narrative constructions that are both perceptual and embodied. In many ways, we see how the stronghold of the ‘single mother’ or the ‘at risk family’ script restricted imagination in Tammy’s experience. Tammy often sent Aiden off to kindergarten and after-school care by saying ‘you have to be good, because otherwise they might call child welfare on us and they will take you away’. It is hard to imagine otherwise, when care provided by people such as the kindergarten teacher, social worker or nurse remains conditional or based on judged behaviours. This is counter to the ways in which we consider narrative care.

World travelling would perhaps allow us to view Tammy and Aiden from new perspectives, in ways that do not restrict who they are and what they are becoming based on narratives created about them, rather than with them. In this situation, narrative care would not only be focused on Tammy and Aiden but also marked by turning inwards to contemplate who we are in Tammy’s and Aiden’s lives. This creates the possibility for what Sarbin⁴⁶ called ‘believed-in imaginings’. In our opinion, such world travelling is in line with Addams’¹⁴ pragmatism. As noted by Siegfried,⁴⁷ Addams’ pragmatism draws on a wide and diverse range of experiences, ‘particularly those outside of the white, male middle class’ (p. 221), which demonstrates ‘the radical consequences of taking the pluralism, perspectivism, and finite limitations of human understanding seriously’ (p. 222).

Narrative care and relational ethics: a way forward

While we encounter narrative care as nurses, it is not restricted to any particular discipline for us. Rather, narrative care represents practices that hold the possibility to engage with people in ways that are marked by relational ethics and concerns for equity and social justice.

Addams linked democracy to dialogue, joint experiences and social equality; that is, the replacement of ‘individual ethics represented by charity work with the social ethics represented by settlement work’ (p. 222).⁴⁷ Charity work is about doing good for others. It is characterized by ‘knowing’ what is best for others and acting thereafter. Consequently, other people’s experiences and stories, and therefore dialogue, are of less importance. However, settlement work is about doing good with others, which calls for the development of ethical frameworks grounded in care, with a specific awareness of relational ethics.³⁰ Relationships in narrative care are not only marked by relational ethics but also by a commitment to dialogical and relational democracy and the prioritization of community. Doing good with others implies the involvement of the person in need of care in the naming of and working for improvement.²⁹ Moreover, doing good requires a willingness to travel into the other’s worlds – both in a concrete sense by living alongside others and in a figurative sense by being open to the playful uncertainty of the narrative co-construction of new stories, new selves and new possible futures. Addams introduced the method of sympathetic interpretation, in which ‘one must really engage the people involved in the problematic situation at hand and work to construct a narrative that gives meaning to the experience and proposes ways of making the situation better’ (p. 50).²⁹ We call this method narrative care.

Footnotes

Acknowledgements

We would like to acknowledge Tammy and Aiden for sharing their stories with us. Ethics approval was obtained through the University of Alberta Research Ethics Board (Pro00040818) and written consent was provided by participants.

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: We would like to acknowledge the Canadian Institutes of Health Research (CIHR) for funding Vera’s work alongside Tammy (CIHR CBA 1217102). Vera was also funded by a CIHR New Investigator award. The author(s) received no additional financial support for the research, authorship and/or publication of this article.

ORCID iD

Bodil H Blix

Note

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