PERSONAL COMPLEXITIES OF COMMUNICATING HEALTH AND ILLNESS

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PERSONAL COMPLEXITIES OF COMMUNICATING HEALTH AND
ILLNESS

• Personal Complexities of Communicating Health and
  Illness
• Health narratives and stories impact and are
  impacted by the personal, cultural, and political
  complexities of our lives.
• Christopher Reeves autobiography, Still Me,
  sheds light on the personal, cultural, and
  political complexities of his new life and his
  changed perspective.
• Narratives are a foundation for understanding
  health communication, and this chapter focuses on
  personal complexities.

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Narrating Personal, Cultural, and Political
Complexities

• Narrative refers to the process of making a
  story and to the and to the end result of the
  process the story, tale, or history.
• Narrative reasoning helps to understand the
  whole by experiencing the parts of an
  experienced, and is not focused on proving.
• Logical reasoning structured around proving
  what we experience.

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Narratives often serve as vehicles for social
change as they are both a process and a product.

• As a process, Christopher Reeves experience in
  writing his autobiography was a powerful source
  of motivation and satisfaction.
• As a product, the narratives contained in Reeves
  book may inspire, persuade, comfort, or motivate
  others, and we can see boundaries collapse and
  new forms of communication emerge among diverse
  communities.

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Our identity is a process and product of our
personal life experience, along with the cultural
and political systems we inhabit.

• Reeves experience sheds light on the politics of
  spinal cord injuries, something we may not have
  previously known.
• Boundaries of ones personae begin to collapse
  and the personal becomes public just as what is
  public can become personal.
• Narratives are representations of truth, and
  stories lived are not necessarily the stories
  told.

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Narratives represent different versions of
different stories.

• Exploring health narratives involves
  consideration of both the story itself and the
  context cultures and political beliefs of the
  people communicating.
• Culture and politics affect the stories we tell
  and hear about health.
• Communicating about health and illness
  incorporates economic status, language
  proficiency, education and assertiveness.

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Narratives of Health and Illness

• Significant emphasis has been placed on patients
  narratives, as patients are seen as the central
  construct in the connection to illness.
• Health care providers stories reflect
  experiences in providing care for patients and
  their families.
• Providers are typically revered as the voice of
  medicine interrupting the voice of the
  patient.
• Health care providers may be confined by negative
  characterizations of patients, politics of the
  medical setting, managed care mandates, and time
  limitations that limit their ability to listen to
  patients.

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Patients families, friends and other
acquaintances all provide insight to a health
situation via their own narratives and stories.

• By juxtaposing narratives of family or friends
  with patients narratives, we gain a fuller
  understanding of issues such as social support,
  tension resolution, and the overall illness
  experience.

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Narrating Embodiment and Identity

• The body is central to health narratives, as it
  is through our bodies that we are enabled,
  constrained, managed, disciplined, accepted and
  rejected by ourselves and others.
• We may feel embodied and disembodied at the same
  moment because of our perception of self,
  injuries, and perception of others.
• At moments of breakdown, we experience
  dys-appearance in that we may experience both
  limits on our functions as well as a sense of
  self-consciousness.

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Spoiled identity

• When ill, diagnosed with a disease, or disabled,
  the ideal body image becomes impossible to
  attain because of our perception that we are in
  some way damaged, changed, less than whole,
  unable, and incomplete.
• Our spoiled identity becomes embarrassing and
  stigmatizing.
• At those same moments of illness, however, other
  people have the power to heal, care for us, and
  help us feel whole again.

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Communication about our health and illness status
is becoming more acceptable

• By sharing an illness experience in the form of a
  story, we create an opportunity for others to
  communicate caring and understanding.
• Communication about illness can occasion crossing
  the boundaries between embodied and disembodied
  selves.

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Stories of Embodiment and Disembodiment
Communicating Trans-formation

• Narratives reflect peoples lives and the changes
  in their identity just as they affect the lives
  of those to whom the narratives are told.
• Identities are composed in over the course of an
  illness journey.

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People may change their lives through narratives
in many ways.

• A person may discover him or herself anew as
  what I have always been.
• A person may discover what he or she might
  become.
• A third change is that a person may not feel a
  moment of discovery that is life changing, and
  may feel that he or she is what I have always
  been.
• A narrative may also reveal little self-change
  following an illness, but in the process of
  writing and reading the story, and hearing
  responses, a person may discover changes.

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Seeing them as a person and not as the other

• Narratives also allow readers to reflect upon
  their own experiences and relationships to
  understand and make sense of our own and others
  lives.
• Reading a narrative (or watching it performed)
  provides the occasion to humanize persons or
  situations that we may know nothing about, as in
  Philadelphia or the Clothesline Project..

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Being othered

• Just as narratives can be empowering and
  enabling, they can make us feel othered because
  we perceive the stories coming from someone else
  as not supportive or understanding.
• Someones story is always worse or better!!

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Conclusion

• As we theorize about communicating health, we
  need to remember to think with stories, rather
  than think about them.
• We must consider the utility of comparing our own
  interpretations of health narratives with others,
  and to consider the personal, cultural, and
  political complexities of health care decisions.
• Encouraging to share their experiences and to
  tell their stories of being silenced or
  stigmatized just as they share their stories of
  being heard and encouraged is vital to
  communicating health.