The genesis of chronic illness: narrative re‐construction

Abstract

In this paper I demonstrate the way in which people's beliefs about the aetiology of their particular affliction (arthritis) need to be understood as part of a more comprehensive imaginative enterprise v^fhich I refer to as narrative reconstruction. The intrinsically teleological form of this enterprise means that identified 'causes' represent r only putative efficient connexions between the disease and antecedent factors but also narrative reference points between the individual and society in an unfolding process which has become profoundly disrupted. TTirough the presentation of case material taken from lengthy interviews I illustrate the way in which my question to the subjects about the cause of their disease: 'Why do you think you got arthritis?' was translated by them into a narrative reconstruction of their changing relationship to the world in which they live and the genesis of illness within it.

Shattering the Bell Jar: Metaphor, Gender, and Depression

“…Depression remains a very common illness for which an increase in resources is likely to be directed -hence the value of understanding a possible role for metaphor in the 'talking therapies' (such as cognitive behaviour therapy). Depression produces biographical disruption (Bury, 1982), interfering with the 'normal' performance of social roles and often requiring a concomitant narrative reconstruction of the self (Williams, 1984;Riessman, 1990) to which language use, or discourse, can contribute.…”

“It struck me that they didn't understand pain”: The specialist pain clinic experience of patients with chronic musculoskeletal pain

“…A social-scientific perspective informed our analysis, namely social factors that impacted the nature of patients' relationships with biomedicine. In particular we drew on theories explaining how individuals whose lives are disrupted by chronic pain experience biographic disruption (13)(14)(15) and how they attempt to cope with their uncertainty about whether pain could be alleviated (16,17). We used this perspective to avoid reporting patients' experiences and beliefs in an overly simplistic fashion, without locating these experiences within the broader social context of their lives.…”

Constructing embodied identity in a ‘new’ ageing population: A qualitative study of the pioneer cohort of childhood liver transplant recipients in the UK

“…These pioneering cohorts have rarely been the subject of sociological or anthropological enquiry, for example to what extent they challenge the theory that their lives have been biographically disrupted (Bury 1982), and, if so, whether childhood organ transplantation as a biographical disruption could be seen as a unique opportunity to develop the self (Bell 2012), or whether today's young organ recipients conceptualise their identities more in context with their donor (Sharp 1995). In addition, what opportunities exist for narrative reconstruction (Williams 1984), and what sort of social conditions might support and legitimate particular identities, are also areas that need to be examined. Here we hope to set an agenda for further work in the context of these 'new' ageing populations.…”

“…Identity is also conveyed through understandings of oneself being bound and constructed in relationship with various other individuals and organisations (Williams 1984). This is especially so for transplant recipients who work post-surgery to redefine and restructure their identities in public arenas; here transplantation creates new or complicates existing social relationships that affect how organ recipients assess their own worth (Sharp 1995).…”