Every patient has a story, and making sense of it is part of the healing.

Welcome to the Carlyte Psychiatry podcast, keeping psychiatry honest since 2003.

I'm Chris Haken, the editor-in-chief of the Carlat Psychiatry Report.

And I'm Kelly Newsom, a psychiatric MP and a dedicated reader of every issue.

Today, we pick up with Margaret Chisholm on how to assess behavioral addictions,

how to talk to patients about their temperament, and how to appreciate the meanings they've made of their life story.

Thank you. to appreciate the meanings they've made of their life story. Life story perspective is all about the meaning somebody gets to events.

So asking about how somebody's dealing with this event, how they understand this event, how

they explain it.

You know, if they've had a tragic loss

of a family member, are they feeling guilty about it? Like, they did something wrong. It's their fault.

Do they have a religious story that they're telling themselves that, you know, God is angry at them,

punishing them, those sorts of things.

So it all eventually comes out, if not at the first interview over time, as people share more and more of their stories.

So the life story naturally includes psychosocial external stressors along the timeline of your life.

Exactly. Each of these perspectives has a conceptual triad. I've alluded to a couple of the other ones, but the life story perspective

triad is setting, sequence, and outcome. So it's just like any narrative. I often use the example

of Star Wars, right? A long time ago in a galaxy far, far away, right?

So everybody has these events that occur in a particular setting, in a particular sequence,

and the outcome really is the story that they tell themselves about the events.

So, you know, somebody might have an infant die of SIDS. And then the story they tell

themselves could be that, you know, it was their fault. They weren't attentive enough or they were

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