IDENTITY LIFE NARRATIVES: REVELATION OF SELF IN APHASIA
Melissa Phillips and Claire Penn
University of the Witwatersrand
INTRODUCTION
STROKE AND IDENTITY
•
15 Million people worldwide suffer a stroke annually, with 50% left chronically disabled.
•
The many losses due to aphasia culminate in an overall loss of a sense of self.
•
An increased midlife stroke incidence and resultant identity challenge is confounded by the normative Eriksonian 7th stage identity conflict, Generativity vs. Stagnation.
•
Limited research into personal identity renegotiation in A) Speech-Language Pathology  Social identity and Life coaching approach, and B) Psychology  Assessment of post stroke mood disorders.
IDENTITY AND NARRATIVE
•
Identity  Narrative
•
Previous research has provided the underlying theory and basic tools to investigate narrative identity construction: McAdams' "Triarchic“ Identity
IDENTITY
NARRATIVE
theory, interview and coding framework, and life transition identity processes.
NARRATIVE
IDENTITY
APHASIA
NARRATIVE AND APHASIA
•
In aphasia, narrative semantic content is preserved with language that is reduced in quantity and complexity.
•
The narration of the experiences that challenge and transform identity i.e. difficult life experiences, negative events, and mortality events e.g. stroke, offer
unique opportunities for optimal identity development.
STROKE
Previous research has not addressed the narrative mechanisms of identity reconstruction in aphasia, which is located at the intersection of "Identity, Narrative and Aphasia".
RESEARCH QUESTIONS
1) How do people with aphasia engage in narrative identity renegotiation post stroke?
2) What narrative mechanisms of identity reconstruction are reflected within identity narratives post stroke?
METHODS
The study took the form of a mixed method, embedded multiple-case study in which three participants with aphasia were interviewed using an adapted McAdams (2008) life-story interview technique, designed
to elicit pertinent identity confirming events or experiences across a life span. The typed narrative transcripts, derived from audio-video-taped narrative episodes (including the participant's verbal, gestural, and
facial expressions), the proxy's supplementary contributions, and researcher field notes, were thematically coded using three non-aphasic prior research derived thematic coding systems (Figure 1), with
comprehensive empirical associations to identity development and well-being.
1) The thematic profiles of the individual narratives were quantitatively and qualitatively analysed.
2) The overarching thematic trends, or potential conceptual divisions (according to similar narrative features and processes), across the three narratives, were analysed.
MCADAMS' THEMATIC CODING FRAMEWORK
STROKE NARRATIVE PROCESSES (research-derived processes which
Generativity: THE REDEMPTIVE SELF THEMES
• Emotional tone
differentiated the narration of difficult life events, transitions, and trauma,
• Number of Redemptive Sequences
• Super-ordinate themes
leading to either ego development or well-being)
• Perceived Childhood Advantage
• Subordinate themes
• Exploratory Narrative Processing
• Early Awareness of the Suffering of Others
• Imagoes
• Coherent Positive Resolution
• Moral Depth and Steadfastness
• Growth themes
• Accommodative Change
• Conflict between Agency and Communion
Figure 1
• Pro-Social Goals
RESULTS
Type A's Narrative profile
Type B's Narrative profile
A relative sparsity of
 The motivational themes: agency and communion (the
protagonist's mastery over the environment, or integration
with the environment or collectivism, respectively).
 Redemptive sequences (deriving positive meanings from
negative events).
 Growth themes.
Numerous widely distributed themes.
A "Post-stroke Narrative Framework" (Figure 2) seemed to predicted
identity development after stroke. Two dynamic narrative processes are
fundamental to the framework.
1) The narration of agenic growth themes or growth redemptive sequences
would seem to generate new perspectives on self.
2) The integration of the new perspectives on self into identity i.e. identity
development.
Limited narration of redemptive sequences, with an over
representation of contamination sequences (positive
beginnings contaminated by negative endings), particularly in
Stroke.
Redemptive processing of negative life events, with
relatively more stroke redemptive sequences.
 New self-perspectives derived from agenic growth themes in
pre-stroke events.
 A sparsity of post stroke growth themes.
 Growth in self-insight was absent.
 A large number of growth themes, with a majority of
redemptive growth sequences (the redemptive resolution
of a negative event leading to a new perspective on self/
others).
 Twice as many growth themes in post stroke events.
IDENTITY
DEVELOPMENT
Two patterns in narrating stroke
Stroke was narrated as a positive self transformation, in the
narration of:
 Exploratory Narrative Processing.
 Coherent Positive Resolution.
 Accommodative Change.
INTEGRATIVE
AGENIC GROWTH
THEMES
1) a. Exploratory Narrative Processing of stroke.
No exploration of stroke and thus a dissociation of stroke
from identity.
b. No Coherent Positive Resolution i.e. no redemptive
resolution involving growth of self from stroke.
2) Accommodative Change i.e. an integration of the negative
perspective on self into identity.
Generativity: A deviation from the prototypical Eriksonian
Redemptive midlife developmental script.
Narratively speaking, specific themes influence these two narrative
processes.
COMMUNAL GROWTH
THEMES
AGENIC GROWTH
THEMES
Generativity: The narration of the Redemptive midlife
developmental script with subjective well-being and life
satisfaction.
INTRINSIC
COMMUNAL
GROWTH THEMES
PERSONAL WELL-BEING
AND SATISFACTION
WITH LIFE
REDEMPTIVE
GROWTH
SEQUENCES
GENERATIVITY
Figure 2
CONCLUSIONS AND RECOMMENDATIONS
It is hoped that further research into identity narratives in aphasia will facilitate an understanding of the process of intentional post-stroke identity development in self narratives, which will enable SpeechLanguage pathologists, in consultation with Clinical psychology, to develop the insights and skills to contribute meaningfully towards the remediation of the loss identity in aphasia.
REFERENCES
Bauer, J., & McAdams D, P. (2004a). Personal Growth in Adults' Stories of Life Transitions. Journal of Personality , 72 (3) 574 - 593.
Bauer, J., & McAdams, P. (2004b). Growth Goals, Maturity , and Well-Being. Developmental Psychology , 40 (1) 114-127.
Bauer, J., McAdams, D., & Pals, J. (2008). Narrative identity and Eudaimonic Well-being. Journal of Happiness Studies , 9, 81-104.
Brumfitt, S. (1998). The Measurement of Psychological Well-being in the person with Aphasia. International Journal of Language and Communication Disorders , 33,116-120.
Brumfitt, S., & Barton, J. (2006). Evaluating wellbeing in people with aphasia using speech therapy and clinical psychology. International Journal of Therapy and Rehabilitation , 13 (7) 305-309.
King, L. (2001). The Hard Road to the Good Life: The Happy, Mature Person. Journal of Humanistic Psychology , 41 (1),51-72.
King, L., Scollon, C., Ramsey, C., & Williams, T. (2000). Stories of Life Transition: Subjective Well-Being and Ego Development in Parents of Children with Down Syndrome. Journal of Research in Personality , 34, 309-536.
McAdams, D. (1996). Personality, Modernity, and the Storied Self: A Contemporary Framework for Studying Persons. Psychological Inquiry , 7 (4), 295-321.
McAdams, D. (1998). Coding System for Contamination Sequences . Retrieved June 9, 2012, from Foley Centre for the Study of Lives: http://www.sesp.northwestern.edu/foley/instruments/contamination/
McAdams, D. (1999). Coding Narrative Accounts for Autobiographical Scenes for Redemption Sequences. Retrieved June 6, 2012, from Foley Centre for the Study of Lives: http://www.sesp.northwestern.edu/foley/
McAdams, D. (2002). Coding Systems for Themes of Agency and Communion. Retrieved June 6, 2012, from The Foley Centre for the Study of Lives: http://www.sesp.northwestern.edu/foley/
McAdams, D. (2006). The Redemptive Self: Generativity and the Stories Americans Live by. Research in Human Development , 3, 81-100.
McAdams, D. (2008). The Life Story Interview. Retrieved June 3, 2012, from Foley Centre for the Study of Lives: http://www.sesp.northwestern.edu/foley/instruments/interview/
McAdams, D. (2009). The problem of meaning in personality psychology from the standpoints of dispositional traits, characteristic adaptations, and life stories. The Japanese Journal of Personality , 18 (3) 173-186.
McAdams, D. P., Diamond, A., de St. Aubin, E., & Mansfield, E. (1997). Stories of Commitment: The Psychosocial Construction of Generative Lives. Journal of Personality and Social Psychology , 72 (3), 678-694.
McAdams, D., & Hooker, K. (2003). Personality Reconsidered: A New Agenda for Aging Research. Journal of Gerontology , 58 (6) ,296–304.
Pals, J. (2006). Narrative Identity Processing of Difficult Life Experiences: Pathways of Personality Development and Positive Self-Transformation in Adulthood. Journal of Personality , 74 (4) 1079-1109.
Pals, J., & McAdams, D. (2004). The Transformed Self: A Narrative Understanding of Posttraumatic Growth. Psychological Inquiry , 15, 65-69.
Shadden, B. (2005). Aphasia as identity theft. Aphasiology , 19. 211-223.
Shadden, B., & Agan, J. (2004). Renegotiation of Identity: The Social Context of Aphasia Support Groups. Topics in Language Disorders , 24 (3) 174-186.
Simmons-Mackie, N. (2008, September 30). Thinking about aphasia, thinking about success. Retrieved July 19, 2011, from Australian Aphasia Association: http://www.aphasia.org.au/NationalEventsConf2008.htm
Smith, B., & Sparkes, A. (2006). Narrative inquiry in psychology: exploring the tensions within. Qualitative Research in Psychology , 3, 169-192.
Worrall, L., Brown, K., Cruice, M., Davidson, B., Hersh, D., Howe, T., et al. (2010). The evidence for a life-coaching approach to aphasia. Aphasiology , 24 (4), 497–514.
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