On the Concept of History,^{Reference Benjamin, Eiland and Jennings1} the posthumously published last work by German philosopher and cultural critic Walter Benjamin (1892–1940), is a concise, dense and masterful station along a brilliant intellectual trajectory, which was cut short by Nazi persecution. Here, he took issue with the ‘historicist’ approach to the past, which he accused of being reductively linear. Overshadowed by dominant narratives, ‘historicism’ is prone to reinforce them and serve the interests of history’s ‘victors’ or ‘oppressors’. Instead, Benjamin counterposes reconstructing history by integrating underlying, marginal and fragmented elements in order to facilitate thinking and action for radical and just social change. How might reading history this way, for him ‘against the grain’, be relevant to psychiatrists in everyday practice?

For clinicians, such a perspective may seem counterintuitive. Training regularly encourages physicians to follow a linear path in tracing a patient’s medical history, and rightly so. With Benjamin’s insights, however, it is suggested that too rigid an adherence to such an approach may be inappropriately restrictive. The suggested complementary approach is that clinicians remain open to unexpected moments in a patient’s behaviour and speech, particularly those that may appear as fragmentary, discarded or rejected. This way, it is implied, psychiatrists could better help patients to radically re-examine and reconstruct their narratives to empower themselves to move on from their past towards a better future.

Benjamin’s theory can represent a new clinical outlook, which can be translated as follows: not only the past, and its narratives, but a narrow medical approach to history taking and reconstruction may be too oppressive and reductive. Instead, an approach is required which also opens a breach and disrupts hierarchical forms of narration, acknowledges the patient as a specific individual and deactivates the unhelpful power dynamics at play within the clinical relationship. This way, clinicians can create a more nuanced understanding of illness and suffering.

Two accounts – one literary, one clinical – illustrate this issue. Boulder, the rebellious protagonist of a novel by Eva Baltasar,^{Reference Baltasar2} states: ‘I was tired of […] having to pretend life had a structure, as though there were a metal rod inside me keeping me upright and steady. […] If we had to reduce life to a story it can only be a bad one. […] It’s like living in an occupied territory.’ A patient’s account is also relevant: ‘Whenever I went in, the psychiatrist would run through the same checklist of questions […] I felt reduced to a cluster of symptoms instead of seen as a human being. I refuse being imprisoned in a story that is not my own.’

Benjamin’s philosophy of history may help us acknowledge more clearly that the clinician is a de facto authority which needs to be rethought at each encounter. Truly benevolent intent and beneficent practices in general aside, there is always a risk that these may prove oppressive, instead, in a particular patient’s case. Moreover, there is some affinity between Benjamin’s ‘oppressed’ and Freud’s ‘repressed’, as both need sensitivity, space and freedom to surface, to be expressed and overcome. The patient is then someone equally entitled in the clinical relationship, someone to be empowered, not just to be ‘understood’. To discover their own past and shape their agency and future.