title: 'Listen, listen trust your own strange voice' (psychoanalytically informed conversations with a woman suffering serious illness).
abstract: This paper argues that the authentic voice of suffering can be denied to people with serious illness. Anguish and expressions of grief are sometimes replaced by joviality. Amid suffering, voices of anguish become strange inner voices that challenge defences of cheeriness and so are avoided, go unheard or are ignored. Bolstered by the everydayness of ward events and hospital life, suppression, repression and denial mean that people with serious illness can suffer without a voice. Listening to others requires the ability to listen to one's own inner voices and recognize how they might guide exchanges. By avoiding conducting conversations in ways dictated by our own fears, worries and fantasies we can listen, and in doing so allow shifts in awareness. Silent suffering can change to expressive suffering allowing a person to reach an autonomous self and so an authentic voice. The seriousness of a situation can be grasped and so life appreciated for what it is. Decisions can be made, business finished and relationships esteemed or otherwise. Through the format of brief therapeutic conversations, listening has a role to play in helping people with serious illness discover their autonomous and authentic voice. The discussion concludes with the suggestion that the need for throughput and roles and tasks demanded on nurses in general settings limits time and resources, and so liaison mental health nursing has a role to play. A specialist practitioner might offer conversational therapies, support nursing and medical staff and teach psychological concepts, thus contributing to an environment in which uncertainty is tolerated.
authors.affiliation: School of Nursing, Midwifery and Health Visiting, University of Manchester, UK.
authors.forename: A
authors.initials: A
authors.lastname: Jones
mesh_terms: D003674:Defense Mechanisms; D004532:Ego; D004993:Ethics, Nursing; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000451:nursing / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011575:Psychoanalytic Therapy / Q000379:methods*; D012944:Social Support; D014844:Vulva / Q000601:surgery; D014846:Vulvar Neoplasms / Q000451:nursing / Q000523:psychology / Q000601:surgery