Chapter published in:
The Language of Crisis: Metaphors, frames and discourses
Edited by Mimi Huang and Lise-Lotte Holmgreen
[Discourse Approaches to Politics, Society and Culture 87] 2020
► pp. 255–280

Chapter 9
Narrative modulation in the storytelling of breast cancer survivors’ transitional experiences

This chapter aims to investigate breast cancer survivors’ diverse experiences and complex needs during the critical transitional periods between diagnosis, treatment and survivorship. The chapter proposes and develops an original concept of “narrative modulation” in storytelling, which is employed to analyse breast cancer survivors’ written narratives. The study finds that narrative modulators that function by image schemas, metaphors, frames, as well as psychosocial coping and adjustment strategies are instrumental in configuring and navigating breast cancer survivors’ journeys from health crisis to survivorship. The model of narrative modulation offers an original and useful analytical approach for researchers and healthcare practitioners to gain a nuanced and contextualised understanding of patients’ continual adaptations during cancer survivorship within their own socio-cultural and personal environments.
Keywords: narrative modulation, storytelling, transitional experience, metaphor, social cognition
Article outline
  • 1.Introduction
  • 2.Using narrative analysis to understand cancer survivors’ transitional experiences
  • 3.Narrative modulation in the storytelling of breast cancer survivors’ transitional experiences
    • 3.1Narrative modulation in storytelling
    • 3.2A cognitive-linguistic and socio-cognitive understanding of narrative modulation
  • 4.Study design and data analysis
  • 5.Narrative modulation and meaning configuration in the narrative data
    • 5.1The storyline of crisis
    • 5.2The storyline of restitution
    • 5.3The storyline of inner growth
    • 5.4The storyline of continuous pain and suffer
  • 6.Conclusion
  • Notes
  • References
Published online: 16 July 2020
https://doi.org/10.1075/dapsac.87.09hua
References
Allen, Jennifer, D., Sanghamitra Savadatti, and Andrea G. Levy
2009 “The Transition from Breast Cancer ‘Patient’ to ‘Survivor’.” Psycho-Oncology 18:71–78. CrossrefGoogle Scholar
Armitage, Christopher, and Mark Conner
2000 “Social Cognition Models and Health Behaviour: A Structured Review.” Psychology & Health 15 (2):173–189. CrossrefGoogle Scholar
Brdar, Mario, Stefan Thomas Gries, and Milena Žic-Fuchs
2011 Cognitive Linguistics: Convergence and Expansion. Amsterdam: John Benjamins. CrossrefGoogle Scholar
Brennan, James
2001 “Adjustment to Cancer: Coping or Personal Transition?” Psycho-Oncology 10:1–18. CrossrefGoogle Scholar
Brown, Philip H., and Caroline Theoharides
2009 “Health-Seeking Behavior and Hospital Choice in China’s New Cooperative Medical System.” Health Economics 18:S47–S64. CrossrefGoogle Scholar
Bury, Michael
2001 “Illness Narratives: Fact or Fiction.” Sociology of Health & Illness 23 (3):263–285. CrossrefGoogle Scholar
Calhoun, Lawrence G., and Richard G. Tedeschi
2006 Handbook of Posttraumatic Growth: Research and Practice. Mahwah, N. J.; London: Lawrence Erlbaum.Google Scholar
Chick, Norma, and Afaf Ibrahim Meleis
1986 “Transitions: A Nursing Concern.” In Nursing Research Methodology: Issues and Implementation, edited by Peggy L. Chinn, 237–257. Rockville, MD: Aspen.Google Scholar
Crawford Paul, Gilbert Paul, Gilbert Jean, Gale Corinne, Harvey Kevin
2013 The Language of Compassion in Acute Mental Health Care. Qualitative Health Research. 23(6):719–27. CrossrefGoogle Scholar
Dancygier, Barbara, and Eve Sweetser
2014 Figurative Language. Cambridge: Cambridge University Press.Google Scholar
Deimling, Gary T., Karen F. Bowman, and Louis J. Wagner
2007 “Cancer Survivorship and Identity among Long-Term Survivors.” Cancer Investigation 8:758–765. CrossrefGoogle Scholar
DelVecchio Good, Mary-Jo, Tseunetsugu Munakata, Yasuki Kobayashi, Cheryl Mattingly, and Byron J. Good
1994 “Oncology and Narrative Time.” Social Science and Medicine 38:855–862. CrossrefGoogle Scholar
Denford, Sarah, Diana Harcourt, L. Rubin, and A. Pusic
2011 “Understanding Normality: A Qualitative Analysis of Breast Cancer Patients Concepts of Normality after Mastectomy and Reconstructive Surgery.” Journal of the Psychological, Social and Behavioral Dimensions of Cancer 20 (5):553–558.Google Scholar
Fallowfield, Lesley, and Valerie Jenkins
2015 “Psychosocial/Survivorship Issues in Breast Cancer: Are We Doing Better?” Journal of the National Cancer Institute 107 (1). CrossrefGoogle Scholar
Ford, Leigh A., and Brigitte C. Christmon
2005 “ ‘Every Breast Cancer Is Different’: Illness Narratives and the Management of Identity in Breast Cancer.” In Understanding Breast Cancer Stories via Frank’s Narrative Types, edited by Eileen B. Ray, 157–169. Mahwah, N. J.; London: L. Erlbaum.Google Scholar
Frank, Arthur W.
1995 The Wounded Storyteller: Body, Illness and Ethics. Chicago; London: University of Chicago Press. CrossrefGoogle Scholar
Geeraerts, Dirk, and H. Cuyckens
2007 The Oxford handbook of cognitive linguistics. Oxford: Oxford University Press.Google Scholar
Gibbs, Raymond
2011 "The Social Nature of Embodied Cognition: A View from the World of Metaphor", Intellectica 56: 81-98.Google Scholar
Gubrium, Jaber F., and James A. Holstein
1998 “Narrative Practice and the Coherence of Personal Stories.” The Sociological Quarterly 39 (1):163–187. CrossrefGoogle Scholar
Hack, Thomas F., Lesley F. Degner, and Patricia A. Parker
2005 “The Communication Goals and Needs of Cancer Patients: A Review.” Journal of the Psychological, Social and Behavioral Dimensions of Cancer 14 (10):831–845.Google Scholar
Hesketh, Therese, Dan Wu, Linan Mao, and Nan Ma
2012 “Violence Against Doctors in China.” BMJ:e5730. CrossrefGoogle Scholar
Johnson, Mark
1987 The Body in the Mind: The Bodily Basis of Meaning, Imagination, and Reason. Chicago: University of Chicago Press. CrossrefGoogle Scholar
2005 “The Philosophical Significance of Image Schemas.” In From Perception to Meaning: image schemas in cognitive linguistics, edited by Beate Hampe and Joseph E. Grady, 15–33. Berlin; New York: Mouton de Gruyter. CrossrefGoogle Scholar
Knapton, Olivia
Framing the Onset of Obsessive-Compulsive Disorder (OCD): Women’s Experiences of Changes in the Body.” In The Language of Crisis: Metaphors, Frames and Discourses, edited by Mimi Huang and Lise-Lotte Holmgreen. Amsterdam: John Benjamins. Crossref
Knobf, M. Tish
2011 “Clinical Update: Psychosocial Responses in Breast Cancer Survivors.” Seminars in Oncology Nursing 27 (3):1–14. CrossrefGoogle Scholar
Kralik, Debbie, and Antonia van Loon
2007 “Understanding Transition in Chronic Illness.” Australian Nursing Journal 15:29.Google Scholar
Kralik, Debbie, Kate Visentin, and Antonia van Loon
2006 “Transition: A Literature Review.” Journal of Advanced Nursing 55:320–329. CrossrefGoogle Scholar
Lakoff, George, and Mark Johnson
2003 Metaphors We Live by. Chicago: University of Chicago Press. CrossrefGoogle Scholar
Langellier, Kristin M.
2001 “ ‘You’re Marked’: Breast Cancer, Tattoo and the Narrative Performance of Identity.” In Narrative and Identity: Studies in Autobiography, Self, and Culture, edited by Jens Brockmeier and Donal Carbaugh, 145–184. Amsterdam and Philadelphia: John Benjamins. CrossrefGoogle Scholar
McCann, Lisa, Nicola Illingworth, and Yvonne Wengström
2010 “Transitional Experiences of Women with Breast Cancer within the First Year following Diagnosis.” Journal of Clinical Nursing 19:1969–1976. CrossrefGoogle Scholar
Ministry of Health, Ministry of Finance, Ministry of Agriculture
2003 Notice on the Establishment of New Rural Cooperative Medical System Beijing: The General Office of the State Council, China.Google Scholar
Morris, Bronwyn A., Meredith Campbell, Megan Dwyer, Jeffrey Dunn, and Suzanne K. Chambers
2011 “Survivor Identity and Post-Traumatic Growth after Participating in Challenge-Based Peer-Support Programmes.” British Journal of Health Psychology 16:660–674. CrossrefGoogle Scholar
Moskowitz, Gordon B.
2005 Social Cognition: Understanding Self and Others. New York; London: Guilford.Google Scholar
Pauwels, Evelyn E. J., Caroline Charlier, Ilse De Bourdeaudhuij, Lilian Lechner, and Elke Van Hoof
2013 “Care Needs after Primary Breast Cancer Treatment: Survivors’ Associated Sociodemographic and Medical Characteristics.” Journal of the Psychological, Social and Behavioral Dimensions of Cancer 22 (1):125–132.Google Scholar
Reeve, Joanne, Mari Lloyd-Williams, Sheila Payne, and Christopher Dowrick
2010 “Revisiting Biographical Disruption: Exploring Individual Embodied Illness Experience in People with Terminal Cancer.” Health 14 (2):178–195. CrossrefGoogle Scholar
Riessman, Catherine K.
2003 “Narrative Analysis.” In The Sage Encyclopaedia of Social Science Research Methods, edited by Michael S. Lewis-Beck, Alan Bryman Bryman and Tim Futing Liao, 705–709. Thousand Oaks, California; London: Sage.Google Scholar
Rowland, Julia H.
2019 “Cancer Survivorship: Overview of Case Studies.” In Advancing the Science of Implementation across the Cancer Continuum, edited by David A. Chambers and Cynthia A. Vinson, 220–239. New York: Oxford University Press.Google Scholar
Schmid-Büchia, Silvia, Ruud J. G. Halfensb, Theo Dassenc, and Bart van den Borned
2011 “Psychosocial Problems and Needs of Posttreatment Patients with Breast Cancer and Their Relatives.” European Journal of Oncology Nursing 15 (3):260–266. CrossrefGoogle Scholar
Semino, Elena, Zsófia Demjén, and Jane Demmen
2016 “An Integrated Approach to Metaphor and Framing in Cognition, Discourse and Practice, with an Application to Metaphors for Cancer.” Applied Linguistics:1–22.Google Scholar
Semino, Elena, Zsófia Demjén, Jane Demmen, Veronika Koller, Sheila Payne, Andrew Hardie, and Paul Rayson
2017 “The Online Use of Violence and Journey Metaphors by Patients with Cancer, as Compared with Health professionals: a Mixed Methods Study.” BMJ Supportive & Palliative Care 7:60–66. CrossrefGoogle Scholar
Sigrunn, Drageset, Torill Lindstrøm, Christine, and Kjell Underlid
2010 “Coping with Breast Cancer: Between Diagnosis and Surgery.” Journal of Advanced Nursing 66 (1):149–158. CrossrefGoogle Scholar
Sparkes, Andrew, C.
2005 “Narrative Analysis: Exploring the Whats and Hows of Personal Stories.” In Qualitative Research in Health Care, edited by Immy Holloway, 191–209. Maidenhead: Open University press.Google Scholar
Stanton, Annette L., Sharon Danoff-Burg, Christine L. Cameron, Michelle Bishop, Charlotte A. Collins, Sarah B. Kirk, and Lisa A. Sworowski
2000 “Emotionally Expressive Coping Predicts Psychological and Physical Adjustment to Breast Cancer.” Journal of Consulting and Clinical Psychology 68 (5):875–882. CrossrefGoogle Scholar
Sullivan, Karen
2013 Frames and Constructions in Metaphoric Language. Amsterdam and Philadelphia: John Benjamins. CrossrefGoogle Scholar
Talmy, Leonard
1983 “How Language Structure Space.” In Spatial Orientation: Theory, Research and Application, edited by Herbert Pick, L. and Linda Acredolo, P., 225–282. New York: Plenum Press. CrossrefGoogle Scholar
2000 Toward a Cognitive Semantics. Cambridge, Mass.; London: MIT Press.Google Scholar
Tedeschi, Richard G., Crystal L. Park, and Lawrence G. Calhoun
1998 Posttraumatic Growth: Positive Change in the Aftermath of Crisis. Mahwah, N. J.; London: Lawrence Erlbaum Associates. CrossrefGoogle Scholar
Thomas-Maclean, Roanne
2004 “Understanding Breast Cancer Stories via Frank’s Narrative Types.” Social Sciences & Medicine 58:1647–1657. CrossrefGoogle Scholar
Thorne, Sally E., and Kelli I. Stajduhar
2012 “Patient Perceptions of Communications on the Threshold of Cancer Survivorship: Implications for Provider Responses.” Journal of Cancer Survivorship 6:229–237. CrossrefGoogle Scholar
Tighe Clark, Maria, Alex Molassiotis, Jenny Morris, and Janet Richardson
2011 “Coping, Meaning and Symptom Experience: A Narrative Approach to the Overwhelming Impacts of Breast Cancer in the First Year Following Diagnosis.” European Journal of Oncology Nursing 15:226–232. CrossrefGoogle Scholar
Towsley, Gail L., Susan L. Beck, and John F. Watkins
2007 “ ‘Learning to Live with It’: Coping with the Transition to Cancer Survivorship in Older Adults.” Journal of Aging Studies 21:93–106. CrossrefGoogle Scholar
Watson, Maggie, Steven Greer, Susan Blake, and Karen Shrapnell
1984 “Reactions to Diagnosis of Breast Cancer: Relationship between Denial, Delay and Rates of Psychological Morbidity.” Cancer 53:2008–2012. CrossrefGoogle Scholar
Willett, Alexis M., Michael J. Michell, and Martin Lee, J. R.
(eds.) 2010 Best Practice Diagnostic Guidelines for Patients Presenting with Breast Symptoms. London: Uk Department of HealthGoogle Scholar
Yip, Winnie C, Hong Wang, and Yuanli Liu
1998 “Determinants of Patient Choice of Medical Provider: A Case Study in Rural China.” Health Policy and Planning 13 (3):311–322. CrossrefGoogle Scholar
Zhang, Xin-qing, and Margaret Sleeboom-Faulkner
2011 “Tensions Between Medical Professionals and Patients in Mainland China.” Cambridge Quarterly of Healthcare Ethics 20:1–8. CrossrefGoogle Scholar