Understanding breast cancer stories via Frank's narrative types

Abstract

While breast cancer narratives have become prevalent in Western culture, few researchers have explored the structure of such narratives, relying instead on some form of thematic analysis based upon content. Although such analyses are valuable, Arthur Frank (The Wounded Storyteller, The University of Chicago Press, Chicago, 1995) provides researchers with an additional means of studying stories of illness, through the examination of their structures. In this article, the author applies Frank's work to a phenomenological study of embodiment after breast cancer. Frank's three narrative types are used to enhance understanding of the ways in which stories are culturally constructed, using data collected through one focus group discussion and two in-depth interviews with each of 12 women who had experienced breast cancer. The author then conveys the significance of this form of analysis for future research.

Introduction

Frank (1995) writes that those who are ill “need to become storytellers in order to recover the voices that illness and its treatment often take away”. (p. xii) Frank's ideas are supported by the fact that stories of breast cancer have become ubiquitous in Western culture (Couser, 1997), while Bury (2001) provides compelling illustration of the historical failure of bio-medical narratives to address illness experiences and the subsequent “expansion of information about illness…via media coverage, the internet and alternative forms of health care” (p. 268). For instance, a recent search of a major internet bookseller returned 1054 texts related to breast cancer, including numerous autobiographies, while comparative searches of “prostate cancer” and “colorectal cancer” returned only 300 and 71 hits, respectively. Nonetheless, while published accounts of breast cancer and thematic analyses of illness experiences are prevalent (e.g., Bury, 1982; Cope, 1994; Couser, 1997; Kleinman, 1988; Langellier & Sullivan, 1998; Williams, 1984), it remains that few have questioned the structure of such stories in relation to the meaning of illness.

In contrast to thematic approaches, Frank's (1995) exploration of various sub-genres of illness narratives in The Wounded Storyteller is extremely useful in understanding how stories are created and presented, following specific plot sequences or “emplotments” (Sandelowski, 1991, p. 164). As such, Frank's (2001) ideas about illness narratives are reflective of both form and content, with form assuming a key role in this particular work, thus creating a means of “thinking with the story” (p. 361). Rather than providing an analytical prescription, Frank's work suggests ways in which stories might be reflected upon, in order to be better understood by those who have experienced illness, as well as those who live with them.

In this article, I explore Frank's (1995) work in relation to stories of breast cancer. I begin this article with a description of the significance of stories or narratives, situating stories in their social context and provide an overview of Frank's narrative types. Next, I briefly summarize my research approach. Then, I relate Frank's conceptualizations of illness narratives to the stories of breast cancer that were shared with me as I completed in-depth interviews with 12 women who had experienced breast cancer. Finally, I conclude with a review of the implications of this application for future research.