Mothering Death: A Psychosocial Interpretation of Breast Cancer Biography

Authors

DOI:

https://doi.org/10.7146/qs.v6i1.124454

Keywords:

Breast cancer biography, The breast, Psychosocial studies, depth-hermeneutics, Vortex of suffering, psychosocial reality

Abstract

In this article I take as my point of departure a puzzle presented by a woman who had an apparently ‘bizarre’ reaction to a breast cancer diagnosis. In the clinic, she had exclaimed: “I would rather die than lose the breast!”. My aim is to unpack layers in this woman’s embodied and enculturated experience, with a view towards developing a psychosocial interpretation of breast cancer biography. The single case on which the present study is based, was extracted from a larger longitudinal data set which allowed me to follow ‘Ella’s’ transition from diagnosis to survivorship. I relied on five sources of data to unfold the case: two participant-generated texts (expressive writing and a Breast Biography), two interviews, and my own field notes. The two texts that Ella wrote provided a participant-led frame for depth-hermeneutic group interpretation sessions, the first of which, synergistically, produced a scenic voicing of latent content in the sub-text of Ella’s expressive writing: the fantasy of mothering death. This subsequently became a lead for my further interpretation of the case, and for methodological reflections on the value of shared thinking in qualitative data interpretation. Crucially, and with some bearing on the current healthcare context, this interpretive study sheds light on what goes on beneath the surface of an apparently ‘irrational’ and ‘recalcitrant’ patient, evidenced by Ella’s entry into what I call a ‘vortex of suffering’. Findings point towards her suffering as an expression of a psychosocial reality, against the backdrop of hope and ideals contained within a psychosocial imaginary that revolves around biomedical cure and reparation.

 

Keywords: breast cancer biography; the breast; psychosocial studies; depth-hermeneutics; vortex of suffering; psychosocial reality

References

Arman, M., & Rehnsfeldt, A. (2003). The hidden suffering among breast cancer patients: a qualitative metasynthesis. Qual Health Res, 13(4), 510-527.

Arroyo, J. M., & Lopez, M. L. (2011). Psychological problems derived from mastectomy: a qualitative study. Int J Surg Oncol, 2011, 132461. doi:10.1155/2011/132461

Aydin, E., Gulluoglu, B. M., & Kuscu, K. K. (2012). A Psychoanalytic Study of Subjective Life Experiences of Women with Breast Cancer. Journal of Research Practice, 8(2), 1-15. Retrieved from http://jrp.icaap.org/index.php/jrp/article/view/300/263

Barry, C. A., Britten, N., Barber, N., Bradley, C., & Stevenson, F. (1999). Using reflexivity to optimize teamwork in qualitative research. Qual Health Res, 9(1), 26-44. doi:10.1177/104973299129121677

Bass, A. (2000). Difference and Disavowal: The Trauma of Eros. Stanford: Stanford University Press.

Bereswill, M., Morgenroth, C., & Redman, P. (2010). Alfred Lorenzer and the depth- hermeneutic method. Psychoanalysis, Culture & Society, 15(3), 221-250. doi:10.1057/pcs.2010.12

Bion, W. R. (1962). Learning from Experience. Nortvale, NJ: Jason Aronson.

Bion, W. R. (1970). Attention and Interpretation. London: Tavistock.

Bollas, C. (1987). The Shadow of the Object: Psychoanalysis and the Unthought Known. London: Free Association Books.

Bury, M. (1982). Chronic illness as biographical disruption. Sociology of Health & Illness, 4(2), 167-182. doi:10.1111/1467-9566.ep11339939

Cassell, E. J. (2004). The Nature of Suffering and the Goals of Medicine (2nd edition ed.). Oxford: Oxford University Press.

Cheng, T., Causarano, N., Platt, J., Jones, J. M., Hofer, S. O. P., O’Neill, A. C., & Zhong, T. (2018). Restoring wholeness: Women’s embodied experiences in considering post- mastectomy delayed breast reconstruction. Cogent Social Sciences, 4(1), 1479478. doi:10.1080/23311886.2018.1479478

Clarke, S., & Hoggett, P. (2009). Researching Beneath the Surface: Psycho-Social Research Methods in Practice. London: Karnac.

de Boer, M., van der Hulst, R., & Slatman, J. (2015). The Surprise of a Breast Reconstruction: A Longitudinal Phenomenological Study to Women’s Expectations About Reconstructive Surgery. Human Studies, 38(3), 409-430. doi:10.1007/s10746-015- 9360-6

DeShazer, M. K. (2013). Mammographies: The Cultural Discourses of Breast Cancer Narratives. Ann Arbor: The University of Michigan Press.

Forrester, J. (2017). Thinking in Cases. Cambridge: Polity Press.

Frank, A. W. (1995). The Wounded Storyteller: Body, Illness, and Ethics. Chicago: The University of Chicago Press.

Freud, S. (1920-1922). Beyond the Pleasure Principle; Group Psychology; And, Other Works (Vol. 18). London: Hogarth Press.

Froggett, L., & Briggs, S. (2012). Practice-Near and Practice-Distant Methods in Human Services Research. Journal of Research Practice, 8(2). Retrieved from http://jrp.icaap.org/index.php/jrp/article/view/318/276

Geertz, C. (1973). The Interpretation of Cultures: Selected Essays. New York: Basic Books.

Gray, A. (2003). Research Practice for Cultural Studies: Ethnographic Methods and Lived Cultures. London: Sage.

Greco, C. (2015). Shining a light on the grey zones of gender construction: breast surgery in France and Italy. Journal of Gender Studies. doi:10.1080/09589236.2014.987653

Gripsrud, B. H. (2006). Spectacular Breasts: Mapping Our Historical and Contemporary Cultural Fascination with the Breast. (PhD Monograph). University of Leeds, Leeds.

Gripsrud, B. H. (2008). The Cultural History of the Breast. In V. Pitts (Ed.), A Cultural Encyclopedia of the Body (Vol. 1, pp. 31-44). Westport: Greenwood Publishing.

Gripsrud, B. H., Brassil, K. J., Summers, B., Søiland, H., Kronowitz, S., & Lode, K. (2016). Capturing the Experience: Reflections of Women With Breast Cancer Engaged in an Expressive Writing Intervention. Cancer Nursing, 39(4), 51-60. doi:10.1097/ncc.0000000000000300

Gripsrud, B. H., Mellon, K., & Ramvi, E. (2018). Depth-hermeneutics: a psychosocial approach to facilitate teachers’ reflective practice? Reflective Practice, 19(5), 638-652. doi:10.1080/14623943.2018.1538955

Gripsrud, B. H., Ramvi, E., Froggett, L., Hellstrand, I., & Manley, J. (2018). Psychosocial and Symbolic Dimensions of the Breast Explored through a Visual Matrix. NORA - Nordic Journal of Feminist and Gender Research, 1-20. doi:10.1080/08038740.2018.1482958

Gripsrud, B. H., Ramvi, E., & Ribers, B. (2020). Couldn’t care less? A psychosocial analysis of contemporary cancer care policy as a case of borderline welfare. Journal of Psychosocial Studies. doi:https://doi.org/10.1332/147867320X15985348674895

Gripsrud, B. H., Søiland, H., & Lode, K. (2014). Ekspressiv skriving som egenterapeutisk verktøy ett år etter brystkreftdiagnosen - resultater fra en norsk pilostudie [Expressive writing as a self-therapeutic tool one year after the breast cancer diagnosis - results from a pilot study]. Nordisk Tidsskrift for Helseforskning(2), 45-61.

Gullestad, S. E., & Killingmo, B. (2013). Underteksten. Psykoanalytisk terapi i praksis [The Sub-text: Psychoanalytic Therapy in Practice]. Oslo: Universitetsforlaget.

Hammersley, M., & Atkinson, P. (1983). Ethnography: Principles in Practice. London: Tavistock.

Hollway, W. (2008). The importance of relational thinking in the practice of psycho-social research: ontology, epistemology, methodology, and ethics. In S. Clarke, H. Hahn, & P. Hoggett (Eds.), Object Relations and Social Relations: The Implication of the Relational Turn in Psychoanalysis (pp. 137-161). London: Karnac.

Hollway, W. (2010). Relationality: The intersubjective foundations of identity. In M. Wetherell & C. Mohanty (Eds.), Sage Handbook of Identities (pp. 216-232). London: Sage.

Hollway, W., & Froggett, L. (2012). Researching in-between subjective experience and reality. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 13(3), Article 13. Retrieved from http://www.qualitative- research.net/index.php/fqs/article/view/1899/3428

Hollway, W., & Jefferson, T. (2000). Doing Qualitative Research Differently: Free Association, Narrative and the Interview Method. London: Sage.

Hollway, W., & Jefferson, T. (2001). Free association, narrative analysis and the defended subject: The case of Ivy. Narrative Inquiry, 11(1), 103-122.

Hollway, W., & Volmerg, B. (2010). Interpretation group method in the Dubrovnik tradition. Manual.

Kirshner, L. A. (1994). Trauma, the good object, and the symbolic: a theoretical integration. Int J Psychoanal, 75 ( Pt 2), 235-242.

Klein, M. (1997). Envy and Gratitude and Other Works 1946-1963. London: Vintage Books.

Kleinmann, A. (1988). The Illness Narratives: Suffering, Healing and the Human Condition. New York: Basic Books.

Krüger, S. (2017). Dropping depth hermeneutics into Psychosocial Studies – A Lorenzarian perspective. The Journal of Psycho-social Studies, 10(1), 47-66.

Langellier, K. M., & Sullivan, C. F. (1998). Breast talk in breast cancer narratives. Qual Health Res, 8(1), 76-94. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10558328

Laplanche, J., & Pontalis, J.-B. (1973). The Language of Psychoanalysis. London: Karnac Books.

Larsen, B. N. (2017). Ingen plads til angst. Patienters erfaring fra den diagnostiske periode af kræftforløb for hoved-og halskræft. (Ph.d.). Roskilde Universitet, Roskilde.

Layton, L. (2020). Toward a social psychoanalysis: Culture, character, and normative unconscious processes. London: Routledge.

Leithäuser, T. (2013). Psychoanalysis, socialization and society – The psychoanalytical thought and Interpretation of Alfred Lorenzer. Forum Qualitative Sozialforschung / Forum: Qualitative Social Research, 13(3), 56-70. Retrieved from http://www.qualitative-research.net/index.php/fqs/article/view/1907

Lévi-Strauss, C. (1966). The Savage Mind. Chicago: The University of Chicago Press.

Levine, S. K. (2009). Trauma, Tragedy, Therapy: The Arts and Human Suffering. London: Jessica Kingsley Publishers.

Lorde, A. (1980). The Cancer Journals (Second edition ed.). San Francisco: Aunt Lute Books.

Lothane, H. Z. (2018). Free Association as the Foundation of the Psychoanalytic Method and Psychoanalysis as a Historical Science. Psychoanalytic Inquiry, 38(6), 416-434. doi:10.1080/07351690.2018.1480225

Malterud, K. (2001). Qualitative research: standards, challenges, and guidelines. Lancet, 358(9280), 483-488. doi:10.1016/s0140-6736(01)05627-6

Meyers, W. R. (2015).Social Science Methods for Psychodynamic Inquiry: The Unconscous and the World Scene. London: Palgrave Macmillan.

Ogden, T. H. (2008). Bion’s four principles of mental functioning. Fort Da, 14B, 11-35.

Pennebaker, J. W. (1997). Opening Up: The Healing Power of Expressing Emotions. New York: The Guilford Press.

Pines, D. (1993). A woman’s unconscious use of her body. New Haven: Yale University Press.

Ramvi, E. (2015). I am only a nurse: a biographical narrative study of a nurse's self- understanding and its implications for practice. BMC Nursing, 14(23), 1-9.

Ramvi, E., & Gripsrud, B. H. (2017). Silence about encounters with dying among healthcare professionals in a society that ‘de-tabooises’ death. International Practice Development Journal, 7. doi:https://doi.org/10.19043/ipdj.7SP.009

Ramvi, E., Manley, J., Froggett, L., Liveng, A., Lading, A., Hollway, W., & Gripsrud, B. H. (2019). The visual matrix method in a study of death and dying: Methodological reflections. Psychoanalysis, Culture & Society, 24(1), 31-52. doi:10.1057/s41282-018- 0095-y

Rodin, G., & Zimmermann, C. (2008). Psychoanalytic reflections on mortality: a reconsideration. J Am Acad Psychoanal Dyn Psychiatry, 36(1), 181-196. doi:10.1521/jaap.2008.36.1.181

Rustin, M. (2019). Researching the Unconscious: Principles of Psychoanalytic Method. London: Routledge.

Segal, H. (1991). Dream, Phantasy and Art (2nd edition 2004 ed.). Hove: Brunner-Routledge.

Solbrække, K. N., Søiland, H., Lode, K., & Gripsrud, B. H. (2017). Our genes, our selves: hereditary breast cancer and biological citizenship in Norway. Medicine, Health Care and Philosophy, 20(1), 89-103. doi:10.1007/s11019-016-9737-y

Spillius, E.B., Milton, J., Garvey, P., Couve, C. & Steiner, D. (2011) The New Dictionary of Kleinian Thought. London: Routledge

Stake, R. (1995). The Art of Case Study Research. Thousand Oakes: Sage.

Stenner, P. (2014). Psychosocial: qu’est-ce que c’est? Journal of Psycho-Social Studies, 8(1), 205-216.

Vetlesen, A. J. (2009). A Philosophy of Pain. London: Reaktion Books.

Visintin, C., Inacarato, G., & Vaisbert, T. (2020). Imaginaries of women who experienced a pregnancy loss. Estilos da Clinica, 25, 193-209. doi:10.11606/issn.1981-1624.v25i2

Wengraf, T. (2001). Qualitative Research Interviewing. London: Sage.

Yalom, M. (1998). A History of the Breast. London: Pandora.

Downloads

Published

2021-01-21

How to Cite

Gripsrud, B. H. (2021). Mothering Death: A Psychosocial Interpretation of Breast Cancer Biography. Qualitative Studies, 6(1), 38–67. https://doi.org/10.7146/qs.v6i1.124454