Title

Changing Shoes: Metaphorical Descriptions of Rheumatoid Arthritis and Identity

Start Time

6-10-2012 2:35 PM

End Time

6-10-2012 3:05 PM

Session Type

Event

Abstract

People lead storied lives and narrative inquiry makes sense of human experience through analyzing stories told. Personal accounts of episodes and events include narrative devices, like metaphors, which help us understand how individuals interpret and apply meaning to their experiences. This study explored how descriptions of emotional and physical adjustments to living with rheumatoid arthritis (RA) serve as metaphors for the impact of RA on identity.

A secondary analysis of two qualitative studies was undertaken using a narrative approach. Study one explored the impact of RA on the role of mother in 12 women; study two explored the help-seeking process in 37 women diagnosed with RA in the year prior to recruitment. During the original data analysis for both studies, narrative devices were observed in descriptions of daily life experiences that had been disrupted by RA, and this prompted the present analysis. All 49 transcripts were reviewed and metaphorical descriptions of how RA experiences shaped sense of self or identity were extracted. Representative metaphors were then written by research team members, supported by verbatim passages from transcripts, and revised until consensus achieved by the team as a whole.

A number of metaphors illustrated the process of adapting to RA, characterized by adjustments to daily routines from the most basic self care to participation in valued life roles. A powerful example is “changing shoes.” This metaphor arises from descriptions of actual events where women could no longer wear the shoes that reflected their style, preference, or life roles. Underlying the seemingly superficial loss of favored shoes was a loss of self – a professional self, a country-club self, a stylish self. “Changing shoes” metaphorically describes a shift in identity from a healthy person to one living with chronic illness and the new work that entails. The things women did to accommodate arthritis, either on their own or on the advice of a health professional, are shown through narrative analysis to represent emotional and physical adaptation to everyday activities that are meaningful to each individual. Metaphors were observed to exemplify key concepts advancing occupational science, such as the central role of occupation to shaping identity.

In the example presented here, changing shoes represents not only a physical adjustment to accommodate pain, but is also part of an internal process of reshaping identity. Appreciating how small changes carry greater meaning with regard to one’s identity may foster more effective patient-provider communication and client-centered practice.

Discussion Questions:

  1. We’ve found that “shoes” resonate with many people as a symbol of occupation and identity. What are some explanations for this being a strong symbol?
  2. Can you think of other metaphors for concepts, like occupational identity, that are important to building occupational science?

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Research paper

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Oct 6th, 2:35 PM Oct 6th, 3:05 PM

Changing Shoes: Metaphorical Descriptions of Rheumatoid Arthritis and Identity

People lead storied lives and narrative inquiry makes sense of human experience through analyzing stories told. Personal accounts of episodes and events include narrative devices, like metaphors, which help us understand how individuals interpret and apply meaning to their experiences. This study explored how descriptions of emotional and physical adjustments to living with rheumatoid arthritis (RA) serve as metaphors for the impact of RA on identity.

A secondary analysis of two qualitative studies was undertaken using a narrative approach. Study one explored the impact of RA on the role of mother in 12 women; study two explored the help-seeking process in 37 women diagnosed with RA in the year prior to recruitment. During the original data analysis for both studies, narrative devices were observed in descriptions of daily life experiences that had been disrupted by RA, and this prompted the present analysis. All 49 transcripts were reviewed and metaphorical descriptions of how RA experiences shaped sense of self or identity were extracted. Representative metaphors were then written by research team members, supported by verbatim passages from transcripts, and revised until consensus achieved by the team as a whole.

A number of metaphors illustrated the process of adapting to RA, characterized by adjustments to daily routines from the most basic self care to participation in valued life roles. A powerful example is “changing shoes.” This metaphor arises from descriptions of actual events where women could no longer wear the shoes that reflected their style, preference, or life roles. Underlying the seemingly superficial loss of favored shoes was a loss of self – a professional self, a country-club self, a stylish self. “Changing shoes” metaphorically describes a shift in identity from a healthy person to one living with chronic illness and the new work that entails. The things women did to accommodate arthritis, either on their own or on the advice of a health professional, are shown through narrative analysis to represent emotional and physical adaptation to everyday activities that are meaningful to each individual. Metaphors were observed to exemplify key concepts advancing occupational science, such as the central role of occupation to shaping identity.

In the example presented here, changing shoes represents not only a physical adjustment to accommodate pain, but is also part of an internal process of reshaping identity. Appreciating how small changes carry greater meaning with regard to one’s identity may foster more effective patient-provider communication and client-centered practice.

Discussion Questions:

  1. We’ve found that “shoes” resonate with many people as a symbol of occupation and identity. What are some explanations for this being a strong symbol?
  2. Can you think of other metaphors for concepts, like occupational identity, that are important to building occupational science?