Facades of Suffering: Clients' Photo Stories About Mental Illness

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In this article, photo stories are examined that were the result of working with photography as a therapeutic instrument dealing with suffering in mental health care settings. The purpose is to describe the role of facades in the process of suffering and acceptance. Clients took photographs, talked about them in group meetings, and exhibited them to a broader audience. Their photo stories were analyzed using a mixed-methods model. Data from two narrative approaches (semiotics and hermeneutics) were compared with information from other informants and official records to find discrepancies between the photo story and the real life context. Although facades are usually perceived as an obstacle for personal growth, the visual narratives revealed that facades can function as an alternative to common acceptance strategies, such as facing one's losses and reconciliation. Facades can create a distance between the person and the suffering. We conclude that visual narratives can reveal and foster agency in clients.

Section snippets

Suffering

Suffering from a mental illness can be a painful struggle because what we desire or long for is often beyond our reach, for example, being free from severe mental illness. Realizing that one cannot just wish mental illness away can lead to the feeling that mental illness must be endured. One undergoes suffering rather than acting upon it (Fredriksson & Eriksson, 2001). One can be either a “sufferer” or an “agent”(Ricoeur, 1992). Sufferers are those affected by processes in their life story.

Setting

Our research studies and follows nine photography groups in three mental health institutions in the Netherlands. The aim of forming the groups was to help clients in their process of assigning meaning to their illness and experience of suffering. Comparable therapeutic interventions have been used elsewhere (Fleming et al., 2009, Frith and Harcourt, 2007, Hagedorn, 1996, Keller et al., 2008, Wang and Burris, 1997, Weiser, 1993). Participants were invited to endow meaning to pictures made with a

Findings

In this study, we focused on (a) how psychiatric clients give meaning to their broken lives and suffering and (b) how facades play a role in their visual narratives. We will follow these two strands of analysis in the presentation of our findings. First, we will give an overall picture of all cases, then we will select cases for a more in-depth description, and we will end with an integration of findings in which suffering and facades are related to each other.

Suffering and Identity

Much of the literature on suffering departs from the assumption that only a direct confrontation with and assimilation of the sources of suffering can help people to overcome or transcend their suffering. Our study found that persons suffering from severe mental illness can circumvent their suffering in representations of themselves that do not fit a linear development to more acceptance or assimilation of (suffering from) mental illness.

This seems to confirm what Veer van 't, Kraan, Drosseart,

Conclusions

Many photo stories in our study reflect the strength of clients, but this does not necessarily mean they seek a confrontation with sources of suffering. Facades can fulfill useful, sometimes transitory, roles. They protect the storyteller from too direct a confrontation with their suffering. Facades are sometimes an intermediary step in a development in which one learns to face suffering more directly, but they can also offer an alternative to confrontation. Although Pieter is able to give his

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    1

    Address Dr. Abma and Dr. Widdershoven: EMGO InstituteVU University Medical Center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.

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