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Healing stories: Narrative characteristics in cancer survivorship narratives and psychological health among hematopoietic stem cell transplant survivors

Published online by Cambridge University Press:  14 August 2013

Maya Benish-Weisman*
Affiliation:
University of Haifa, Haifa, Israel
Lisa M. Wu
Affiliation:
Mount Sinai School of Medicine, New York, New York
Sarah L. Weinberger-Litman
Affiliation:
Marymount Manhattan College, New York, New York
William H. Redd
Affiliation:
Mount Sinai School of Medicine, New York, New York
Katherine N. Duhamel
Affiliation:
Memorial Sloan-Kettering Cancer Center, New York, New York
Christine Rini
Affiliation:
University of North Carolina, Chapel Hill, North Carolina, and UNC Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina
*
Address correspondence and reprint requests to: Maya Benish-Weisman, Counseling and Human Development, The University of Haifa, Mt. Carmel, Haifa 31905, Israel. E-mail: maya.bw@edu.haifa.ac.il

Abstract

Objectives:

Survivors of hematopoietic stem cell transplant (HSCT) have experienced a life threatening and potentially traumatic illness and treatment that make them vulnerable to long lasting negative psychological outcomes, including anxiety and depression. Nevertheless, studies show that overcoming cancer and its treatment can present an opportunity for personal growth and psychological health (reduced symptoms of anxiety and depression and high levels of emotional well-being) through resilience. However, research has not yet clarified what differentiates HSCT survivors who experience psychological growth from those who do not. By analyzing recovery narratives, we examined whether HSCT survivors’ interpretation of their experiences helps explain differences in their post-treatment psychological health.

Methods:

Guided by narrative psychology theory, we analyzed the narratives of 23 HSCT survivors writing about their experience of cancer treatment. Psychological health was measured by: (1) emotional well-being subscale part of the Functional Assessment of Cancer Therapy Bone Marrow Transplant (FACT-BMT), (2) depression, and (3) anxiety subscales of the Brief Symptom Inventory.

Results:

Findings revealed a positive relation between psychological health and a greater number of redemption episodes (going from an emotionally negative life event to an emotionally positive one) as well as fewer negative emotional expressions.

Significance of the results:

Theoretical and practical implications of these findings are discussed, showing how narratives can inform interventions to assist cancer survivors with their psychological recovery.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

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References

REFERENCES

Andrykowski, M.A., Brady, M.J. & Hunt, J.W. (1993). Positive psychosocial adjustment in potential bone marrow transplant recipients: Cancer as a psychosocial transition. Psycho-Oncology, 2, 261276.CrossRefGoogle Scholar
Baker, F., Denniston, M., Zabora, J.R., et al. (2003). Cancer problems in living and quality of life after bone marrow transplantation. Journal of Clinical Psychology in Medical Settings, 10, 2734.CrossRefGoogle Scholar
Benish-Weisman, M. (2009). Between trauma and redemption: Story form differences in immigrant narratives of successful and nonsuccessful immigration. Journal of Cross-Cultural Psychology, 40, 953968.CrossRefGoogle Scholar
Bonanno, G.A. (2004). Loss, trauma, and human resilience. Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 2028.CrossRefGoogle ScholarPubMed
Bonanno, G.A. & Mancini, A.D. (2008). The human capacity to thrive in the face of potential trauma. Pediatrics, 121, 369375.CrossRefGoogle ScholarPubMed
Broers, S., Kaptein, A.A., Le Cessie, S., et al. (2000). Psychological functioning and quality of life following bone marrow transplantation: A 3-year follow-up study. Journal of Psychosomatic Research, 48, 1121.CrossRefGoogle ScholarPubMed
Burns, R.B. & Burns, R.A. (2008). Business Research Methods and Statistics Using SPSS. Los Angeles: SAGE.Google Scholar
Bushman, B.J. (2002). Does venting anger feed or extinguish the flame? Catharsis, rumination, distraction, anger, and aggressive responding. Personality and Social Psychology Bulletin, 28, 724731.CrossRefGoogle Scholar
Copelan, E.A. (2006). Hematopoietic stem-cell transplantation. The New England Journal of Medicine, 354, 18131826.CrossRefGoogle ScholarPubMed
Derogatis, L.R. (1975). Brief Symptom Inventory. Baltimore: Clinical Psychometric Research.Google Scholar
DuHamel, K.N., Mosher, C., Winkel, G., et al. (2010). Randomized clinical trial of telephone-administered cognitive behavioral therapy to reduce PTSD and distress symptoms after hematopoietic stem cell transplantation. Journal of Clinical Oncology, 28, 37543761.CrossRefGoogle ScholarPubMed
Edman, L., Larsen, J., Hagglund, H., et al. (2001). Health-related quality of life, symptom distress and sense of coherence in adult survivors of allogeneic stem-cell transplantation. European Journal of Cancer Care, 10, 124130.CrossRefGoogle ScholarPubMed
Frank, A.W. (2001). Can we research suffering? Qualitative Health Research, 11, 353362.CrossRefGoogle ScholarPubMed
Graf, M.C., Gaudiano, B.A. & Geller, P.A. (2008). Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research, 18, 389399.CrossRefGoogle ScholarPubMed
Hjermstad, M.J., Knobel, H., Brinch, L., et al. (2004). A prospective study of health-related quality of life, fatigue, anxiety and depression 3–5 years after stem cell transplantation. Bone Marrow Transplant, 34, 257266.CrossRefGoogle ScholarPubMed
Hefferon, K., Grealy, M. & Mutrie, N. (2009). Posttraumatic growth and life threatening physical illness: a systematic review of the qualitative literature. British Journal of Health Psychology, 14, 343378.CrossRefGoogle ScholarPubMed
Iwamitsu, Y., Shimoda, K., Hajime, A., et al. (2003). Differences in emotional distress between breast tumor patients with emotional inhibi-tion and those with emotional expression. Psychiatry and Clinical Neurosciences, 57, 289294.CrossRefGoogle ScholarPubMed
Kettmann, J.D.J. & Altmaier, E.M. (2008). Social support and depression among bone marrow transplant patients. Journal of Health Psychology, 13, 3946.CrossRefGoogle Scholar
King, L.A. & Miner, K.N. (2000). Writing about the perceived benefits of traumatic events: Implications for physical health. Personality and Social Psychology Bulletin, 26, 220230.CrossRefGoogle Scholar
Lieberman, M.A. & Goldstein, B.A. (2006). Not all negative emotions are equal: The role of emotional expression in online support groups for women with breast cancer. Psycho-Oncology, 15, 160168.CrossRefGoogle ScholarPubMed
Lieblich, A., Tuval-Mashiach, R. & Zilber, T. (1998). Narrative Research: Reading, Analysis and Interpretation. Thousand Oaks: Sage.CrossRefGoogle Scholar
Liehr, P., Marcus, M.T., Carroll, D., et al. (2010). Linguistic analysis to assess the effect of a mindfulness intervention on self-change for adults in substance Use Recovery. Substance Abuse, 31, 7985.CrossRefGoogle ScholarPubMed
Nenova, M., Duhamel, K., Zemon, V., et al. (2011). Posttraumatic growth, social support, and social constraint in hematopoietic stem cell transplant survivors. Psycho-Oncology. doi:10.1002/pon.2073.Google ScholarPubMed
McAdams, D.P. (1993). The Stories We Live By: Personal Myths and the Making of the Self. New York: Morrow.Google Scholar
McAdams, D.P. (1999). Coding System for Redemption Sequences. http://www.sesp.northwestern.edu/foley/instruments/redemption/ (Accessed on August 9, 2013).Google Scholar
McAdams, D.P., Diamond, A., de St. Aubin, E., et al. (1997). Stories of commitment: The psychosocial construction of generative lives. Journal of Personality and Social Psychology, 72, 678694.CrossRefGoogle Scholar
McAdams, D.P., Reynolds, J., Lewis, M., et al. (2001). When bad things turn good and good things turn bad: Sequences of redemption and contamination in life narrative and their relation to psychosocial adaptation in midlife adults and in students. Personality and Social Psychology Bulletin, 27, 474485.CrossRefGoogle Scholar
Mosher, C.E., Redd, W.H., Rini, C.M., et al. (2009). Physical, psychological, and social sequelae following hematopoietic stem cell transplantation: a review of the literature. Psycho-Oncology, 18, 113127.CrossRefGoogle ScholarPubMed
Murray, E.J., Lamnin, A.D. & Carver, C.S. (1989). Emotional expression in written essays and psychotherapy. Journal of Social and Clinical Psychology, 8, 414429.CrossRefGoogle Scholar
Omer, H. & Alon, N. (1997). Constructing therapeutic narratives. Northvale: Jason Aronson.Google Scholar
Pennebaker, J.W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162166.CrossRefGoogle Scholar
Pennebaker, J.W. (2003). Telling stories: The health benefits of disclosure. In Social and cultural lives of immune systems, Wilce, J.M. Jr. (ed.). London: Routledge, pp. 1934.Google Scholar
Pennebaker, J.W. & Seagal, J.D. (1999). Forming a story: The health benefits of narrative. Journal of Clinical Psychology, 55, 12431254.3.0.CO;2-N>CrossRefGoogle Scholar
Raggatt, P.T.F. (2007). Forms of positioning in the dialogical self: A system of classification and the strange case of Dame Edna Everage. Theory Psychology, 17, 355382.CrossRefGoogle Scholar
Singer, J.A. (2001). Living in the amber cloud: A life story analysis of a heroin addict. In Turns in the Road: Narrative Studies of Lives in Transition, McAdams, D.P., Josselson, R. & Lieblich, A. (eds.). Washington, DC: American Psychological Association, pp. 253277.CrossRefGoogle Scholar
Tallman, B.A., Altmaier, E. & Garcia, C. (2007). Finding benefit from cancer. Journal of Counseling Psychology, 54, 481487.CrossRefGoogle Scholar
Taylor, S.E. (1989). Positive Illusions. New York: Basic Books.Google Scholar
Tedeschi, R.G. & Calhoun, L.G. (1995). Trauma and Transformation: Growing in the Aftermath of Suffering. Thousand Oaks: Sage.CrossRefGoogle Scholar
Tuval-Mashiach, R. (2006). Where is the story going? Narrative forms and identity construction in the life stories of Israeli men and women. In Identity and story: Creating Self in Narrative, McAdams, D.P., Josselson, R. & Lieblich, A. (eds.). Washington, DC: APA, pp. 249268.CrossRefGoogle Scholar
Widdershoven, G. (1993). The story of life: Hermeneutic perspectives on the relationship between narrative and life history. In The Narrative Study of Lives, Josselson, R. & Lieblich, A. (eds.). Newbury Park: Sage, pp.120.Google Scholar
Zakowski, S.G., Ramati, A., Morton, C., et al. (2004). Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Health Psychology, 6, 555563.CrossRefGoogle Scholar