Dialectics and transformations in liminality: the use of narrative therapy groups with terminal cancer patients in Hong Kong

Abstract

The rich literature about death and dying, the use of narrative analysis, and the extensive study of liminality in the field of medicine and the social sciences provide valuable insights into the experience of end-of-life care. However, the study of the transformation(s) in liminality, especially with regard to people suffering from terminal cancer, is still limited. Based on use of a narrative therapy group with people suffering from terminal cancer, this paper explores how the use of double-listening technique in narrative therapy groups, through the seeking of the dialectical experiences of the group members, facilitates transformations in liminality. The facilitation of the ‘transformative power’ of liminality is important because entering into the ‘transformative space’ of the liminality of patients with terminal cancer not only helps the social workers and other helping professions better understand the ambiguous experience of ‘knowing and not knowing’ and ‘acting and not acting’, but also extends the possibilities and alternatives in making sense of the dialectics (e.g., so weak and yet so strong, so little and yet so great, etc.) of the patients' narratives.

有关死亡和临终的丰富文献、叙述性分析的运用，以及医学和社会科学关于阈限期的广泛研究都为临终护理经验提供了有意义的见解。可是，有关阈限期转变的研究依然有限，尤其是对于晚期癌症病人的研究。本文根据一项为晚期癌症病人提供叙述治疗小组的实践经验，探讨如何在叙述治疗小组使用双重聆听技巧，从而了解小组成员的辩证经验，去促进阈限期的转变。促进阈限期的「转变力量」非常重要，因为如果能够进入晚期癌症病人的阈限期「转变空间」，就可以协助社工和其他辅助性专业更妥善地理解「知与不知」和「行动与不行动」的暧昧经验，亦能同时找到理解病人辩证叙述(例如很弱却很坚强、很小却很伟大)的可能性和另类方案。

Keywords::

• dialectics
• transformations
• liminality
• narrative therapy group
• terminal cancer

Acknowledgements

I would like to express my heartfelt thanks to all participants, including the group members and their family members, for their bravery to join this journey; and the gratitude to the social workers, nurses and staff of the Bradbury Hospice, with special thanks to Dr Raymond Lo, for their support.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

^1. A specialist hospice unit with facilities for healthcare service, education and research in the field of care for incurable diseases patients: see http://www3.ha.org.hk/BBH/