Life disruption and generic complexity: a social linguistic analysis of narratives of cancer illness

• Published in: Social science & medicine (1982) Vol. 53; no. 9; pp. 1227 - 1236
• Main Authors: Jordens, Christopher F.C, Little, Miles, Paul, Kim, Sayers, Emma-Jane
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.11.2001; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Anecdotes as Topic; Australia; Biological and medical sciences; Cancer; Colectomy; Colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - psychology; Colorectal Neoplasms - therapy; Communication; Culture; English Language; Fundamental and applied biological sciences. Psychology; Humans; Illness; Illness narrative; Interviews; Interviews as Topic; Life Change Events; Life Events; Linguistics; Medicine; Miscellaneous; Narratives; Patients; Psychology and medicine; Psychology. Psychoanalysis. Psychiatry; Psychology. Psychophysiology; Quality of life; Self Disclosure; Social factors; Social linguistics; Social linguistics Illness narrative Colorectal cancer Story quote; Sociolinguistics; Stories; Story quote; Verbal Accounts; Verbal Behavior; Australia; Story quote; Illness narrative; Social linguistics; Colorectal cancer; Human; Rectal disease; Malignant tumor; Verbal communication; Interview; Colonic disease; Personal experience; Narrative; Rectum; Social analysis; Linguistics; Digestive diseases; Intestinal disease; Colon
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(00)00422-6

This paper draws on social linguistics to inquire into the meaning and function of complexity in illness narratives. According to social linguists, five different story-type genres occur in spoken English. These are illustrated and differentiated using examples drawn from 10 interviews with people who have undergone colectomy for colorectal cancer. In order to test a hypothesis that complexity in illness narratives is related to life disruption, the 10 accounts were ranked in terms of their generic complexity. Measures of life disruption were based on rankings furnished independently by two readers from different disciplines who were blind to the hypothesis being tested. These two rankings showed a high level of agreement ( r s=0.85, p<0.01). When the two life disruption rankings and the generic complexity ranking were compared, a high degree of concordance between the three rankings was observed ( W = 0.91, p<0.01). No evidence was found of associations between generic complexity and gender, interviewer, surgical outcome in terms of stoma ( p>0.05), age ( p>0.7) nor time since diagnosis ( p>0.1). We conclude that in this study, generic complexity was strongly and significantly related to life disruption. To explain the function of complexity in interaction, we characterise the illness narrative as a genre in its own right, and argue that illness narratives need to be considered both in terms of the work they do both on the listener and for the narrator. In the former case, complexity opens up a discursive space for the dynamic positioning of the interlocutor. In the latter case, we propose that complexity reflects the degree to which the process of re-ordering life by assigning meaning is occurring as the interaction unfolds. In both cases, complex narratives can thus be understood as “hard working” narratives.