- This post is gonna be super-long, but it's intended to summarize all the narrative pieces—a whole segment of this week's reading.
- I'm cribbing unashamedly from a lit review I did some time ago.
- It focuses on illness-narratives research (INR, for short, in this post), or narrative in health communication contexts, rather than narrative more generally.
Bruner (1990) ultimately proposes that the human brain is hardwired for processing, creating, sharing and storing narratives, and that narratives serve as a basic mode through which individuals organize experience. He further discusses how this notion creates a fascinating role for narrative at the systems level and even the cultural level (Bruner, 1986; 1990). Narratives are inscribed in cultural artifacts, from books to DVDs to Post-it notes. Entire societies share myths and story genres with ancient roots.
Some anthropologists have found a great deal of synergy between these ideas and the notion in anthropology of the cultural life course. The cultural life course has become a prominent construct in anthropology, employed in the description of everything from infertility (Becker, 2000) to aging (Fry & Keith, 1982) to the experience of adolescence in Pacific Island societies (Rubinstein, 2001). It is the idea that every society has culturally constructed views on what constitutes proper individual development and how people should progress through life over time. While biology sets limits on the sorts of behaviors and social roles people can perform at different ages, each culture has a distinct expected “life course,” with different stages, and different details concerning individual achievement and the roles people should fill at each stage.
In American culture, the life course is reified continually. Its assumptions are apparent in advertisers’ direct mailings based on age demographics, promotion policies based on marital status, whose pictures are on the home-loan and retirement advertisements at the local bank, and countless other cultural messages. Life is even a board game from Milton-Bradley, in which children learn what sorts of social roles are acceptable at different phases of existence. Gay Becker (1997) also points to popular metaphors, such as “life is a journey,” that express normative notions of progression through life (p. 7).
Anthropologists are keen on using the cultural life course to unearth our deeply rooted cultural norms and assumptions. One particularly good way of doing this is to examine what happens when these norms are breached, and this is a primary focus of INR. Severe acute and chronic illnesses are good focal points for this research because people who fall ill with these often default on their social roles and obligations. They run afoul of the cultural life course, often in spite of the fact that they are fully invested in its normative assumptions.
Becker is one author who has done a particularly good job of unifying anthropological notions of the cultural life course and Bruner’s style of narrative theory. She takes the cultural life course to be much like a myth, a story pervasive in our culture, with which we are all implicitly—and often explicitly—familiar (Becker, 1997). In other words, the cultural life course is a narrative in Bruner’s sense. Becker (1993; 1994; 1997) terms the break that ill or traumatized individuals experience with this life course disruption. The notion of disruption is a common one across INR, but a common term for it has not yet been established.
Bruner (2002) terms it peripeteia, after a similar notion from Aristotle (p. 4). Others shy from expanding the academic lexicon and provide qualitative descriptions that amount to the same thing. Cheryl Mattingly (1998) refers to disruption as “ruptures from the normal course of events” in life (p. 107). Sociologist Arthur Frank (1995) calls it “the ‘loss of destination and map’ that had previously guided the ill person’s life” (p. 1). Arthur Kleinman (1988) describes it as the state of being “shocked out of our common-sensical perspective on the world” (p. 27). Regardless of the term or description employed, disruption is a pivotal concept in INR.
Another essential common element of this research perspective is what follows disruption. As Kleinman (1988) describes it, after a disruptive event, “we are then in a transitional situation in which we must adopt some other perspective on our experience” (p. 27). INR, and many narrative theorists, assume that human experience is disorganized and chaotic and that narrative is a tool for organizing our experience (Bruner, 1990; Mattingly, 1998, p. 107). As Kleinman describes it, humans employ narrative “to make over a wild, disorderly natural occurrence into a more or less domesticated, mythologized, ritually controlled, and therefore cultural experience” (quoted in Kirmayer, 1993, p. 162).
The topic of narrative as an organizing tool for experience is an area where different traditions in narrative theory differ somewhat. Bruner’s (1986) theoretical tradition draws a distinction between different methods by which humans organize experience, taking narrative and logic to be complementary ways in which humans organize and process information (pp. 11-43). Fisher’s (1987) narrative theory, on the other hand, views logic as subsidiary to—or even embedded in—narrative rationality (pp. 24-54). Thus, INR, in accepting the validity of logic as a mode of organizing experience, is in fact saying that narrative is the more important organizing tool in disruptive situations, as opposed to the only available one.
In narrative theory, individuals make sense of their lives by telling stories. Charlotte Linde is another author whose work is an intellectual root of illness narratives research. In her book, Life Stories, Linde (1993) maintains “narrative is among the most important social resources for creating and maintaining personal identity” (98). By telling stories about our lives and our past actions, we express a rationale for our actions and identify ourselves with the values we want others to associate with us. Every person is differently situated in society, expresses different goals in life, different visions for the future, and gives different reasons for what they have done in the past—all of which is to say that each person has a unique narrative structure for their own life. In short, according to Linde (1993), narrative is a tool for identity management, through which we not only manipulate our appearance to others, but also create our own sense of self (pp. 98-126).
Further, Linde (1993) asserts that this is a collaborative effort. In social interaction, people help each other to manage identities by recalling stories that reinforce or even manipulate this sense of self (pp. 98-126). For instance, a would-be grandmother might ask her daughter to recall a narrative frame used in the past: “Do you remember when you were twelve and used to tell me you wanted to have children someday?” This social aspect of narrative further elucidates how social norms form around the narrative an individual projects. A person who breaks with the narrative she has sought to convey does so at the expense of the social relationships that have grown up around this projected identity.
According to INR, individuals tend to view past and future events in their lives as connected in a sensible way by a narrative thread that draws its purpose both from the cultural life course and from more individualistic narratives, also formed in social contexts. When a disruptive event occurs, the seemingly natural order and purpose of these events is destroyed; they no longer appear to lead logically toward any desired end. Frank (1995) terms this to be a state of “narrative wreckage” (p. 53). In response, individuals go about a process of creating new narratives for themselves, which stitch together the now-seemingly disparate events of their lives in a sensible way. As Frank (1995) puts it, new “stories have to repair the damage that illness has done to the ill person’s sense of where she is in life, and where she may be going. Stories are a way of redrawing maps and finding new destinations” (p. 53).
Becker (1997) refers to this phenomenon as the way in which “the corpus of our individual histories is brought together by a work of imagination that, in articulating the various points of connection, transforms it into a coherent story” (p. 26). For the individuals who engage in it, this is a process fraught with difficulty. It involves both making sense out of the devastating experience of disease on the one hand and forming new social relationships to replace those that, sadly, often break down in the face of illness.
People constructing new narratives for themselves are likely to need new information, thus the narrative literature has the potential to tie in nicely with the existing health/risk literature on information seeking and processing. I took a shot at doing this in the original lit review, but I digress—I've written more than enough for our blog's purposes.
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